Psychosis

A Humanistic Approach

What is Psychosis?

Section 1:
Psychosis

The American Psychological Association (APA) and World Health Organization (WHO) have developed a clear definition of psychosis. They define psychosis as the presence of auditory and or visual hallucinations, delusions, and disorganized speech. Even though this definition is limited it serves as a differential diagnosis.

The Stigma of Mental Health Disorders 

The Oxford Dictionary describes mental health as: “A person’s condition concerning their psychological and emotional well-being.

People with mental disorders are at an elevated risk of stigma, which leads to adverse outcomes in life. Stigma can result in substantial barriers to an individual’s pursuit of healthcare, housing, and vocational goals.

The term psychosis and its use

Psychosis Overview

Psychosis is a physiological condition that affects a persons contact with reality. Usually, it affects how an individual processes information, making it hard for the person to differentiate between what is real and what is not. It is critical to note that psychosis is not a mental disease but a disorder symptom. Co-occurring Mental health challenges such as delusional disorder, dissociative identity disorder, schizoaffective disorder, and Schizophrenia can result in psychotic episodes. Psychosis can occur due to various factors, including mental illness, substance use, medications, trauma, extreme stressors, and certain medical conditions. The severity of the condition varies from one person to another, depending on personal vulnerabilities and the primary disorder producing the symptoms.
psychosis patient
psychosis patient contemplating the room
The Symptoms

Psychotic Symptoms

People with psychosis present with different symptoms that can prohibit their ability to function in everyday life. These symptoms result from experiences they encounter or behaviors they display. Primary symptoms often include auditory, visual or tactile hallucinations, delusions and disorganized speech. In most cases, people are unaware they are experiencing a psychotic episode and can perceive the manifestations as real experiences. People with psychotic episodes tend to have dysregulated behaviors and emotions. These individuals can undergo rapid mood changes, high anxiety levels, fear, and cognitive confusion.
Psychosis and Hallucinations

Hallucinations

Hallucinations are the primary clinical manifestations of a psychotic experience. Hallucinations present as sensory perceptions without corresponding somatic or external stimuli and are described based on the sensory organ where they occur. An individual with hallucinations will experience unreal sensations that others do not. While these sensations feel real, they are cognitive distortions. For example, someone with auditory hallucinations might hear sounds or voices that others cannot. In contrast, someone with visual or olfactory hallucinations might see images or detect odors that are not present. Some people experiencing tactile hallucinations feel like something is crawling on or under their skin.
young man suffering from psychosis contemplating at a different version of himself on the mirror
Young woman looking at a timer while laying in bed.
loss of contact with reality

Delusions

Delusions are psychotic symptoms that present psychosis as a behavior. A delusion is a false belief founded in fictitious or inaccurate conclusions about reality despite the availability of evidence that incontrovertibly and irrevocably challenges the view. Delusions can take different forms, such as somatic, jealous, persecutory, grandiose, or bizarre beliefs. Disorganized behaviors accompany delusions as people attempt to adhere to their false beliefs. It is essential to understand that delusions are not mistaken beliefs, and people experiencing delusions will hold firm to their beliefs even when reasonable and unmistakable evidence to the contrary is available. The behavior element of psychosis relates to the cognitive impairments resulting from different aspects that affect how a person acts.
diagnose psychosis

Diagnosis of Psychosis

The diagnosis of psychosis should entail a thorough medical workup, psychiatric consultation along with an evaluation of the patient’s bio-psychosocial history and presenting symptoms. Information noted in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5 can aid in the diagnosis of psychosis, including symptomology of hallucinations, delusions, disorganized speech, negative symptoms, and abnormal motor behavior.
It is important to note that a person’s display of emotional and behavioral dysregulation may or may not be a sign of an internal disease process with a singular biological answer. Empirical research indicating a specific relational roadway between biological disruption and disease process arguably has merit; however, it may fall short in recognizing that such relational pathways do not, and most often cannot, abide concerning a person’s feelings, emotions, and behaviors.

young man depressed sitting by a window
alternative psychosis diagnosis
Alternative Viewpoints

Alternative Viewpoints

The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is one of the current diagnostic manual’s clinicians utilize to determine diagnoses. The DSM-5 classification of psychotic disorders indicates that this disorder develops along a spectrum with two extreme ends. At one end is Schizotypal personality disorder, including mild symptoms of psychosis. At the other end is Schizophrenia, which illuminates the severity of the condition.

The Power Threat Meaning Framework is a non-diagnostic conceptual framework system developed by members of The British Psychological Society. This diathesis-stress model understands an alternative etiology of psychosis suggesting that some psychiatric symptoms may be logical reactions to experiencing an environment of extreme stressors, and these rational reactions, both activated and socially guided, serve a protective role and illustrate a person’s capacity for purpose-making and meaning. Diagnosis in practice is, at its fundamental core, a striving to make sense of symptomology, to make sense of what is wrong with a patient and how to assist them through researching empirical data, looking at recurrent themes and patterns in the human body’s function and dysfunction. A diagnosis is limited in identifying emotional and behavioral symptoms because it is based on theoretical systems for figuring out our bodily dysregulation rather than feelings, emotions, and behaviors.

The false diagnosis

Misunderstood Diagnosis

Many factors contribute to misdiagnosed or misunderstood physiological conditions. Many factors can make people experience hallucinations. In some cases of severe post-partum depression, psychotic features may be present. Recreational and some prescription medications can make people see or hear things that are not there. The first factor is that an accurate diagnosis depends on a thorough history-taking and a specific inventory of ongoing, current symptomology. Additionally, there is a significant overlap of symptoms among disorders, and the instability of the symptoms of these disorders is essential, especially when they involve hallucinations and or delusions. Many factors can make people experience hallucinations.
Recreational and some prescription drugs can make people hear or see things that are not real. In some situations, this can lead to a false diagnosis. Furthermore, the limited knowledge and experience of the professionals conducting assessments can also contribute to misdiagnoses.

Young woman reflecting against a window
sad girl touching a glass and water drops
available treatments

Treatments of Psychosis

Current therapeutic interventions may involve any number of approaches, including Antipsychotic Medications, Cognitive Behavioral Therapy (CBT), Group Therapy, Cultural Perspectives & Interventions and Therapeutic Alliance.