psychosis

Statistically speaking, around one percent of German citizens contract one at least once in their lifetime psychosis. However, the term itself is very complex and should not necessarily be confused with schizophrenia, which, however, happens very often. Nowadays, a psychotic illness no longer has to mean a devastating diagnosis. A psychso is to be distinguished from a neurosis.

What is psychosis?

Psychoses comprise a very extensive repertoire of symptoms and are therefore difficult to standardize. Nevertheless, there are often manifest characteristics of the disease.
© Pixel-Shot - stock.adobe.com

The term psychosis is an umbrella term, distinguishing on the one hand between organic and non-organic psychoses, but also between affective psychoses and psychoses from the schizophrenic group of forms.

Organic psychoses can be triggered, for example, by a brain injury (such as a traumatic brain injury). Non-organic psychoses in turn include both manic-depressive episodes, so-called schizoaffective disorders (disorders of the emotional experience) and psychoses from the schizophrenic group of forms.

A characteristic of all psychoses is always a persistent or even temporary loss of reality (hearing voices, either grossly overestimating or underestimating yourself, delusions, etc.). The term is therefore very comprehensive and differential diagnoses for a more detailed definition of the clinical picture are inevitable.

causes

Currently, science is assuming a vulnerability-stress model as the cause model Psychosis out. According to this, some people are more sensitive (more vulnerable, more injured) than others and tend to develop psychosis in certain situations (for example, with persistent stress). This model rightly includes the genetic aspect, since it is referred to that not everyone develops psychosis under the same circumstances. For this reason, it is also a fact that some people using drugs like hashish lead to psychosis, but not others.

Overall, drug use, difficult social conditions, persistent stress, traumatic experiences as well as a strong genetic expression can be the cause of a psychosis. Usually, however, it is a mixture of several factors. It has meanwhile been established that the brain metabolism of the person concerned is not in balance when a psychosis breaks out.

In particular, too large an amount of the messenger substance dopamine is held responsible for psychosis. Of course, social components or drug consumption also have an effect on dopamine metabolism.

Typical psychoses

• schizophrenia
• Affective disorders
• depressions
• Drug psychosis

Symptoms, ailments & signs

Psychoses comprise a very extensive repertoire of symptoms and are therefore difficult to standardize. Nevertheless, there are often manifest characteristics of the disease. In the early stages, patients suffer from increasing nervousness and lack of concentration.

This also includes slightly pronounced communication problems when communicating with other people. Thinking blocks or a veritable flood of incoherent thoughts also impair intellectual performance. Later on, delusions and hallucinations manifest themselves.

People with psychosis have an unusually strong tendency to distrust, hear voices in their head, and feel constantly under observation of real or imaginary people. With the ego disorder, sufferers come to the conclusion that other people hear their thoughts and influence them in a targeted manner. Great irritability or a noticeable lack of emotion occur as a result.

In severe cases, this leads to hostility and aggression towards fellow human beings or the environment. Patients often develop an unusual interest in content with a mystical background or follow a strongly religious path in life. The symptoms do not always worsen gradually. They can also appear completely surprising and quickly subside again. Social contacts also suffer from the strange changes in behavior. People in the immediate vicinity often perceive this as unreasonable or threatening and therefore increasingly withdraw from those affected.

Course of disease

Statistically, around a third of those affected only experience one once in their life psychosis, the second third falls ill twice or more, and in the last third the clinical picture becomes chronic and manifests itself as permanent schizophrenia.

Normally, a psychosis announces itself when those affected initially perceive their environment as strange, feel strange and cannot explain this properly. As a result, the person concerned tries to put together a therapy to explain what is happening. This is usually the beginning of the delusions and the loss of reality.

This in turn can lead to those affected perceiving their environment as hostile and therefore possibly also becoming violent - after all, they are victims of an alleged "conspiracy".

Complications

Psychoses, especially hallucinations and delusions, are always frightening for the patient himself and his social environment, which is why they should be treated in any case. However, psychotic disorders usually only become problematic when the person concerned can no longer cope with his job and everyday life on his own due to the illness or when he poses a danger to himself or others.

Complications result in particular from actions that are harmful to oneself and others and from insufficient care for one's own body. Psychotic disorders also make people more susceptible to abuse of alcohol and other drugs, which can exacerbate the symptoms of psychosis. Hallucinations often take extreme forms under the influence of drugs. There is a risk that the patient will be seriously injured while fleeing from what he sees or that he will take counter-measures that also endanger others.

In severe cases, the patient may attempt suicide in order to escape a supposedly worse danger. Delusions, especially if they are concomitant drug abuse, can become so severe that patients try to fly or walk over water and seriously injure themselves or drown.

When should you go to the doctor?

People who show abnormal behavior should be observed further. A distinction must be made whether it is a question of personality traits or real disorders. If generally applicable social rules are permanently disregarded or seemingly deliberately ignored, a doctor should be visited. Unpunctuality, baseless insults, perceptual disorders or uncontrolled actions are alarming signs of illness. If dealing with other people regularly causes conflict, discomfort or fear in the other person, a check-up visit with a doctor or therapist is indicated.

Hearing voices, inspiration from an imaginary power, or seeing objects that are not there is considered worrying. The indications must be distinguished from spiritual or religious perceptions. In the case of psychosis, the person affected does not behave in accordance with the social norm. He is overreacting, has impulse control problems, and is harmful to himself and others in his behavior. If it becomes a danger to yourself or the environment, an emergency service must be alerted.

Affected people cannot fulfill their day-to-day obligations due to their complaints. If drug induced behavior disorders are found, medical attention is needed. A doctor should be consulted in the event of withdrawal behavior, indifference, loss of appetite or depression. Problems of concentration or attention as well as delusions should also be clarified.

Treatment & Therapy

Psychosis are usually treated with neuroleptics in hospital. In contrast to the drugs used in earlier decades, the so-called atypical neuroleptics of the newer generation are preparations with fewer side effects, which is why they are preferred for therapy. In recent years, a large number of new neuroleptics have come onto the market.

In the case of psychosis, however, psychotherapy is also necessary in addition to drug therapy. The right medication and a coherent psychotherapy are often the key to success, i.e. to subside the psychosis. Above all, there is no alternative to drug therapy; psychotherapy has only proven to be effective in combination with the right medication. It is now considered obsolete to want to cure a psychosis only with psychoanalysis or only with psychotherapy.

In order to find the right drug or the right drug combination, it is often only possible to feel and try it out, as psychoses and metabolic processes in the brain run very differently. The drugs available on the market are usually very effective, which was not necessarily the case with the older generation of neuroleptics.

In the acute phase of psychosis, hospitalization in a psychiatric clinic is often necessary.

You can find your medication here

➔ Medicines to calm down and strengthen nerves

prevention

To one psychosis To prevent it, it is important not to overuse yourself, i.e. the stress is kept in check and social problems are resolved. Prevention also includes not using drugs because nobody knows whether they have a genetic predisposition to psychosis that can be caused by intoxicants.

In particular, people who have already experienced one or more psychoses should use their powers carefully and under no circumstances take drugs. In addition, it is necessary to regularly take the prescribed medication and consult a specialist doctor regularly to avoid relapse.

Aftercare

Suffering a relapse from a psychosis is not only very stressful for the person affected, but also for his social environment. However, this can be prevented by appropriate follow-up care. The follow-up examinations determine whether the patient is still well prepared for the medication prescribed in the treatment.

In addition, the attending physician will hold appropriate discussions with the patient about the effects and side effects of the antipsychotics. The problem with unauthorized withdrawal of medication is that there will be improvements in health in the first period. After that, however, the same symptoms reappear during a relapse. This can be prevented through consistent follow-up care.

In addition to GP and neurological therapy, psychological support is also important during aftercare. Social contacts that were lost during the illness can be re-established in this way. Cognitive abilities such as memory and the ability to concentrate are also regained and stabilized.

Therapies to reduce stress and avoid excessive demands are also advisable. The basis for successful follow-up is that the patient gets involved with the team of doctors and therapists. Psychosocial follow-up treatment is then also successful.

You can do that yourself

To improve the situation, a healthy lifestyle is important. This includes a very economical consumption of stimulants such as coffee, tobacco and sugar as well as a renunciation of illegal and legal drugs. Eating and drinking healthily and getting enough and regular sleep are better alternatives. The daily routine should be clearly regulated.

The social factor is also crucial. Discussing a crisis plan with close friends or relatives is just as much a part of it as regular contact with mentally stable people. These do not necessarily always have to come from the closest social network. They can be found doing numerous activities that are also good for you. This includes sports, hiking and volunteering. Since stressful or otherwise stressful situations can occur again and again, relaxation should always be provided as compensation. This should not be postponed until later.

In order to discuss a situation that is perceived as stressful with others or to receive new tips for dealing with a psychosis, it may be advisable to join a self-help group. These and similar contacts should be maintained over the long term, as this is the only way to ideally deal with a later crisis situation.