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.

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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.  

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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.