Psychosis

Psychosis is a mental condition when you are unable to distinguish between what is real, and what is imaginary.

It is usually caused by an underlying mental illness, but can also be caused by other factors such as drug abuse. Symptoms of psychosis include hallucinations and delusions. Treatment depends on the cause of the psychosis, and includes prescribed medicines and talking therapies such as counselling.

Symptoms

When you have the symptoms of psychosis, it is known as a psychotic episode. The most common symptoms are hallucinations, and delusions. A psychotic episode can be short-term, or long-term. Hallucinations are when you hear, feel, see or smell things that arent real. The most common form of hallucination is hearing voices. Delusions are when you have unusual beliefs that arent shared by other people. For example, you may think that you are famous, or that other people are controlling what you do, or how you act. You may feel like there is nothing you can do to control your behaviour. If you are having a psychotic episode, you may be unaware that there is anything wrong with you. You may find it hard to admit that you are experiencing symptoms, or you may find it hard to ask for help. If you have the symptoms of psychosis for a long time, you may find it increasingly hard to deal with daily routines and activities.

Causes

Psychosis usually happens because of an underlying mental illness such as bipolar disorder (manic depression) or schizophrenia. It can also happen because of severe depression, post-natal depression, or following a traumatic event. Some people experience a psychotic episode when they take recreational drugs such as amphetamines (speed), ecstasy, cannabis, and LSD, and if they sniff or inhale solvents or glue. There is also evidence that extensive use of illegal drugs such as cannabis can increase your chances of developing long-term psychosis and mental illness. A psychotic episode can also be caused by lack of sleep, through illness such as a severe fever, or if you are withdrawing from drugs or alcohol after being dependant on it. It is thought that psychosis can run in your family and be passed down from your parents. Then, certain events or experiences that happen in your life can trigger a psychotic episode, or a mental illness such as schizophrenia.

Diagnosis

People who have psychosis may find it hard to realise that they have a problem, or may be unaware of their symptoms. If this is the case, those around them such as friends and family may have to persuade them to seek help. The first point of contact if you are experiencing psychotic episodes is your GP. There is no test to positively diagnose psychosis, but your GP can look at your symptoms, and rule out short-term causes such as drug misuse. They may also refer you to a psychologist or psychiatrist to diagnose an underlying mental illness that is causing your symptoms. They will ask you questions about the symptoms you have, and your lifestyle. They may also ask if your family has a history of mental illness.

Treatment

If psychosis is caused by an underlying medical condition, it can be treated with:

  • prescribed drugs, and
  • psychological therapies.

Drugs that treat psychosis are called antipsychotic drugs. They have a tranquillising effect that relaxes your nervous system. This reduces symptoms such as hallucinations, and delusions. The two major groups of antipsychotics are typical (older) and atypical (newer) antipsychotics. Antipsychotic drugs can take between one and three months to take effect and are taken as tablets or syrup. Some are available as longer-lasting depo injections, which are useful if you keep forgetting to take your medication. Antipsychotics can have a range of side effects, which can be unpleasant. The most severe include muscle spasms, unusual body movements and acute movement disorders. The side effects of atypical antipsychotics are milder than typical antipsychotics, but atypical antipsychotic drugs are usually only prescribed for you if you are newly diagnosed with a form of psychosis. If you are already taking typical antipsychotic drugs and have no problems with side-effects, you should continue to take them. Psychological therapies relate to your thoughts and behaviour and are often called talking treatments. They include counselling, when you have a guided discussion with an independent trained person to help you understand your thoughts, and cognitive behaviour therapy (CBT). Cognitive behaviour therapy can change or eliminate your unwanted thoughts and beliefs, and help you change your behaviour in response to those thoughts. If a person is very distressed by a psychotic episode, they may be admitted to hospital for treatment. People are usually encouraged to go to hospital as voluntary patients, but they can be admitted to hospital against their wishes as part of the Mental Health Act. This is called sectioning. They can then be assessed by doctors, and treated as necessary.

The information shown here is Crown copyright and has been reproduced with the permission of NHS Direct. Last updated June 2007.