Affecting more than 50 million people worldwide and mostly targeting individuals aged 12-30, psychosis is not a disease as known, but a symptom of psychotic disorders such as schizophrenia. The way a person evaluates what is happening around him, his perspective on events, and his relationship with other people are reshaped under the influence of this disorder. In psychosis, the person experiences the real world and his own impaired thought world simultaneously while awake. Correct forms of perception and interpretation are foreign to him. While concepts that he previously valued become meaningless, the values, fears, and thoughts he creates in his own world come to the forefront.
What is Psychosis?
Psychosis is one of a series of psychotic disorders that generally develop between adolescence and young adulthood, cause the individual to be unable to establish a connection between reality and imagination, and affect the brain's information processing process. Individuals with psychosis can have delusions about things that are not real, while hallucinating about things that do not actually exist. They have delusional beliefs and can experience hallucinations. Changes occur in their personalities. There are changes seen particularly in the individual's way of thinking and behavior. Psychosis may occur due to mental or physical illnesses, substance use, experiencing extreme stress, or psychosis resulting from trauma. According to research, although this disorder is mostly seen in young people, it is not known why it is seen specifically in young individuals.
What Are the Symptoms of Atypical Psychosis?
Changes are observed in the behavior, thoughts, and personality of a person with psychosis. He may fall prey to delusions and hallucinations. Aside from this, to list the symptoms of psychosis in more detail:
- Experiencing more difficulties in his social life
- Problems experienced in focusing on a task
- Continuous negative conditions occurring in his thought system
- Feeling uneasy and this unease becoming continuous
- Not paying attention to his personal hygiene
- Not wanting to spend time in public, becoming isolated
- A state of being emotionless in certain situations and conditions
- Seeing, hearing, and feeling different things that are not there
- Disregarding and ignoring the things that are told to him
- The person not seeing himself competent and willing in any matter
- Being unable to think healthily
What Are the Types of Psychosis?
1. Atypical Psychosis
Atypical psychosis can be defined as a personality disorder that bears the symptoms of multiple types of psychosis and cannot be classified. Having a genetic predisposition and environmental factors have an effect on the formation of the disease. It is possible to treat atypical psychosis with medication, but the probability of the disease recurring is high.
What Are the Symptoms of Atypical Psychosis?
- In more than half of the patients diagnosed with atypical psychosis, mystical and abnormal thoughts (delusions) are observed. For example, these individuals fall into delusions that the apocalypse is about to happen at any moment.
- In the early stages of the disease, behavioral disorders and asociality are observed. Patients have trouble communicating and harbor mistrust toward the environment. They tend to isolate themselves from society.
- Atypical psychosis also has physical effects. Loss of appetite and sudden weight losses are also among these physical symptoms.
- In this type of psychosis, sleep patterns become unbalanced. The person, who is already asocial and shuts himself in, can spend the entire day in bed. Sometimes the person sleeps 3-4 hours a day or even less. Therefore, as a byproduct of sleep imbalances, attention deficit and forgetfulness problems can also emerge.
- Psychosis patients perceive the outside world as a threat. Similar paranoias are a frequent situation in psychological illnesses such as schizophrenia and psychosis. The person, who constantly thinks he is being followed, monitored, and searched, can reach a point where he cannot leave the house over time.
2. Non-Organic Psychosis
In non-organic psychosis, the person cannot establish a bond of reality with the world. The non-organic type of psychosis can occur due to environmental influences such as living conditions, and most of the time due to the use of drugs, etc.
What Are the Symptoms of Non-Organic Psychosis?
The symptoms found in this type of psychosis vary from person to person. In general, the symptoms of psychosis diseases are the same. Hallucinations are seen in the disease. They may hear various sounds. They find themselves in a number of feelings and emotions that they cannot explain. From time to time, it may be difficult for him to express this situation. Psychosis patients believe in the existence of special powers within themselves. Symptoms such as jumping from topic to topic during conversation and connecting with irrelevant topics are also among the frequently seen symptoms of the disorder.
3. Acute Psychosis
Acute psychosis is a type of psychosis that starts suddenly and occurs only once. Depending on certain situations, while acute psychosis may indicate an early stage of chronic psychosis, from time to time it can also cause recurring psychosis attacks in the person. Acute psychosis can occur in a person due to grief felt after a death, a ended marriage, unemployment, having an accident, giving birth, or being isolated from the social circle.
What Are the Symptoms of Acute Psychosis?
Acute psychosis symptoms can be explained as experiencing short-term delusions and changes in thought due to these delusions, changes in perception as a result of delusions, low motivation, and asociality.
4. Schizophrenia
Schizophrenia, one of the psychosis subtypes, is a severe brain disorder that distorts a person's thinking, movements, way of expressing emotions, perception of reality, and impairs his relationships with others. For a person to be diagnosed with schizophrenia, symptoms must persist for at least 6 months.
What Are the Symptoms of Schizophrenia?
- Delusions: These are bizarre beliefs that are not based on reality and which the person refuses to give up even when explained with fact-based information. For example, the person may believe that he can hear other people's thoughts, that he is God or the devil, or that others are planting thoughts into his head.
- Hallucinations: "Unreal sensations" are perceived, such as seeing things that do not exist in reality, hearing voices, smelling strange odors, experiencing a "peculiar" taste in the mouth, and the feeling of touch even though no one is touching his body. The most common in schizophrenia patients is hearing voices (auditory hallucinations). Voices can make comments about the person's behavior, harass the person, or give orders.
- Disorders in speech or behavior: These symptoms encompass the person's lack of ability to think clearly and react correctly:
- The person using meaningless words that make it difficult for him to communicate and participate in conversation, and constructing sentences that have no meaning at all
- Quickly switching from one thought to another
- Moving slowly
- Lacking the faculty of decision-making
- Writing excessive but meaningless things
- Forgetting or losing things
- Repeated movements such as walking in circles
- Having trouble making sense of daily sights, sounds, and emotions
Negative symptoms:
The word "negative" reflects the absence of certain normal behaviors in schizophrenia patients. Negative symptoms can be listed as follows:
- Lack of emotion and emotional expression, or affect, thoughts, and mood that do not fit the situation (for example; crying instead of laughing at a joke)
- Withdrawal from family, friends, and social activities
- Low energy
- Lack of motivation
- Not enjoying life and lack of interest in life
- Poor hygiene habits
- Problems at school, work, and other activities
- Instability (being very happy or very sad, or mood swings)
- Catatonia (the person remaining motionless in the same position for a very long time)
What Causes Schizophrenia?
Genetic Transmission
There is a possibility of the disease passing from parent to child.
Brain Chemistry
In psychosis patients, there are certain imbalances in certain chemicals in the brain. They are either sensitive to a neurotransmitter called dopamine or they produce too much dopamine. Dopamine imbalance affects the brain's reaction to certain stimuli such as sound, smell, and sight, which can lead to hallucinations and delusions.
Brain Anomaly
Recent research has detected abnormal brain structure and function in psychosis patients. Still, this type of abnormality is not seen in all schizophrenia patients, and such abnormalities can also be seen in individuals who are not psychosis patients.
Environmental Factors
Research has shown that social factors such as viral infection, poor social interactions, or high-stress situations can trigger the disease in people who are hereditarily prone to psychosis. Psychosis usually surfaces during puberty and youth when hormonal and physical changes occur in the body.
5. Delusional Disorder
Delusional disorder, which is among the psychosis subtypes and also known as paranoia, is a rare type of disease. In cases of delusional disorder, the patient has a well-organized, usually single delusion. Around this delusion, there are a series of thoughts that are not plausible. For example, in the Jealousy type, the person claims that his spouse/partner is cheating on him with someone else and cannot be convinced by rational evidence that this belief is not true. He is in an effort to gather evidence in line with his own delusion, interpreting every piece of information in this direction. If left untreated, the person may even resort to violence against his partner.
6. Brief Psychotic Disorder
The main feature of Brief Psychotic Disorder is the presence of psychotic symptoms such as delusions, hallucinations, disorganized speech, and behavior that last longer than one day but not more than one month.
7. Schizophreniform Disorder
Schizophreniform disorder symptoms, which are among the psychosis subtypes, are very similar to the symptoms of schizophrenia, but last at least 1 month and at most 6 months. After this disorder resolves, they return to their previous levels of functioning.
8. Schizoaffective Disorder
Schizoaffective disorder, one of the psychosis subtypes, contains elements of both psychosis and mood disorder. Psychotic symptoms mean the loss of contact with reality and may include hallucinations (seeing things that do not actually exist or hearing voices) and delusions (false, fixed beliefs). Symptoms of mood disorder include very low or very high mood, energy and appetite changes along with sleep disorders, concentration impairment, and inadequacy in performing daily tasks.
9. Psychoactive Substance/Medication-Induced Psychotic Disorder
It is the presence of delusions and hallucinations due to the direct physiological effects of a substance (a substance-medication that can be abused).
10. Psychotic Disorder Due to a Medical Condition
Psychosis is the type of disorder where the identified psychotic symptoms occur due to an underlying medical condition. Therefore, the illness causing this condition in the present situation must be treated.
What Is Psychosis Treatment?
With a treatment combination to be applied in the treatment of psychosis and the support of medication therapy, an improvement can be seen in the existing symptoms in the person.
In the treatment of psychosis, since patients are overly restless, anxious, or stressed, they tend to harm themselves and others. In this case, a doctor or medical personnel can administer a fast-acting injection to comfort and calm the patient. In the treatment of psychosis disease, support is taken from a group of medications used in the treatment of psychopathological illnesses called antipsychotics. While these drugs play an effective role in reducing delusions and hallucinations, they help the person think more clearly and consciously. Antipsychotic drugs used for the purpose of controlling the symptoms of the disease are not used long-term. However, schizophrenia patients may have to use these drugs for life. Cognitive behavioral therapy plays an important role in the treatment process in order for the patient with psychotic attacks to recognize and control the attacks. It helps the person distinguish between reality and hallucinations. Cognitive behavioral therapy is more effective on the disorder that cannot be entirely treated with antipsychotic drugs.
Do Psychosis Medications Work in Treatment?
Although antipsychotic drugs used in the treatment of psychotic illnesses are effective in improving the symptoms of the disease, symptoms such as cognitive and residual symptoms, asociality, lack of motivation, and a decline in the person's quality of life can be observed. The reason for this situation may stem from the drugs having only a certain degree of effect or the drugs not being used as recommended. According to research, many patients terminate the drug treatment by attributing it to achieving a complete "state of well-being" resulting from the negative effects of the disease on them decreasing with drug treatment. This situation causes the disease to relapse and flare up again. Therefore, the treatment process of the disease must be well managed, drug treatment must be carried out in the most effective way and must not be disrupted. At this point, cognitive behavioral therapy is very useful for the person to learn how to manage the disease and the treatment process.
