 Psychosis is one of the rarer mental health problems, but it can have a huge impact on the person and those around them. Talking about psychosis is difficult because the language has changed a lot over the years. A simple but useful way to think about it is that psychosis is when someone's perceptions are altered to the point where it is causing distress to the person and impacting on their ability to function in everyday life. We all have experiences when our perception is altered from time to time. Perhaps you think you recognize someone in the street, but then you realize it is not who you thought it was. Or maybe you hear your name being called, but there is no one there. Or maybe that odd feeling we call deja vu, which is the feeling like you've already experienced something before. Psychosis is an extreme version of this, where perceptions and reality are altered and it can be a very frightening experience. Our mind is very interesting and there are so many things we don't understand about how it works. And when it comes to psychosis and psychotic disorders, this is one area where even the professionals are quite stumped as to exactly what is going on. Everyone who experiences a psychotic disorder will experience it very differently and in this module we will discuss what those symptoms are and the different types of psychosis. A significant symptom of psychosis is having unusual perceptual experiences that used to be referred to as hallucinations and are described as seeing, hearing, tasting or feeling something that isn't there. However, to the person experiencing it, it is very real and very much there. In fact, telling a person that is experiencing something like this that it isn't there can be quite disrespectful as it totally negates their experience. So instead, the current trend is to refer to this experience as unusual perceptual experiences or simply seeing, hearing or feeling things that other people can't or don't. The next symptom is having unusual beliefs. These used to be called delusions, which were described as fixed false beliefs. But beliefs are different for every person, so when a person has a different belief, to say it is false is again not respecting the person's view of the world. So instead, we now talk about unusual beliefs. So the person has some beliefs that the majority of the population where they live does not. These unusual beliefs usually fall into two categories. Firstly, grandeur that is believing that I am someone of high status or very well known. For example, it could be that I am the next prime minister or president, that I am Elvis Presley reincarnated or Jesus Christ. There are often religious undertones to the beliefs, but they seem to be dependent on the religious background of the person. For example, a Christian person would be more likely to believe they are Jesus or the Virgin Mary, whereas a Buddhist would be more likely to believe they are Buddha. The other type of unusual belief is one about persecution, the belief that someone or something is out to get me or someone close to me. For example, that the police have tapped my phone, that the CIA is spying on me, the neighbors or my colleagues are talking about me, or that aliens can read my mind, or any combination of those. These type of beliefs are usually much more distressing for the person than the other type. Besides unusual perceptions and unusual beliefs, some of the other common signs and symptoms of a psychotic disorder developing include withdrawing socially, and that makes sense because it could be very difficult for the person to communicate with others if they are hearing lots of voices. Next is an apparent lack of motivation. Again, this can be because the person is so busy dealing with everything going on for them that it can take a huge effort to engage in other activities. Lastly, a blunted or inappropriate expression. They may laugh when you say something sad, or simply show very little expression at all. Psychosis is usually episodic, so it can come and go over time. There seems to be a build-up period which can vary from being a few days to a few months, depending on the person, then an acute episode, and then a recovery period. Some people might have a psychotic episode fairly frequently, whereas others may go months or even years between episodes. It's worth noting, too, that some people will have a psychotic episode once in their life and never again. Usually psychotic episodes happen in times when the person is under more stress than usual. Remember, for these experiences to be considered as a mental disorder, they have to have a negative impact on the person's life. So, for example, if someone hears voices that other people can't, but they are not distressed by it, and it doesn't impact negatively on their life, then it's not a problem. For example, many psychics hear voices, and in many cultures it is completely appropriate to see or hear people who have passed on. These things are not considered a mental disorder. What are the different types of psychosis? Probably the most well-known psychotic disorder is schizophrenia. It doesn't mean split personality as is commonly thought, but instead it is more about the disorganization and disjointedness of thoughts. Someone diagnosed with schizophrenia is likely to experience many of the signs and symptoms we spoke about, but they won't necessarily have them all. It is very different for different people. Besides schizophrenia, some of the other types of psychotic disorders are schizoaffective disorder, which is a combination of schizophrenia and depression, and drug-induced psychosis. This is where the symptoms are clearly brought on by some kind of drug, including both illegal drugs and legal ones. For example, you might know someone who has had a bad reaction to an anesthetic or a painkiller after having an operation. What causes psychosis and how do we treat it? Apart from a drug-induced psychosis, we really don't know what causes psychosis for people, but we do know that. Genetics may be involved. While we understand cannabis does not cause psychosis, there may be some link with smoking cannabis that we don't fully understand. And a psychotic episode is usually experienced during a period of high stress. The treatment for psychotic disorders tends to be medication, although this doesn't necessarily treat the disorder, but it can take the edge off the symptoms, making it easier for the person to cope. Having said that, it is possible to fully recover from a psychotic disorder. In fact, longitudinal studies conducted around the world over the last 100 years have repeatedly shown that on average about 60% of people with a severe psychotic disorder will recover to the degree that they no longer experience the symptoms of mental disorder. And in some countries around the world, there are even higher success rates using a form of counseling therapy called open dialogue.