Psychosis

A psychosis means that you experience reality changed and different, and have a hard time distinguishing between fantasy and reality. For example, you can hear voices or feel persecuted, though no one else sees it that way. Early treatment reduces the risk of new psychoses.

Sometimes a psychosis is because you have a so-called psychotic illness, but not always. For example, a traumatic event, illness, or use of certain drugs may trigger psychotic symptoms.

The most common psychotic illness is schizophrenia, which you can read more about  here.  You who are related to someone who has a mental illness can read more  in this article .

Symptoms of psychosis

A psychosis can come on suddenly or develop over a long period of time. It can last for a few weeks, or several years. A psychosis can come a single time or come back repeatedly. When you are in a psychosis you are usually very busy with your own thoughts and experiences, which can be very intense.

You may have had a psychosis if you have the following symptoms:

  • Delusions
  • hallucinations
  • thought disorders

These symptoms are sometimes called positive symptoms. This means that symptoms are added to a person. The opposite is negative symptoms, and are those taken from a person.

Examples of negative symptoms are being apathetic, forgetful or losing the ability to communicate with the surroundings. Negative symptoms are common in schizophrenia.

Delusions

When you have delusions, you perceive existence changed or different. Others often find it hard to believe you when you tell about your experiences. For example, you may feel persecuted even though no one else sees it that way. It’s called paranoia.

It is common for you to feel monitored, or think that you have supernatural powers and are selected to do something significant. Another common experience during a psychosis is that you feel threatened, that you are exposed to radiation or something else harmful.

You may also think that you have contact with dead people or a higher power, which can be evil or good. You may also find that things in the area send signals or messages directly to you, for example via radio, television or the internet. The experiences can be very powerful, and feel real.

hallucinations

Hallucinations are the mental impressions that you may experience during a psychosis. You experience them as real, even though it doesn’t match reality. For example, you can hear voices or sounds that no one else hears.

Sometimes it is possible to recognize the voices, but they can also be perceived as foreign. It may feel like they are coming from inside the head, or they are coming from the outside. The voices can comment on what you do or what you look like, often in an unpleasant way.

The voices may also encourage you to do things that can sometimes be dangerous or risky. It can feel difficult to resist the votes.

Sometimes hallucinations may mean that you see things that others do not see, but this is less common. You can also feel scents that no one else knows, or experience things happening in the body that cannot be explained.

thought disorders

When you have mental disorders, you have a hard time thinking about a thought, and thinking contiguous thoughts. It may feel like new thoughts are coming in and interrupting. You may also find that your thoughts are being transmitted to other people, or that others know what you are thinking.

Mind disorders can also affect your way of talking, writing and reading. You might stop talking in the middle of a sentence, or suddenly start talking about something completely different. You may also have difficulty following a reasoning or reading a text without losing focus.

Other symptoms associated with psychosis

Experiences during psychosis can cause strong anxiety . You can have a hard time getting to rest and sleeping both before, during and after a psychosis. You may also feel apathetic, listless and powerless or have other symptoms reminiscent of depression .

A psychosis can sometimes be triggered during a manic period, when you are aroused and have a very hard time getting to rest and sleeping. Read more about mania in the article about bipolar disorder .

There is an increased risk of suicidal thoughts and suicide attempts in psychosis. This is one of the reasons why it is important to seek care on time.

How a psychosis can be felt for others

Psychotic behavior can be felt in different ways, depending on what experiences you have during psychosis. Some people live out their thoughts and feelings in a way that is felt by others, while others pull away and become passive and inward.

For the surroundings, it is often clear that the person suffering from a psychosis behaves differently or strangely. It can be difficult to get in touch with the person, who is often full of their own experiences, which is often inexplicable to the surroundings.

An example is that the person talks about their delusions, such as being persecuted or threatened. It can also be noted that the person cannot listen to what someone else is saying, or speak for themselves. For example, the person may suddenly start laughing, for no reason.

The person often isolates himself, and avoids or gets into conflict with other people.

Read more about being close to someone with psychotic illness here.

When and where should I seek care?

Contact a health care center if you have symptoms of a psychosis or if you think you are developing a psychosis disease. You can also contact a psychiatric clinic directly.

  • You hear voices urging you to perform actions that you feel you cannot resist
  • You are worried that you may be hurting yourself or someone else.
  • You feel very bad and have thoughts of taking your life.

If you are under 18 years of age

Contact in the first place, contact student health or a youth reception . You can also contact a health center or child and adolescent psychiatry, BUP .

Talk to an adult about how you’re feeling, and ask that person to help you seek care.

If you have had a psychosis before

Contact your psychiatric ward if you have had a psychosis before, and notice that you are getting sick. A relative can also contact the care provider in your place.

Treatment and support for psychoses

The purpose of the treatment of psychosis is to treat the symptoms, and reduce the risk of having a new psychosis. You often need several types of treatment:

  • Treatment with drugs.
  • Psychotherapy or call support.
  • Training, group meetings and support efforts.

Medication  can relieve the symptoms , but does not remove the cause of psychosis.

It is important that you get to sleep properly as soon as possible, if you have recently had a psychosis. You can also get treatment with medicines for insomnia, anxiety suppressants and antidepressants.

Conversational therapy can help you process your experiences and strengthen your self-confidence. Having a psychotic illness can often be associated with shame and anxiety, which you may need to get help dealing with. Read more about psychotherapy and psychological treatment .

In addition to the treatment given during the first period, you often need other support to recover in the longer term. It is the social service in your municipality that is responsible for that part of the treatment. You apply for the intervention yourself, with the help of relatives or your contact person.

What can I get for support?

The support can, for example, be part of a conversation group with people with their own experience or you get a housing assistant who comes to your home to help you with everyday chores, such as cleaning, washing or paying bills.

An important part of the support is that you and your loved ones together learn about psychosis and psychosis treatment, so-called psycho education.

The purpose of the support efforts is to make you feel better and be able to cope with your everyday life and be able to recover and come back to a life that you enjoy.

You should be able to feel safe

It is important that you feel safe in the place where care is provided. You can be treated at a psychiatric clinic or at home. The faster you can get treatment, the faster you can recover.

You will receive a contact person if this is your first time receiving psychiatric care. It may be someone who specializes in psychiatry, a nurse or an experienced mental health nurse.

It is important that you trust and feel confident in your contact person. Talk to your doctor if you do not like your contact person. You have the right to get a new contact person because it is an important person in your recovery.

You should be involved in your treatment

It is important that you are involved in the decisions regarding your treatment, as far as possible. The treatment should be based on you and your needs. The goal is for you to come back to a working everyday life. Your relatives can join in and plan if you agree to it.

If you have been in contact with care for a long time, you can request a coordinating contact person or so-called permanent care contact . Read more in the section Influencing and participating in your care.

After how long do you feel better?

How long a psychosis will last is hard to know. The amount of treatment needed varies from person to person.

Many people often get better within one to three months after becoming ill, if the drugs have an effect. It is common to experience strong feelings of depression, insecurity and anxiety up to one year after the illness.

The recovery to get a working everyday life is a process that is moving forward, though it may take time. The risk of getting sick in a new psychosis decreases the longer it goes.

Psychosis due to a psychotic illness

Mental illness is a collective name for illnesses where reality is perceived differently. The most common psychotic disorder is schizophrenia. Other psychotic disorders are reactive psychosis, schizoaffective syndrome and delusional syndrome.

When you are diagnosed with a psychosis, it is important that the doctor first ensures that the psychosis is not due to another underlying illness, injury or condition.

Reactive psychosis

A reactive psychosis can be triggered in connection with a particularly frightening or severe event, such as, for example, violence or abuse. Such an experience is called a mental trauma. Then the symptoms will come into contact with the event fairly quickly.

The psychosis reaction also goes on quickly, often in less than two weeks or for at most about a month. Such a psychosis is called reactive or acute and transient.

Reactive psychosis does not have to lead to long-term illness. However, psychosis may come back in connection with a new trauma. If a reactive psychosis comes back, it may happen that it becomes a longer-lasting psychotic illness. 

Schizoaffective syndrome

Schizoaffective syndrome is similar to schizophrenia , but at the same time has features of bipolar disorder . This means that you have alternating manic and depressive periods. Between these periods you may have psychosis symptoms without either mania or depression.

Schizoaffective syndrome differs from schizophrenia in that it is not enough for antipsychotic medication alone. Then you also need to take a mood stabilized drug such as lithium.

Once you have found the right treatment and take your medication without interruption, you can often have a working everyday life, without getting sick with new psychoses.

delusional Disorder

Delusional syndrome means that you have a belief about something that does not match reality. The conviction may seem reasonable, thus sound credible to the environment but still lacks a basis for reality.

For example, the delusion may mean that you are convinced of one of the following:

  • That you are persecuted.
  • That you are admired from a distance.
  • That you are powerful or specially selected.
  • That you are deceived by your partner.
  • That you have a disease.

You often have difficulties in close relationships, but otherwise work well in society. Some people with delusional syndrome are often preoccupied with their ideas and withdraw from other people when they discover that others do not share their views.

It is uncommon for those who have delusions to seek care. Therefore, there is no indication of how common it is. However, the person can be discovered during a criminal act, such as pursuing someone who believes they have a love relationship with or who they are convinced is deceiving them.

If a person with delusional syndrome comes into contact with health care, they often find it difficult to accept treatment because they still believe in the delusional disorder.

postpartum Psychosis

The risk of getting sick in a new psychosis increases in pregnancy. It depends on the hormonal change in the body. The risk increases especially at the end of pregnancy, during childbirth and in the months following childbirth.

A birth psychosis is an unusual but serious form of psychosis. For the psychosis to be classified as a birth psychosis, the psychosis must have arisen within six weeks after childbirth. If you have had a childbirth psychosis there is a risk that the psycho condition may return. 

Talk to your midwife or doctor if you become pregnant, have had a psychosis before and are worried about getting sick. Read more about pregnancy and drugs in medicines for schizophrenia and psychosis .

Psychosis due to another illness, injury or condition

Sometimes the psychosis may be due to an underlying illness or may have been triggered by some physical injury or condition affecting the brain. It is important that it is properly investigated, to rule out that psychosis is due to one of these conditions.

Then you may not need antipsychotic treatment, but should instead receive treatment for the cause of the symptoms. Here are some illnesses, conditions and injuries that can cause psychotic symptoms.

Injury or damage to the brain

A brain injury can cause psychotic symptoms, especially if the injury is in the forehead or temporal lobe and causes epilepsy. It also applies to certain hormonal diseases, tumors and inflammations of the brain.

Early dementia, cortisone drug overdose, and severe nutritional deficiency can also trigger psychotic symptoms.

drugs

Many drugs can trigger psychosis. Some examples are cannabis, amphetamine, PCP, LSD and Ecstacy. It may also be new synthetic drugs that are spread over the internet, although some of them are not yet drug classified. Examples of such drugs are Spice, NPS and MDPV.

Most often, psychosis decreases when the drug is no longer in the body. The exception is cannabis, which can both trigger and cause lasting symptoms of psychosis.

Influence and participate in your care

Being able to influence and participate in your care is a right that is regulated by the  Patient Act . In order for you to be involved in your health care, it is important that you understand what the health care provider says.

Ask if you do not understand

Ask questions  if you don’t understand. Once you have received information about the treatment you can give your consent or express a yes in another way. You can also refuse a treatment. Someone who does not give their consent can only be treated if they receive care with the support of  the Psychiatric Compulsory Care Act .

Fixed care contact and interpreter can be a good support

You are entitled to a so-called  permanent care contact  if you meet many different people in connection with your care. It is a person who among other things helps to coordinate your care. It can often be the same person as the coordinating contact person.

The interpreter can often be booked by the health care center or reception that treats you. It is good to inform the healthcare provider at the first contact if you need interpretation. The interpreter has a  duty of confidentiality  just like everyone else who works in the health care sector. This means that they are not allowed to disclose information about you.

Coordinated individual planning

When both psychiatry and social services are to work together on your treatment, it can be good to have joint meetings, where you can plan your care and treatment. It is called SIP meetings, and is an abbreviation of coordinated individual planning. 

SIP can be a good support for you and your loved ones by making it clear who is responsible for what. In psychiatry on the one hand, and in the social services on the other.

To get a SIP, you need to give your consent. The plan may not be changed unless you are a member. You can take the initiative for a SIP yourself. Ask your contact or a relative for help if you need it. Read more about regular care contact and SIP here.

If you are not satisfied with the care

You have the right to complain and to comment if you are not satisfied with the care you receive. This applies whether you are dissatisfied with the psychiatric care or the care you receive, for example at a health care center. There are several ways you can complain . A relative may also complain to you if you give them your permission.

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