When we see news stories involving very bizarre or inexplicable behaviour, it is common to pause and think, “that person is psychotic”. I hear this comment frequently from people when talking about strange or unsettling behaviour.

The statement may indeed be correct, but there are a lot of misconceptions out there about what constitutes psychosis and what it means for someone to be psychotic.

Psychosis is actually a symptom rather than an illness in itself. Psychotic episodes are experienced in several psychiatric disorders as well as some general medical conditions and as a result of substance use.

So what does psychosis entail? It is derived from the greek words “psyche” for mind and “osis” for abnormal condition – and that is truly what it is-- an abnormal condition of the mind. It is used in connection with a disconnection with reality as with hallucinations and delusions. When people are hearing or seeing things that others around them cannot hear or see we say they are hallucinating and are psychotic.

Hallucinations involve perceiving things that are not there or are unreal. Hearing voices is one of the more commonly portrayed types of hallucinations, especially in schizophrenia. There are also olfactory hallucinations when a person smells something that is not there or tactile hallucinations when someone, feels something that is not there such as insects or parasites crawling in their skin.

Delusions are fixed beliefs that are out of keeping with those in one’s social circle. Paranoid delusions are among the most common. These may involve the belief that that another person or organization is conspiring against one.

As mentioned above psychosis can occur as a symptom in schizophrenia. It can also occur in bipolar disorder, severe depression, post partum depression, Alzheimer’s disease, Parkinson’s, multiple sclerosis and some other medical conditions. Some prescription medications can also cause psychotic side effects and psychotic symptoms can also occur from the use of street drugs.

Psychosis is more common than you might think – affecting more than one in every 100 people. A psychotic episode can occur only once in a person’s life or as a recurring symptom.

Since psychosis is by definition an abnormal brain state involving a disconnection with reality, they can be dangerous. People sometimes act on their false beliefs and/or perceptions to the detriment of themselves and those around them.

Treatment for psychosis depends to some degree on what is causing the symptom. Often, hospital admission is necessary in the midst of a psychotic episode for the safety of the patient and others. There are a number of antipsychotic medications such as quetiapine, risperidone, olanzapine, and aripiprazole to name a few. These will provide symptomatic relief in most situations.

Psychosis is a serious symptom and a physician should always be consulted as quickly as possible if the cause and appropriate treatment are unknown.


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