Schizophrenia is most well-known condition that involves psychosis, but psychosis can arise in other mental health conditions, too.
While the word “psychotic” is often used in a stigmatizing context, there is no the term “psychosis” actually comes from the Greek word “psyche,” a word that describes the mind or soul.
You might experience an episode of psychosis for various reasons, including as part of schizophrenia, bipolar disorder, major depressive disorder, or dementia.
Psychosis is not the same as psychopathy. Psychosis is a symptom of mental health conditions like schizophrenia.
Schizophrenia is classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as a psychotic disorder.
Psychotic disorders are conditions that involve symptoms like:
- disorganized thinking and speech
- disorganized motor behavior
- negative symptoms (e.g., limited emotional expression)
Positive and negative symptoms of psychotic disorders
- Positive symptoms: Symptoms that add to existing functionality (hallucinations, delusions, disorganized speech).
- Negative symptoms: Symptoms that involve a loss of functionality (decreased pleasure, lack of emotional expression).
Schizophrenia is one of the most common forms of psychotic disorder, but you can also experience psychosis for other reasons.
Psychosis itself isn’t a diagnosis. The experience involves a lapse in your perception of reality. It’s a period where your mind is unable to tell the difference between fact and fiction.
Psychosis can be a symptom of a mental health disorder.
According to the DSM-5-TR, most psychotic disorders involve positive symptoms of psychosis.
During an episode of psychosis, these can include:
- Delusions. A belief in things that are untrue, irrational, or inconsistent with your culture.
- Hallucinations. These are sensory experiences that occur without stimulus.
- Disorganized speech and thinking. This involves communication that may be difficult for others to follow or understand.
- Disorganized motor behavior: This is unpredictable behaviors and movements.
With schizophrenia, you can also experience negative symptoms.
These may include:
- Diminished emotional expression. This may involve reduced eye contact, slack facial expression, and emotionless speech.
- Avolition. This may involve a lack of motivation or inability to get started on tasks.
- Anhedonia. This involves the inability to feel pleasure.
- Alogia. This may involve being quiet and unresponsive.
- Asociality. This involves a limited interest in social interactions.
Psychosis as a symptom
Experiencing one episode of psychosis doesn’t mean you have a lifelong mental health condition.
According to the
Psychotic disorders that can cause psychosis include:
- schizophreniform disorder
- schizoaffective disorder
- delusional disorder
- brief psychotic disorder
- substance or medication-induced psychotic disorder
Outside of psychotic disorders, other mental health conditions that can involve psychosis include:
- bipolar disorder
- post-traumatic stress disorder (PTSD)
- severe forms of major depressive disorder
- postpartum psychosis
- borderline personality disorder
You can even develop psychosis because of
- traumatic brain injury
- Parkinson’s disease
When is psychosis considered schizophrenia?
Psychosis becomes part of a mental health diagnosis when it meets certain criteria.
For schizophrenia, the DSM-5-TR says that you must have two or more symptoms for a significant amount of time during a 1-month period. Signs must also be present for at least 6 months.
Of the symptoms, one must be:
- disorganized speech
Like all disorders in the DSM-5-TR, doctors diagnose schizophrenia when it interferes with major parts of your life, like:
- personal care and hygiene
- school or work
Psychosis or imagination?
So how do you know the difference between imagining something and experiencing psychosis?
When you experience psychosis, your brain isn’t able to recognize the altered perception of reality. You believe what you’re hearing, feeling, tasting, or seeing.
Imagination is the ability to willfully manifest a potential sensory event based on past experiences. When you’re imagining something, you’re aware you’re doing it.
Treatment for psychosis and schizophrenia can differ.
Treatment for psychosis will depend on why you’re experiencing these types of symptoms.
Regardless of the cause, treating psychosis as early as possible will likely result in a better outcome.
Early warning signs of psychosis
- hearing, seeing, or feeling things that aren’t there
- mood swings or lack of emotion
- social withdrawal
- lack of hygiene and personal care
- difficulty thinking or concentrating
- unusual thoughts and beliefs that you can’t dismiss
A common first-line treatment approach for early psychosis is called coordinated specialty care (CSC). CSC is a holistic treatment plan that incorporates:
- lifestyle support
- family education
Specific treatments will depend on why you’re experiencing psychosis. Often, treatment will involve a form of cognitive-behavioral therapy (CBT), which aims to change unhelpful thought patterns and behaviors.
Psychosis treatment may also involve medications called antipsychotics. These can help limit the intensity of hallucinations, delusions, and other symptoms.
If your psychosis is related to a physical condition, treatment may involve addressing the underlying cause.
In some cases, like with substance-induced psychosis, a psychotic episode can be temporary. Once the effects of the substance wear off, your symptoms will go away.
Schizophrenia is a lifelong mental health condition. But it’s possible to manage the condition.
Schizophrenia treatment involves:
- psychosocial interventions
Your doctor may prescribe first or second generation antipsychotic medications based on the severity of your symptoms.
First-generation antipsychotics work primarily on your dopamine system, while second-generation medications target dopamine and serotonin.
Examples of first-generation medications include:
- chlorpromazine (Thorazine)
- loxapine (Loxitane)
- haloperidol (Haldol)
- fluphenazine (Proxlixin)
Examples of second-generation medications include:
- clozapine (Clozaril)
- aripiprazole (Abilify)
- asenapine (Saphris)
While medications can help calm symptoms, your doctor may also recommend:
- cognitive-behavioral therapy (CBT)
- supportive psychotherapy
- cognitive enhancement therapy
Additionally, your doctor or healthcare team may recommend the following complementary therapies:
- assertive community treatment (ACT)
- peer group support
Because schizophrenia is a lifelong condition, you may find it helpful to develop new life skills and coping mechanisms for everyday life.
Psychosis and schizophrenia aren’t the same things.
Psychosis is an experience that involves a disruption in your interpretation of reality. Schizophrenia is a mental health condition involving symptoms like psychosis.
You can experience psychosis because of a number of mental and physical conditions. And the intensity and duration of an episode depends on the underlying cause.
If you’re seeing, hearing, or touching things that aren’t there, or feel like your thoughts are becoming skewed, speaking with a mental health professional may help.
To learn more about psychosis and schizophrenia, or to find resources in your area, consider talking with a qualified mental health representative at any time by calling the SAMHSA National Helpline at 1-800-662-4357.
SAMHSA also offers an Early Serious Mental Illness (ESMI) Treatment Locator, allowing you or your loved ones to locate CSC programs in your area.