When people are experiencing psychosis or instability of the mind, the way their brain processes information has been affected and their reality is altered. These individuals think differently than most people, and they are likely to hear voices that other people don’t, see things that are not there, smell odours other people can’t, and in some cases believe that other people are out to harm them, or that they are a significant people like presidents or a God. Their reality is very real to them, and convincing them otherwise while they are in that state of mind is not successful. People find the experiences of psychosis overwhelming and confusing.

Important to note is that psychosis is not an illness; rather it’s a symptom of an illness, and is common among mental illnesses, such as schizophrenia, bipolar and depression. However, psychosis can also be elicited by substance abuse like drugs

or alcohol; other illnesses or injuries, such as traumatic brain injuries or tumours, strokes, dementia, Alzheimer’s or HIV; extreme stress or trauma – loss of loved ones, sexual assault or serving in the war, or it can be genetic.

Psychosis is temporary in most cases and can last between a few days to a year unless untreated, and occurs in three different phases:

The first phase is called the prodromal phase – which is a gradual onset of the psychotic episode. Usually, the people in this phase will experience changes in their behaviour, feelings and thoughts without having full-blown psychotic episodes (hallucinations and delusions). However, a full psychotic episode is required to diagnose anyone with psychosis. 

The indicators of prodromal phase are:

- irritability

- depressed mood

- sleep disturbances (decreased need for sleep)

- suspiciousness

- need to be alone (social withdrawal)

- feeling disconnected

- unexplained difficulty at work/school (high absenteeism/poor performance)

- trouble thinking clearly or concentrating

- lack of self-care or poor hygiene

- changes in perceptual experiences – things appear brighter than usual

- feeling overload with information or thoughts

- difficulty screening out distracting information or sensations

The second phase is the acute phase where people experience full-blown psychotic episodes. The psychotic episode is severely distressing to the individuals and those around them and causes a functional breakdown in the affected person’s life. This stage requires diagnoses and treatment.

 The indicators are:

- disorganised speech – saying irrelevant or nonsensical things

- disorganised behaviour – undressing in public, talking to self or wandering from home

- hallucinations – (auditory) hearing voices when they are alone; (visual) seeing things which are not there; and (tactile) strange sensations or feelings that can’t be explained

- delusions – beliefs that are culturally unacceptable, such as people are stealing their thoughts, or they have special powers or is on a special mission.

The third phase is known as the recovery phase. 

This indicates that people are likely to recover from their first psychotic episode after receiving treatment as symptoms will dissipate, and in most cases, people can return to their natural functioning. However, in some cases, some people may experience residual symptoms from the acute phase post first episode, therefore, need to be on chronic antipsychotic medication.

Worthwhile to note is that psychosis only occurs in certain mental illnesses, and even when it occurs in those mental illnesses not everyone who has that specific mental illness is likely to experience psychosis as a symptom. Also, persons

diagnosed with schizophrenia spectrum disorders where psychosis is predominant and is required to give such diagnoses; are not all subjected to experience all three psychotic phases – the symptoms vary from person to person therefore, some people may not experience the prodromal phase before the acute phase and vice versa. 

Psychosis is a treatable symptom so when you experience it, consult with trained mental health professionals, such as psychologists, psychiatrists and medical doctors that can provide you with proper diagnosis and correct treatment.

Justine /Oaes

Biweekly (oaesjustine@gmail.com)