Understanding and identifying psychosis

Psychotic symptoms, otherwise known as psychosis, can affect a variety of different types of people and does not always constitute a mental health disorder. Psychotic symptoms can be found among many different types of mental health disorders including schizophrenia, schizoaffective disorder and bipolar disorder. A psychotic disorder NOS (not otherwise specified), is usually diagnosed when a person has experienced a psychotic episode, but doesn’t meet the criteria for any other psychotic based disorder (Randle 2015). Determining the exact cause of psychosis and who is at risk of developing it, has still yet to be determined (Diamond 2010).

Schizophrenia is a well-known mental illness which is characterized by the presence of psychosis, of which .5 percent to 1.5 percent of the population has. According to recent studies, most psychiatrists and clinical psychologists approach psychosis as a biological problem rather than as an environmental or learned behavior (Diamond 2010). Hallucinations, delusions and negativism are some of the psychotic symptoms present in schizoaffective disorders and bipolar disorder. Generally, it is during mania or depression when psychotic episodes occur in people with bipolar disorder.

What does psychosis look like?

There are a few main characteristics that can be identifiers of psychosis. The following are criteria used for assessing psychosis according to John Hendrick, M.D. assistant professor of psychiatry at East Tennessee State University:
Empathic dysfunction

  • Unable to recognize, analyze or properly understand the reasons behind other’s actions or emotions
  • Can display “autistic” type of personality traits that make them vulnerable and unsuspecting, due to their inability to gauge other’s motives or reasons behind other’s actions


  • Less tolerant of frustration and exhibit violent behavior
  • Verbal or physical altercations frequently occur
  • Difficulty accepting thoughts, ideas or processes that alter from his or her pathologically structured world

Diffuse ego boundaries

  • Failure to perceive or admit denial
  • Failure to perceive or admit imitation of others’ behavior
  • Projection
  • Paranoid thinking

An individual may also need to keep an eye out for warning signs of a psychotic episode. If someone seems to be depressed, withdrawing from friends and family, struggling with sleep issues or having suicidal thoughts it may indicate they are dealing with psychosis. Other symptoms can include:

  • Disorganization
  • Paranoia
  • Ongoing unusual thoughts and beliefs
  • Difficulty concentrating
  • Psychomotor poverty (poverty of speech, poor motivation, social withdrawal, flat affect)
  • Delusions and hallucinations
  • Disorganized speech – Switching topics erratically
  • Difficulty functioning

Psychosis due to another medical condition

Psychosis is normally related to schizophrenia or bipolar disorder but it can be a sign of a different medical issue. Psychosis is a generic term that lumps together various symptoms from different disorders or medical conditions. It is also considered to be a form of delirium, of which the onset can be brought on by various types of medical conditions that result in infection to the brain. (NHS 2015) Several different medical conditions that can attack the brain and cause psychosis to occur can include head injuries, brain tumors, lupus, Parkinson’s, Alzheimer’s or Huntington’s disease, dementia, STD’s such as HIV or syphilis, epilepsy or stroke. (Krucik 2014)

Roughly 1.5 percent of Traumatic Brain Injury (TBI) patients develop psychotic symptoms. Studies show that what distinguishes TBI psychosis from schizophrenia is a later age of onset, shorter duration and less common family history. Traumatic Brain Injury psychosis is an interictal psychosis, which is another way to describe schizophrenia psychosis (Nicoll; LaFrance 2009) Delusions, hallucinations, difficulty functioning and depression are all common symptoms when people have a form of brain injury. Illnesses such as chronic alcoholism can even induce the same symptoms.

There hasn’t been a lot of research done on how the brain gets to the point of psychosis; however, some scientists have found through MRI scans that patients who had psychosis had less grey matter in the brain. (NHS 2015)

Treating psychosis

Cognitive behavioral therapy (CBT) is a combination of psychotherapy and behavioral therapy. that attempts to understand the meaning behind a person’s world-views and how thinking patterns begin in childhood. and simultaneously focuses on the relationship between people’s problems, their behavior and their thoughts. Particularly for psychosis patients, CBT helps people identify patterns of negative thinking and worldviews and is particularly helpful with psychosis, as it’s able to allow the patient to see what his or her thinking patterns are, how they differ from what would be considered normal thoughts and how they may be negatively affecting his or her mental, emotional and cognitive abilities. (NAMI 2014)

If you would like more information on where to receive treatment for mental health disorders, you can call the Mental Health Helpline at 855-653-8178 to speak to a member of our team and start the journey to recovery today.