A psychosis is a major psychiatric disorder characterized by the inability to tell what is real from what is not real. Hallucinations, delusions, and thought disorders can accompany psychosis. People who are psychotic often have a difficult time communicating with or relating to others. Sometimes they become agitated and violent. Among the conditions that include symptoms of psychosis are schizophrenia and manic depression (also known as bipolar disorder).
Psychotic episodes may last for a brief period or for weeks and months at a time. Psychosis can arise from emotional or organic causes. Organic causes include brain tumors, drug interactions, or drug or alcohol abuse. Since the 1950s, new medications have been developed to effectively treat psychosis, allowing a person suffering from delusions or hallucinations to regain a more accurate view of reality.
Schizophrenia (skitz-o-FREN-ee-uh) is most frequently associated with psychosis. It is a mental illness that is characterized by delusions, hallucinations, thought disorders, disorganized speech and behavior, and sometimes catatonic behavior (an abnormal condition in which a person remains quiet and paralyzed). Emotions tend to flatten out (lose the normal peaks and valleys of happiness and sadness) and it becomes increasingly more difficult for the person to function normally in society.
Whereas schizophrenia is a thought disorder, manic-depressive disorder is a mood disorder. While the mood of a person suffering from schizophrenia is flat, the mood of a person suffering from manic depression can swing from great excitability to deep depression and feelings of hopelessness. Many manic-depressive patients also experience delusions and hallucinations.
Delusions: Incorrect beliefs about reality that are clearly false.
Hallucinations: Seeing, feeling, hearing, or smelling something that does not exist in reality.
Manic depression: Also called bipolar disorder, a mental illness characterized by severe mood swings from depression to mania (great enthusiasm, energy, and joy).
Schizophrenia: A serious mental illness characterized by isolation from others and thought and emotional disturbances.
Synapses: Junctions between nerve cells in the brain where the exchange of electrical or chemical information takes place.
Hallucinations are a major symptom of psychosis and can be defined as sense perceptions that are not based in reality. Auditory hallucinations are the most common form. Patients hear voices that seem to be either outside or inside their heads. The voices may be argumentative or congratulatory. Patients who experience visual hallucinations may have an organic problem, such as a brain lesion. Other types of hallucinations involve the sense of smell and touch.
Delusions, incorrect beliefs about reality, are another symptom of psychosis. There are various types of delusions. Delusional patients may believe they are extremely important and powerful, or that they have a special relationship with a political leader, a Hollywood star, or God. Other delusional patients may feel they are being persecuted or mistreated by someone when no such persecution or mistreatment is taking place. Further delusions include unwarranted jealousy or the strongly held belief that one suffers from a disease or physical defect.
Antipsychotic drugs are prescription medications used to treat psychosis. The vast majority of antipsychotics work by blocking the absorption of dopamine, a chemical that occurs naturally in the brain. Dopamine is responsible for transmitting messages across the synapses, or junctions between nerve cells in the brain. Too much dopamine in a person's brain speeds up nerve impulses to the point of causing hallucinations, delusions, and thought disorders.
Antipsychotic medications were not used in the United States before 1956. Once these drugs, such as Thorazine™, were introduced, they gained widespread acceptance for the treatment of schizophrenia. The use of these drugs allowed the release of many people who had been confined to mental institutions.
Despite their benefits, antipsychotic medicines have a number of strong side effects. Among the most severe are muscle rigidity, muscle spasms, twitching, and constant movement. Perhaps the most serious side effect is neuroleptic malignant syndrome (NMS). This condition occurs when a patient taking an antipsychotic drug is ill or takes a combination of drugs. People suffering from NMS cannot move or talk. They also have unstable blood pressure and heart rates. Often, NMS is fatal.
Recently, a new generation of antipsychotic drugs has been developed as a result of discoveries about how the brain works. These new drugs have fewer side effects. Some do not completely block dopamine receptors; others are selective, blocking only one type of dopamine receptor.