Psychosis, Self Harm, Hallucinations and more.
Psychosis (from the Greek
ψυχή "psyche", for mind/soul, and -ωσις "-osis", for abnormal
condition) means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality". People suffering from psychosis are described as psychotic.
Psychosis is given to the more severe forms of psychiatric disorder,
during which hallucinations and delusions and impaired insight may
occur.
Some professionals say that the term psychosis is not sufficient as
some illnesses grouped under the term "psychosis" have nothing in common
(Gelder, Mayou & Geddes 2005).
People experiencing psychosis may report hallucinations or delusional beliefs, and may exhibit personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out the daily life activities.
A wide variety of central nervous system diseases, from both external poisons and internal physiologic illness, can produce symptoms of psychosis.
Signs and symptoms
A hallucination is defined as sensory perception in the absence of external stimuli. Hallucinations are different from illusions, or perceptual distortions, which are the misperception of external stimuli. Hallucinations may occur in any of the five senses and take on almost any form, which may include simple sensations (such as lights, colors, tastes, and smells) to more meaningful experiences such as seeing and interacting with fully formed animals and people, hearing voices, and having complex tactile sensations.
Auditory hallucinations, particularly experiences of hearing voices, are a common and often prominent feature of psychosis. Hallucinated voices may talk about, or to, the person, and may involve several speakers with distinct personas. Auditory hallucinations tend to be particularly distressing when they are derogatory, commanding or preoccupying. However, the experience of hearing voices need not always be a negative one. One research study has shown that the majority of people who hear voices are not in need of psychiatric help. The Hearing Voices Movement has subsequently been created to support voice hearers, regardless of whether they are considered to have a mental illness or not.
Psychosis may involve delusional beliefs, some of which are paranoid in nature. Karl Jaspers has classified psychotic delusions into primary and secondary types. Primary delusions are defined as arising suddenly and not being comprehensible in terms of normal mental processes, whereas secondary delusions may be understood as being influenced by the person's background or current situation (e.g., ethnic or sexual orientation, religious beliefs, superstitious belief).
Thought disorder describes an underlying disturbance to conscious thought and is classified largely by its effects on speech and writing. Affected persons show loosening of associations, that is, a disconnection and disorganization of the semantic content of speech and writing. In the severe form speech becomes incomprehensible and it is known as "word-salad".
Psychiatric Functional causes of psychosis include the following:
A psychotic episode can be significantly affected by mood. For example, people experiencing a psychotic episode in the context of depression may experience persecutory or self-blaming delusions or hallucinations, while people experiencing a psychotic episode in the context of mania may form grandiose delusions.
Stress is known to contribute to and trigger psychotic states. A history of psychologically traumatic events, and the recent experience of a stressful event, can both contribute to the development of psychosis. Short-lived psychosis triggered by stress is known as brief reactive psychosis, and patients may spontaneously recover normal functioning within two weeks. In some rare cases, individuals may remain in a state of full-blown psychosis for many years, or perhaps have attenuated psychotic symptoms (such as low intensity hallucinations) present at most times.
Sleep deprivation has been linked to psychosis. However, this is not a risk for most people, who merely experience hypnagogic or hypnopompic hallucinations, i.e. unusual sensory experiences or thoughts that appear during waking or drifting off to sleep. These are normal sleep phenomena and are not considered signs of psychosis.
Vitamin B12 deficiency can also cause symptoms of mania and psychosis.
Vitamin D overdose can cause altered thinking and psychosis.
Genetics may also have a role in psychosis. The Genain quadruplets were identical quadruplets who were all diagnosed with schizophrenia. Although having grown up in the same environment means it could be any other common factor, like for example having the same parents with the same behavior towards them.
Psychosis arising from "organic" (non-psychological) conditions is sometimes known as secondary psychosis. It can be associated with the following pathologies:
Main article: Substance-induced psychosis Various psychoactive substances (both legal and illegal) have been implicated in causing, exacerbating, and/or precipitating psychotic states and/or disorders in users. Frequent use of cannabis doubles the risk of both psychosis and schizophrenia Older studies indicate that certain strains containing large proportions of THC and low proportions of CBD, merely lowers the threshold for psychosis, and thus helps to trigger full-blown psychosis in some people. On the other hand, cannabis use has increased dramatically over the past few decades but declined in the last decade, whereas the rate of psychosis has not increased. This suggests that a direct causal link is unlikely for all users.[56]
People experiencing psychosis may report hallucinations or delusional beliefs, and may exhibit personality changes and thought disorder. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out the daily life activities.
A wide variety of central nervous system diseases, from both external poisons and internal physiologic illness, can produce symptoms of psychosis.
Signs and symptoms
- Hallucinations
A hallucination is defined as sensory perception in the absence of external stimuli. Hallucinations are different from illusions, or perceptual distortions, which are the misperception of external stimuli. Hallucinations may occur in any of the five senses and take on almost any form, which may include simple sensations (such as lights, colors, tastes, and smells) to more meaningful experiences such as seeing and interacting with fully formed animals and people, hearing voices, and having complex tactile sensations.
Auditory hallucinations, particularly experiences of hearing voices, are a common and often prominent feature of psychosis. Hallucinated voices may talk about, or to, the person, and may involve several speakers with distinct personas. Auditory hallucinations tend to be particularly distressing when they are derogatory, commanding or preoccupying. However, the experience of hearing voices need not always be a negative one. One research study has shown that the majority of people who hear voices are not in need of psychiatric help. The Hearing Voices Movement has subsequently been created to support voice hearers, regardless of whether they are considered to have a mental illness or not.
- Delusions
Psychosis may involve delusional beliefs, some of which are paranoid in nature. Karl Jaspers has classified psychotic delusions into primary and secondary types. Primary delusions are defined as arising suddenly and not being comprehensible in terms of normal mental processes, whereas secondary delusions may be understood as being influenced by the person's background or current situation (e.g., ethnic or sexual orientation, religious beliefs, superstitious belief).
- Thought disorder
Thought disorder describes an underlying disturbance to conscious thought and is classified largely by its effects on speech and writing. Affected persons show loosening of associations, that is, a disconnection and disorganization of the semantic content of speech and writing. In the severe form speech becomes incomprehensible and it is known as "word-salad".
Psychiatric Functional causes of psychosis include the following:
- brain tumors
- drug abuse amphetamines, cocaine, marijuana, alcoholamong others
- brain damage
- schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder
- bipolar disorder (manic depression)
- severe clinical depression
- severe psychosocial stress
- sleep deprivation
- some focal epileptic disorders especially if the temporal lobe is affected
- exposure to some traumatic event (violent death, etc.)
- abrupt or over-rapid withdrawal from certain recreational or prescribed drugs
A psychotic episode can be significantly affected by mood. For example, people experiencing a psychotic episode in the context of depression may experience persecutory or self-blaming delusions or hallucinations, while people experiencing a psychotic episode in the context of mania may form grandiose delusions.
Stress is known to contribute to and trigger psychotic states. A history of psychologically traumatic events, and the recent experience of a stressful event, can both contribute to the development of psychosis. Short-lived psychosis triggered by stress is known as brief reactive psychosis, and patients may spontaneously recover normal functioning within two weeks. In some rare cases, individuals may remain in a state of full-blown psychosis for many years, or perhaps have attenuated psychotic symptoms (such as low intensity hallucinations) present at most times.
Sleep deprivation has been linked to psychosis. However, this is not a risk for most people, who merely experience hypnagogic or hypnopompic hallucinations, i.e. unusual sensory experiences or thoughts that appear during waking or drifting off to sleep. These are normal sleep phenomena and are not considered signs of psychosis.
Vitamin B12 deficiency can also cause symptoms of mania and psychosis.
Vitamin D overdose can cause altered thinking and psychosis.
Genetics may also have a role in psychosis. The Genain quadruplets were identical quadruplets who were all diagnosed with schizophrenia. Although having grown up in the same environment means it could be any other common factor, like for example having the same parents with the same behavior towards them.
Psychosis arising from "organic" (non-psychological) conditions is sometimes known as secondary psychosis. It can be associated with the following pathologies:
- neurological disorders, including:
- electrolyte disorders such as:
- hypoglycemia
- lupus
- AIDS
- leprosy
- malaria
- Adult-onset vanishing white matter leukoencephalopathy
- Late-onset metachromatic leukodystrophy
- Cerebral involvement of scleroderma (a single case report).
- Hashimoto's encephalopathy, an extremely rare condition (about 100 reported cases).
- Psychoactive drugs
Main article: Substance-induced psychosis Various psychoactive substances (both legal and illegal) have been implicated in causing, exacerbating, and/or precipitating psychotic states and/or disorders in users. Frequent use of cannabis doubles the risk of both psychosis and schizophrenia Older studies indicate that certain strains containing large proportions of THC and low proportions of CBD, merely lowers the threshold for psychosis, and thus helps to trigger full-blown psychosis in some people. On the other hand, cannabis use has increased dramatically over the past few decades but declined in the last decade, whereas the rate of psychosis has not increased. This suggests that a direct causal link is unlikely for all users.[56]
- Prescription medication