The signs may be quite subtle at first. A friend or loved one may seem “off” recently, with an unkempt appearance that is not their norm at all. A coworker may have let their quality of work slip, becoming incrementally substandard over time. Maybe you are plagued with an unsettling sense that someone is watching you, or have become increasingly suspicious of others.
These early signs of a potential psychotic break from reality may not seem worrisome when seen in isolation, but when a cluster of unusual symptoms begin to gather steam it may indicate that you or someone you care about is experiencing the sense of losing touch with reality.
Psychosis—including such features as hallucinations and delusional thinking—is the symptom of an underlying mental health disorder, not an illness itself. According to the National Alliance on Mental Health, an estimated 100,000 Americans experience psychoses annually. Early intervention is key, so do not ignore the symptoms. These will center on difficulty recognizing what is real and tangible versus a figment of their imagination. Behaviors and thoughts will be unusual, not the norm for the afflicted person.
When you notice that you or a loved one seems to be losing touch with reality it is important to seek professional help. It may be that the symptoms are related to a physical or neurological condition that needs attention. If it is indeed the early signs of a psychotic disorder, receiving timely, proactive care is essential in containing the effects of the psychosis.
What are Psychotic Disorders?
Psychotic disorders represent the types of mental illnesses that feature symptoms around losing touch with reality. These disorders are characterized by odd behaviors, feelings, thoughts, and emotions, including seeing or hearing things that are not really there. When a mental health condition has psychosis as a primary symptom, it will be classified as a psychotic disorder.
According to an article published in JAMA Psychiatry, about 3.5% of the U.S. adult population will experience psychosis at some point. Psychotic features can be associated with severe anxiety, severe depression, and bipolar disorder, as well as identified as its own standalone mental health disorder.
The cause of psychotic disorders is still mainly unknown, although there are some theories exists to explain the cause. These include neurological malfunctioning, certain viruses, extreme trauma or prolonged excessive stress, certain drugs of abuse, and genetics.
Treatment for this complex mental health disorder will rely on a comprehensive approach of multiple elements for the best recovery results. Generally, an individual with a psychotic disorder can learn to manage many of the symptoms associated with the disorder.
Different Types of Psychotic Disorders
Psychotic disorders emerge in varying ways and with differing features, while sharing core characteristics. The different types of psychotic disorders include:
- Schizophrenia, embodies the sense of losing touch with reality, with audible and/or visual hallucinations, delusional thoughts, angry, erratic behavior, and extreme moodiness.
- Schizoaffective disorder, combines features of schizophrenia with a mood disorder involving depressive or manic episodes.
- Brief psychotic disorder is a short-lived disorder that is sometimes triggered by a traumatic event, such as the death of a loved one, a natural disaster, or a serious accident that lasts less than a month.
- Schizophreniform disorder is like schizophrenia but tends to affect young adults and teens, and lasts 1-6 months in duration.
- Shared psychotic disorder is one that involves two people who both believe in a delusional situation, such as a husband and wife who both believe the same delusion.
- Delusional disorder features false and often suspicious beliefs that the individual believes are true, such as thinking someone is out to murder you or your spouse is having an affair.
- Substance induced psychotic disorder is the presence of hallucinations or delusions occurring as a withdrawal symptom for several drugs, including alcohol, LSD, methamphetamine, cocaine, benzodiazepines, and PCP.
What Are the Symptoms of Psychosis?
Generally, psychosis comes on gradually, with signs that indicate a developing mental illness. Those might include inappropriate emotions, a decline in personal hygiene, difficulty thinking straight or concentrating, a decline in job or academic performance, emotional detachment or intense inappropriate emotions, isolating behaviors, and acting highly suspicious of others. These are psychotic features, early symptoms of a possibly emerging psychotic disorder.
The primary feature of psychosis is losing contact with reality. While the different types of psychotic disorders will have unique features, there are some general symptoms that can indicate the onset of a psychotic disorder. These include:
- Persistent feelings of being watched.
- Increasingly disorganized thinking
- Mental confusion
- Auditory and visual hallucinations
- Delusional thoughts
- Strange or disorganized speech or writing
- Inappropriate behavior
- Avoidance of social situations
- Decline in academic or work performance
- Unusual body positioning or movement
- Suspicious or paranoid behavior
- Unusual preoccupation and fears centered on a person or situation
- Irrational or angry behaviors
- Inability to concentrate
- Loss of interest in appearance and hygiene
- Personality changes
Treatment for Psychotic Disorders
Generally, a residential setting provides a more intensive and tailored treatment approach in a setting that is safe and offers 24-hour monitoring and support. However, if the individual is displaying signs of a psychiatric break or has become a danger to themselves or others, they should be admitted to a psychiatric hospital for stabilization.
Treatment of psychotic disorders relies primarily on psychotherapy and psychotropic drug therapy will likely involve an integrated approach, including:
Psychotherapy: While in a residential treatment the individual will be involved in various types of psychotherapy. The focus for therapy involves helping the individual recognize irrational thoughts and behaviors and to replace those with healthy thought-behavior patterns. Individual therapy, group therapy, and family therapy are all provided in a residential program as part of the psychotherapy piece of treatment for psychosis.
The individual cognitive behavioral therapy sessions allow the therapist to help the individual identify irrational thoughts and fears and maladaptive emotional responses.
Group therapy: Group sessions provide opportunities for small groups to discuss and share their mental health issues while being facilitate by a therapist who guides the topics. These intimate group settings provide a safe environment for sharing and foster peer support in the process.
Psychosocial interventions: An important component of treatment is assisting the individual in improving their ability to get along with others. These interventions can offer new communication skills, conflict resolution techniques, and vocational rehabilitation.
Medication: Medication will be prescribed depending on the specific diagnosis. In many cases medication will include antipsychotics, benzodiazepines, antidepressants, and mood stabilizers. For some individuals with a psychotic disorder, these medications will necessary to help manage the disorder on a daily basis, and will likely be prescribed for a lifetime.
Adjunctive therapies: Electroconvulsive therapy (ECT) is reserved for the most severe forms of psychosis in individuals who are not responsive to the medications.
Holistic therapies: Increasingly, holistic therapies, most of which are derivative of Eastern practices, are utilized for the treatment of psychosis or other mental health disorders with psychotic features. Activities such as yoga, mindfulness training, guided meditation, acupuncture, and massage therapy are helpful in controlling stress and promoting relaxation. Patients can learn how to initiate mindfulness exercises on their own at any time of day, which is helpful when sudden symptoms emerge.
When Does a Psychotic Break Require Hospitalization?
When someone experiences a psychotic break, or the sense that they are no longer tracking with reality, it may be appropriate to consider hospitalization. This might be a psychiatric hospital or a psychiatric wing within a general hospital. This level of care is distinct from residential care, in that the hospital environment is equipped to manage a psychiatric emergency. In the hospital setting the individual will likely be segregated from other patients and may be restrained to avoid the risk of self harm or harm to others.
In the hospital settling, the individual will receive very close observation. Medications will be reviewed and adjusted, and the emphasis will be on acute stabilization measures. This process of stabilizing the individual may take a couple of days, before they can be released to a residential mental health treatment center.
When Severe Depression Causes Psychosis
In some severe cases of depression, the emotional anguish may cause an individual to exhibit a break from reality with symptoms of hallucinations or delusions. The actual diagnosis may be coined depression with psychotic features or psychotic depression. In the case of depression that is so profound that it sparks feelings of losing touch with reality, there may be a co-occurring medical condition or substance use disorder that is contributing to the symptoms.
Psychotic depression features the following symptoms:
- Sleep disturbances
- Experiencing hallucinations, voices or visions, telling them they are worthless or evil
- Delusional thoughts
- Suicidal ideation
- Difficulty concentrating
- Falsely thinking they have another disease or illness
When Severe Anxiety Causes Psychosis
Can severe anxiety cause psychosis? Research suggests that symptoms of psychosis may be preceded by an extreme even, such as a panic attack or trauma. The intense emotional distress suffered as a result of anxiety can trigger psychotic symptoms. According to a study published in the Journal of Clinical Psychiatry, anxiety disorders, such as panic disorder, OCD, or PTSD can result in psychotic symptomology. These symptoms resolved with treatment involving both benzodiazepines and antidepressants.
When this condition occurs it may be referred to as a psychotic break or a nervous breakdown. The symptoms are clearly related to the anxiety disorder, rather than a psychotic disorder such as schizophrenia. Stabilizing the individual should be the first step in care, followed by enhanced treatment for the core anxiety disorder.
Elevation Behavioral Health Leading Residential Mental Health Center in Los Angeles
Elevation Behavioral Health is a luxury residential mental health program featuring an intimate, home-like environment. Elevation Behavioral treats all forms of mental health disorders, including psychotic disorders, using a proven integrated approach. If you are feeling you’re losing touch with reality, contact our compassionate team at Elevation Behavioral today at (888) 561-0868.