Lesson 3 Schizophrenia and Psychosis

Psychosis and Schizophrenia are not the same, even though the terms are sometimes used interchangeably.

Schizophrenia is a mental illness that impacts thought processes, emotions and behavior and can be a very frightening experience. It is the third common mental disorder. Schizophrenia can cause psychosis or lead to symptoms of psychosis. But: Individuals experiencing psychosis do not necessarily have schizophrenia.

Psychosis is a symptom defined by losing touch with reality. A period of psychosis is a psychotic episode, limitation to one period is possible (in difference to Schizophrenia). A psychotic episode can occur on its own or may be associated with a mental disorder (like Schizophrenia or bipolar disorder). 

Causes of Schizophrenia and Psychosis

Schizophrenia (and also bipolar disorder) may share a common genetic cause.

Hormones may also have an influence: Some people experience postpartum psychosis after giving birth. Due to this, and the fact that the early signs of psychosis often occur first in adolescents, some have suggested that hormonal factors may play a role in those with a genetic susceptibility.

Brain changes: Tests have found differences in brain chemicals – specifically, the activity of the neurotransmitter dopamine in people that suffer from psychosis. 

Sleep deprivation, certain prescription medication (including sedatives and stimulants), substance use of a medical condition like dementia may also lead to symptoms of psychosis.

Schizophrenia vs. Psychosis

  • Hallucionations (thought echo, thought insertions or withdrawal, voices commenting or discussing the patient in the third person))
  • Delusional perception and delusions of control
  • Disorganized speech
  • Catatonic behavior
  • thought disorders or negative symptoms (lessend emotional expresses)
  • Hallucinations
  • Delusions
  • Agitation
  • Disorganized thought and behavior
  • difficulty focusing
  • decline in overall hygiene
  • inappropriate or lack of emotional response
  • withdrawing from others

Types of psychotic disorders

  • Schizzoaffective disorder (symptoms may include hallucinations, delusions, disorganized thinking, along with either a depressed or manic mood)
  • Schizophreniform disorder (symptoms of schizophrenia for a period shorter than six months)
  • Delusional disorder (strong unchangeable beliefs in things that are not real or true, without experiencing hallucinations)
  • Brief psychotic disorder (psychotic symptons with a sudden onset, lasting one month or less, can or cannot be limited to one episode)
  • Substance-induced psychotic disorder (psychosis brought on by the use of substances such as cannabis, cocaine, esctasy and alcohol)
  • Psychotic disorder due to a medical condition (such as brain tumors or strokes)

Three stages of Schizophrenia

  • from weeks to years (but lengths of all stages may differ individually, but they all tend to occur sequenally)
  • symptoms develop gradually
  • symptoms typically involve loss of interest in activities, social withdrawal, difficulty concentrating
  • symptoms have reduced, but the individual may feel withdrawn and have difficulty focusing
  • no symptoms but they may recur throughout the life of a person with schizophrenia

Treatment options of Schizophrenia and Psychosis

As experiences of schizophrenia vary individually, treatments work out differently for people suffering from schizophrenia. Treatment can manage or prevent psychosis but there is no cure for schizophrenia. However treatments can improve the symptoms or lead to a longer period without symptoms. 

  • antipsychotic medication
  • talking therapies
  • arts and creative therapies
  • family intervention

Schizophrenia and Psychosis come along with a higher risk of suicide.

  1. Try to inform yourself about the disease (diagnosis, origin, treatment options, etc.).
  2. Be realistic, professional help is necessary. You can support the person in recovery, but you cannot cure them.
  3. Be by the side of your loved one, be there and do not turn away, even if you find it difficult to endure situations due to the disease. Do not press them and avoid appeals, reproaches, but also encouragement, euphemisms and supposedly good advice.
  4. Try, as far as possible, to continue with your normal life. Do not sacrifice relationships, work, leisure time to the disease.
  5. Talk openly and honestly with the affected person, let him or her share your feelings, even if they are not positive. Feelings such as anger, resentment, fear, worry, the feeling of being rejected are also part of you and your relationship. But do not make an accusation out of it.
  6. Do not take the person’s behavior personally. She is not withdrawing because you are not attractive, nice, loved….
  7. Also get help yourself: from family and friends but also from professional help providers and counseling centers. You can also contact your doctor.
  8. You are both affected. Together they are allies in the treatment of the disease.