Psychosis: Losing touch with reality

What is it?

Psychosis is a mental health condition characterized by a disconnection from reality. People experiencing psychosis may have difficulty distinguishing what is real from what is not. It can involve hallucinations (seeing or hearing things that aren't there) and delusions (false beliefs). Psychosis can occur as a result of various conditions, including schizophrenia, severe depression, bipolar disorder, or substance use.

Prevalence and statistics

• About 3% of people will experience psychosis at some point in their life.

• Schizophrenia, a primary condition related to psychosis, affects around 1% of the global population.

• Psychosis can also occur in 30–50% of people with severe mood disorders, such as bipolar disorder and major depression.

• Early onset psychosis (before age 18) occurs in 1 in 1,000 individuals.

• Substance-induced psychosis affects 1 in 4 people with drug or alcohol dependency.

How to identify?

Emotional signs –

• Extreme paranoia, fear, or distrust of others

• Distorted emotions, feeling detached or disconnected from reality

• Sudden mood swings, including irritability or emotional flatness

Physical signs –

• Disorganized speech or behavior

• Difficulty maintaining focus or completing tasks

• Unusual or odd movements, postures, or gestures

Behavioural signs –

• Withdrawal from family, friends, or social situations

• Belief in things that seem bizarre or impossible (delusions)

• Responding to voices or things that others don’t perceive (hallucinations)

Cognitive signs –

• Disorganized thinking, incoherent speech

• Difficulty distinguishing between real and unreal events or people

• Impaired decision-making or logical thinking

Common Causes of Psychosis:

• Schizophrenia – A chronic condition characterized by delusions, hallucinations, and disorganized thinking

• Bipolar Disorder – Psychotic symptoms can occur during manic or depressive episodes

• Severe Depression – Psychotic depression involves delusions or hallucinations in severe cases

• Substance-Induced Psychosis – Triggered by drug use (e.g., stimulants, hallucinogens, alcohol withdrawal)

• Psychotic Spectrum Disorders – Disorders that include psychosis as a key feature, such as schizoaffective disorder

Common types of psychosis -

Delusions (False beliefs that are strongly held, even when proven wrong)

1. Paranoid delusion – Believing people are out to harm you, spy on you, or talk behind your back.

2. Delusion of grandeur – Thinking you have special powers, fame, or are very important (e.g., believing you're a celebrity or god).

3. Delusion of reference – Believing that random things (like TV shows, songs, or signs) are sending special messages to you.

4. Somatic delusion – Believing something is wrong with your body even though doctors say you're fine (e.g., worms inside you).

5. Erotomanic delusion – Thinking someone, often a stranger or celebrity, is secretly in love with you.

6. Delusion of control – Believing that outside forces (like machines or people) are controlling your thoughts or actions.

7. Nihilistic delusion – Thinking that you, others, or the world no longer exist or are about to end.

8. Jealous delusion – Being convinced your partner is cheating without any proof.

   
   

Hallucinations (Seeing, hearing, or feeling things that aren't really there)

1. Auditory hallucinations – Hearing voices or sounds that others don't hear (e.g., voices talking to or about you).

2. Visual hallucinations – Seeing people, lights, shapes, or things that aren’t actually there.

3. Tactile hallucinations – Feeling things on or under your skin (like bugs crawling) that aren’t real.

4. Olfactory hallucinations – Smelling strange or bad odors that no one else can smell.

5. Gustatory hallucinations – Tasting things that aren’t there, often unpleasant or metallic.

   
   

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