What is Psychosis?

The word psychosis is used to describe conditions that affect the mind, where there
has been some loss of contact with reality. When someone becomes ill in this way it
is called a psychotic episode. During a period of psychosis, a person’s thoughts and
perceptions are disturbed and the individual may have difficulty understanding what
is real and what is not. Symptoms of psychosis include delusions (false beliefs) and
hallucinations (seeing or hearing things that others do not see or hear). Other
symptoms include incoherent or nonsense speech, and behavior that is
inappropriate for the situation. A person in a psychotic episode may also experience
depression, anxiety, sleep problems, social withdrawal, lack of motivation, and
difficulty functioning overall.

Q: What causes psychosis?

A: There is not one specific cause of psychosis. Psychosis may be a symptom of a mental
illness, such as schizophrenia or bipolar disorder, but there are other causes, as well. Sleep
deprivation, some general medical conditions, certain prescription medications, and the
abuse of alcohol or other drugs, such as marijuana, can cause psychotic symptoms.
Because there are many different causes of psychosis, it is important to see a qualified
health care professional (e.g., psychologist, psychiatrist, or trained social worker) in order to
receive a thorough assessment and accurate diagnosis. A mental illness, such as
schizophrenia, is typically diagnosed by excluding all of these other causes of psychosis.

Causes
We are still learning about how and why psychosis develops, but several factors are
likely involved. We do know that teenagers and young adults are at increased risk of
experiencing an episode of psychosis because of hormonal changes in their brain
during puberty.

Several factors that can contribute to psychosis:

 Genetics. Many genes can contribute to the development of psychosis, but just
because a person has a gene doesn’t mean they will experience psychosis. Ongoing
studies will help us better understand which genes play a role in psychosis.
 Trauma. A traumatic event such as a death, war or sexual assault can trigger a
psychotic episode. The type of trauma—and a person’s age—affects whether a
traumatic event will result in psychosis.
 Substance use. The use of marijuana, LSD, amphetamines and other substances
can increase the risk of psychosis in people who are already vulnerable.
 Physical illness or injury. Traumatic brain injuries, brain tumors, strokes, HIV and
some brain diseases such as Parkinson’s, Alzheimer’s and dementia can sometimes
cause psychosis.
 Mental health conditions. Sometimes psychosis is a symptom of a condition like
schizophrenia, schizoaffective disorder, bipolar disorder or depression.
 Signs of early psychosis: You may:
o Hear, see, or taste things others don’t
 o Hang on to unusual beliefs or thoughts no matter what
others say
o Pull away from family and friends
o Stop taking care of yourself
o Not be able to think clearly or pay attention
 Symptoms of a psychotic episode: Usually you’ll notice all of
the above plus:
o Hallucinations:
 Auditory hallucinations: Hearing voices when no
one is around
 Tactile hallucinations: Strange sensations or
feelings you can’t explain
 Visual hallucinations: You see people or things that
aren’t there, or you think the shape of things looks
wrong
o Delusions: Beliefs that aren’t in line with your culture
and that don’t make sense to others, like:
 Outside forces are in control of your feelings and
actions
 Small events or comments have huge meaning
 You have special powers, are on a special mission,
or actually are a god
 Clinically, psychoneuroses implies a bodily disturbance
without any structural or organic defect These symptoms in
fact are the functions of certain mental disturbances the origin
of which the patient is unable to understand; but nevertheless,
he realizes that something is wrong with him.
 Psychoses are major personality disorders marked by gross
emotional and mental disruptions. These diseases make the
individual incapable of adequate self management and
adjustment to society.
 The distinction between psychotics and neurotics in general
are symptomatic, psychopathological and therapeutic.
 1. Psychoses involve a change in the whole personality of the
person in whom it appears, while in psychoneuroses only a
part of the personality is affected. With the development of
psychoneuroses, there is often no marked outer change of
personality of any kind. As Meyer puts it, a psychoneuroses is
a part reaction, while a psychoses is a total one.
 2. In a psychoses, contact with reality is totally lost or
changed. The reality contact practically remains intact in a
psychoneurotic, though its value may be quantitatively
changed. In fact insight and reality have the same meaning for
them as the rest of the community.
 3. The changes in the reality values of the psychotic, psycho-
pathologically is partly expressed through projection, for
example, the strong belief that one is being constantly
watched. Projection of this sort often based on a sense of guilt,
subjective but unconscious, does not occur in the
psychoneuroses.
 ADVERTISEMENTS:

 4. Language, which is a means of communication, is the

symbolizing function for social adaptation. In the
psychoneuroses language as such is never disturbed, whereas
in the psychoses language often undergoes gross distortion.
 5. Some psychoses are primarily organic. Even in the
functional psychoses organic factors enter into the etiology.
The psychoneuroses on the other hand are predominantly
socially conditioned. Horney has therefore remarked
“Psychoneurotic is the individual who deviates in his
behaviour from the norms accepted by his culture because of
 anxiety and who feels lonely and inferior because of this
deviation.”
 6. In psychoanalytic theory the psychoses may be
differentiated from the psychoneuroses in terms of the amount
of ego and libido regression and in terms of the topographical
location of the conflict. In psychoses therefore the libidinal
regression goes as deep as the early anal period i.e., beyond
the level of reality testing.
 Psychoses may therefore be considered dynamically as a
disorder in which the ego looses much of its contact with
reality and is more concerned with the forces of the id. The
psychoneurotic on the contrary, suffers libidinal regression
only to the phallic or late anal period as his conflict may be
considered as a struggle between the forces of the id and the
ego, in which the ego maintains its contact with expressed
reality. The regression is only to the level of reality testing and
so the neurotic retains insight and does not deny reality.
 ADVERTISEMENTS:

 7. As regards etiology Page says that in psychoneuroses the

psychogenic factors and heredity are of considerable
importance, where as neuro physiological and chemical factors
are insignificant. On the other hand, in psychoses, heredity,
toxic and neurological factors are the determining agents.
Psychogenic factors as such may or may not be important.
 8. So far as general behaviour is concerned, in the neurotic the
speech and thought processes are coherent and logical. There
are little or no delusions, hallucinations and confusion in case
of psychoneurotic. On the contrary, in case of the psychotics
speech and thought processes are incoherent, disorganised,
 bizzare and irrational. There is constant confusion. Delusion
and hallucination are marked symptoms.
 9. Neurotics are capable of self management, partial or
completely self supporting, are rarely suicidal. They do not
need hospitalisation on the other hand; psychotics are
incapable of self management. They often attempt to commit
suicide and need hospitalization or equivalent home care.
 10. The personality of the neurotic undergoes little or no
change from normal self. A neurotic has good insight. In case
of a psychotic, on the other hand, there is radical change in
personality, insight is partially or completely lost.
 ADVERTISEMENTS:

 11. The psychotics and psychoneurotic also differ in treatment

procedure.
 Psychoneurotic respond favourably to psychotherapy, such as
suggestion, psychoanalysis and other forms of psychotherapy
while the psychotics do not effectively respond to
psychotherapy and treatment is mainly chemical and
physiological.
 12. As regards prognosis, the symptoms of psychoneurotics are
transitory and outcome of treatment is usually favourable. The
deterioration and mortality rate is quite less.
 On the other hand, in psychotics, the symptoms are relatively
constant from day to day, outcome less favourable and cure
temporary and death rate is high.
 In spite of these differences, the psychotics and neurotics
cannot be separated by watertight compartments and there is
no sharp break between behaviour which is to be called
psychotic and the behaviour which is to be called neurotic.
Neurosis vs Psychosis

Neurosis Psychosis

Mild functional neuro-psychical disorders that A severe mental illness characterised by loss of
manifest themselves in specific clinical phenomena contact with reality and relationship with other
in the absence of psychical phenomena. people causing social maladaptation.

Doesn’t affect personality Affects personality

The contact with reality is partially lost The contact with reality is completely lost

Hallucinations and delusions are not present Hallucinations and delusions are present

Lower risk of self-harm Higher risk of self-harm

Obsessive-compulsive disorders, Somatoform Schizophrenia and delusional disorders are a few

disorders, Depression and Post-traumatic disorders types of psychosis.
are a few types of neurosis.

The causing factor for neurosis are biological, socio- The causing factors for psychosis are genetic,
psychic climate, psychological, pedagogical, and biochemical and environmental.
socio-economic.

The treatment is usually psychological and Psychosis is treated by antipsychotic medicines,

medicines can also be prescribed. psychological therapy, social support.
Difference Between Psychosis and Neurosis
Definition
Psychosis: Psychosis is defined as a major personality disorder which disrupts one’s
emotional and mental aspects of life.
Neurosis: Neurosis refers to a constant struggle between an individual’s personality
and his patterns of behavior in a stressful condition, often associated with physical and
mental disturbances .
According to most non-medical people, Neurosis is a mild mental disorder in contrast
to Psychosis, which is none other than complete insanity or madness.

Effect on Personality
Psychosis: Those with Psychosis has a complete alteration of their personality with a
considerable impairment or loss of insight.
Neurosis: In patients with Neurosis, only a part of their personality has been affected
by the condition along with a mild loss of insight.

Awareness
Psychosis: Psychotic patients often lose their touch with the reality with an absolute
distortion of it which may even require hospitalization. They also have this
characteristic feature of not accepting the fact that they have a problem.
Neurosis: Neurotic patients know that they have been affected by a certain illness, so
only a small external support will help them to overcome their condition.

Treatment
Psychosis: Psychotics need medications like antipsychotics which mainly act on their
behavior, thoughts, and emotions.
Neurosis: Neurotics may only require counseling, behavioral therapy and supportive
measures to control their symptoms.
Even though the two conditions completely differ from each other in the aspects of
pathology, symptoms, treatments and prognosis, studies have shown that about 4-7%
of people affected by Neurosis will become psychotics later in their lives.