Psychosis
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Key Symptoms of Psychosis
The experience of psychosis typically involves two main categories of symptoms:
1. Positive Symptoms: “Adding” something to the experience.
These are experiences and behaviors that are present but should be absent.
· Hallucinations: Sensing things that are not there. These can involve any of the five senses.
· Auditory (most common): Hearing voices that others don’t hear. The voices may be critical, commanding, or conversational.
· Visual: Seeing people, lights, or patterns that aren’t real.
· Tactile: Feeling sensations on the skin, like bugs crawling (formication).
· Olfactory/Gustatory: Smelling or tasting things that aren’t present.
· Delusions: Fixed, false beliefs that are not based in reality and are not shared by others in the person’s culture, even when presented with clear proof to the contrary.
· Persecutory Delusions: The belief that one is being followed, poisoned, spied on, or plotted against.
· Grandiose Delusions: The belief that one has exceptional abilities, wealth, fame, or is a famous or powerful figure (e.g., a messiah or a historical leader).
· Referential Delusions: The belief that public communications (like TV shows, song lyrics, or newspaper articles) are sending special messages directly to the person.
· Somatic Delusions: False beliefs about the body, e.g., that one’s organs are rotting or have been removed.
· Disorganized Thinking: This is often inferred from a person’s speech.
· Derailment or Loose Associations: Switching from one topic to an unrelated topic mid-sentence.
· Word Salad: Incoherent speech where words are jumbled together nonsensically.
· Tangentiality: Answering questions in an oblique or irrelevant way.
2. Negative Symptoms: “Taking away” from the experience.
These involve the absence or reduction of normal emotional and behavioral functioning.
· Avolition: A severe lack of motivation or initiative to accomplish tasks.
· Anhedonia: Inability to feel pleasure in activities that were once enjoyable.
· Flat Affect: A severe reduction in the expression of emotions through facial expression, voice tone, or eye contact.
· Alogia: Poverty of speech, giving brief, empty replies.
· Asociality: A lack of interest in social interactions.
What Causes Psychosis?
Psychosis is a symptom with many potential causes, which can be broadly categorized:
1. Primary Psychiatric Disorders:
· Schizophrenia: The most well-known disorder where psychosis is a primary feature.
· Schizoaffective Disorder: A condition with symptoms of both schizophrenia and a mood disorder (like bipolar disorder or major depression).
· Bipolar Disorder: Psychosis can occur during severe manic or depressive episodes.
· Severe Depression with Psychotic Features: Psychosis occurring exclusively during a major depressive episode.
2. Medical Conditions:
· Neurological Disorders: Brain tumors, dementia (like Alzheimer’s), Parkinson’s disease, Huntington’s disease, stroke.
· Infections: HIV/AIDS, encephalitis, syphilis.
· Endocrine and Metabolic Disorders: Thyroid issues, adrenal disorders, electrolyte imbalances.
· Autoimmune Diseases: Lupus, multiple sclerosis.
3. Substance-Induced:
· Drug Use: Psychosis can be triggered by the use of (or withdrawal from) substances like methamphetamines, cocaine, LSD, PCP, and high doses of cannabis.
· Alcohol: Withdrawal from alcohol can cause psychosis.
· Prescription Medications: Certain steroids, stimulants, or other drugs can rarely induce psychotic symptoms.
4. Other Causes:
· Sleep Deprivation: Extreme and prolonged lack of sleep.
· Trauma and Extreme Stress: In some vulnerable individuals, a major stressor can trigger a brief psychotic episode.
The Prodromal Phase
Often, psychosis is preceded by a prodromal phase—a period of gradual functional decline and subtle changes that occur before the full-blown psychotic break. These early warning signs can include:
· Withdrawing from family and friends
· A drop in performance at work or school
· Difficulty concentrating or thinking clearly
· Suspiciousness or unease around others
· Neglecting personal hygiene
· Strong, inappropriate emotions or a lack of any emotion
· Sleep disturbances