Psychosis, mental illness in which a person loses contact with reality and has difficulty functioning in daily life. Psychotic symptoms can indicate severe mental illnesses, such as schizophrenia and bipolar disorder (manic-depressive illness). Unlike people with less severe psychological problems, psychotic individuals do not usually recognize that their mental functioning is disturbed.
Mental health professionals generally divide psychotic symptoms into three broad types: hallucinations, delusions, and bizarre behavior. Hallucinations refer to hearing, seeing, smelling, feeling, or tasting something when nothing in the environment actually caused that sensation. For example, a person experiencing an auditory hallucination might hear a voice calling her or his name even though no one else is actually present. A delusion is a false belief held by a person that appears obviously untrue to other people in that person’s culture. For example, a man may believe that Martians have implanted a microchip in his brain that controls his thoughts. Bizarre behavior refers to behavior in a person that is strange or incomprehensible to others who know the person. For example, hoarding unused scraps of tin because of their “magical properties” would be a type of bizarre behavior.
Psychosis can occur in a number of mental illnesses. These include schizophrenia and schizophrenia-related disorders, bipolar disorder, paranoid personality disorder, and delusional disorder. Less commonly, psychotic symptoms occur in major depression (severe depression), dissociative disorders, and post-traumatic stress disorder.
Psychotic symptoms can also result from substance abuse. Stimulants, such as cocaine and amphetamines, can cause psychotic symptoms, especially if taken in high doses or over long periods of time. Hallucinogenic substances, such as lysergic acid diethylamide (LSD), mescaline (see Peyote), and phencyclidine (PCP), can cause psychosis. Alcohol and marijuana can occasionally cause psychotic symptoms as well. Individuals with alcoholism may experience psychotic symptoms, especially hallucinations, as they withdraw from alcohol use (see Delirium Tremens). Alcohol dependence over a long period of time can result in Korsakoff’s psychosis, a syndrome that may include psychotic symptoms and an inability to form new memories. Certain medical conditions can also cause psychosis. Syphilis, especially if untreated for many years, can lead to psychosis. Brain tumors can also lead to psychotic symptoms.
Treatment of psychotic symptoms usually involves taking antipsychoticdrugs, also called neuroleptics. Common antipsychotic drugs include chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine (Mellaril), trifluoperazine (Stelazine), clozapine (Clozaril), haloperidol (Haldol), olanzapine (Zyprexa), and risperidone (Risperdal). These medications can help reduce psychotic symptoms and prevent symptoms from returning. However, they can also cause severe side effects, such as muscle spasms, tremors, and tardive dyskinesia, a permanent condition marked by uncontrollable lip smacking, grimacing, and tongue movements. Psychotic symptoms in individuals with bipolar disorder may respond to other types of medication, including lithium, carbamazepine (Tegretol), and valproate (Depakene).
Psychotic symptoms that occur as a result of substance abuse usually disappear gradually after the person stops using the substances. Physicians sometimes use antipsychotic medications temporarily to treat these individuals. Physicians have not discovered any effective treatments for Korsakoff’s psychosis. Psychotic symptoms resulting from medical conditions often disappear after treatment of the underlying medical problem.