Psychosis Vs. Schizophrenia: Signs, Symptoms, And Key Differences

Medically reviewed by Nikki Ciletti, M.Ed, LPC and Melissa Guarnaccia, LCSW
Updated October 16, 2024by BetterHelp Editorial Team
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While psychosis and schizophrenia can share several similarities, they are often distinct in their causes, symptoms, and impact. Understanding the differences between these two may help individuals identify whether they or someone they care about are experiencing psychosis vs. schizophrenia. To begin, it may be beneficial to delve deeper into the collection of symptoms known as psychosis.

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What is psychosis?

While typically not considered a mental health condition on its own, psychosis can be a symptom of numerous mental health disorders, such as schizophrenia, severe depression, and bipolar disorder. Psychosis may occur after significant stress, traumatic experiences, alcohol or drug misuse, physical conditions like brain tumors, childbirth, and as a result of medication side effects. 

The length of a specific instance of psychosis (sometimes referred to as a “psychotic episode”) may vary depending on the cause. In some cases, these episodes may only last for a few days, while others may last for weeks.

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Psychosis signs and symptoms

According to the UK National Health Service, there are three primary symptoms of psychosis: delusions, disordered thinking and speaking, and hallucinations. 

Delusions

Delusions can cause a person experiencing psychosis symptoms to hold beliefs that others do not share, specifically regarding perceptions or experiences that only they believe are true. These delusions can seem real to the individual experiencing them. For example, people may think they have supernatural abilities or knowledge they do not truly possess. In some cases, these delusions may inflate their sense of self in what is sometimes called “delusions of grandeur.” 

Disordered thinking and speaking

Psychosis may also cause a person to become confused or struggle to collect their thoughts, which can make it difficult to speak and communicate. This disorganized thinking may result from racing thoughts, where a person experiences rapid ideas or thought patterns and struggles to stay on one for a significant period. Outwardly, an individual experiencing disordered thinking and speaking may appear unable to talk in a way others understand or jump from topic to topic too quickly for effective communication. 

Hallucinations

Hallucinations can cause an individual experiencing psychosis to see, hear, feel, smell, or taste stimuli that are not truly present. These objects, people, and places often exist entirely within their own minds, but to an individual experiencing hallucinations, they may appear authentic. In some cases, individuals who are hallucinating may hear the voices of people who are not there, potentially holding conversations with these non-existent individuals.

The early warning signs of psychosis may be detectable before a psychotic episode occurs. Changes in a person's thoughts and behaviors may happen gradually, particularly if they are experiencing their first episode. These individuals may stop engaging in self-care, start to act unusually to their standard behavior, and withdraw from loved ones. Contact a mental health professional or medical doctor immediately if you notice these signs or symptoms. 

What is schizophrenia? An overview of the mental illness 

Schizophrenia is a mental health disorder that can significantly impact an individual’s thought patterns, emotions, and behavior. Without schizophrenia treatment, the symptoms of schizophrenia may make it difficult to function in an academic or professional environment. This difficulty may be due to the symptoms of schizophrenia, which can affect how a person views objective reality, their environment, and the people around them. 

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While the signs and symptoms of schizophrenia may vary depending on an individual's age and the severity of their condition, the National Institute of Mental Health (NIMH) states that there are three main symptomatic categories: cognitive, negative, and psychotic.

Cognitive symptoms

The positive symptoms and cognitive symptoms of schizophrenia typically affect an individual's concentration, attention, and memory capabilities. Those living with schizophrenia may have difficulty with decision-making due to the disorder's ability to impact information processing. These individuals may also struggle to use information they’ve learned, even if it was learned recently. In addition, those with schizophrenia may have difficulty focusing on a specific subject or activity. 

Negative symptoms

Negative symptoms may cause an individual to lose motivation, interest, and enjoyment in daily activities. In addition, those living with schizophrenia may have a difficult time functioning and showing their emotions (often marked by limited facial expressions), which could contribute to social withdrawal. These symptoms may make it difficult to plan and execute necessary activities, like purchasing food and other necessities. Those with schizophrenia can also struggle with low energy, which may lead them to engage in more passive activities. 

Psychotic symptoms

Psychotic symptoms can impact how an individual views their environment and experiences the world around them. Those living with schizophrenia may lose touch with reality and experience the symptoms of psychosis, such as delusions, hallucinations, and disordered thoughts and speaking. In addition, the psychotic symptoms of schizophrenia may affect an individual's movements. This condition, known as movement disorder, may cause someone to repeat specific motions involuntarily. 

The early warning signs of schizophrenia can vary depending on when an individual starts to develop symptoms. According to the National Alliance on Mental Illness (NAMI), schizophrenia typically occurs between the late 20s and early 30s for women and the late teens and early 20s for men. It is uncommon for a person to receive a schizophrenia diagnosis before the age of 12 or after the age of 40. 

What is the difference between psychosis and schizophrenia?

One of the primary differences between psychosis and schizophrenia is their classification. Schizophrenia is a mental health disorder, while psychosis is a collection of symptoms that relate to an underlying condition or disorder. One of these underlying disorders may be schizophrenia, of which psychosis can be a primary symptom, often causing the two to be associated. However, psychosis may also result from substance misuse, the side effects of certain medications, or physical health conditions like the following: 

  • Alzheimer’s disease
  • Parkinson’s disease
  • HIV and AIDS
  • Malaria
  • Syphilis
  • Brain tumors
  • Hypoglycemia
  • Lupus
  • Multiple Sclerosis (MS)
  • Sleep disorders 
  • Head injuries, such as a traumatic brain injury (TBI) 

Whether a person is experiencing psychosis alone or schizophrenia, it may be beneficial to seek a diagnosis from a medical or mental health professional. Once diagnosed, a professional can create a treatment plan to potentially address and alleviate schizophrenic or psychotic symptoms. 

Psychosis vs schizophrenia in teens

If an individual in their teens is experiencing schizophrenia, it may be more difficult to distinguish common adolescent behaviors like irritability, self-isolation, difficulty in school, and interpersonal conflicts from the symptoms of the disorder. However, if you notice that someone you love is displaying symptoms, it may be beneficial to take them in for a mental health or medical evaluation. A care provider may be able to determine whether an individual is experiencing psychosis, schizophrenia, or another condition.

Psychosis vs schizophrenia: Options for mental health services 

Psychosis and schizophrenia may each have distinct treatment plans that can vary from person to person. These treatments may involve medications, such as antipsychotic medications and therapeutic approaches. 

Psychological therapy, including specific approaches such as cognitive behavioral therapy, may be an effective schizophrenia or psychosis treatment. A survey of several meta-analyses found evidence that suggested the efficacy of psychological therapy, particularly concerning psychotic symptoms. 

CBT for psychosis and schizophrenia

In a separate scientific review, researchers looked to see the specific efficacy of cognitive behavioral therapy (CBT) in treating psychosis. This review found that CBT could be used to prevent the first episode of psychosis for individuals classified as ultra-high risk. In addition, CBT was effective in improving self-esteem, psychological well-being, and depression. Researchers found the intervention was also associated with positive thinking, mood, and sleep quality changes, which may improve everyday life. CBT could also reduce the number of involuntary hospitalizations related to psychosis compared to patients with usual care while increasing voluntary hospitalization.

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.

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How online therapy can help

Individuals who are not experiencing schizophrenia or psychosis may also benefit from therapy. However, it may not be attainable to everyone. Some areas may not have sufficient mental health providers, which may result in significant waits for appointments or long commutes to reach therapists. In these cases, it might be beneficial to explore alternatives, such as online therapy through a platform like BetterHelp.

Through an online platform, clients can get matched with a therapist with experience in their area of concern, often within 48 hours of signing up. In addition, clients can schedule a session with some therapists on their own time, including outside of standard business hours.  

Research indicates that online therapy can be as effective as in-person therapy. One meta-analysis, which looked at 12 trials involving 931 patients, examined the differences in efficacy between teletherapy and psychotherapy delivered face-to-face. Researchers found that there were no significant differences between face-to-face therapy and telehealth in several key areas, including:

  • Symptom severity
  • Overall improvement
  • Function
  • Working alliance (client and therapist)
  • Client satisfaction 

Takeaway

Schizophrenia can be a complex mental health disorder with numerous symptoms, including those that may be classified as cognitive, negative, and psychotic. Psychotic symptoms in schizophrenia are often similar to those of psychosis, a collection of symptoms including delusions, disorganized thinking or behavior, and hallucinations. 

The difference between schizophrenia and psychosis may be summed up as the following: while individuals with schizophrenia can experience psychosis, schizophrenia has other symptoms unrelated to psychosis. In addition, psychosis can be caused by other situations, such as substance misuse, medication side effects, and physical and mental health conditions. However, treatments for both psychosis and schizophrenia may have similar elements, such as the use of therapeutic approaches.

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