Psychosis

What is psychosis?

Psychosis is usually a symptom of a mental disorder. Psychosis means there is a loss of contact with reality.

What is the cause?

The exact cause of psychosis is not known. If it is caused by something physical, it is called organic psychosis. Organic psychosis can be brought on by brain tumors, epilepsy, head injuries, a severe lack of sleep, or infections such as meningitis. Too much or too little of certain brain chemicals called neurotransmitters may lead to psychosis.

Psychosis may also be the result of a mental disorder such as schizophrenia, bipolar disorder, or severe depression.

Drugs such as marijuana, speed, or LSD can trigger psychosis, as can drug withdrawal from substances such as alcohol.

What are the symptoms?

The main symptoms are:

• Hallucinations: People may hear voices that no one else can hear, see people or objects that are not there, or feel something that is not there. Hearing voices is usually a sign of a psychiatric problem. Hallucinations that involve seeing, feeling, smelling, or tasting are more likely to be a sign of a medical problem.
• Delusions: People with psychosis have false beliefs or ideas that are not true. For example, they might believe there is a plot against them by powerful people, or that they have special powers no one else has.
• Changed feelings: People may feel strange and cut off from the world, with everything moving in slow motion. Mood swings are common, so they may feel very excited or depressed. Or people may feel or show almost no emotion.
• Changed behavior: People with psychosis behave differently than the way they usually do. They may be very active, or just sit around all day. They may get angry or aggressive without apparent cause.
• Disorganized thinking: Everyday thoughts become confused. Sentences don't make sense. A person may have trouble concentrating, following a conversation or remembering things. Thoughts may seem to speed up or slow down.

How is it diagnosed?

A healthcare provider will ask about symptoms and examine you. He or she will make sure that a medical problem or mind-altering drugs, such as LSD or cocaine, are not causing the symptoms. Some diseases can cause many of the symptoms of psychosis. A mental health professional should help make the final diagnosis. The diagnosis is made based on a thorough psychiatric interview and medical tests.

How is it treated?

The treatment of a psychosis depends on the cause. Medicines are usually the most important part of the treatment. Many medicines are available. These medicines can cause some side effects, but you and your healthcare provider will watch for them closely.

It is very important to take your medicine even when you are feeling well and thinking clearly. Without the medicine, symptoms are very likely to get worse. Work with your healthcare provider to decide if you can do without medicine.

Psychosis changes the way you relate to others and the way you think about everyday activities. Therefore, you will probably need a therapist or case manager to help you manage your daily needs. Cognitive behavioral therapy (CBT) is a way to help you identify and change thoughts you have that are not realistic. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns. You may need to spend some time in a hospital if you are thinking about hurting yourself or someone else, or if you are unable to take care of yourself.

How can I take care of myself?

• Get support. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, take walks. Try deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

For more information, contact:

• National Alliance for the Mentally Ill (NAMI)
  Phone: 1-800-950-NAMI
  Web site: http://www.nami.org
• Mental Health America
  Phone: 1-800-969-6642
  Web site: http://www.mentalhealthamerica.net