Psychosis - causes, symptoms, and treatment explained

 Psychosis – Causes, Symptoms, and Treatment

Psychosis is a mental health condition in which a person loses touch with reality. Individuals experiencing psychosis may have distressing symptoms that broadly fall into three categories:

1. Delusions (False Beliefs)

• Paranoid/Persecutory delusions: Belief that others are out to harm them.

• Grandiose delusions: Belief in having extraordinary powers or abilities.

• Delusions about others: Belief that friends or people are talking about or laughing at them, sometimes causing retaliatory behaviors.

2. Hallucinations (Perceptual Disturbances)

• Auditory hallucinations: Hearing voices that may give commands or make critical remarks.

• Other modalities: Hallucinations can also involve touch, smell, taste, or visual perceptions (seeing things that aren’t there).

3. Thought Disorders

• Difficulty expressing or organizing thoughts clearly.

• Confused speech or inability to communicate ideas effectively.

Causes of Psychosis

• Acute stress or overwhelming life events.

• Substance use: Illicit drugs or alcohol.

• Prescription medications: e.g., steroids.

• Underlying mental illnesses: Schizophrenia or mood disorders.

• Organic causes: Brain conditions like tumors or other physical abnormalities.

Treatment of Psychosis

1. Medications (Antipsychotics)

   • Used to control symptoms and may be prescribed for 2–3 years or longer depending on the condition.

   • Choice depends on effectiveness and side effect tolerance.

2. Talking Therapies

   • Cognitive Behavioral Therapy (CBT) and other psychotherapies help patients manage symptoms and improve coping skills.

3. Community Integration & Support

   • Helping patients reintegrate into daily life and maintain productive routines.

Prognosis

• Psychosis can be transient (lasting a few days) or chronic, as in schizophrenia.

• Approximately:

  • 1/3 have one episode and may not experience psychosis again.

  • 1/3 may never fully recover from their symptoms.

  • The remaining may have multiple episodes throughout life.

• With medication, therapy, and support, many individuals can lead normal and fulfilling lives.

Key Takeaway

Psychosis is a complex condition requiring early diagnosis, careful monitoring, and a combination of pharmacological and psychological support. Understanding symptoms, causes, and treatment options can help patients and caregivers manage the condition effectively.

_{Childhood Schizophrenia: What Are the First Signs? | Child Mind Institute}

 Childhood Schizophrenia – Early Signs

Childhood schizophrenia is rare compared to adolescent or adult-onset schizophrenia. When it occurs, the onset is usually gradual and often subtle, making early detection challenging.

Early Signs in Children

1. Social Withdrawal

   • Children may become isolated or disengaged from friends and family.

2. Attention Difficulties

   • Trouble focusing in school may occur because children are attending to internal stimuli like hallucinations or delusional thoughts.

3. Heightened Anxiety and Fear

   • Hallucinations can be threatening or accusatory, causing intense fear and stress.

4. Irritability and Mood Changes

   • Children may act out, become angry, or show unusual irritability due to confusion or fear about their experiences.

5. Decline in Academic Performance

   • Difficulty concentrating and retaining information can affect schoolwork.

6. Sleep Disturbances

   • Problems falling asleep are common, often because hallucinations become more apparent in quiet or evening settings, leading to anxiety and a need for parental reassurance.

Key Takeaway

Early signs of childhood schizophrenia often involve behavioral changes, social withdrawal, anxiety, and unusual perceptual experiences. Awareness of these subtle symptoms can help parents and caregivers seek professional support promptly, improving outcomes for the child.

^{Psychosis explained simply [Introduction to Drug-Indcued Psychosis]}

Schizophrenia & Dissociative Disorders

1. Schizophrenia Overview

• Schizophrenia is one of the most stigmatized and misunderstood mental disorders, affecting about 1% of the population.

• Despite the literal meaning “split mind,” schizophrenia does not involve multiple personalities. Instead, it is a break from reality.

• Onset: Usually in early adulthood (men in early-mid 20s, women in late 20s), can be gradual or sudden.

• Spectrum: Now classified as part of a spectrum of disorders (DSM-5), sharing symptoms such as disorganized thinking, disturbed perceptions, and incongruent emotions/behaviors.

2. Psychotic Symptoms

• Positive symptoms: Add experiences, like hallucinations and delusions.

• Negative symptoms: Subtract from normal functioning, like social withdrawal, flattened emotions, or neglect of personal hygiene.

• Disorganized symptoms: Impaired thought processes, incoherent speech, or “word salad.”

• Hallucinations: Commonly auditory (hearing voices), often abusive or commanding.

• Delusions: False beliefs of grandeur or persecution; affect ~80% of patients.

• Symptoms impair daily functioning but can be managed with treatment.

3. Physiological Brain Abnormalities

• Schizophrenia is linked to brain differences, including:

  • Overactive dopamine receptors

  • Abnormal activity in thalamus and amygdala

• These abnormalities may cause hallucinations and difficulty distinguishing internal thoughts from external reality.

• Antipsychotic medications work primarily by blocking dopamine activity.

4. Diathesis-Stress Model

• Schizophrenia arises from genetic vulnerability (diathesis) combined with environmental stressors.

• Family history significantly increases risk (10% if a parent/sibling has it; ~50% for identical twins).

• Studies have identified 100+ genes linked to schizophrenia, involving dopamine regulation and immune function.

5. Dissociative Disorders

• Disorders of consciousness marked by a disruption in awareness, memory, or identity.

• Mild dissociation is common (e.g., zoning out while driving).

• Dissociative Identity Disorder (DID), formerly Multiple Personality Disorder, is rare and involves two or more distinct identities.

• The famous Sybil case contributed to misconceptions; some argue DID may not always be a real disorder.

• In some cases, distinct physiological or neurological states have been observed between identities, possibly as an extreme coping mechanism for stress or trauma.

6. Key Takeaways

• Schizophrenia: characterized by psychotic symptoms, cognitive disruption, and abnormal brain activity, treatable with medication and therapy.

• Dissociative disorders: involve identity or memory disruptions, less understood, and sometimes controversial.

• Understanding these conditions promotes compassion, accurate diagnosis, and effective treatment.

Psychotic disorders are severe mental illnesses characterized by significant impairments in an individual's perception of reality. People experiencing psychosis lose touch with reality, which may involve symptoms such as hallucinations (seeing or hearing things that are not present) and delusions (strongly held beliefs that are not based in reality). These disorders encompass a range of conditions, including schizophrenia, schizoaffective disorder, and delusional disorder. The experience of psychosis can disrupt thoughts and perceptions, making it difficult for individuals to distinguish what is real.