Stress-Induced Psychosis: Signs, Effects, And Treatment
Stress is a normal part of life. However, extreme stress or chronic stress can be detrimental to a person’s mental and physical health. In some cases, especially in people with mental health conditions like bipolar disorder, extreme stress or a traumatic event may trigger psychosis. Stress may also trigger isolated psychosis events, called brief psychotic disorder. Psychosis is often considered a mental health emergency, as it can lead to a severe lack of connection with reality.
Understanding how stress may contribute to psychosis may help someone prevent psychotic episodes and seek treatment early on, when the first signs of psychosis appear. In this article, we’ll explore how stress may contribute to psychosis and brief psychotic disorder.
What is stress-induced psychosis?
Psychosis isn’t a mental health condition, but a set of symptoms that affect someone’s mind and causes them to lose touch with reality. Stress-induced psychosis refers to psychosis caused by severe stress or traumatic events. A person experiencing psychosis may experience hallucinations, delusions, and disorganized or confused thinking, which may manifest when communicating thoughts and ideas.
What are psychotic disorders?
Psychotic symptoms are also associated with various mental health conditions, such as psychotic disorders, whose symptoms may worsen or be caused by stress. Below are a few conditions related to this form of psychosis.
Brief psychotic disorder and stress-induced psychosis
Someone experiencing a brief psychotic episode may have severe symptoms, but that only last for a short amount of time. These symptoms may include delusions, hallucinations, and disorganized speech.
Symptoms of brief psychotic disorder: Anxiety, hallucinations, and delusions
If there's a specific, marked stressor that causes a brief psychotic disorder, the condition is then referred to as brief reactive psychosis. Reactive psychosis relates to symptoms of psychosis stemming from a traumatic event or situation that might be considered unsettling for those of a similar culture and under similar circumstances.
Causes and risk factors
A person who experiences severe stress and trauma may be more prone to developing brief psychotic disorder, making it a possible cause of stress-induced psychosis. However, genetic, neurological, and environmental factors may also play a role. Brief psychotic disorder is more likely to affect vulnerable populations experiencing high stress levels, such as refugees and survivors of natural disasters. It may also be more prevalent in developing countries.
Treatment of brief psychotic disorder: Medication and additional therapies
Treatment of brief psychotic disorder often involves the use of antipsychotic medication and psychotherapy with a mental health professional.
Bipolar disorder and psychosis
Bipolar disorder is often considered a mood disorder that causes extreme mood swings of mania and depression. A person with bipolar disorder may experience symptoms of psychosis, especially in connection with a mania episode, which is only present in people with bipolar I disorder.
Stress is known for precipitating psychotic episodes in bipolar disorder. This factor may be partly attributed to early life stressors like childhood trauma and early dysfunction in biological systems. Moreover, being exposed to stress at critical points in life, such as childhood, is associated with "the development of the brain dysfunction that represents psychosis vulnerability."
What is psychosocial stress?
According to findings, individuals with psychosis "tend to experience high levels of psychosocial stress and social withdrawal"—factors linked with increasing the risk of a relapse of psychosis.
Moreover, stress has been implicated in the onset and worsening of psychotic symptoms. A systematic review examining evidence of psychosocial stress, interpersonal sensitivity, and social withdrawal in people identified as Clinical High Risk (CHR) indicates that "greater exposure to psychosocial stress, emotional abuse, and perceived discrimination significantly increased risk of transition to psychosis."
How stress can cause hallucinations and delusions
The role of stress in inciting symptoms of psychosis— within or without mental disorders—has been noted by researchers.
Recent studies suggest that high stress levels are associated with increasing psychotic symptoms in clinical and non-clinical populations. These studies also indicate that "perceived stress and coping styles can be critical factors affecting the association between cognitive biases and psychotic-like experiences." Cognitive biases refer to one's subjective perception of reality. Researchers also note that more adaptive coping strategies are linked with reducing attenuated psychotic experiences. A coping strategy may be considered adaptive when it focuses on problem-solving and cognitive reconceptualization.
Psychosis treatment: Medication and other options
Treatment of psychosis often involves a combination of psychotherapy (talk therapy), antipsychotic medications, self-help groups, family intervention, and other approaches, such as rehabilitation for psychosis.
Cognitive-behavioral therapy (CBT) is an evidence-based treatment approach specifically geared toward reexamining the way one thinks and behaves and finding healthy ways of coping with stressors.
Effectiveness of cognitive-behavioral therapy for mental health conditions
CBT has been found to address a wide range of mental health conditions, including bipolar disorder and psychotic disorders, alleviating symptoms and improving functioning.
Ways to manage stress and anxiety
Stress can also be managed independently alongside treatment as a psychosis prevention method. Below are a few stress-relief activities to try:
- Exercising to alleviate the intensity of certain emotions and clear the mind
- Keeping in touch with friends, family, and significant people in your life
- Participating in hobbies or activities you enjoy
- Avoiding unhealthy habits, such as drinking excess coffee and alcohol
- Seeking out nature to unwind: Spending time in nature has been proven to reduce stress and anxiety. One study suggests that 20 minutes in nature can reduce stress hormone levels.
- Taking a yoga class
- Trying deep breathing exercises
- Practicing mindfulness meditation to be more grounded and present: Numerous studies have linked mindfulness meditation with the ability to reduce stress and foster mental health.
- Taking a hot bath or shower
- Aiming to get at least seven to nine hours of sleep
- Eating nutritious meals
Mental health care through online therapy
If you or someone you know are experiencing symptoms of psychosis, a physical and psychiatric evaluation can be valuable. Sessions with a therapist can also be supportive, as a therapist can help you manage stress and increase your toolbox of coping strategies to manage symptoms. They may also help you integrate approaches like mindfulness into your life.
The benefits of online therapy
Online therapy through platforms like BetterHelp can be convenient for some people. These platforms allow clients to speak with a licensed therapist by phone, video, or in-app messaging. Therapists working through online platforms often specialize in cognitive-behavioral therapy, an approach that is considered a gold standard for addressing mental health conditions and symptoms of psychosis.
Efficacy of online therapy for psychotic symptoms
One study suggests that "online interventions are both feasible and acceptable to individuals with psychotic disorders and may be effective in assisting with clinical and social outcomes." The same study noted that online therapy is associated with a reduction in psychotic symptoms.
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