Psychotic Disorders

Psychotic disorders are mental health conditions characterized by a disconnection from reality, known as psychosis. Psychosis is a collection of symptoms, such as hallucinations and delusions, but it’s not a disorder in itself. Symptoms of psychotic disorders tend to have a severe impact on not only a person’s quality of life but also their safety. 

If a person is experiencing severe psychotic disorder symptoms, including psychosis, and they’re a danger to themselves or others, call emergency services.

An episode of psychosis occurs approximately in 50 out of every 100,000 people. The symptoms of psychosis include:

Hallucinations — Perceiving things that aren’t real, such as seeing something that isn’t there or hearing a nonexistent sound

 Delusions — Having false, rigid beliefs that aren’t based on reality or evidence, like a person believing they’re being followed by someone who wants to hurt them

Disorganized speech and thoughts — Having trouble organizing and relaying information in an understandable way, causing incoherent speech or rambling

Of course, not every experience of psychosis is the same. Here are some examples of psychotic disorders:

Schizophrenia 

Schizophrenia is a mental health condition that affects the clarity of a person’s thoughts, emotions and behaviors. It involves symptoms of psychosis, such as disorganized speech, hallucinations and delusions. It can also involve concentration and memory issues, making it difficult to carry out everyday tasks. People with schizophrenia can become withdrawn from others due to the lack of emotions and behaviors that are socially expected.

Schizophrenia is a long-term mental health condition. It can persist or worsen without proper treatment.

Schizoaffective disorder

It’s possible to experience symptoms of both schizophrenia and a mood disorder, like bipolar disorder or major depressive disorder. People with schizoaffective disorder can experience delusions, hallucinations and intense mood changes — but they may not all occur at one time. 

This disorder can involve depressive or manic episodes that interfere with a person’s ability to carry out their daily activities and maintain relationships with others. Episodes are followed by periods of improved emotional stability before the arrival of another episode.

Brief psychotic disorder

A person can have a short-term psychotic disorder that doesn’t last longer than a month. This is called brief psychotic disorder. Even though it’s temporary, it can cause severe symptoms that develop suddenly. It’s possible to return to regular functioning after the period of symptoms is over. 

Although they can occur without a clear cause, brief psychotic disorders are often linked to a traumatic event or experience. They typically aren’t related to other mental health condition diagnoses.

It’s also possible to experience psychosis as a result of taking substances, such as cannabis or psychedelic drugs.

Like all mental health conditions, there isn’t one clear cause of a psychotic disorder. It’s often a combination of many factors that increase the likelihood of developing psychotic symptoms. Many of the factors are out of a person’s control. Here’s an overview of the most common factors that can contribute to the development of psychotic disorders:

Biological factors

• Genetic predisposition from a family history of psychotic disorders
• Multiple gene variations
• Altered chemistry in specific regions of the brain
• Brain damage

Environmental factors

• Traumatic experiences, especially during childhood or adolescence
• Persistent stress or stressful life changes (e.g., losing a job)
• Substance use
• Exposure to toxins (e.g., lead, air pollution)

Medical conditions

• Infections (e.g., meningitis)
• Brain tumors
• Epilepsy
• Dementia or Alzheimer’s disease

Being diagnosed with a psychotic disorder is a thorough, comprehensive process. The goal is to determine if you align with the diagnostic criteria of a disorder. The criteria are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).

Assessing a person for a potential psychotic disorder involves:

Medical history review

As part of the initial assessment, the provider will ask questions about the client’s medical history and family history. This review is to identify potential risk factors for a psychotic disorder as well as learn about past mental health treatments to determine recurring issues.

Physical exam

It’s important to rule out other possible explanations for the symptoms, such as a medical health condition. This can include a general physician checking for signs of infections or brain damage that could lead to psychosis symptoms.

Psychological evaluation

A diagnosis requires a full mental health assessment by a physician, psychiatrist or psychologist. A psychological evaluation involves discussing one’s thoughts, feelings, behaviors and potential perceptions to see how they may align with psychotic disorder symptoms. The person will also be asked to share about how they believe their quality of life has been affected by the concerns.

During the evaluation, the provider will determine if the person is experiencing symptoms that fit a psychotic disorder diagnosis, as well as the severity of the symptoms, to determine the level of care that may be needed. 

Lab tests

A provider wants as much information as possible before making a diagnosis and resulting treatment plan. Lab tests may be used in an assessment for a mental health condition. They provide a comprehensive view of a person’s overall health. A few example tests that a person may be asked to undergo include a blood test, urine test and CT scan.

Treating a psychotic disorder can vary from person to person. Acute episodes may require hospitalization. However, every client experiencing psychosis-related symptoms can benefit from therapy and medication to help manage their symptoms and improve their overall quality of life. The best outcomes stem from a combination of the two. 

Therapy

Psychotherapy is a core element of psychotic disorder treatment. Talking to a therapist can help people with psychotic symptoms gain a deeper understanding of their emotional and mental health. They’re able to express themselves in a safe, judgment-free zone while developing skills that can help them reduce symptoms.

There are several different psychotherapy approaches that can help a person with a psychotic disorder. Cognitive behavioral therapy (CBT) is usually one of the most effective. CBT focuses on the relationship between thoughts, emotions and behaviors. It works to acknowledge and adjust negative thought patterns that contribute to symptoms, such as distress that leads to harmful behaviors.

Medication

Most people who have been diagnosed with a schizophrenia spectrum disorder will be prescribed antipsychotic medication, for example, aripiprazole (Abilify). Antipsychotics work to reduce symptoms like hallucinations and delusions that come from having too much dopamine in the brain. Dopamine is a neurotransmitter that affects emotions as well as the mind’s pleasure and reward system. The medication works to block the dopamine receptors to decrease the levels and reduce the symptoms.

Psychotic disorders are severe mental health conditions that require intensive levels of care during episodes. Even though regular therapy sessions and medication can help, many people with psychosis require more support for their behavioral health. At Guidelight, we offer the following levels of care:

Intensive Outpatient Program (IOP)

Our Intensive Outpatient Program can help people who need more steady care for their psychosis than what can be provided through outpatient therapy. It involves intensive care that still allows you to continue with regular activities to maintain a sense of stability throughout your week. Guidelight’s IOP takes place over six weeks. Treatment involves programming that lasts three hours per day for three days each week.

Our IOP involves programming that combines one-on-one and group therapy sessions. In your individual sessions, you’ll talk through your challenges with a licensed therapist and gain the skills necessary (e.g., CBT techniques like challenging negative thinking) to help you navigate them.

In group sessions, you can learn coping strategies for hallucinations and delusions by seeing what has helped others who have similar experiences. You can also find comfort in having a support system of people who can relate to you. 

Partial Hospitalization Program (PHP)

Our Partial Hospitalization Program is an excellent option if you need intensive, structured support, especially if you’re transitioning from inpatient care, such as being admitted into a hospital after an episode. While you’ll still receive acute care that combines highly individualized one-on-one and group sessions, you’ll be able to return to the comfort of your home each day. 

At Guidelight, our Partial Hospitalization Program takes two weeks to complete on average. Programming takes place every weekday, leaving your weekends free for your regular routines. It requires 30hours per week, with five hours of treatment, Monday through Friday.

Not only does our PHP focus on therapy using evidence-based modalities like cognitive behavioral therapy, but we also make sure that every client has proper medication management. We ensure that your prescription is as effective as possible, which may include changing the type or dosage if you’re having severe side effects or if it’s not helping you progress.

Guidelight helps adults with psychotic disorders get the support and care they need. We do help adolescents as well, ages 12-17, though psychosis is less common in younger people. We believe in helping clients get the support they need as quickly and efficiently as possible. Guidelight is a direct access provider. Whether referred by a provider or self-referred, you can receive an evaluation within 24 hours of the referral. 

Everyone has a seat at Guidelight. Contact our team today for more information or to schedule an initial evaluation.