Psychosis can be frightening to experience, and it’s often a poorly understood set of symptoms. It may be confused with other issues like psychopathy and other mental health problems. Psychosis is associated with several different causes, but there may be several different types of psychosis that a person can experience. Learn more about psychosis and its causes.
What Is Psychosis?
Psychosis isn’t a disorder on its own. Instead, it describes a set of mental health symptoms that can be caused by several different mental health disorders or psychoactive substances. Psychosis refers to symptoms that occur as a person loses contact with reality. These symptoms can be disturbing and debilitating if they are not addressed and treated. There are several different kinds of psychotic symptoms, but they can be separated into two major groups: positive and negative symptoms. The words positive and negative are often associated with good and bad, but in those cases, they refer to something added or something taken away.
What Are the Types of Psychosis?
Psychosis is complex, and there is a long list of potential symptoms. However, not everyone who experiences psychosis will have the same set of symptoms. For that reason, psychotic disorders can be difficult to diagnose. In some cases, two people with the same disorder can have very different experiences and symptoms. There are two major types of psychosis: positive and negative symptoms. Within those categories, there are many other types of symptoms a person may experience. Here’s a breakdown of some of those types:
Positive Symptoms of Psychosis
Positive symptoms add to the normal function of your brain and your perception of reality. These symptoms are the most easily recognizable and include things like delusions and hallucinations.
Delusions are characterized by false beliefs despite logic or evidence to the contrary. There are several types of delusions, including paranoid delusions and delusions of grandeur. Paranoid delusions may involve thinking there is a conspiracy against you or that everyone you know is an impostor. Delusions of grandeur may cause you to believe that you are uniquely gifted or powerful. These two may be combined in delusions where there is an unseen threat that only you have the power or intelligence to stop. The six major types of delusions include:
- Somatic. This is the belief that you have some physical defect, even if a medical checkup can’t find anything wrong with you.
- Erotomanic. This is the belief that someone is in love with you, and it often involves famous people. This can sometimes cause stalking behavior.
- Jealous. Jealous delusions usually involve the belief that your partner or spouse is unfaithful, whether or not it’s true.
- Grandiose. This involves an overinflated and unhealthy sense of self-worth, importance, power, or identity. You may believe you’ve found a great discovery or that you’re uniquely talented.
- Persecutory. This is the belief that people or organizations are against you. You may feel you are being mistreated or that a malevolent force is spying on you.
- Mixed. This involves a combination of two or more of the other types of delusions. In many cases, delusions are complex and resist evidence that contradicts them.
Hallucinations are another type of positive symptom of psychosis. While delusions mark a loss of touch with reality in your beliefs and thinking, hallucinations mark a loss of touch with reality in your senses. Hallucinations are when you see and hear something that isn’t there. In some cases, hallucinations can be perceived by touch or smell.
Hallucinations can be caused by substances and psychological disorders, but they can also be caused by more common things like periods of high stress or sleeplessness. Hallucinations can be extremely disturbing. Even if the thing you perceive isn’t frightening in and of itself, questioning your sense of reality can be unnerving.
However, many people with mental health disorders that cause hallucinations don’t realize what they’ve perceived isn’t actually there. Even after receiving treatment, hallucinations can continue even when you know they aren’t real. For instance, the famous mathematician John Nash struggled with schizophrenia for decades and learned to cope by intellectually rejecting the hallucinations he experienced.
Hallucinations often come in the form of voices that give you commands or advice. They are often negative, and many experience voices that put them down or convince them that other people don’t like them. Visual hallucinations can come in the form of something in the corner of your eye or even fully visible people, animals, or objects that aren’t really there. Hallucinations may occur alongside delusions, like a voice in your head telling you that people are conspiring against you.
Other Positive Symptoms
Other positive symptoms of psychosis include disorganized speech and disorganized behaviors. Disorganized speech is often called a word salad. You may have trouble articulating your thoughts, and they’ll come out as a mix of random words. You may also have disorganized thoughts that make it difficult to communicate or complete tasks. It may be hard to focus on a single thought, and several thoughts run through your mind at once. This makes it difficult to work out some information or an idea you’ve had. In some cases, disorganized thinking may make people withdrawn and silent instead of speaking unclearly.
It’s also possible for your movements and behaviors to become disorganized. As your thinking is disordered, what you do may also seem erratic. This can also be a debilitating symptom that gets in the way of your normal life. Positive symptoms can also include agitations and irritability.
Negative Symptoms of Psychosis
Negative symptoms include things that are taken away from your normal thinking and behavior. These symptoms may be more subtle and difficult to notice. They may also overlap with other mental health issues, which can make them hard to diagnose.
Here are some negative symptoms of psychosis that you may experience:
- Concentration problems. You may have difficulty focusing on tasks and concentrating on the things in front of you. This may be tied to disorganized thinking and behaviors.
- Social isolation. Social isolation can be caused by a mix of symptoms coming together to make you feel cut off from others. Paranoia, cognition issues, communication problems, and other symptoms may make you feel withdrawn and isolated.
- Loss of energy. You may feel fatigued or unmotivated. It may be easy to mistake this symptom for depression, but if it comes with other psychotic symptoms, it may be caused by something like schizophrenia.
- Emotional flatness. This is officially called a flat affect. It can manifest as a lack of emotion, even when an emotional response is appropriate. Even when you hear very good or very bad news, you may not be able to respond with more than a baseline emotion. It may also be difficult to match the emotional energy of other people.
What Can Cause Psychosis?
Again, psychosis isn’t a disorder itself, but it is a set of symptoms that can be caused by mental health disorders and even high-stress situations. Most people that experience brief moments of psychotic symptoms are going through a period of high stress. However, recurring and prolonged psychosis that gets in the way of your life may be something more than stress. Here are some common causes of psychotic symptoms:
- Schizophrenia. Schizophrenia is one of the most common disorders that are known to cause psychosis. It can be a debilitating mental health issue without treatment. The symptoms of schizophrenia usually consist of the list of symptoms associated with psychosis. Though different people may experience different sets of these symptoms and not others.
- Schizoaffective disorder. Schizoaffective disorder is a combination of symptoms of psychosis and a mood disorder. It’s often described as a mix between schizophrenia and depression. In addition to psychosis, you may also experience depression symptoms.
- Bipolar mania. Bipolar disorder can cause symptoms of mania, depending on the type of bipolar you have. Mania is a period of very high mood, excitement, high energy, and less of a need for sleep. However, severe mania can also involve delusional thinking that’s consistent with psychosis. You may experience delusions of grandeur or paranoid delusions.
- Bipolar depression. Bipolar disorder can also cause periods of severe depression, which includes social isolation, feelings of worthlessness, or suicidal ideation. In some severe cases, depressive episodes can cause persecutory delusions that feed into depressive thoughts.
Since psychosis is a set of symptoms and not a diagnosis, the treatment for psychotic symptoms will depend on the disorder that is causing it. However, there are a few common medications that are used to treat psychotic symptoms across the different causes for it. Antipsychotic medications can help to alleviate some of the symptoms of psychosis.
However, first-generation antipsychotics may alleviate symptoms like hallucinations and delusions but make other symptoms, like flat affect, worse. Antipsychotics in the second generation are relatively new but may treat symptoms more holistically. Psychosis that’s caused by bipolar disorder may be treated differently. Since psychosis is caused by a severe mood, doctors and therapists may try to control mood symptoms first.