Different Types of Psychosis

Someone experiencing psychosis often feels a break with reality. They experience delusions, hallucinations, and disordered thinking, among other symptoms. It is these disruptive thoughts and sensory experiences that lead someone with psychosis to disconnect from reality, and struggle knowing what is real from what isn't.

Approximately 3 in 100 people will experience an episode of psychosis in their lifetime, but not everyone experiences psychosis the same way. This is because there are many types of psychosis, depending on the conditions and events that can lead to it.

Psychosis is not a diagnosable condition on its own. It is actually a symptom that is present in a variety of severe mental health disorders, or as a response to brain changes, traumatic events, injuries, or substance use.

Definition of Psychosis

Psychosis is a collection of neuropsychiatric symptoms that lead to an impaired sense of reality. These symptoms cause a disruption in a person's ability to function in everyday life, whether that's going to school, work, or maintaining relationships.

According to both the American Psychiatric Association (APA) and World Health Organization (WHO), psychosis is defined by the experience of hallucinations (without insight to the cause of the hallucinations), delusions, or both.

Types

There is no universally recognized system for "typing" psychosis, but it can be helpful to categorize psychosis by the types of events or conditions that might cause it:

Psychotic Disorders

Psychosis is a primary symptom of schizophrenia spectrum disorders. These disorders are included in the "Diagnostic and Statistical Manual of Mental Disorders (DSM-5)" category labeled "Schizophrenia Spectrum and Other Psychotic Disorders." 

Psychotic disorders in this category include:

• Schizophrenia
• Schizophreniform disorder
• Schizoaffective disorder
• Delusional disorder
• Brief psychotic disorder
• Unspecified schizophrenia spectrum and other psychotic disorder
• Other specified schizophrenia spectrum and other psychotic disorder

Other Mental Health Conditions

Other mental health conditions, not within the DSM-5's psychotic disorder category, can also lead to psychosis.

These conditions include:

• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Postpartum psychosis
• Severe major depressive disorder

Organic Psychosis

Organic psychosis is also referred to as "secondary psychosis." It occurs when a person has an acquired change in brain function and develops psychosis symptoms secondary to that change.

Causes of organic psychosis include:

• Traumatic brain injury (TBI)
• Neurodegenerative conditions such as dementia
• Stroke
• Other brain abnormalities

Substance-Induced Psychosis

Psychosis can also be caused by substance or medication use. Alcohol, cannabis, and certain illicit drugs, including methamphetamine and cocaine, can cause psychosis.

Some prescription medications, including anxiolytics and sedatives among others, can cause psychosis. Withdrawal from medications can also lead to psychosis.

This type of psychosis is included in the DSM-5 psychotic disorders category as "substance/medication-induced psychotic disorder."

Signs and Symptoms

Pyschosis is, itself, a symptom of other conditions, including psychotic disorders like schizophrenia. However, there are a few specific symptoms that are under the "umbrella" of psychosis. These symptoms must be present for someone to be said to be experiencing a psychotic episode.

Psychosis symptoms include:

• Hallucinations
• Delusions
• Disordered thinking

Hallucination

Hallucinations are defined as sensory experiences in the absence of a stimulus. Hallucinations are described depending on the sensory system, and can include auditory hallucinations or visual hallucinations.

For a hallucination to be considered a symptom of psychosis, it needs to occur with no insight to its origin. This means that a person experiencing psychosis believes that their hallucination is real, even though it is not.

Delusion

A delusion is defined as a fixed, false belief. Examples of common delusions include thinking that the television is talking to you, believing others are plotting against you, believing someone (usually a celebrity) is in love with you, believing your thoughts are being controlled, and more.

Disordered Thinking

Disordered thinking is another symptom of psychosis, when it is severe to the point that it impairs communication. Examples of disordered thinking include fast, racing thoughts, derailment, perseveration (uncontrollable repetitive thoughts), illogicality, tangentiality, and more.

Early Warning Signs and Symptoms

There are additional symptoms to be aware of, that present before a person experiences a full-blown psychotic episode. Knowing these early warning symptoms can help reduce the risks of psychosis by seeking help before things get worse.

Early warning symptoms of psychosis include:

• A drop in grades or job performance
• Difficulty concentrating
• Increased isolation
• Withdrawal from family, friends, and colleagues
• Sudden decline in self-care and hygiene
• Strong emotions or lack of emotions
• Suspiciousness or distrust of others
• Unusual thoughts or beliefs that are contradictory to what the majority of others believe

Diagnosing the Type

If you or someone you know experiences a psychotic episode, or symptoms of psychosis, it is important to seek a diagnosis.

Psychosis is always a symptom of a broader condition, which could include anything from a psychotic disorder, to another mental health condition, to an organic cause, to a substance or medication-related cause.

Sometimes, a person only experiences one psychotic episode. If this episode lasts longer than one day and shorter than one month, your doctor might diagnose you with brief psychotic disorder.

However, it's still important to seek a diagnosis to help avoid further psychotic episodes. Seeking a diagnosis can help you receive the correct treatment for your specific condition, and alleviate other symptoms you might be experiencing.

If you are experiencing psychosis as a result of medication or substances, your doctor can also work with you to find the best medication regimen for you, or work on a withdrawal plan.

A Word From Verywell

Psychosis is experienced along a spectrum, and everyone's experience will be unique. It is important to talk to your primary care doctor or psychiatrist if you experience symptoms of psychosis.

Diagnosing the correct type of psychosis will help determine the most effective treatment for you, so you can get back to living your life freely without hallucinations or delusions.