Summary


Psychotic disorders cause severe and abnormal patterns of thinking and perceptions. People tend to lose touch with reality and experience delusions and hallucinations. Hallucinations are when someone experiences something through their senses (smell, touch, see, feel, hear) that doesn't exist. Delusions are when someone believes something is true when it is not, such as someone is out to get them or someone receiving secret messages over the radio. These disorders can vary in duration, some are lifelong disorders, while others can be short-term, some are induced through another disease (such as Alzheimer’s) or through psychedelic drugs, or even a strong fever.

It’s important to keep in mind, Psychosis is usually a major symptom, however, some disorders are classified based on their emphasis on giving someone a psychotic break. Therefore other disorders can cause short-term psychotic breaks, such as major depression or bipolar disorder.

Some specific psychotic disorders are Postpartum Psychosis and Schizophrenia

Types


Postpartum Psychosis

Postpartum psychosis occurs when the mother experiences a break from reality, this break contains delusions. While these delusions are not necessarily violent or destructive, most women do not harm themselves or anyone else, however, there is always a risk of danger. This is because delusional thinking is often irrational, therefore the illness must be quickly assessed and treated. The psychosis always feels very real and makes sense to the mother experiencing it, they are often religious in nature.

Symptoms include delusions, hallucinations, hyperactivity, decreased need or inability to sleep, paranoia, rapid mood swings, and difficulty communicating.

This disorder is considered an emergency, therefore a person needs to call a doctor or emergency crisis right away so they can receive help. Research has shown that Postpartum psychosis prevalence rates are between 0.89 and 2.6 in every 1000 births, therefore 1 to 2 cases per 1000.

Substance-induced Psychotic Disorder

This disorder occurs when an individual is taking medication or illegal drugs that can cause a psychotic disorder in vulnerable people. It typically occurs when a person is either taking the drugs or is withdrawing from a drug. For example, the use of cannabis with an individual with the predisposition to psychotic disorders or schizophrenia may cause the onset of the disorder to come sooner, or raise the chance of the person getting a Psychotic disorder or schizophrenia. Other illicit substances that can cause the disorder are hallucinogens, and crack cocaine. About 3% of people will experience at least one episode of psychosis in their lifetime due to substance abuse.

Psychotic disorder due to underlying medical condition

This type of psychotic disorder can occur when an individual is already suffering from a medical condition that affects normal brain functioning. These conditions can cause symptoms of delusions and hallucinations, thereby easily mistaking them for a mental condition due to the similarities. A brain tumor or a traumatic brain injury (TBI) are examples of conditions that can cause symptoms of psychotic disorders.

Schizophrenia

 This is a severe and long-term mental health condition and causes a range of varying symptoms. Like any psychosis, a person is not always able to distinguish their own thoughts and ideas from reality. The main differentiating symptoms of this disorder are hallucinations, delusions (especially delusions of grandeur), decreased emotional expression, and social withdrawal.

This disorder can cause significant problems, as an individual may be unable to hold a job, continue studying, homelessness and unemployment, exploitation, and a high suicide rate.

Causes of the disorder are not known, however, some research has pointed out some genetic factors, and environmental factors such as cannabis use during adolescence, ages of parents, poor nutrition during pregnancies, or a traumatic trigger during adolescence. Schizophrenia can also affect an individual as a young child, or adolescence, and adulthood.

Schizophrenia is found in about 1.5 people out of every 10,000

Causes


While there are no specific causes for Psychotic disorders, there are risk factors involved in developing such a disorder

  • Genetics: someone may have genetic vulnerabilities towards psychosis or psychotic-like symptoms
  • Family history of Psychotic disorders
  • Trauma: death of a loved one, or war, sexual assault, may lead to psychosis. The point in time in a person’s life and the type of trauma play a significant role as well
  • Injuries and chronic diseases: Traumatic brain injuries, brain tumors, stroke, Parkinson’s disease, Alzheimer’s disease, dementia, and HIV can bring about psychosis
  • Drugs and substance abuse may interact with genetic vulnerabilities and life experiences which may bring about a psychotic disorder

There are a number of conditions that co-exist with psychotic disorders, such as:

  • Anxiety disorder
  • Panic disorder
  • Post-traumatic stress disorder
  • Obsessive-compulsive disorder
  • Social anxiety disorder
  • Substance abuse
  • Depression
  • Traumatic Brain Injury
  • Depression
  • Huntington’s disease
  • Multiple sclerosis
  • Epilepsy
  • Auditory of Visual nerve injury
  • Migraines

Diagnosis


The first step to diagnosing any mental health condition is to exclude any possible physical conditions.

A diagnosis requires a qualified professional to examine the individual

Only trained healthcare providers (such as a psychologist, psychiatrist, or pediatrician) can diagnose and/or treat any mental health condition.

There is no direct test for Psychotic disorders, therefore, trained mental health professionals look for symptoms that tend to affect an individual in many aspects of their lives, such as work, interests, relationships, and overall well-being.

A physical examination must be collected, as well as gather a comprehensive medical and psychological history. Two or more of the core symptoms of psychotic disorders must be present for a diagnosis to be made. Such as Hallucinations, disorganized speech or behavior, negative emotional or diminished emotional expression, and delusions. These symptoms must be present for at least one month. These symptoms have affected an individual’s daily life and are causing problems in their social and professional settings.

Treatments


The main treatment methods for Psychotic disorders are through the use of antipsychotics and mood-regulating medication, prescribed by a Psychiatrist. As well as therapy, and social therapy. There is no cure for Psychotic Disorders, however when well managed it's possible to reduce the chances of psychotic breaks. Due to the nature of the disorder, it's difficult to keep a person on track and they may have paranoid thoughts about medication and therapy. It is important that the treatment is personalized to fit the individual's needs and that it is lifelong.

Medication: There are different classes of medications that work for Psychotic disorders. A person should never take any kind of medication unless under the supervision of a trained mental health service provider. They should also ensure that they take it exactly according to the instructions and dosage given to them. Medications for Psychotic disorder works best in combination with an appropriate and individualized therapy, there are several kinds of medications that work such as:

  • Antidepressants: A type of medication that helps relieve symptoms of depression, anxiety, as well as other conditions. The goal is to correct any chemical imbalances in the brain that are responsible for mood and mood regulation. Different classes of medications work differently in the brain, some work better than others depending on the individual, their age, their reaction to the medication, and what medications are available to them. As with all kinds of medications, side effects exist for all types of antidepressants and must be discussed with their mental health care provider in order to mitigate these side effects. Antidepressants also carry the risk of abuse and addiction if they are mishandled.
  • Antipsychotics: A class of psychotropic medication primarily used to help relieve symptoms of Psychosis, and improve quality of life. They are often used in combination with other medications depending on what is being treated. They work by helping to restore the balance of natural chemicals in the brain. Antipsychotics can usually reduce feelings of anxiety within a few hours. However, symptoms of Delusions and Hallucinations may take up to several weeks to reduce.
  • Mood Stabilizers: A group of medications that are used primarily to treat bipolar disorder, and other mental disorders that may be associated with mood swings. Depending on what type of bipolar disorder an individual has, a qualified doctor will prescribe a combination of medications in order to tackle symptoms. They reduce symptoms of Mania, stabilize mood, and prevent symptom relapses

Psychotherapy: There are many different approaches under psychotherapy that can help someone experiencing Psychotic disorders. Different approaches are successful with different individuals therefore, the process of finding the right approach and therapist may be difficult at first. It can also lead to some people going for the wrong therapist or technique, and thereby leaving therapy altogether. However, people must keep in mind that therapy is not a “one size fits all” process, and sometimes a person may need to try different approaches in order to determine the best one for themselves using the help of a trained mental health professional. Some types of therapy include:

  • Behavior Therapy: The goal is to eliminate unwanted behaviors, and strengthen positive behaviors. This would be usually done in environments that are familiar to the individual, such as at home, school, workplace, and others.
  • Cognitive Behavior Therapy (CBT): The goal of CBT treatment is to eliminate negative, and irrational patterns of thinking for other symptoms that come due to living with the condition. Some individuals may have unhealthy internal dialogues, and CBT helps to eliminate those thought patterns.

It is also important to note that these therapies should also be done in the family, group, and individual settings.

Electroconvulsive Therapy (ECT): ECT is a type of treatment that is used for individuals with treatment-resistant Depression or Bipolar Disorder. This means that an individual has tried different treatment methods for some time and has not responded to any of them.

The ECT machine is hooked to a patient's head, and brief electrical volts are applied to the person’s head, while under general anesthesia. This can look very scary and terrifying for an observer, the procedure is uncomfortable but not painful. These electric shocks are given multiple times a week, over the course of a few weeks.

Healthy diet and lifestyle: Research suggests that developing a consistently healthy diet, adequate sleep, and exercise plan can play a big factor in mitigating symptoms and improving over the quality of life

Support Groups: A group of people with common mental health conditions who can provide comfort, and advice, knowing that they share similar experiences. These groups can be led with and without a mental health professional. Research has shown that the group can provide a common purpose for its members which lead to many benefits such as:

  • Leaving the isolation of suffering from a mental health condition
  • Being able to talk openly and honestly
  • Gaining control over their emotions
  • Helping others with their experiences therefore also helping themselves

Self Help Techniques: There are plenty of self-help techniques available for any individual to try that may help them deal with their symptoms. Examples include volunteering, positive self-talk, breathing exercises, and meditation

Social and professional support: Individuals experiencing psychotic disorders may need help with their social circle and environments. For example, a person may need to work, securing a job, practicing job interviews, etc.

Resources

References