Psychotic Disorders

Psychotic disorders are a group of severe and complex mental disorders that affect the mind. Psychotic disorders can make it hard for someone to focus, respond emotionally, communicate effectively, and make sound judgments.

There are multiple psychotic disorders, and symptoms vary from person to person. Most psychotic disorders involve severe symptoms, including hallucinations, delusions, and a detachment from reality.

For people struggling with a psychotic disorder, symptoms can seriously disrupt daily activities and functioning. However, with proper treatment, even people with severe mental disorders can learn to manage their symptoms and live fulfilling lives.

How Common Are Psychotic Disorders?

According to the American Psychiatric Association, schizophrenia occurs in approximately 1% of the population in the United States (APA). According to a 2007 study, the percentage of people diagnosed with some type of psychotic disorder during their lifetime is close to 3%.

Psychotic disorders are most common in late teens and young adults, and the prevalence is equally common for men and women.

Symptoms of Psychotic Disorders

Under the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), all psychotic disorders share five categories of symptoms:

• Delusions: Delusions are fixed false beliefs based on incorrect inferences about reality and maintained despite the presentation of evidence against them. Delusions can range from common ideas (thinking you have a brain tumor) to more eccentric views (believing you can read another person’s thoughts).

• Hallucinations: Hallucinations are sensory perceptions that occur in the absence of a corresponding external or somatic stimulus. Hallucinations feel like real experiences to the person experiencing them and can happen with any sense. Auditory hallucinations are especially common among people with psychotic disorders.

• Disorganized thinking and speech: Disorganized thinking or speech makes it difficult for a person to think or speak in commonly accepted ways. People with psychotic disorders might switch topics frequently, speak incoherently, or string together unrelated thoughts.

• Disorganized motor behavior: Disorganized motor behavior involves physical action that appears unusual or abnormal. People with psychotic disorders may appear agitated or repeat the same motion over and over again. In some cases, disorganized motor behavior means becoming less reactive to the outside world.

• Negative symptoms: Common examples of negative symptoms include difficulty expressing emotion, inability to experience pleasure, and a loss of or the decrease in the ability to speak.

The symptoms of schizophrenia and other psychotic disorders usually appear in early adulthood. Substance use, failure to take antipsychotic medications as prescribed, and environmental factors like stress can exacerbate the onset of symptoms.

Types of Psychotic Disorders

The symptoms of each type of psychotic disorder vary from person to person, and not everyone with a psychotic disorder will experience all five categories of psychotic symptoms. The major types of psychotic disorders include:

• Schizophrenia: People with schizophrenia experience two to five groups of psychotic symptoms within a month-long span. The diagnostic criteria of schizophrenia under the DSM-IV require that psychotic symptoms continue for at least six months. They must interfere with one major area of the person’s life (i.e., relationships, work, school). Clinicians use the term “schizophrenia spectrum disorder” to describe the variability of the presence of symptoms (catatonic, disorganized, paranoid, residual, and undifferentiated).

• Schizophreniform disorder: Schizophreniform disorder is similar to schizophrenia, but symptoms last between one and six months. If psychotic symptoms last for six months or more, an individual is diagnosed with schizophrenia.

• Schizoaffective disorder: Schizoaffective disorder has similar symptoms to schizophrenia. However, people with schizoaffective disorder also experience an episode of major depression or mania combined with psychotic symptoms.

• Brief psychotic disorder: People with brief psychotic disorder experience one or more of the first four categories of psychotic symptoms (delusions, hallucinations, disorganized thoughts/speech, and disorganized motor behavior). Unlike schizophrenia and schizophreniform disorder, brief psychotic disorder symptoms do not last longer than one month.

• Delusional disorder: People with delusional disorder experience one or more delusions over one month. Unlike schizophrenia, patients with delusional disorder do not experience other psychotic symptoms.

• Substance/medication-induced psychotic disorder: People with substance or medication-induced psychotic disorder experience delusions or hallucinations in response to a drug, medication, or other substance. This type of psychotic disorder can occur in reaction to substance abuse, alcohol abuse, or the use of hallucinogens, amphetamines, cocaine, or other substances.

• Psychotic Disorder due to another medical condition: This psychotic disorder is diagnosed when people experience delusions or hallucinations due to another medical condition, such as an endocrine disorder or autoimmune disorder. Bipolar disorder can also cause psychotic symptoms.

What Should You Do If You’re Experiencing Psychotic Symptoms?

If you or a loved one is experiencing a psychotic disorder, early intervention is critical. It’s essential to seek professional help for psychotic disorders to receive an accurate diagnosis, pursue potential treatment options, and effectively manage symptoms. The most effective treatment plans for psychotic disorders typically include:

• Therapy: Therapy can help patients with mental disorders live fulfilling and rewarding lives. Working with a mental health professional can help individuals with psychotic disorders manage their symptoms, cope with stress, and recognize the warning signs of a psychotic episode.

• Check-ups: Because psychotic disorders can be linked to medical conditions, it’s important to schedule regular check-ups with your health care professional to rule out physical conditions.

• Medication: Antipsychotic medication can reduce the symptoms of schizophrenia and other psychotic disorders. Your health care provider may prescribe antipsychotic drugs to help patients manage the symptoms of psychosis. Health care providers may also prescribe medicine to help manage co-occurring mental health problems, such as major depressive disorder, bipolar disorder, and obsessive-compulsive disorder.

• Support groups: Support groups allow young adults and late teens to connect with and learn from other young people with similar mental health experiences. The National Alliance on Mental Illness provides valuable mental health resources and educational programs for patients and family members.

• Hotlines: If you’re having suicidal thoughts, experiencing a psychotic episode, or need immediate support, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or National Alliance on Mental Illness Helpline at 1-800-950-NAMI.

What Should You Look For in a Therapist to Treat Psychotic Disorders?

For individuals with psychotic disorders, working with a mental health professional experienced in the treatment of schizophrenia-related mental disorders can provide the most effective treatment. Some common therapeutic approaches include:

• Cognitive-behavioral therapy (CBT): CBT helps patients change unhelpful thinking patterns and behaviors, manage psychotic symptoms, and develop coping mechanisms to distinguish between real and unreal experiences.

• Family therapy: Schizophrenia and other psychotic disorders are complex, and it can be stressful to help a loved one experiencing a psychotic episode. Family therapy enables family members to understand and learn how to support loved ones with mental disorders.

• Group therapy: Group therapy has been shown to provide valuable opportunities to socialize, boost self-esteem, and reduce anxiety among schizophrenia patients.

If you’re seeking professional help for schizophrenia or a related mental illness, consider reaching out to a therapist through WithTherapy. We’ll connect you with a qualified mental health professional you feel comfortable with, regardless of your personal preferences and requirements. One of the experienced mental health professionals on the WithTherapy platform will help you effectively manage your symptoms and learn healthy coping mechanisms to improve your quality of life.

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