Psychosis is a serious but treatable condition in which one's perception of reality is altered. This post provides a thorough and accessible explanation of what psychosis is, how it manifests, and what can help – both medically and humanely.
What is meant by psychosis?
Psychosis is a state in which a person's perception of reality is altered. It is not about being confused, having difficulty remembering or interpreting impressions. Instead, it is about experiencing reality in a way that differs qualitatively from how others perceive it.
Psychosis means believing that physical or social reality is different from what those around you perceive. In clinical terms, this is called impaired reality testing.
What distinguishes psychosis from ordinary differences in perception?
It's important to understand that psychosis isn't about differing opinions on details. We all have such differences, and they lead to different perspectives and values. In psychosis, it's about the person perceiving fundamental aspects of reality in a completely different way than others.
For example, one might believe that a loved one has hostile intentions, or that one sees or hears things that others do not perceive – but still experience it as completely real.
Partially influenced perception of reality
A person with psychosis is rarely affected in all aspects of their life. It's common for some parts of their reality testing to remain intact. For example, a person might believe that their food is poisoned, but at the same time know who they are, what they like, and function in many everyday situations.
Psychosis therefore affects parts of thinking, not the entire personality. It is rarely as black and white as it can be portrayed in films or media.
Is it possible to determine who is psychotic?
In healthcare, it is rarely difficult to determine whether someone is experiencing psychosis. It is not a philosophical problem but a clinical assessment. Psychotic experiences are not integrated with the person's other feelings, thoughts, and behaviors. This often leads to contradictions, illogical reasoning, and strong, disproportionate emotions.
The psychotic person also has a diminished ability to discern what is true or real. For those around them, it is often clear when someone no longer adds up to a functioning psychological whole.
Three main symptoms of psychosis
1. Misconceptions
This concerns the content of a person's thoughts – what they believe to be true or not. Common examples are paranoid delusions, where one believes that others have malicious intentions towards them. One may also believe that they are omnipotent, or that someone is trying to murder them.
2. Hallucinations
Hallucinations are sensory experiences that are perceived as real but originate from within the person. One may hear voices, see people, or experience bodily sensations that have no external source. These experiences are often frightening or distressing.
3. Disorganized speech or behavior
In psychosis, the ability to organize one's actions and speech can be impaired. The person may speak in incoherent sentences, jump between topics, or behave in ways that lack logic. It can become difficult to follow a train of thought or understand context.
Treatment of psychosis
If the psychosis does not have a clear external cause, such as drugs, it is common for the condition to develop on its own. In such cases, there are few psychological methods that can directly alleviate the condition. What primarily helps in the acute phase is antipsychotic medication, also called neuroleptics.
The effect can sometimes come quickly, but usually the improvement occurs gradually. Side effects occur, but are usually outweighed by the relief of being free from the symptoms – which are often frightening, chaotic and make everyday functioning difficult.
Psychological and psychosocial interventions
Although medication is important in the acute phase, the way people are treated is just as significant. A responsive, kind, and respectful approach is often what lingers in memory – if that's what the person received.
Good communication, low stress, and empathy can positively influence symptoms. Therefore, medical treatment should always be combined with psychological and psychosocial interventions.
Summary
Psychosis is a condition in which the perception of reality is profoundly altered. It manifests as delusions, hallucinations, and disorganized behavior or speech. Psychosis doesn't always affect the entire personality, but it changes how the person interprets the world.
Treatment consists partly of antipsychotic medication and partly of a safe and respectful approach. It is a combination of medical and human efforts that makes a real difference.