Psychosis

Psychosis is a term used to describe a range of conditions that affect the mind, where the functioning of a person’s brain is severely disrupted. Psychosis will affect around 3% of the population at some time in their lives. The translation of the word psychosis is formed from the Greek words of ‘psyche’ which means ‘mind’ and ‘osis’ meaning ‘illness’.  When someone experiences psychosis they are unable to distinguish from what is real, and there is a loss of contact with reality.

Psychosis can occur at any age but is most prevalent in late adolescence and early adulthood. An estimated 80% of patients affected by a psychotic episode experience their first episode between the ages of 15-30. Up to 30% of patients do not experience any relapse after the first psychotic episode (known as ‘first episode psychoses), the remainder will develop long-term problems.

Psychotic symptoms can occur in an isolated episode or as part of an ongoing diagnosed illness such as schizophrenia, bipolar disorder, schizoaffective disorder, drug induced psychosis (symptoms usually appear quickly and last a short time, from a few hours to days), delusional disorder, major depression and post-partum psychosis.

Early Signs & Symptoms

Symptoms of psychosis are generally described as either positive or negative.  Positive symptoms reflect an excess or distortion of normal functions while negative symptoms reflect a loss of normal function.

Positive symptoms include;

• Hallucinations – this is a distortion of the senses, the brain hears, sees, smells, tastes or feels things that are not actually there. The most common type of hallucination involves hearing things – such as voices or a particular sound. These hallucinations can be so real that the individual may not realise that what they are hearing is false.

• Delusions – A person may develop false ideas or beliefs about reality. There are 3 types of delusions; Delusions of grandeur (is believing you are psychic or someone famous like Jesus Christ), delusions of paranoia (where you believe you are being persecuted, followed or plotted against & family and friends are in a conspiracy against you) and finally being suspicious of a partners fidelity (psychotic jealousy).

• Disorganised/confused thinking– the ability to concentrate, remember things, or make plans can be impaired. Everyday thoughts that let us live our daily lives become confused and don’t join up properly.

Negative symptoms include;

• Diminished range of emotional expressiveness most of the time (flat affect)

• Reduced speech

• Inability to initiate and sustain goal-directed activities

 Phases of a psychotic episode

There are three phases to psychosis; however, not all people having a psychotic episode will experience clear symptoms of all three phases. Firstly there is the prodromal phase which is the time between the first disturbance of normal thinking, feeling or behaviour and the onset of psychosis. The prodromal phase involves the early warning signs including;

• Social withdrawal

• Reduced concentration, attention

• Depressed mood

• Sleep disturbance

• Anxiety

• Suspiciousness

• Skipping school or work

• Irritability

The second phase is the acute phase, this period is when psychotic symptoms are present (delusions, hallucinations and though disorder). Finally, is the stable phase also known as the recovery stage, this is when the symptoms start to remit and recovery begins.

Causes

Although the cause of psychosis is still not fully understood, they are likely to be a combination of factors, the three most common theories are;

• Family history – Psychosis may have a biological link therefore if a family member experiences a psychotic episode others may be at higher risk.

• Stressful events – stress may trigger a psychotic episode, especially for those who suffer from a mental illness such as schizophrenia, schizoaffective disorder or bipolar disorder

• Drugs – taking drugs such as hallucinogens, amphetamines and cannabis may trigger a psychotic episode

Treatment

Fortunately treatment can do a lot to reduce and even eliminate the symptoms of psychosis. Early assessment and treatment is helpful in preventing psychosis or in limiting the extent and impact. The most effective form of treatment is a combination of medication (pharmacological), therapeutic support (psychosocial) and education.

Longer duration of untreated psychosis has been shown to predict poorer outcomes. The potential consequences of delaying assessment and treatment include;

• Slower and less complete recovery

• Increased social and occupational dysfunction

• Interference with psychological and social development

•  Strain on relationships; loss of family and social supports

• Disruption of patient’s parenting skills(for those with children)

• Disruption of study and/or employment

• Substance abuse

• Increased risk of harm, violence or criminal activities

• Unnecessary hospitalisation

• loss of self-esteem and confidence

Friends and Family can help by;

• Listening to the person without judging them or being critical of them

• Helping to keep their lives as stress free as possible to reduce chance of relapse

• Encouraging the person to get appropriate professional help

• Checking to see if the person is feeling suicidal and taking immediate action if they are

• Find out as much information as you can; knowledge is power!

• Look for support from a support group

Resources

• Sane Australia at www.sane.org.auor the sane helpline on 1800 18 SANE (7263)

• Mental illness fellowship of Australia at www.mifa.org.au

• Mental Health Association Australia at www.mentalhealth.asn.au

• Headspace – National Youth Mental Health Foundation at www.headspace.org.au

• Reach Out Australia at www.reachout.com

• Mental Health First Aid at www.mhfa.com.au