What is Psychosis?
“Psychosis” is a distorted or nonexistent connection with reality. A person with psychosis cannot distinguish between the external, objective “real world” & their own subjective perceptions which are distorted & characterized by delusions or hallucinations. Delusions & hallucinations seem real to the person who is experiencing them; confused & disturbed thinking often accompany them.
Psychosis is a serious mental disorder characterized by false thoughts (delusions) or seeing or hearing things that are not there (hallucinations). These are referred to as “positive” symptoms; “negative” symptoms, such as loss of motivation & social withdrawal, may also occur. These experiences can be frightening & may cause people who are suffering from psychosis to hurt themselves or others. [It is important to see a doctor right away if you or someone you know is experiencing symptoms of psychosis.] Psychosis affects only about three percent of the population.
When these symptoms are experienced as part of a mental illness, mental health professionals say people are having a psychotic “episode.” Psychotic episodes can vary in length: they can last for just a few days; they can continue indefinitely until they are treated; the symptoms can come & go. When people have a psychotic episode, they are often unaware that they are unwell; this “lack of insight” prevents them from seeing beyond their delusional reality.
People who have a serious mental illness, such as schizophrenia, bipolar disorder, schizoaffective disorder, or psychotic depression, experience some or all of the symptoms of psychosis. People who have some types of personality disorder can also experience these symptoms.
Signs of early stage psychosis include difficulty concentrating, depressed mood, sleep changes (sleeping too much or not enough), anxiety, suspiciousness, withdrawal from family & friends, & ongoing unusual thoughts & beliefs. Signs of later stage psychosis include delusions, hallucinations, disorganized speech (switching topics erratically), depression, anxiety, suicidal thoughts or actions, & difficulty functioning. If the symptoms are severe, people can find it impossible to tell the difference between the experiences they are having & reality, extremely difficult to think logically or talk about how they are feeling, or to put their strange thoughts, emotions, & fears in context.
The symptoms of psychosis may feel emotionally overwhelming. Delusions & hallucinations take over the way people see the world & severely alters their reality. A person experiencing these symptoms needs a quiet, calm & controlled environment to keep them safe. The risk is that the person acts on a delusional belief (e.g., they may believe they have the ability to fly & then try to jump out of a tenth floor window) which puts them, or another person, in danger.
What is the Science of Psychosis?
One type of neurotransmitter, which are chemicals in the brain used to communicate information between brain cells, or neurons, is dopamine, which is released during pleasurable experiences. When dopamine is low, someone with bipolar disorder may sink into a depressive episode, whereas, if the chemical level is higher, they may experience a manic episode—or, in my case, hypomanic episode. Drugs can release this chemical, which is why many people struggling with mental illness choose to self-medicate rather than seeking professional help.
Dopamine also has a role in memory, attention, problem-solving, & motor skills. Research has shown that too much dopamine in the brain can lead to hallucinations, delusions, or disordered thoughts, particularly during mania for someone with bipolar disorder.
Researchers think other neurotransmitters may also have a role in the development of psychosis & are carrying on studies to try to find out whether this is the case. Researchers are particularly interested in the neurotransmitters glutamate & GABA. Glutamate stimulates the brain while GABA slows down its activity. Glutamate is involved in many brain functions, including thinking, memory, & learning. Researchers think abnormalities in the activity of glutamate may have an effect on dopamine levels. Studies have shown that both stress & the use of cannabis can affect glutamate activity.
What are Delusions & Hallucinations?
Delusions and hallucinations can sometimes occur during a severe episode of major depression, with delusions being a much more common occurrence than hallucinations. These symptoms are commonly referred to as “psychotic” symptoms.
“Delusions” are false, illogical, or irrational beliefs that are held firmly despite it being contradicted by reality & what is commonly known to be true. Most bipolar delusions are grandiose, involving exaggerated feelings of power, wealth, sexual attractiveness, luck, or insight. These inflated beliefs about ability, or overall situation & prospects, can be very dangerous & may lead to reckless behavior.
In addition to grandiose delusions, other types of delusions include paranoia, where they might think they’re being followed when they’re not or that secret messages are being sent only to them through media, & somatic delusions where they believe they’re terminally ill when in reality they’re fully healthy.
“Hallucinations” are when a person senses things while awake that do not exist, but have been created by the mind. Hallucinations involve hearing, seeing, feeling, smelling, or sensing things which are not really there. Bipolar hallucinations tend to be brief, grandiose, often related to delusional beliefs, & often religious or mystical in nature (e.g., “seeing the face of God”).
Often people also experience heightened sensory perceptions such as colors being brighter and more vivid or music being “sweeter” & more complex & meaningful; this has happened to be during hypomanic episodes, & it beautifully mimics the euphoric highs of ecstasy/ thizz, molly (pure MDMA), or cocaine.
Visual, tactile, smell, & taste hallucinations are usually identifiable by the person’s interaction with the hallucination, such as visual focus on something you cannot see, or touching, scratching or brushing things off themselves that aren’t there.