Psychosis and Early Psychosis

Psychosis and early psychosis are serious mental health symptoms that can stem from a variety of underlying causes—medical, neurological, or psychiatric. At Amen Clinics, we use advanced brain imaging and comprehensive testing to uncover the root cause, allowing for more accurate diagnosis and a targeted, effective treatment plan.

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What are Psychosis and Early Psychosis?

Psychosis is characterized by the temporary inability to distinguish what is real from what isn’t real. Losing touch with reality in this way is called a psychotic episode. During a psychotic episode, a person may see or hear things that don’t exist. They may believe things that aren’t true. Early psychosis, also referred to as first-episode psychosis (FEP), is when an individual first begins to experience a break with reality. Seeking help for psychosis, especially for early psychosis, is critical because the earlier treatment begins, the better the outcome.

It is important to understand that psychosis is not a psychiatric condition, rather it is a symptom of serious mental illness or it can be related to another condition. (See below for more information on Types of Psychotic Disorders and Psychosis in Related Conditions.) 

Who has Psychosis / Early Psychosis?

There are many misconceptions about psychosis. For example, most people think psychosis is rare, but it occurs more frequently than you might imagine. It is estimated that 3 out of 100 people will have a psychotic episode during their lifetime. And each year, approximately 100,000 American adolescents and young adults experience their first psychotic episode. People also mistakenly believe that those who are psychotic are also dangerous. In reality, they are no more likely to be violent than the general population; however, they may be more inclined to injure themselves.

What are the Symptoms? 

During a psychotic episode, a person may have difficulty with everyday functioning. They may feel anxious, depressed, and unmotivated. And they may have trouble sleeping and isolate themselves from friends and family. Learn more by reviewing the “Early Psychosis Warning Signs” below.

Hallmarks of Psychosis include: 

  • Hallucinations: Hearing voices (auditory hallucinations), seeing things that aren’t real, or having strange sensory experiences 
  • Delusions: Unshakable beliefs that aren’t true, such as thinking you are an exceptionally important person, have special powers, or that outside forces are controlling you 
  • Disordered thinking: Disjointed thoughts, illogical thinking, random utterances, or incoherence
  • Disorganization: Unpredictable, agitated behaviors
  • Trouble concentrating: Inability to maintain focus
  • Catatonia: Decreased motor or verbal responsiveness 

Early Psychosis Warning Signs: 

  • Difficulty concentrating
  • Being suspicious of others
  • Spending an unusual amount of time alone
  • Poor school grades or work performance
  • Neglecting self-care (e.g. not showering)
  • Changes in emotional responses
  • Trouble sleeping

What Causes It? 

The medical community is still uncovering the exact causes of psychosis, but we have discovered several factors that likely contribute to it. We do know that teenagers and young adults are at increased risk of experiencing an episode of psychosis because of hormonal changes in their brain during puberty. 

Contributing factors include: 

  • Genetics – Having a close relative with schizophrenia or bipolar disorder increases the risk of psychosis.
  • Trauma – Exposure to a traumatic event can trigger a psychotic episode. 
  • Drugs and Alcohol – Addictions to drugs and alcohol are strongly linked to psychosis. In one study, 74% of people with first episode psychosis had a substance use disorder at some point during their lifetime. Cannabis, LSD, alcohol, amphetamines, and other substances are associated with increased risk of psychosis in people who have an underlying predisposition.
  • Head Injuries – Traumatic brain injuries increase the risk of psychosis in the months and years following the head injury. 
  • Brain Disorders – Alzheimer’s disease and other dementias, as well as strokes, brain tumors, and Parkinson’s disease may lead to psychosis. 
  • Mental Health Conditions – Psychosis is often seen as a symptom of mental health disorders. 
  • Infections – Chronic infections, such as Lyme disease, have been associated with psychotic episodes. 
  • Hormonal Changes – The hormonal changes that occur during puberty put adolescents and young adults at greater risk of developing psychosis. 
  • Sleep Deprivation – Chronic insomnia can lead to symptoms of psychosis. 
  • Medication Use – Certain medications—including some common antibiotics, muscle relaxants, pain relievers, and others—have been found to induce psychosis in some people. 

Why Choose Amen Clinics for Treating Psychosis and Early Psychosis?

Because there are so many possible contributing factors of psychosis, it is very important to find the root cause (or multiple causes) of your symptoms. At Amen Clinics, we perform brain imaging to identify head injuries or other brain abnormalities, as well as use extensive lab tests to detect any infections or other conditions that may contribute to symptoms of psychosis and early psychosis. 

Note: If you have a loved one or child who is experiencing psychosis or early psychosis, encouraging them to get help is critical. Early treatment offers the greatest hope of recovery. Be aware, however, that the delusions, disordered thinking, and other aspects of psychosis may make an individual hesitant to seek help. In this case, be calm, kind, supportive, and encouraging when suggesting they seek help.

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Psychosis and Early Psychosis Brains Work Differently

Psychosis and psychotic disorders are complex and involve several brain areas. Research in a 2018 issue of JAMA Psychiatry found that people with an initial psychotic episode and later psychosis showed abnormal connections in the brain. Specifically, reduced integration and increased segregation of brain regions disrupt the way the neurons communicate with each other.

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Types of Psychotic Disorders

Mental health conditions in which psychosis is a primary symptom are known as psychotic disorders. There are many types of psychotic disorders, including:

Schizophrenia

This is a severe and debilitating disorder that affects a person’s ability to distinguish reality from what is not real.

Schizophreniform Disorder 

Symptoms are generally the same as schizophrenia, but the episodes of symptoms are shorter in duration. 

Schizoaffective Disorder

This condition exhibits symptoms of both schizophrenia and a major mood episode of mania or depression. 

Delusional Disorder

Delusions that contain persecutory, grandiose, jealous, erotomanic, or somatic content are the main symptoms of this condition. 

Brief Psychotic Disorder

People with this condition experience a sudden temporary psychotic episode, sometimes triggered by a stressful or traumatic event. Symptoms are resolved within 30 days, although relapses can occur. 

Schizotypal Personality Disorder

This condition is characterized by eccentric, strange, superstitious, or unusual beliefs and behaviors, and discomfort with interpersonal functioning.

Psychosis in Related Conditions

Psychosis may also be present in other mental health conditions, including:

  • Bipolar Disorder: A condition characterized by intense and unstable emotions. 
  • Psychotic Depression: A type of major depressive disorder in which psychosis is present. 
  • Postpartum Psychosis: The most severe form of postpartum mental illness. 
  • Substance Use Disorders / Dual Diagnosis: Psychosis can be induced by substance use or may be present in addition to addiction and another mental health disorder.