What Is Psychosis? An Introduction to the Psychotic Mood Disorder

A psychotic mood disorder is a mental health disorder characterised by a loss of contact with reality. This means that a person with psychosis may see or hear things that aren't there, or may believe things that aren't true.

This illness can be very distressing and frightening for both the person who is experiencing it and their loved ones. If you are worried that someone you know may be suffering from psychosis, it's important to understand the symptoms and how to get help.

Also read: What To Expect From a Psychiatric Consultation

What Is Psychosis?

Psychosis is a severe mental disorder that affects how a person thinks, feels, and behaves. It can make it difficult for people to tell the difference between what is real and what is not. Psychosis can cause a person to have hallucinations (seeing or hearing things that are not there) and delusions (believing things that are not true).

Bipolar psychosis is a type of psychosis that is associated with bipolar disorder. It can cause people to experience mood swings, hallucinations, and delusions. Apathy is a common symptom of psychosis. It can cause people to feel detached from their emotions and surroundings, and they may lose interest in activities they once enjoyed.

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Who Is at Risk of Psychosis?

Some people are more at risk of psychosis than others.

• Risk factors for psychosis include a family history of mental illness, drug abuse, stressful life events, and being in a high-stress environment. Some illnesses, like bipolar disorder, can also increase the risk of psychosis. People who have had a traumatic experience, such as abuse or a natural disaster, are also at increased risk.
• If you have any of these risk factors, it does not mean that you will develop psychosis. But it is important to be aware of the risks and to get help if you are having any symptoms.
• If you are experiencing any of the following symptoms, please see a doctor right away: hallucinations, delusions, disorganised thinking, social withdrawal, extreme mood swings, and apathy.

What causes Psychosis?

Psychosis is not a single condition but a symptom that reflects a loss of connection with reality. It can appear in different mental health disorders or arise due to medical or substance-related reasons. While the exact cause isn’t always clear, research shows that psychosis often results from an interaction of biological, psychological, and social factors.

1. Biological Factors

Having a family member with schizophrenia or bipolar disorder increases the risk of psychosis. Brain chemistry is another key factor. Imbalances in neurotransmitters like dopamine and glutamate can disrupt how the brain processes information, leading to hallucinations or delusions. Structural and functional changes in certain brain regions, such as the prefrontal cortex or hippocampus, are also linked to psychotic experiences.

2. Medical and Substance-Related Causes

Certain medical conditions, like brain tumours, epilepsy, Parkinson’s disease, or severe infections affecting the brain, can trigger psychosis. Substance use, especially cannabis, LSD, amphetamines, or alcohol withdrawal, can also induce or worsen psychotic episodes.

3. Psychological and Social Triggers

Stressful life experiences like trauma, abuse, neglect, or extreme social isolation can act as catalysts, particularly in those already vulnerable due to genetic or biological factors. Early life adversity and ongoing stress can sensitise the brain’s stress response system, making a person more likely to experience psychosis under pressure.

4. Mental Health Disorders

Psychosis commonly occurs in schizophrenia, schizoaffective disorder, bipolar disorder (during manic or depressive episodes), and major depression with psychotic features.

Symptoms of Psychotic Mood Disorder

There are many different symptoms that can indicate a psychotic mood disorder. Hallucinations and delusions are two of the most common, although people with psychosis can experience a wide range of symptoms.

Other symptoms of psychosis can include:

• Disorganised or confused thinking
• Strange or unusual behaviour
• Difficulty communicating
• Inability to care for oneself
• Suspicion or paranoia
• Hallucinations can be auditory, visual, olfactory, gustatory, or tactile.

People with psychosis may see, hear, or smell things that are not really there. They may also have delusions, which are false beliefs that are not based in reality. For example, a person with psychosis may believe that they are being watched or followed, even when there is no evidence to support this belief.

Delusions can be very persuasive, and people with psychosis may be unable to think clearly or make decisions. As a result, they may become isolated and withdrawn from friends and family. In some cases, people with psychosis may become violent.

For example, you may hear voices that no one else can hear, see things that aren't there, or believe things that aren't true. You may also feel very paranoid and like everyone is out to get you. Additionally, people with psychosis may experience a lack of emotion or apathy towards things that used to matter to them.

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Types of Psychotic Mood Disorders

• Schizophrenia: The illness is characterised by changes in behaviour and other symptoms, such as delusions and hallucinations, that last longer than six months. 
• Schizoaffective disorder: This disorder combines the symptoms of schizophrenia with a mood disorder, such as depression or bipolar disorder.
• Schizophreniform disorder: This includes symptoms of schizophrenia, but the symptoms last for a shorter time: between 1 and 6 months. 
• Brief psychotic disorder: People with this illness have a sudden, short period of psychotic behaviour, often after experiencing a very stressful event such as a death in the family. Recovery is often quick, usually less than a month. 
• Delusional disorder: The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn't, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month. 
• Shared psychotic disorder (also called folie à deux): When one person in a relationship has a delusion and the other person also adopts it.
• Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from drugs, such as hallucinogens and cocaine, that cause hallucinations, delusions, or confused speech. 
• Psychotic disorder due to another medical condition: Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumour.
• Bipolar Psychosis: This condition can occur in people who have bipolar disorder. It's a type of mental illness that causes a person to lose touch with reality. This can lead to hallucinations, delusions, and – in rare cases – catatonia. It can also be dangerous, as a person may act on delusions or hallucinations. People with bipolar psychosis may experience symptoms such as apathy, social withdrawal, changes in personality, and paranoia.

Treatments for Psychotic Mood Disorder

There are a number of effective treatments for psychotic mood disorders, but it's important to seek help as soon as possible. Treatment usually includes a combination of medication and therapy.

Medication can help to reduce the symptoms of psychosis, and therapy can help you learn how to cope with your condition and manage your moods. Medication is often prescribed to help manage psychotic symptoms. This could include antipsychotic drugs, antidepressants, or mood stabilisers. You may also be prescribed anti-anxiety medication.

There are a number of different therapies that may be effective, including cognitive behavioural therapy (CBT), family-focused therapy, and dialectical behaviour therapy (DBT).

CBT is a type of therapy that helps you identify and change negative patterns of thinking or behaviour. It's based on the idea that your thoughts, feelings and actions are interconnected. CBT works by helping people understand how their thoughts lead to certain emotions and behaviours. By identifying these connections between thoughts, feelings and behaviour, we can change how we react to different situations. 

Your psychiatrist may also use techniques like Dialectical Behavioural Therapy (DBT) in order to help you identify the emotional triggers and develop strategies for addressing those problems in a healthy way. 

When To Consult A Doctor?

It’s important to seek medical help as soon as you notice signs that someone may be losing touch with reality. Early intervention can significantly improve outcomes and prevent symptoms from worsening. You should consult a doctor or mental health professional if you or someone you know experiences hallucinations, delusions, disorganised thinking, extreme mood changes, or withdrawal from daily life.

Even subtle changes such as difficulty concentrating, feeling suspicious of others, or losing interest in once-enjoyed activities can be early warning signs of psychosis. A healthcare professional can conduct an assessment to determine the cause and recommend suitable treatment, such as therapy or medication.

If the person becomes confused, agitated, or expresses thoughts of self-harm or harm to others, seek immediate medical attention or contact emergency services. Remember, psychosis is treatable, and timely help can make a significant difference in recovery and quality of life. Early support not only reduces the duration of untreated psychosis but also helps individuals regain stability, function, and confidence in their everyday lives.

Also read: What Is the Difference Between a Psychologist and a Psychiatrist?

Conclusion

If you're struggling with psychosis, it's important to get help from a mental health professional. Don't try to cope with it on your own—psychosis can be very debilitating and can significantly impair your quality of life. There is no shame in seeking help, and with the right treatment, you can manage your condition and live a happy and productive life.

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Frequently Asked Questions

What is the first stage of psychosis?

The first stage of psychosis, known as the prodromal phase, involves subtle changes in thoughts, emotions, and behaviour. People may experience increased anxiety, social withdrawal, difficulty concentrating, or a decline in daily functioning before more obvious psychotic symptoms appear.

Does psychosis go away?

Yes, psychosis can go away, especially with early intervention and appropriate treatment. Many people recover fully with the right combination of medication, therapy, and support, though some may experience recurring episodes that require long-term management and follow-up care.

What is the main cause of psychosis?

Psychosis doesn’t have a single cause. It often results from a mix of biological, genetic, and environmental factors, including mental health conditions like schizophrenia or bipolar disorder, trauma, substance use, extreme stress, or underlying medical conditions affecting the brain.

What are the three stages of psychosis?

The three stages of psychosis are: prodromal (early warning signs), acute (active symptoms like hallucinations or delusions), and recovery (symptom reduction and regaining daily function). Early treatment during the prodromal phase greatly improves long-term outcomes.

What happens in the brain during psychosis?

During psychosis, there are disruptions in brain chemistry and communication, particularly involving dopamine and glutamate. These imbalances affect how the brain processes information, leading to distorted perceptions, false beliefs, and difficulty distinguishing reality from imagination.