What is Psychosis ?

Could the way I'm feeling be due to psychosis?

The word "psychosis" is used to describe when someone is having unusual or strange experiences which may be distressing. Someone experiencing psychosis may have difficulty recognizing what is real and what is not real.

The experience of psychosis varies greatly from person to person and individuals experiencing psychosis may have very different symptoms. Some people report the experience as being like a ‘dream’ that you find hard to wake up from.

Psychosis describes a number of experiences that may happen together and usually includes one or more of the following:

• Disturbances in perception (hallucinations):
• Fixed bizarre or false beliefs (delusions):
• Confused thinking or speech,
• Daily Functioning
• Mood changes

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Phases of Psychosis

Research has shown that there are generally 3 phases to psychosis. However, not all people having a psychotic episode will experience clear symptoms of all three phases.

Phase 1: Early Warning Signs
This is the period before the psychosis becomes more obvious. There are often changes in feelings, thoughts, perceptions and behaviours. Early symptoms vary from person to person and some people may not experience a prodrome. The duration of this phase is quite variable, although it usually spans several months. Possible symptoms of Phase 1 (Early signs):

	social withdrawal
	loss of energy
	reduced concentration or attention; memory problems; feeling thoughts have been speeded up or slowed down
	emotional changes, e.g. depressed mood, anxiety, irritability, anger
	sleep disturbance
	suspiciousness
	skipping school or work
	‘something not right’

These symptoms are very general and could be signs of many different things, including normal adolescent behaviour. It is always important to be aware of such changes in thoughts, feelings, perceptions and behaviour, especially when they are prolonged over a period of time. The earlier intervention starts, the greater the chance of a successful recovery.

Phase 2: The Acute Phase
This is the stage when the typical psychotic symptoms emerge. It is also the stage that is easiest to recognise and diagnose. Therefore the acute phase is when most people begin receiving treatment.
Possible symptoms of Phase 2 (Definite psychotic symptoms):

These are the symptoms that are hard to miss. They are intense, active and continuous. They interfere with normal life functioning. The symptoms of psychosis have often been divided into “positive” and “negative” categories. Positive symptoms are referred to as “positive” because they are viewed as an excess or distortion of the person’s normal functioning. Positive symptoms can be seen as adding something to your behaviour, whereas negative symptoms take something away from your behaviour. Delusions, Hallucinations and Disorganised Speech or Behaviour are all examples of positive symptoms.
Negative symptoms reflect a decrease in, or loss of, normal functions. These symptoms are often less evident than positive symptoms and require careful assessment. Some examples of negative symptoms include:

	little display of emotions
	feelings of apathy (not caring about what goes on)
	not speaking very much
	difficulties in thinking or coming up with ideas
	withdrawal, decreased ability to initiate tasks
	lowered levels of motivation or drive, a lack of energy
	loss of interest or enjoyment

It is also common for other symptoms or problems to occur along with the psychotic symptoms. Some examples of other problems include:

	depression
	anxiety
	suicidal thoughts or behaviours
	substance abuse
	difficulties functioning
	sleep disturbance

Phase 3: Recovery
Some of the symptoms that are apparent in the Acute Phase may linger in recovery. With appropriate treatments, the great majority of people successfully recover from their first episode of psychosis.

Possible Symptoms of Phase 3: In the recovery stage, the acute symptoms of Phase2 will lessen and start to fade. However, after the psychosis has responded to treatment, some symptoms may linger. Problems such as depression, anxiety, decreased self esteem, social problems and difficulties with work or school may also occur but these are also treatable symptoms.