Psychosis

Forget the ignorance, fear, and tacky tabloid hype. What does psychosis really mean?

What is psychosis?

Psychosis is a psychiatric term used to describe experiences or beliefs you may have that are not shared with other people. These can take the form of hallucinations or delusions in which you might be unable to distinguish between your own intense thoughts and reality. Your thoughts might jump around and you may find it difficult expressing yourself in a way that others can understand. You may have little insight into the condition, and not recognise that you are ill. If you have psychotic experiences it may lead to a doctor diagnosing a mental illness such as schizophrenia or manic depression.

What are the symptoms?

You might have hallucinations; hearing, seeing or smelling things that others don't experience. The most common form of hallucination that people have is hearing voices in their head, but you could taste or smell things that other people can't, or have physical sensations with no obvious cause. These experiences can be very distressing, particularly if the voices in your head are saying unpleasant things or encouraging you to do things you don't want to.

You might experience delusions; having unusual beliefs that are not shared by other people, for example that you are rich, famous or powerful. You could believe that other people are controlling your mind; placing thoughts in your head or controlling your behaviour. You could feel paranoid, powerless and out of control of your own behaviour.

Who experiences it?

Anyone could have a brief, one-off psychotic experience as a result of alcohol or drug use, jet-lag or lack of sleep, or as a result of physical illness or fever. However, if you have ongoing problems with psychosis, it is most likely that you are experiencing some form of mental health problem. Psychosis is a common feature of mental illnesses such as schizophrenia, manic depression and schizoaffective disorder, but can also be a symptom of severe depression or post-natal depression.

What causes it?

There is no one cause of psychosis. For some people psychosis is triggered because the person has a diagnosable mental illness such as schizophrenia or manic depression. For others, it appears to be caused by a combination of factors including: genetics; changes in brain chemistry; stressful life events; or usage of street drugs. Overall, it appears likely that some people may be born with a genetic predisposition towards psychosis but it takes stressful life events or experiences to trigger the onset of symptoms.

What can be done?

The first step towards recovery from any illness is usually to recognise that there is a problem and to seek help. However, people experiencing psychosis often do not have the insight to recognise that they have a problem that can be treated. If this is the case, friends or family may have a role in encouraging the person to seek help. The first point of contact would usually be a GP who may be able to diagnose the underlying cause, prescribe drug treatment, or refer the person to a psychiatrist or psychologist for more intensive treatment.

Psychosis is usually treated with antipychotic drugs, which have a tranquillising effect and aim to reduce distressing psychotic symptoms such as delusions and hallucinations. Some people may experience unpleasant or distressing side effects from medication that makes them reluctant to take the drugs. If someone stops taking their medication it can lead to relapse. It is important to discuss with your doctor any problems or side effects you may be having from your prescribed drugs, as they may be able to help.

Other forms of treatment are known as talking treatments; these include counselling, cognitive behaviour therapy (CBT) and psychotherapy. If a person is very distressed, they may be admitted to hospital for treatment. People are usually encouraged to go to hospital as voluntary patients, but sometimes if someone's behaviour is very disturbed, usually during psychotic episodes, they can be admitted to hospital against their will under the Mental Health Act 1983.

Who can help?

Friends and family can help by encouraging the person to seek treatment and support. They can offer general support and show the person that they are cared for. It is important to ensure that you don't say anything that might collude with delusional beliefs or feed any paranoia, as this can worsen the situation. It can be quite distressing being with someone having a psychotic experience, so friends and family might wish to seek some support for themselves too. Many organisations can provide advice, information and practical or emotional support for people experiencing psychosis, their friends and family. These include mental health and drug charities, helplines, counselling and therapy services, social services, GPs and the health service.