Psychosis refers to a clinical syndrome comprised of hallucinations, delusions and thought disorder (changes in thinking).
Because psychosis affects the way your brain processes information, it may cause you to experience reality differently and have difficulty discerning what is real and what is not.
Symptoms of Psychosis
Hallucinations – When you see, hear, feel or smell things that others cannot. For example:
- hearing voices;
- seeing things others cannot;
- feeling someone or something touch you;
- smelling things others cannot.
Delusions – Strong beliefs that are unlikely to be true, and which may seem irrational to others and are not in keeping with your culture, such as:
- thinking others may be following or monitoring you;
- believing someone or something is controlling your thoughts, feelings or behaviours;
- believing seemingly trivial events, objects or people have specific personal meaning or significance;
- thinking you have special powers, have a special mission, or believing you are a high profile figure.
Thought disorder – May include:
- difficulty with memory;
- trouble concentrating and focussing;
- difficulty making decisions;
- difficulty processing new information;
- thought blocking ie getting stuck midway through a train of thought;
- racing thoughts.
Early Warning Signs of Psychosis
Generally, early warning signs of psychosis develop in late adolescence to early adulthood. Changes in thinking and behaviour often precede positive psychotic symptoms and can include:
- poor attendance to personal hygiene;
- concerning decline in grades or job performance;
- trouble thinking clearly or concentrating;
- suspiciousness of others;
- unusual or strange new ideas;
- difficulty communicating or confused speech;
- withdrawing, spending a lot of time alone.
What Causes Psychosis?
Developing research has indicated several factors are likely involved, with teenagers and young adults at particular risk of developing psychosis due to hormonal changes in the brain during puberty.
Contributing factors to psychosis include:
- Genetics – A substantial body of research has found a strong genetic component to psychosis, however, just because someone has a gene doesn’t particularly mean they will experience psychotic symptoms.
- Substance abuse – Particularly in those who are already vulnerable (eg have a familial history of psychosis, have experienced trauma or have other mental health conditions), the use of marijuana, LSD, amphetamines and other substances significantly increases the risk of developing psychosis.
- Trauma – Experiencing or witnessing a traumatic event can predispose you to developing psychosis. The type of trauma, as well as the person’s age, genetics and lifestyle affects whether this will trigger a psychotic episode.
- Physical injury – Traumatic brain injury, strokes, brain tumours, HIV and sometimes Parkinson’s or dementia can lead to a psychotic episode.
- Other mental health conditions – Sometimes psychosis can be a symptom or feature of other mental health disorders, such as bipolar disorder, depression, schizophrenia or schizoaffective disorder.
Treatment for psychosis may involve several health and allied health professionals including psychiatrists, psychologists, social workers and occupational therapists. Treatment may consist of the following:
- Antipsychotic medication – Medication is generally the first line treatment for symptoms of psychosis. Antipsychotic medication blocks the effect of dopamine in the brain, which has been found to be associated with psychotic symptoms.
- Psychological therapies – Cognitive Behavioural Therapy for Psychosis (CBTp) has been shown to be an effective psychological therapy in reducing distress associated with psychotic symptoms when used in conjunction with antipsychotic medication. CBTp explores the beliefs that influence the way we perceive and react to events. For example, perceiving auditory hallucinations as sinister and evil may increase distress levels associated with the experience and may lead to withdrawal and/or anxiety.
- Family interventions – Family interventions may involve programs where family members are engaged in learning about psychosis and how they can be involved in treatment. Additionally, intervention may include family group therapy where the family members and persons with psychosis attend group therapy sessions.
Author: Tara Pisano, BA (Psych) (Hons), M Psych.
Tara Pisano is a registered psychologist with a special interest in early intervention in adolescents and young adults, as this is when three quarters of mental health conditions emerge. In her practice, she draws on a range of evidence-based therapies such as CBT, DBT, IPT, ACT and Motivational Interviewing, to promote recovery and positive outcomes.
To make an appointment with Tara Pisano, try Online Booking. Alternatively, you can call M1 Psychology Loganholme on (07) 3067 9129 or Vision Psychology Wishart on (07) 3088 5422.
- American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition). American Psychiatric Association
- Gaebel, W., & Zielasek, J. (2015). Focus on psychosis. Dialogues in clinical neuroscience, 17(1), 9–18. https://doi.org/10.31887/DCNS.2015.17.1/wgaebel
- Galletly, C., Castle, D., Dark, F., et al. (2016) Royal Australian and New Zealand College of Psychiatrists clinical practical guidelines for the management of schizophrenia and related disorders. Australian and New Zealand Journal of Psychiatry, 50(5) 1-117.
- MHFA Psychosis Guidelines (2020). Mental Health First Aid International.