Different Types of Psychosis - Verywell Health

Psychosis occurs when a person has a break from reality which includes symptoms like delusions, hallucinations, and disordered thinking. These disruptive thoughts and sensory experiences make it hard for them to distinguish what is real from what is not.

Approximately three in 100 people will experience an episode of psychosis in their lifetime. The experience of psychosis is unique to each person.

Psychosis is not a condition on its own. Rather, it's a symptom of several mental health disorders, including psychotic disorders. Psychosis can also be a response to brain changes, traumatic events, injuries, or substance use.

This article will cover the types of psychosis and how they are diagnosed and treated.

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Definition of Psychosis

According to the American Psychiatric Association (APA) and the World Health Organization (WHO), psychosis is defined by the experience of having hallucinations, delusions, or both. People experiencing psychosis may have little or no insight into their symptoms.

The neuropsychiatric symptoms of psychosis lead to an impaired sense of reality. They disrupt a person's ability to function in everyday life, whether that's going to school, work, or maintaining relationships.

Types of Conditions Displaying Psychosis

There is no universally recognized system for classifying psychosis. However, researchers recognize that different types of events or conditions can cause psychosis.

Psychotic Disorders

Psychosis is a primary symptom of schizophrenia spectrum disorders. These disorders are included in the "Diagnostic and Statistical Manual of Mental Disorders (DSM-5)" category labeled "Schizophrenia Spectrum and Other Psychotic Disorders."

Psychotic disorders in this category include:

• Schizophrenia (causes symptoms like delusions, hallucinations, abnormal social behavior, and disorganized thinking)
• Schizophreniform disorder (similar to schizophrenia, but that only lasts six months or fewer)
• Schizoaffective disorder (symptoms of both schizophrenia and a mood disorder like depression)
• Delusional disorder (having false beliefs despite evidence that they are not true)  
• Brief psychotic disorder (sudden psychotic symptoms that don't last more than one month)
• Unspecified schizophrenia spectrum and other psychotic disorders (symptoms that don't fit the full criteria for a specific disorder and are not caused by another medical condition)
• Other specified schizophrenia spectrum and other psychotic disorders (symptoms of more than one disorder that don't fit the full criteria for any and can't be explained by another medical condition)

Other Mental Health Conditions

Other mental health conditions that are not included in the DSM-5's psychotic disorder category can also lead to psychosis.

These conditions include:

Organic Psychosis

Organic psychosis, also referred to as secondary psychosis, occurs due to an acquired change in brain function.

Causes of organic psychosis include:

Substance-Induced Psychosis

Psychosis can be caused by substance or medication use. This type of psychosis is defined as "Substance/Medication-Induced Psychotic Disorder" in the DSM-5. Alcohol, cannabis, and certain illicit drugs (such as methamphetamine and cocaine) can cause psychosis.

Some prescription medications, including anxiolytics and sedatives, may cause psychosis. Withdrawal from medications can also lead to psychosis.

Signs and Symptoms of Psychosis

Psychosis is a symptom of other conditions, including psychotic disorders like schizophrenia. There are a few specific symptoms that define psychosis:

• Hallucinations
• Delusions
• Disordered thinking

Hallucinations

Hallucinations are false sensory experiences in the absence of a stimulus. What hallucinating feels like depends on the sensory system affected, but it is often auditory (hearing things that are not there) or visual (seeing things that are not there).

Delusions

A delusion is defined as a fixed, false belief. Examples of common delusions are believing that the television is sending special messages to you, that others are plotting against you, that someone (usually a celebrity) is in love with you, and that your thoughts are being controlled.

Disordered Thinking

Disordered thinking that's severe enough to impair a person's ability to communicate effectively is another symptom of psychosis. Examples of disordered thinking include fast, racing thoughts, derailment, perseveration (uncontrollable repetitive thoughts), illogicality (belief and thoughts that are not based on logic or reason), and tangentiality (jumping from one topic to another without any apparent connection).

Psychosis vs. Schizophrenia

Psychosis can include hallucinations, delusions, and agitation. While it can be associated with schizophrenia, psychosis can also occur in other mental health conditions or be linked to substance use and sleep deprivation.

Schizophrenia is a mental health condition that can cause psychosis. However, not all people with psychosis have schizophrenia.

Early Warning Signs and Symptoms

Sometimes, other symptoms come on before a person experiences a full-blown psychotic episode. Knowing these early warning symptoms can help you get help to reduce the risks of psychosis.

Early warning signs of a psychotic disorder may include:

• A drop in grades or job performance
• Difficulty concentrating
• Increased isolation
• Withdrawal from family, friends, and colleagues
• Sudden decline in self-care and hygiene
• Strong emotions or lack of emotions
• Suspiciousness or distrust of others
• Unusual thoughts or beliefs that are contradictory to what the majority of others believe

Diagnosing the Type of Psychosis and Underlying Disorder

If you or someone you know experiences a psychotic episode or symptoms of psychosis, it is important to seek medical attention.

Sometimes, a person only has one psychotic episode. If the episode lasts longer than one day but is shorter than one month, it might be diagnosed as a brief psychotic disorder.

Getting a diagnosis can help you receive the best treatment for your condition and help you cope with the symptoms you're having. If you are experiencing psychosis because of a medication or substance, your healthcare provider can work with you to find the support you need.

Treatment of Psychosis

Treatment for psychosis depends on the cause but can include medication, therapy, or both.

Antipsychotic medications are usually prescribed to help people experiencing psychosis. These medications can help with current symptoms as well as prevent future episodes of psychosis.

Examples of antipsychotics include:

• Haldol (haloperidol)
• Prolixin (fluphenazine)
• Navane (thiothixene)
• Adasuve (loxapine)
• Mellaril (thioridazine)
• Stelazine (trifluoperazine)

Another type of antipsychotic medication called atypical antipsychotics may also be used:

• Clozaril (clozapine)
• Abilify (aripiprazole)
• Risperdal (risperidone)
• Zyprexa (olanzapine)
• Seroquel (quetiapine)

They can also benefit from working with a mental health provider, especially in the weeks and months while they are recovering from an acute episode.

For example, research has shown that people with psychosis may benefit from individual cognitive-behavior therapy (CBT) and dialogue therapy (DT).Some people with psychosis benefit from going to group therapy.

A person who is experiencing an episode of psychosis may need to go to the hospital or an inpatient mental health facility to get treatment and make sure that they are safe while they recover.

However, it's important to note that treatment for psychosis can be difficult for people to access and continue with. Other research has suggested that even combinations of therapy and medication are not beneficial for everyone with psychotic disorders, and there is an urgent need for better treatments.

Summary

Psychosis is always a symptom of another condition, such as a psychotic disorder, another mental health condition, an organic cause, or a substance or medication-related cause.

Talk to your healthcare provider or psychiatrist if you are having symptoms of psychosis. Once you get a diagnosis, you can take steps to manage the underlying issue and cope with symptoms. 

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