One Morning You Wake Up And You're no Longer yourself... How Does Psychosis Begin?

Psychotic disorders, or psychosis, are a group of serious illnesses that affect the mind. They make thinking, proper judgment, emotional response, effective communication, understanding of reality, and appropriate behavior difficult for individuals. When the symptoms are severe, people with psychotic disorders struggle to relate to reality and are often unable to manage daily life.

Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality.

Psychotic disorders come in different types that vary based on the severity of symptoms, the type of signs an individual shows, and other factors. The main types of psychotic disorders include:

• Brief psychotic disorder

• Substance or alcohol-induced psychotic disorder

• Schizophrenia

• Delusional disorder

• Schizoaffective disorder

• Schizophreniform disorder

• Shared psychotic disorder

• Psychotic disorder due to another medical condition

• Paraphrenia

Each of these disorders has its own specific symptoms. The last option, called paraphrenia, is a condition that exhibits symptoms similar to schizophrenia or delusional disorder and is not officially recognized as a psychotic disorder in the DSM-5 This condition typically begins in older individuals during a period when various neurological problems emerge. Below, we will explore some of these disorders and their symptoms. A chronic brain disorder that affects an individual’s thinking, emotions, and behavior. People with schizophrenia may experience hallucinations, delusions, disorganized speech, disordered behavior, and loss of interest or motivation.
Hallucinations, delusions, disorganized speech, disordered behavior, loss of interest or motivation, memory and concentration problems.

A mood disorder that causes extreme mood swings. People with bipolar disorder may experience manic (high, energetic moods) and depressive (low, energy-less moods) episodes.
Mania (high, energetic mood, racing thoughts, insomnia, increased activity), depression (low, energy-less mood, negative thoughts, fatigue, trouble sleeping).

Schizotypal Disorder
A psychotic disorder similar to schizophrenia but with milder and less severe symptoms. People with schizotypal disorder may experience hallucinations, delusions, disorganized speech, and disordered behavior.
Hallucinations, delusions, disorganized speech, disordered behavior, strange beliefs.

Paranoid Disorder
A psychotic disorder marked by distressing delusions. People with paranoid disorder may believe they are being persecuted, followed, or conspired against. They may also experience jealousy, suspicion, and anger.
Distressing delusions (believing they are being persecuted, followed, or conspired against), jealousy, suspicion, anger.

Dissociative Disorder
A psychotic disorder characterized by unstable identity and memory. People with dissociative disorder may have multiple identities and their memory of the past may be unclear or lost.
Unstable identity and memory (multiple identities, unclear or lost memory of the past).

Types of Psychotic Disorders:

1. Brief Psychotic Disorder
   A form of psychosis where individuals experience a short, sudden psychotic episode, often triggered by a very stressful event such as a family death. Recovery is usually quick – typically within a month, after which psychotic symptoms gradually disappear.

Psychotic disorders involve conditions that separate a person from reality and often include delusions and hallucinations.

2. Substance or Alcohol-Induced Psychosis
   This condition is caused by the use or withdrawal from substances, such as hallucinogens and crack cocaine, which induce hallucinations and delusions, and may lead to significant problems. Alcohol can also cause psychosis.

3. Organic Psychosis
   Another type of psychosis, also called organic psychosis, is caused by damage to other organs. Stroke, infection, various injuries, or similar issues can trigger this type of disorder and cause serious mental health problems.

4. Postpartum Psychosis
   In some cases, psychotic symptoms may emerge after childbirth. A few weeks postpartum, individuals may develop postpartum psychosis. They typically exhibit a combination of depression, mania, and other psychotic symptoms. Mood swings are intense, with restlessness, difficulty sleeping, and lack of concentration being other signs.

5. Severe Depression
   Some individuals with severe depression also experience psychotic symptoms when they are at their most depressed. Symptoms of severe depression and mood changes often occur alongside psychosis.

   

6. Psychosis in Bipolar Disorder
   One of the types of psychotic disorders includes the occurrence of psychosis alongside bipolar disorder. This condition affects an individual’s mood. A person with bipolar disorder may experience episodes of low mood (depression) and high energy moods (mania). Psychotic symptoms can occur during manic episodes, where the individual may experience a mix of hallucinations and delusions.

7. Delusional Disorder
   Another form of psychosis is delusional disorder. The key symptom of this disorder is the presence of a delusion (a fixed, false belief). This delusion involves a situation in real life that could be true but isn’t, and does not exist in the person’s actual life. For example, a person with psychotic disorder may believe someone is constantly following them or that they have a terminal illness. The delusion lasts for at least one month.

8. Schizoaffective Disorder
   Another form of psychosis is schizoaffective disorder, where individuals exhibit both symptoms of schizophrenia and a mood disorder, such as depression or bipolar disorder. This type of disorder is particularly noted for its mood characteristics, such as severe depression or bipolar disorder. It can lead to hallucinations, paranoia, and delusions. Both genetics and chemical changes in the brain are likely causes of this mental health disorder.

People with schizoaffective disorder have symptoms of schizophrenia and a mood disorder (depression and bipolar disorder).

Psychotic disorders include schizophrenia, schizoaffective disorder, and brief psychotic disorder.

9. Psychotic Disorders in DSM-5
   The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association has a comprehensive classification of psychotic disorders, including the following:

• Schizophrenia or psychosis

• Brief psychotic disorder

• Delusional disorder

• Schizoaffective disorder

• Schizophreniform disorder

• Schizotypal personality disorder

• Substance/medication-induced psychosis

• Psychosis due to another medical condition

The symptoms of psychosis may vary across mental health disorders. In addition, symptoms differ depending on the type of psychotic disorder. The most common symptoms shared by all types of psychosis include hallucinations, delusions, and disorganized thinking. Other possible symptoms include:

• Difficulty concentrating

• Brain fog

• Increased anxiety or restlessness

• Loss of interest or pleasure in ordinary activities

• Increased or decreased appetite

• Hallucinations, where the person hears or sees things that seem real to them

• Social withdrawal

• Neglect of personal hygiene

• Holding strong beliefs that are not actually true

• Paranoia regarding people and situations around them

• Changes in sleep habits

• Withdrawal from family and friends

• Lack of emotional response

• Disorganized speech, incoherent or reduced verbal interaction with others

• Wearing strange clothes

• Suspicion or hostility

• Having strange or unbelievable ideas, such as “My parents are poisoning my food.”

• Disorganized or incoherent speech

• Disturbed thoughts

• Slow or unusual movements

  Causes of Psychotic Disorders
  There is no single cause of psychosis. Genetics and chemical changes in the brain can be important factors contributing to the onset of psychosis. Traumatic events, substance use, and underlying health conditions can sometimes lead to changes in how the brain functions. Previous research has shown that disorders of dopamine, serotonin, and glutamate in the brain may contribute to the development of certain types of psychotic disorders. A family history of mental health issues may also be a contributing factor. People with certain psychotic disorders, such as schizophrenia, may experience issues in parts of the brain that control thinking, perception, and motivation.

Certain individuals are at higher risk for developing various psychotic disorders. For example, high stress or a history of depression can increase the likelihood of psychosis. The following conditions are associated with a higher risk of developing psychotic disorders:

• Alzheimer's disease and other types of dementia

• Conditions related to hormonal problems, such as Addison's disease and Cushing's disease

• Those with an overactive or underactive thyroid gland

• Brain or spinal cord infections (encephalitis or meningitis)

• Lupus

• Lyme disease

• Multiple sclerosis

• Childbirth

• Stroke and other brain-related neurological conditions

• Deficiencies in vitamin B1 and B12

• Individuals with substance abuse problems, such as alcohol or prescription drugs

• Individuals with a history of severe brain injuries, such as concussions

• People who have experienced high levels of stress and anxiety