Understanding The Differences And Similarities: Psychosis Vs. Schizophrenia
Psychosis vs schizophrenia: Are they the same?
Psychosis and schizophrenia are often mistaken for one another, as each term tends to be associated with specific symptoms that can be common to both. When navigating mental health and diagnosis, fully understanding the terminology can ensure you receive the most appropriate support. In general, psychosis refers to a break from reality, and although this is not a diagnosable disorder, psychosis can be a symptom of schizophrenia and several other forms of mental illness. In many cases, individuals who have experienced psychosis can benefit from attending therapy to recover from episodes.
Understanding the difference: Psychosis vs schizophrenia
Schizophrenia and psychosis are not the same. Psychosis can be seen as a symptom or episode involving a cluster of symptoms, but this is not a diagnosable disorder. Meanwhile, schizophrenia is a mental illness that can involve psychosis, and multiple mental illnesses list psychotic episodes as a symptom. For this reason, psychosis is not unique to schizophrenia.
What is schizophrenia?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), schizophrenia is a mental illness that falls under the Schizophrenia Spectrum and Other Psychotic Disorders category. In the previous version of the DSM, the DSM-IV, schizophrenia was organized into subtypes. In the DSM-5, schizophrenia’s classification as a spectrum disorder generally indicates that any individual with schizophrenia may be unique in the way their symptoms present.
Positive, negative and cognitive symptoms of schizophrenia
Symptoms of schizophrenia are usually sorted into three categories: positive, negative, and cognitive.
Positive symptoms of schizophrenia
Below are the positive symptoms of schizophrenia, which are commonly referred to as “psychotic symptoms” and can occur during a psychotic episode:
- Hallucinations (Sensory perceptions of nonexistent stimuli, such as hearing voices or seeing shadows that aren’t there)
- Delusions (Firmly held beliefs that are not based in reality)
- Disorganized thinking and behavior
- In some cases, catatonia (Losing touch with one’s environment, showing a lack of expression and movement, and becoming unresponsive)
Negative symptoms of schizophrenia
Negative symptoms of schizophrenia can be defined as those that cause a lack of certain behaviors or affect, including the following:
- Social withdrawal and disinterest
- A lack of emotional expression
- Numbness or a lack of emotion (anhedonia)
- Difficulty practicing self-care
- A lack of movement
- Difficulty expressing oneself
Cognitive symptoms of schizophrenia
Cognitive symptoms of schizophrenia generally include those that impact the mind, such as disorganized thoughts and difficulty forming words.
What is psychosis?
Psychosis is usually defined as an experience of several symptoms that involve difficulty connecting with reality. People with active psychosis may experience delusions, hallucinations, and disorganized behavior.
Psychotic symptoms of schizophrenia, bipolar disorder & more
Below are some of the mental health conditions that may involve psychotic episodes:
- Schizophrenia
- Schizoaffective disorder
- Bipolar I disorder
- Major depressive disorder with psychotic features
- Severe stress
- Severe sleep deprivation
- Postpartum depression with psychosis
- Delusional disorder
Psychotic symptoms as a manifestation of other physical health conditions
Psychosis can also be a symptom of some physical health conditions, such as Parkinson’s disease, Alzheimer’s disease, and other dementias. Misuse of substances or certain prescribed medications may also cause psychosis.
Similarities between psychosis and schizophrenia
Psychosis can be a symptom of schizophrenia, so the signs of a psychotic episode typically line up with the positive symptoms of schizophrenia that providers look for when diagnosing the disorder.
Differences between psychosis and schizophrenia
Because schizophrenia is a spectrum disorder, not every person with the condition will experience psychosis in the same way. Some people may experience only hallucinations, while others may experience primarily delusions. These experiences of psychosis tend to be unique to schizophrenia and may not be the same in other disorders.
Psychosis and its impact on mental illness
In addition, psychosis as a symptom is usually only present in schizophrenia during an active episode. In other mental health disorders, psychosis might arise once or at different intervals. When someone with schizophrenia is not in an episode, they are usually not experiencing psychosis.
In general, psychosis does not involve other symptoms of schizophrenia, such as negative symptoms and cognitive challenges. For example, psychosis may not cause social isolation or anhedonia unless occurring alongside another disorder that can cause these symptoms, such as major depressive disorder.
Schizophrenia and psychosis treatment options
Schizophrenia and psychosis are often treated with the same strategies, including the following options.
Medication and medication management
Prescription medication is often considered the primary schizophrenia treatment and can reduce symptoms of psychosis. Antipsychotic medications may reduce the severity of hallucinations and delusions, in some cases causing symptoms to go into remission. Typical and atypical antipsychotics may be prescribed, depending on symptom severity and an individual’s reaction to the medications.
Consult a medical doctor before starting, changing, or stopping medication for any condition. If you experience severe side effects or other symptoms that concern you, talk to your doctor before discontinuing your medication. The information in this article is not a replacement for medical advice or diagnosis.
Mental illness crisis support for schizophrenia, bipolar disorder, and more
Psychotic episodes can lead to mental health crises for some people. Because delusions and hallucinations can seem so real, individuals experiencing an episode may act in ways they wouldn’t normally. In some cases, these episodes can involve becoming a risk to oneself or others.
When this risk occurs, hospitalization or inpatient care may be recommended to monitor the episode, offer medical intervention, and provide the individual with support when they return to daily life. Acute care is often short-term. However, some severe cases may require longer-term treatment in a facility.
Inpatient hospitalization can be beneficial with one potential benefit being to reduce the risk of an individual being sent to prison or experiencing legal challenges due to their symptoms. A mental health facility can offer medication and potentially halt the episode, whereas a prison may worsen symptoms and could be severely traumatic for an individual with a mental illness.
Social support, environmental factors, and lifestyle changes
Social support can be another aspect of care when an individual is experiencing psychosis. Loved ones can keep an eye out for signs that psychosis is approaching and help a person reach out for help. In some cases, a caregiver may be beneficial for people who frequently experience psychotic episodes.
Some people with schizophrenia and other psychotic disorders may live in group homes or assisted living facilities. Without family support, symptoms of conditions like schizophrenia can worsen significantly.
Therapy
Talking to a therapist may be beneficial before and after a psychotic episode to process symptoms and develop a safety plan for the future. A therapist can guide clients through research-based techniques for coping with daily challenges that can be common in conditions like schizophrenia. However, some clients may avoid in-person therapy due to barriers like distance or finances.
Online therapy
If you face barriers to receiving care, trying online therapy through a platform like BetterHelp might be beneficial. An online platform typically allows clients to be matched with a therapist who meets their preferences after filling out a brief questionnaire, often within 48 hours of signing up. In addition, clients can choose between phone, video, or live chat sessions with their therapist.
Effectiveness of online therapy
Studies have found that online therapy may be beneficial for people living with psychotic disorders like schizophrenia. One study published in 2015 found that individuals with schizophrenia who tried an online intervention group with their family members usually experienced lower perceived stress and a higher perceived level of social support after three months of treatment.
Takeaway
Frequently asked questions
Read more below for answers to questions commonly asked about this topic.
What environmental factors cause psychosis?
One meta-analysis of 44 studies has identified the following as risk factors for psychosis:
- Complications during pregnancy or delivery
- Tobacco use
- Physical inactivity
- Childhood trauma, including emotional abuse and neglect
- High stress
- Low-functioning in childhood and adolescence
Of these, this review determined that there is a strong association between the risk of psychosis and traumatic events in childhood.
Other factors that may contribute to psychosis may include being male, being single, being unemployed, and having a low educational level.
What environmental factors contribute to schizophrenia?
Research has shown that environmental factors that contribute to schizophrenia can include the following:
- Complications during pregnancy or delivery that resulted in oxygen deprivation
- Maternal viral, bacterial, and parasitic infections during pregnancy
- Living in an urban area
- History of traumatic brain injury
- Adverse childhood experiences, including parental separation, financial difficulties, emotional or physical abuse, or the death of a family member
This review also found that childhood trauma may be correlated with the severity of symptoms of schizophrenia and other psychotic disorders.
What is the difference between bipolar disorder with psychosis and schizophrenia?
People with psychosis in bipolar disorder have hallucinations, delusions, or both. It can be challenging to distinguish between bipolar disorder with psychotic symptoms and schizophrenia. BPD with psychotic symptoms is often misdiagnosed, and there is “no qualitative distinction in psychotic symptoms found in BD or schizophrenia.”
Researchers speculate that there is a spectrum of psychotic disorders ranging from severe depression with psychosis to bipolar disorder with psychosis to schizophrenia, which can make it challenging to distinguish between these conditions.
While each has specific diagnostic criteria in the DSM, it can still be challenging for a mental health professional to distinguish between these conditions. The rate of psychotic symptoms during a manic episode can be so high that it can be difficult to distinguish it from a primary psychotic disorder. Between episodes, someone with bipolar disorder may return to a healthy baseline, which can make distinguishing between these conditions less challenging. That said, if someone with bipolar disorder does not receive appropriate treatment, episodes may occur more frequently.
How is psychosis different from schizophrenia?
According to the National Institute of Mental Health, psychosis is a “collection of symptoms that affect the mind, where there has been some loss of contact with reality.” Many things can cause psychosis. Experts believe it may result from a combination of risk factors, including genetics, changes in the brain, and exposure to extreme stress or trauma. Some mental health disorders can also trigger psychosis, including schizophrenia, but a person can experience psychosis without being diagnosed with another mental health condition. Psychosis symptoms include paranoia, trouble thinking clearly, withdrawing socially, confused speech, trouble communicating, and having difficulty telling reality from fantasy.
Schizophrenia is a chronic psychotic disorder. People with schizophrenia may have their initial schizophrenia episode in early adulthood.
According to the American Psychiatric Association, symptoms of schizophrenia vary in duration, severity, and frequency from one person to another. With treatment, many people with schizophrenia can experience improved symptoms with less likelihood of recurrence.
Symptoms are divided into three categories. Positive symptoms are those whose presence is abnormal, like exaggerated or distorted perceptions, hallucinations, or false beliefs. Negative symptoms are those that are abnormally absent, like a lack of emotion or a reduced drive to engage in purposeful activities. The third is disorganized symptoms, which include disorganized speech and thinking or bizarre behavior or movements.
These symptoms must be present for at least six months for a mental health professional to diagnose schizophrenia.
Treating psychosis generally depends on the underlying cause. It can involve antipsychotic medication, cognitive behavioral therapy, and, in some cases, in-patient treatment. This approach is similar to how medical professionals treat schizophrenia, but schizophrenia is a chronic condition that requires life-long management.
What triggers psychosis?
There is no one cause; people can develop psychosis for many reasons. It can occur as a result of a complex combination of genetics, brain development, and stress or trauma, or it can be a symptom of a mental illness.
What is stage 4 psychosis?
While the DSM does not stage psychosis, some professionals have defined three phases of psychosis.
- Prodrome phase: It can be difficult to recognize the early warning signs of psychosis that occur in this phase. In early psychosis, people may experience sleep disturbances, anxiety, depressed mood, or odd beliefs.
- Acute phase: In this phase, clear psychotic symptoms may begin to emerge, and the person may be distressed by what is occurring. Their behavior may become so unusual that family members may begin to encourage them to seek help.
- Recovery: With effective treatment, people with psychosis can recover. Treatment for psychosis typically includes certain prescription medications like antipsychotic drugs and coordinated specialty care.
It can be crucial to seek early treatment when someone experiences psychosis. If treated early, depending on the cause, the person may not experience a second episode.
How do I know if I have psychosis or schizophrenia?
If you suspect you are experiencing symptoms of either psychosis, schizophrenia, or other mental health conditions, contact a mental health professional. An early diagnosis can help you begin treatment right away so you can begin managing symptoms.
What comes first, psychosis or schizophrenia?
Psychosis is often a symptom of schizophrenia, but a person experiencing psychosis does not necessarily have schizophrenia. According to the Substance Abuse and Mental Health Services Administration, there are several mental health and medical conditions that can cause psychosis, including substance use disorders, prescription drugs, and schizophrenia.
How to tell if someone has schizophrenia?
Symptoms to look for may include changes in sleep patterns, socialization habits, and personal hygiene. Someone showing early signs of schizophrenia may experience unusual thoughts and suspicions, experience hallucinations or delusions, lack emotions, speak in a flat, disconnected manner, or show little interest in living their life. Additional symptoms may include having difficulty concentrating or remembering things.
Who is prone to psychosis?
Many factors can contribute to someone having psychosis. Some of these include having a mental illness, like schizophrenia or bipolar disorder, head injury, or substance abuse of drugs like ketamine, LSD, or ecstasy.
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