What is psychosis?

Psychosis affects about 3% of the population at some point in their lives.  While its causes are not yet fully understood, studies suggest that psychosis usually results from a combination of genetic (inherited) risk and environmental exposures such as head injury, stress and drug use. Psychosis is known to result from a chemical imbalance in the brain, and the new medications that have been developed to address this imbalance are often very effective. 

“Psychotic” is a word that has a precise meaning in psychiatry but carries many inaccurate connotations in popular culture.  It does not mean “homicidal” or “mad,” and it does not describe the entirety of a person’s character or experience.  While television and movies often portray psychotic people as dangerous, the vast majority of people suffering from psychosis are in fact withdrawn and socially isolated.  People who suffer from psychosis can be successfully treated and live fulfilling lives.

The term “psychosis” refers to delusions, hallucinations, and thought disorder that occur in schizophrenia and mood disorders.  These all take many forms.  For example, delusions, or erroneous beliefs, may involve the idea that one is being controlled from the outside, that one is being persecuted, or that one has been given magical powers.   Hallucinations are usually auditory and often involve hearing voices, though they can sometimes affect vision, taste, and smell as well.  It is common in psychosis to hear one or more voices speaking or to hear one’s thoughts spoken aloud.  Thought disorder refers to the disorganized thinking that makes it hard for someone to formulate basic thoughts and communicate them in a way that is easily understood.  Difficulty thinking clearly is usually detected when someone is consistently difficult to follow in conversation. 

People who are at risk for psychosis may experience these types of thoughts and perceptions for a very short time, or else they may experience them in a limited way, retaining the ability to see that the delusions and hallucinations are unlikely.  In contrast, people are considered to have developed a psychotic disorder when they lose perspective on their symptoms and can no longer dismiss delusions or recognize hallucinations as unreal.