When your average person says the word "psychotic," they're typically referring to someone "weird" or "wacky" or "wild." The word "psychotic" actually means that a person has lost touch with reality. At the time of a psychotic break, a person with a psychotic disorder is not seeing things in a way that is consistent with generally recognized facts, or is finding it difficult to communicate or find common ground with anyone else. There is more than one way to lose touch with reality. A person can have hallucinations and believe they hear voices or other noises that don't exist, or they can actually see things. A psychotic person can also start to feel confused, disoriented and jumbled. Yet a third kind of psychosis is to become delusional and believe things are happening that are not, or that one is part of a grand scheme or is being plotted against in some kind of grand conspiracy.
People can have some of the symptoms related to psychotic disorder for other reasons. Substances and other chemicals can lead to some of these symptoms, either when ingested or absorbed (substance, chemical or hallucinogen intoxication), or when the body has become accustomed to those substances or chemicals and then develops withdrawal (delirium). Sometimes when the brain malfunctions in various ways that are not related to psychosis, such as when someone develops dementia, confusion can develop that is not completely dissimilar to psychosis. But psychosis develops for very different reasons than substance abuse, delirium or dementia, and thus the character of psychotic symptoms differs quite significantly from those experienced due to chemicals or deterioration of the brain.
In psychosis, confused symptoms, hallucinations, and/or the experience of special importance within strange and twisted conspiracies occurs due to the experience of extremely intense and seemingly destructive emotions quaking and churning within a person who is desperate to deny such emotions. Psychotic symptoms can arise due to either the intensity of the emotions, or the rigidity of the need to deny the emotions, or both. The more intense the emotions, the less rigid one's denial and repression must be for psychosis to develop. The more rigid one's denial and repression, the less intense the emotions need to be for psychosis to develop. Psychotic symptoms are most typically a part of two particular diagnoses, bipolar disorder and schizophrenia.
When psychotic symptoms occur in the bipolar patient, the primary cause is the intensity of emotions. Human emotions are animalistic in nature. That is, human emotions are a more developed version of the survival instincts of the lowest creatures, whether those creatures are more the vicious type or the timid type. Thus, the intensity of human emotions at the extremes can often and easily develop into murderous thoughts or a desire to rip and shred and split. On the other hand, one might become so frightened of violence and aggression in the everyday workings of common day to day experience that one develops a desire to vanish completely or disappear. It's also a common human experience to feel as though one's swallowed up by the chaos of the world and is out of control, or that one's importance is so ubiquitous that one is the controller of life itself or that life itself is the story of that person. In the bipolar person who becomes psychotic, it is primarily the intensity of the emotions that makes it difficult to contain those emotions. The feelings themselves simply have too much potential for destruction to oneself or to loved one's. The intensity itself is not, however, the entire problem. Without some need to deny or repress these intense impulses because they are so destructive, there would be no need for the impulses to be twisted into psychotic symptoms.
In the schizophrenic patient, psychotic symptoms often arise primarily due to rigidity of thought and defense against harmful emotions. The same kinds of emotions described above are often at the core of the problem, but they need not be so intense to cause psychotic symptoms because the schizophrenic has a need to twist and distort the feelings merely because they believe so strongly that these feelings are horrible and unforgivable. The schizophrenic typically has an extremely powerful belief in right and wrong that can be either genetic or trained into them from experience. The schizophrenic often sees any thoughts even remotely close to those described above as extremely damaging, inappropriate, bad, and deserving of punishment. Beliefs about right and wrong in the schizophrenic are so powerful, in fact, that normal feelings of anger, desire, embarrassment, fear, guilt or shame, can lead to psychotic symptoms even though such feelings are so common and not typically thought to be particularly dangerous or harmful to others.
The psychotic need to create symptoms that make little sense, or that do not fit with what others perceive to be reality, or the need to lose touch with what others view as safe and reasonable, often comes from getting too close to the feelings described above because those feelings are potentially so damaging to oneself and to others. In the bipolar patient, psychosis will often occur due primarily to the intensity of the emotions, but also because those emotions could be dangerous if allowed to dominate one's mind unabated. In the schizophrenic patient, psychosis will often occur due primarily to the feeling that even small amounts of these extreme emotions are completely unacceptable. But in identical fashion to the bipolar patient, with the schizophrenic it is the dangerousness of the emotions that remains the central problem.
If one is extremely threatened by the aggressiveness or chaos of the world, it might make sense to withdraw into oneself rather than to perish or disappear. When the mind is convinced that the only other option is psychological death, psychosis can appear to be a far preferable alternative. If a person is having murderous or suicidal impulses and they have been taught to be "good," it can make sense for them to start hearing voices or start seeing things that express those feelings rather than to ascribe those feelings to oneself and being "bad." Within the mind, it is a far better alternative to hear a voice telling one to kill others or oneself than to think of oneself as a killer or as suicidal. Likewise it is a far better alternative to see images related to death than to actually make those images occur in real life. When a person is feeling like they are the ruler of the world, or that their importance is magnificent to the extreme, it can make sense for them to build up a grandiose scheme of their own instrumental importance for the existence of the world. A paranoid plot becomes the clear choice when the only alternatives appear to be accepting one's lack of importance or soberly facing disdain from others who will not tolerate solipsistic grandiose beliefs.
The psychotic process involves a conflict within the mind between horrible, life threatening and relationship damaging emotions on one hand, and the fear of what will happen if those thoughts are directly expressed on the other. Interestingly, it is the expression of the psychosis that results in the ultimate alienation of the individual with psychotic symptoms. Psychotics are generally shunned due to their odd and nonsensical behavior. Nevertheless, those symptoms present a far better alternative, and much less destruction to the world or oneself, than the direct expression of the intense emotions the psychotic fears within themselves. Those emotions, if unleashed, would lead to the most unabashedly aggressive and violent and suicidal impulses imaginable.
Given the circumstances of the particular individual afflicted with psychotic disorder, its symptoms can arise due to extreme intensity or extreme rigidity or both. Intensity can be innate or developed. Rigidity can also be innate or developed. But no matter the particular reason the psychotic symptoms arise, the fact that psychotic symptoms do arise, as opposed to unadulterated animalistic instincts, is far preferable to the extremity of emotional behavior that would occur without the psychosis. In an odd way, psychotic symptoms are actually an expression of an individual's desire to control their animalistic instincts so that they and others are not severely damaged.
In that way one can come to understand why there always appears to be some real sense of humanity in those who become psychotic. With very few exceptions, individual's who become psychotic have been taught to care about others very deeply, or have an inborn and tenacious connection with others. Even if most of the people in their lives have been abusive or manipulative, for some reason the psychotic individual has typically made some significant connection with others that prevents them from being able to act upon extreme emotions.
Some individuals with bipolar disorder or with severe personality disorders act out on extreme emotions with little or no compunction. The intensity of their rage, grandiosity, intimidation, depravity, paranoia or isolation manifests within their relationships often creating terrible trauma and immeasurable pain. Psychosis, as terrible as it is, especially for the individual plagued by its confusion and interpersonal alienation, is from a social perspective, a far safer alternative than the wild, self-centered, manipulative, vitriolic, and often aggressive behavior observed in the unbridled and tumultuous behavior of the most degenerate personality disorders or bipolars. Although psychosis is often thought to be the very worst kind of mental health problem a person can experience, it is somewhat contradictory that psychosis generally indicates some level of the one trait that truly differentiates relatively healthy personalities from relatively unhealthy personalities. A person with psychosis almost always feels some level of responsibility for his fellow man.
The treatment of psychosis has most recently become much simpler than it had ever been before. Medicines for psychosis are almost always effective in helping bipolars and schizophrenics to avert psychotic symptoms. Although at one point in time, psychotherapists believed it was possible to treat psychosis with interpersonal therapy alone, powerful medicines are almost always a part of successful treatment today. A mixture of antipsychotics, mood stabilizers, and antidepressants are typically prescribed. These medicines both calm one's intensity and relieve some level of rigidity. Psychotherapy does continue to be useful on a variety of fronts. Individuals with psychotic symptoms can learn to calm their own emotions and become less judgmental of themselves. Since they often have experienced trauma, discussion of traumatic events is often necessary. In addition, individuals with psychotic symptoms have often been traumatized by their own experience of becoming psychotic, both because they have completely lost control, and due to the interpersonal alienation experienced during a psychotic break.
Psychosis is the clinical term for losing touch with reality and really doesn't mean that the afflicted person is wild, flipped out, or wacky in the way most people seem to think. There are a variety of ways that psychosis takes form, including complete and utter confusion, the experience of hallucinations, and the belief in intricate delusions related to one's importance. Psychotic symptoms are caused by a combination of extremely intense emotions and a brittle rigidity of thinking about one's intense emotions. Bipolars who experience psychotic symptoms do so because their emotions are immoderately intense. In contrast, schizophrenics generally experience their rigidity as their primary difficulty. In both types, it is the perception that the expression of intense emotions could lead to interpersonal destruction that leads to the twisting of these feelings into psychotic symptoms. From an interpersonal perspective it is far better to withdraw into confusion, create elaborate plots or schemes regarding one's importance, or to hallucinate in symbolic ways, than to psychologically eviscerate others or oneself. Strangely, the experience of psychotic symptoms indicates some level of humanity within the person with such symptoms, as opposed to how the most antisocial of the personality disorders seem to directly express intense emotions regardless of how damaging to others that might be. Although individuals who develop psychotic symptoms suffer horribly, and may even be a burden at times, the purpose of their symptoms is to protect themselves and others from the licentious and savage violence their emotions are enacting within them. Thankfully, a mixture of medicine and psychotherapy can help those plagued by psychotic symptoms to regain a sense of normalcy.
With the right help, in fact, those with psychotic symptomology often return to lives of extraordinary and singular vision, of exquisite interests, and of intricacy of thought. With the right help, those afflicted with perhaps the most alienating of all illnesses, psychosis, make use of their most important attribute in regaining their lives. With treatment the relatedness and humanity within the psychotic, the same tendency that led to the urgent and severe sense of responsibility and need to protect others from the seemingly terrible eventuality of exposing others to the psychotics unbridled animalistic nature, begins to grow in a natural and organic fashion within themselves and helps to nurture lively, loving, and fulfilling interpersonal relationships.
