Understanding Different Types of Psychosis and Why Accurate Diagnosis Matters

Psychosis does not describe a particular mental health disorder. Rather, it is a symptom that can arise out of a variety of psychiatric and physical illnesses that cause you to lose touch with reality. These include:

Brief Psychotic Disorder: Brief psychotic disorder occurs when psychotic symptoms appear suddenly and resolve quickly, lasting less than a month. This psychosis is not related to any other mental illness or substance abuse and is often triggered by overwhelming distress, such as trauma or the death of a loved one. Women may experience brief psychotic disorder postpartum. However, this disorder may also appear with no known trigger.

Schizophrenia: Schizophrenia is a chronic mental health disorder that causes psychotic symptoms to persist for at least six months and significantly interfere with your loved one’s ability to function. Psychosis is typically preceded by a variety of early, non-psychotic symptoms such as mood and sleep disruptions, lack of motivation, social withdrawal, and difficulties performing professionally or academically.

Schizophreniform Disorder: Schizophreniform disorder shares the symptoms of schizophrenia for at least one month but does not last longer than six months. If symptoms do persist, it is an indication that your loved one is suffering from another mental health disorder.

Schizoaffective Disorder: People with schizoaffective disorder experience psychotic symptoms along with mood disturbances, such as depression or mania. In order to be diagnosed with schizoaffective disorder, mood disturbances and symptoms of schizophrenia must occur simultaneously at times. However, psychosis must also be present for a minimum of 2 weeks when your loved one is not experiencing a major mood episode.

Bipolar Disorder: Bipolar disorder is at its core a mood disorder, but some people may experience psychotic symptoms during particular mood episodes, and these symptoms typically relate to the state of mood. For example, if your loved one is in a deep depressive episode, they may have auditory hallucinations telling them that life is not worth living. During mania, however, they may have delusions that they are destined for greatness or have special powers.

Depression: Although depression is a mood disorder, people with severe forms of the illness may experience psychotic symptoms. This is known as depression with psychotic features or psychotic depression.

Drug-Induced Psychosis: The use of certain types of drugs, including alcohol, marijuana, cocaine, amphetamines, and LSD, may cause psychotic symptoms. Typically these symptoms resolve as the drug wears off, but in some cases, symptoms can persist.

Organic Psychosis: Organic psychosis means that psychotic symptoms are the result of illnesses such as neurological disorders, brain injuries, endocrine diseases, autoimmune disorders, and sleep disorders. They may also manifest in connection with infectious and post-infectious syndromes such as HIV/AIDS, syphilis, Lyme disease, and even the flu. The nature and duration of these symptoms vary based on the individual and the specific illness.

Delusional Disorder: People with delusional disorder have fixed false beliefs, or delusions, lasting for at least one month. These false beliefs often revolve around a specific theme, such as persecution, grandiosity, jealousy, and somatic delusions, but may also be a combination of multiple themes or no identified theme at all. Those with delusional disorder do not experience hallucinations or exhibit bizarre behavior and their delusions do not typically impair function.

If your loved one has experienced a psychotic episode, it is important that they are thoroughly evaluated by skilled clinicians as soon as possible in order to determine the cause of their psychosis. This is vital, as different types of psychosis will require different kinds of treatment and identifying the underlying condition is essential to ensuring your loved one receives the care they need to heal. Often, you will play a central role in the diagnostic process, as you can provide a perspective on your loved one’s condition that they lack due to their illness.

In some cases, diagnosis is made quickly and treatment rapidly resolves symptoms. However, if there is significant substance use associated with the psychosis, monitored detox from the substance in a residential facility followed with assessment, psychological and neuropsychological testing, and observation are helpful to get to an accurate diagnosis and appropriate treatment plan. It is also possible that there exists an underlying psychiatric illness such as schizophrenia, schizoaffective disorder, bipolar disorder, or depression which may be too severe to be handled on an outpatient basis. In either case, long-term residential care may provide a better environment for your loved one to heal.

In long-term residential treatment environments, your loved one can participate in in-depth assessments and be continuously monitored to achieve diagnostic clarity, allowing clinicians to ensure they can distinguish between closely related disorders to avoid misdiagnosis. Once your loved one has been correctly diagnosed, they can engage in a comprehensive treatment plan tailored to their unique needs using both pharmacotherapy and psychotherapies designed to address their symptoms.

It is important to remember that psychosis is only one of the symptoms they are likely experiencing; simply preventing psychotic episodes does not provide the relief most people with psychotic illness need to live healthy, rich, productive lives. As such, treatment must target both positive and negative symptoms—including thought, behavior, and mood components—while simultaneously imbuing your loved one with the skills they need to increase functionality and process any trauma brought on by their psychosis. By participating in a comprehensive treatment plan that evolves with their changing needs, they may not only gain control of their symptoms but also expand their own ability to create the life they want.