Psychosis is the loss of contact with reality, resulting in symptoms of a psychotic break, such as mental confusion, hallucinations or delusions and difficulty understanding what is real and what is imaginary, for example.
Psychosis is considered a symptom and generally appears in young people or adolescents and can be temporary, being called a brief psychotic disorder, or be related to psychiatric illnesses, such as bipolar disorder, schizophrenia, or depression, and is also common in drug users.
Read too: Psychotic break: what it is, symptoms, causes and treatment
The treatment of psychosis is carried out by a psychiatrist and usually involves psychotherapy and/or the use of antipsychotic medications and mood stabilizers. In some cases, hospitalization may be necessary.
Symptoms of psychosis
The main symptoms of psychosis are:
- Delusions or hallucinations;
- Hearing voices or seeing things that are not real or distorted;
- Feeling smells or flavors that are not there;
- Difficulty organizing thoughts and thinking clearly;
- Mental confusion;
- Agitation, impulsiveness, aggressiveness or self-harm;
- Catatonia, in which the person remains immobile or rigid, with a lack of verbal response, appearing to be “frozen”.
Furthermore, a person with psychosis may have grandiose and magnificent visions of themselves that are not real, such as being a God or being on a special mission, for example.
Other symptoms of psychosis are feeling that other people are controlling your thoughts or actions or erotomanic delusion, in which the person believes that others are in love with him.
Child psychosis
The main symptoms of childhood psychosis are:
- Decrease in school performance;
- Talking or laughing for no apparent reason;
- Not wanting to play with other children;
- Distrust of other people;
- Mental or speech delay.
Furthermore, the child may present irritability, agitation, aggression, depressed mood or loss of interest or motivation.
How to confirm the diagnosis
The diagnosis of psychosis is made by the psychiatrist by evaluating the symptoms, as well as when they started and their severity, and observing the person’s behavior, mood, speech and thought processing.
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The doctor should also seek information about health history and psychiatric illnesses, use of medications or drugs, social history and emotional, physical or sexual trauma, and information obtained from family and friends.
To rule out conditions that may have similar symptoms and/or identify the cause of psychosis, the doctor may order tests such as blood count, metabolic panel, liver function tests, thyroid hormones, urinalysis, computed tomography or magnetic resonance imaging, for example.
Possible causes
The main causes of psychosis are:
- Family history of psychosis, especially in parents or siblings;
- Psychiatric disorders, such as schizophrenia, bipolar disorder, major depression or psychotic disorders;
- Diseases that affect the central nervous system, such as dementia, Alzheimer’s or Parkinson’s;
- Emotional, physical or sexual trauma;
- Moment of great stress;
- Brain tumor, trauma or infections in the brain.
Furthermore, psychosis can also be caused by the use of drugs, alcohol, hallucinogenic substances or medications, such as barbiturates or benzodiazepines, alcohol withdrawal syndrome or lead, mercury or arsenic poisoning, for example.
Puerperal psychosis
Puerperal psychosis, or postpartum psychosis, is rare and can be caused by postpartum depression, due to the hormonal changes that women experience during this period, resulting in agitation, restlessness, delusions or hallucinations. See all the symptoms of postpartum psychosis.
Read too: Postpartum depression: what it is, symptoms, causes and treatment
How the treatment is carried out
The treatment of psychosis must be guided by a psychiatrist and depends on its cause and the severity of the symptoms, therefore, the main treatments that can be indicated by the doctor are:
1. Use of medicines
The use of medication for psychosis may be recommended by a psychiatrist to help control psychotic episodes and symptoms.
The main remedies that may be recommended by your doctor are:
- Antipsychoticssuch as chlorpromazine, thioridazine or clozapine;
- Mood stabilizerssuch as lithium, carbamazepine or valproic acid;
- Benzodiazepinessuch as lorazepam, for the symptoms of catatonia.
Furthermore, in the case of postpartum psychosis, the doctor can also prescribe medication, and when psychosis puts the baby’s life at risk, the mother can be removed from the baby, even requiring hospitalization.
Generally, after treatment, the symptoms disappear and the woman returns to normal, but there is a risk of having a new psychotic condition in another postpartum period.
2. Hospital admission
Hospitalization may be recommended by the doctor in cases of psychotic crises, or when the person presents agitation or aggression, which can put their own life or the lives of other people in danger.
This hospitalization aims to apply medication into the vein and control the psychotic episode.
Hospitalization can take 1 to 2 months until the person is better and can be discharged, continuing to use medications recommended by the doctor.
3. Cognitive-behavioral therapy
Cognitive-behavioral therapy aims to instruct the person and family members about the manifestations of a psychotic episode and develop tools to face the moments when symptoms arise, providing a safe and therapeutic environment for the person.
This type of therapy must be carried out with guidance from a psychologist to complement treatment with medication, and must also include rehabilitation techniques and reintegration of the person into social life.
