Psychosis

Psychosis is a term used in the mental health field to refer to a mental state described as the loss of contact with reality. For people who suffer from psychosis, it is difficult to differentiate what is real from what is not.It is important to clarify that the term psychotic has no relation to the term psychopath. Although the two terms are often confused in pop culture, they are very different.People suffering from psychosis may experience delusions and hallucinations, present drastic changes in personality, and disorganized thinking in general. These characteristics make it difficult to maintain social relationships, and in severe cases, create significant difficulties in daily life.Many people have psychotic experiences in their lives due to physical or mental trauma without developing a psychotic disorder. Likewise, psychosis can appear as a consequence of a large number of diseases, such as Schizophrenia, Alzheimer’s, Parkinson’s, Epilepsy.

• Hallucinations and delusions
• Sudden changes in personality or behavior
• Social isolation
• Paranoia
• Periods of mental confusion
• Memory loss

Because personality changes, social isolation, paranoia, and periods of mental confusion and memory loss usually appear with other disorders or mental states, it is important to emphasize the two main characteristics of psychosis, which are hallucinations and delusions.Hallucinations are defined as sensory perception with a lack of stimulation, which is seeing, hearing, feeling, smelling and even tasting things that are not there at that moment or that simply do not exist. Hallucinations are often vivid and described as uncontrollable.Delusions are false ideas that have no basis in reality. Some delusions are quite common and affect a large part of the population. For example, many people believe they have a special power. What makes a delusion a characteristic of psychosis is the degree of severity and the way in which it affects a person’s functioning.  

• Normal state of Psychosis It is considered normal to have brief visual or auditory hallucinations under the following conditions: When sleeping or waking up and when suffering from sleep deprivation. In some cases, in which a loved one passes away, it is also common to have hallucinations where they are somehow perceived.
• Trauma There is an important correlation between traumatic events (abuse or an accident) in people’s lives and their predisposition to psychosis.
• Psychiatric Disorders Psychosis may be present in a wide variety of psychiatric disorders, such as schizophrenia, depression, bipolar disorder, anxiety disorder, Post Traumatic Stress Disorder (PTSD), dissociative disorders, and acute psychotic disorder.
• Medical Conditions Psychosis may appear as a result of a medical disease. Some examples include Alzheimer’s, Senile Dementia, tumors, epilepsy, heart attack and hypothyroidism.
• Use of substances The use of psychoactive drugs such as alcohol, marijuana, methamphetamines and some types of medications often cause psychotic symptoms.

In the diagnosis of psychosis, it is especially important to be able to exclude other disorders and determine the cause of the symptoms. Because of this, the initial evaluation must include medical as well as psychological factors. Studies should analyze factors such as substance use, side effects of medications and diseases. Blood work and electroencephalogram studies are usually part of the initial evaluations.After excluding physical or medical causes, health professionals will use psychometric evaluations to determine what symptoms are present and to what degree they occur. After eliminating other disorders as possibilities, an interdisciplinary group of psychiatrists and psychologists will determine the diagnosis and treatment.

Treatment of psychosis can be divided into three broad areas: biological treatment, psychological treatment, and social or lifestyle interventions.Biological treatment refers mainly to psychiatric medication. There are a wide range of effective medications with different side effects that a person seeking treatment can choose, and psychiatrists can try different combinations of medications before finding the best option for the patient.Psychological treatment includes familiar approaches such as counseling and psychotherapy. Counseling for acceptance, and Commitment and Acceptance Therapy are common approaches.Social or lifestyle interventions refer to strategies, such as exercise programs, breathing exercises, meditation, healthy eating, taking part in social activities, addressing lifestyle factors, such as alcohol use, and social issues, such as employment problems, career stress, and financial debt. If you think you are suffering from symptoms of psychosis, seek further assessment from a doctor and discuss what sort of treatment might be helpful.Come see us at Tokyo Psychiatry Clinic at American Clinic Tokyo in Akasaka for assessment. Dr Andrew Kissane, our UK-trained, British Tokyo psychiatrist is a native English speaker. He is on the General Medical Council’s medical register in the UK, a member of the Royal College of Psychiatrists, and holds a Japanese medical license.If you do not wish to take a medical approach, but instead prefer to explore a psychological approach, such as cognitive behavioral therapy, breathing exercises, counseling or behavioral interventions, please email us requesting a therapy assessment at our Shintomi office.