What is psychosis?
Psychosis is a general term to describe symptoms of mental health disorders where a person has lost some contact with reality and can believe things to be true that do not actually exist. A person experiencing a psychotic episode will have serious disturbances in their thinking, emotions and behaviour, which can severely disrupt their life. The person will often be totally unaware that their thinking or behaviour is in any way unusual, and relationships, work and self care can be difficult to initiate and maintain as a result.

Psychotic episodes are often very frightening for the person and can also be frightening for those who witness them. Some people will only ever experience one psychotic episode while others will have repeated episodes throughout their lives.

Psychotic symptoms can occur in a number of mental health disorders such as schizophrenia and bipolar disorder (manic depression), but can also be triggered by the misuse of alcohol and some other drugs.

What are the symptoms of a psychotic disorder?
Hallucinations and delusions are common with psychotic disorders. Hallucinations are where a person hears voices that others do not hear but can also involve seeing, feeling, tasting or smelling things that the person perceives to be very real but which do not actually exist. Hallucinations can be very frightening, especially voices which are abusive or make negative comments about the person.

A delusion is having a belief in something that is implausible or untrue, such as delusions of grandeur or of persecution. Examples might include the person’s belief that they are invincible or possess some imaginary power, or that their mind is being controlled by another person or object such as a television or radio.

Changes in emotion and motivation:

• depression;
• anxiety;
• irritability;
• suspiciousness;
• blunted, flat or inappropriate emotion;
• changes in appetite;
• reduced energy and motivation.

Changes in thinking and perception:

• difficulties with concentration or attention;
• sense of alteration of self, others or the outside world (for example, feeling that self or others have changed or are acting differently in some way);
• strange ideas or bizarre thoughts;
• unusual perceptual experiences (for example, a reduction in or greater intensity of smell, sound or colour).

Changes in behaviour:

• sleep disturbance;
• changes in eating habits;
• social isolation or withdrawal;
• reduced ability to carry out work and social roles.

Schizophrenia
The term schizophrenia means ‘fractured mind’ and refers to changes in mental function where thoughts and perceptions become disordered. It has been estimated that 1 in every 100 people will develop schizophrenia. While men and women are equally likely to develop schizophrenia, men tend to develop it earlier in life than women.

The major symptoms of schizophrenia are delusions and/or hallucinations, but a person with schizophrenia may also experience:

• difficulties with concentration, memory or the ability to plan, making it difficult for the person to reason, communicate and complete daily tasks;
• a lack of motivation even for basic self care – this is not laziness but a common symptom of schizophrenia;
• a lack of emotion or display of inappropriate emotions;
• withdrawl from social situations due to the loss of social skills or fear of interacting with others.

What causes psychotic disorders?
Some people will be more vulnerable than other to developing psychosis. It is believed that a combination of factors can contribute to this vulnerability, including genetics and biochemistry, and that stress can combine with these to trigger psychotic symptoms.

People who have a parent with schizophrenia are more likely to develop the illness themselves. Schizophrenia affects only 1% of the general population but affects 10% of people who have a parent with schizophrenia, 50% of those with an identical twin with schizophrenia or 1 in 7 of those with a non-identical twin who has schizophrenia.

Schizophrenia can also be triggered by a stressful event in people who are vulnerable to the disorder.

The misuse of alcohol or other drugs (including cannabis, LSD, cocaine, Ecstasy, amphetamines (speed) and magic mushrooms) can trigger psychosis. The most common symptoms are visual hallucinations, disorientation and memory problems. The symptoms usually appear quickly and last until use of the drug stops and the effects wear off, which may vary from a few hours to several days. However, the person can be left feeling low or anxious.

The use of cannabis can increase the risk of developing schizophrenia in those who are vulnerable to the disorder.

If you are concerned about psychosis speak to your GP or other health professional.

For further information visit Royal College of Psychiatrists website.