What Is the Difference Between Psychosis and Schizophrenia?

Table of Contents
View All
Table of Contents

While the terms are sometimes used interchangeably, psychosis and schizophrenia are not the same. Psychosis is a symptom defined as losing touch with reality, while schizophrenia is a disorder that can cause psychosis.

Individuals who have schizophrenia experience symptoms of psychosis, along with other symptoms. However, not all individuals experiencing psychosis have schizophrenia.

Psychosis vs. Schizophrenia

Laura Porter / Verywell

This article explains the differences between psychosis and schizophrenia, and addresses how they are linked. It also explores each condition's symptoms and treatment options.

What Is Psychosis?

Psychosis describes a loss of contact with reality. A period of psychosis is called a psychotic episode.

A psychotic episode can occur on its own or may be associated with:

  • Certain prescription medications, including sedatives and stimulants
  • Medical conditions, such as dementia, HIV, Parkinson's disease, brain tumor, or stroke
  • Mental disorders, such as schizophrenia, bipolar disorder, or delusional disorder
  • Sleep deprivation
  • Substance use, such as alcohol or cocaine

Psychosis can be limited to one episode. However, it is possible to have recurring episodes as part of certain conditions.

What Is Schizophrenia?

Schizophrenia is a mental health disorder that impacts thought processes, emotions, and behavior.

It can involve psychotic symptoms or losing touch with reality. It could also include cognitive issues, such as trouble processing information, or loss of motivation that makes it difficult to do everyday activities.

Schizophrenia occurs in stages.

  1. Prodromal phase: During this phase, which can last from weeks to years, symptoms develop gradually and typically involve loss of interest in activities, social withdrawal, or difficulty concentrating. Intense fixation with ideas or subjects can also develop.
  2. Active phase: This is known as the acute stage of schizophrenia and is when psychotic symptoms occur. Symptoms can develop gradually after a prodromal phase or appear suddenly.
  3. Residual phase: During this period, symptoms have reduced, but the individual may feel withdrawn and have difficulty focusing.

The length of these stages differs from person to person. However, these phases tend to occur in sequence and may recur throughout the life of someone with schizophrenia.

What Are the Symptoms?

Psychosis can be a symptom of a mental health condition, including schizophrenia. It also has its own set of symptoms that usually come on gradually.

The following outlines psychosis symptoms and schizophrenia symptoms.

Psychosis

Symptoms associated with psychosis include:

  • Agitation: This describes an excessive physical movement or verbal activity. Symptoms of agitation can also include emotional distress, restlessness, or pacing.
  • Delusions: Delusions are false beliefs that are not based on reality. A person experiencing delusions will not change their beliefs even when given evidence that the belief is false. An example may be believing a famous person is in love with them, despite never meeting.
  • Disorganized thinking or behavior: Disorganized symptoms of schizophrenia describe jumbled or difficult-to-understand speech, writing, or thinking. This can make it difficult for someone to communicate with others and keep their thoughts straight.
  • Hallucinations: Hallucinations describe when an individual senses things that aren't real. This can include hearing, seeing, smelling, tasting, and feeling things that feel real, but are not.

Early warning signs of psychosis include:

  • Difficulty focusing
  • Decline in overall hygiene
  • Inappropriate or lack of emotional response
  • Withdrawing from others

Schizophrenia

To receive a diagnosis of schizophrenia, you must have two symptoms more often than not during one month. These symptoms include:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior, which describes restlessness, lack of movement, and/or erratic movement
  • Negative symptoms, such as minimal or no emotional expression and lack of motivation

Psychotic symptoms can manifest in individuals with schizophrenia as:

  • Paranoia, like the belief that they are being spied on or being controlled by outside forces
  • A belief that others can read their thoughts
  • Believing that ordinary events hold special meaning specifically to them, like that a person is sending them messages through the television
  • Delusions of grandeur, such as believing they are of great importance, are very powerful or have special powers
  • Hearing noises or voices that aren't there, like hearing commands
  • Switching quickly from subject to subject when speaking
  • Making up words
  • Discussing ideas that seem unrelated
  • Having difficulty performing everyday tasks such as self-care and hygiene
  • Difficulty planning
  • Experiencing symptoms of catatonia, including physical rigidity, repetitive movements, or lack of a response to their environment

For a schizophrenia diagnosis, an individual must experience delusions, hallucinations, and/or disorganized speech, along with meeting other criteria.

Treatment

Because psychosis is a symptom of schizophrenia, some of the treatment plans for both conditions may overlap. Your healthcare provider will help you decide which treatment options are best for your case.

Psychosis

Early treatment for psychosis is important for the best possible recovery. Treatments often involve both antipsychotic medications and psychotherapy.

Antipsychotics may work by blocking the effects of the overactivity of a brain chemical called dopamine, which impacts emotions, planning, and memory. This overactivity is thought to contribute to the cause of psychotic symptoms.

Antipsychotic drugs generally fall into two categories:

  • Atypical, or second-generation, antipsychotics: These medications inhibit dopamine action and affect levels of serotonin, a chemical related to mood. They are usually the first choice to treat schizophrenia.
  • Typical, or first-generation, antipsychotics: These antipsychotics inhibit dopamine activity but do not affect serotonin.

Antipsychotic medications work differently for each individual and may cause side effects. Speak with your healthcare provider to determine the risks and benefits of these medications.

Psychotherapy may also be recommended on an individual or group basis. The therapy may involve building coping skills, wellness management, and resilience training.

Antipsychotic medications can take up to six weeks to reach their full effect. However, they may begin to help reduce symptoms of psychosis within hours or days. When taken long-term, they may help prevent future psychotic episodes.

Never stop taking an antipsychotic medication without consulting your healthcare provider. Abruptly stopping can be dangerous and lead to withdrawal symptoms.

Schizophrenia

Treatments for schizophrenia will also likely include both medications and psychotherapy. Common options include:

  • Antipsychotic drugs: Medications to treat psychosis, including hallucinations and delusions, will likely be prescribed. You and your healthcare provider will work together to determine the best medication combination and dosages.
  • Psychosocial treatments: This therapy is used alongside medication to help you manage symptoms and handle activities at school, work, and home. One type of therapy is cognitive behavioral therapy, which helps you to modify behaviors by recognizing and changing thought patterns.
  • Coordinated specialty care: In these programs, you work together with healthcare professionals to determine a plan of treatment. It's commonly used in the early stages of schizophrenia. The treatment plan may include medication, psychotherapy, case management, education and employment support, and family education.
  • Drug and alcohol treatment: Drug and alcohol abuse issues often occur along with schizophrenia. Your healthcare provider may recommend a drug or alcohol program that's designed specifically for those with schizophrenia.

Summary

Psychosis is a symptom that refers to a loss of touch with reality. Schizophrenia is a mental health disorder with various symptoms, including psychotic symptoms such as delusions, hallucinations, and disorganized thinking.

Individuals with schizophrenia experience psychotic symptoms, however, those with psychotic symptoms don't necessarily have schizophrenia.

Treatment for both psychosis and schizophrenia involves antipsychotic medication and psychotherapy.

Was this page helpful?
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Mental Health. RAISE questions and answers.

  2. MedlinePlus. Psychosis.

  3. Yale School of Medicine. Phases of psychosis.

  4. National Institute of Mental Health. Schizophrenia.

  5. Centre For Addiction and Mental Health. Schizophrenia: an information guide.

  6. National Alliance on Mental Illness. Psychosis.

  7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.

  8. National Institute of Mental Health. Understanding Psychosis.

  9. Centre For Addiction and Mental Health. Antipsychotic medication.