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PSYCHOTIC DISORDERS – SCHIZOPHRENIA AND SCHIZOAFFECTIVE

When we say that someone has psychosis we mean that they have an impaired ability to perceive reality accurately. Severe confusional states, bizarre and unrealistic thoughts (delusions), hallucinations, and marked impairment in judgment and reasoning are all examples of psychosis. Because psychosis is a symptom it does not tell us the cause of the inability to perceive reality accurately. There are many different causes of psychosis. To make things simpler, it will be easier to group psychotic disorders into three broad categories: schizophrenia, psychotic symptoms associated with mood disorders like bipolar disorder and depression, and psychosis associated with neurological/medical conditions.

Schizophrenia

People with schizophrenia often have bizarre and unrealistic thoughts, hallucinations and strange behavior. Hallucinations usually consist of hearing things that other people don’t hear or seeing things that other people don’t see. Sometimes people will think that the television or radio is communicating special messages to them or that people are putting ideas into their head. Frequently, people with schizophrenia will prefer to be alone and withdraw from social situations.

Preventing measures for Schizophrenia

Schizophrenia is a chronic disorder that must be treated with antipsychotic medication. In addition, more recent (and preliminary) research is showing that omega-3 fatty may help prevent the onset of schizophrenia and may be helpful in modifying symptoms in addition to antipsychotic medications.

Antipsychotic Medication for Schizophrenia

Word of caution: Because schizophrenia is a chronic and relapsing disorder it is important to continue taking the antipsychotic medication even if things seem fine. People will often stop their medications when things are going well and then their symptoms will return. Once the symptoms return it can often be difficult to get them controlled again with medication. Overall, the length of treatment is at least a year and usually much longer for chronic schizophrenia.

Antipsychotic medications are not addictive, but they can have side effects. It is important to discuss these side effects with your mental healthcare provider and let them know if you experience any of these. Most side effects can be treated. People on antipsychotic medication should avoid prolonged exposure to high temperature (such as being outside for a long time on a hot day). Drugs such as marijuana, amphetamines, cocaine, and other street drugs will exacerbate psychosis and should not be used.

Psychosis associated with mood disorders

People with bipolar disorder or depression can also have psychotic symptoms. This is most often the case when people are severely depressed or manic (an extreme energized state). The treatment for this type of psychosis in general is to treat the underlying mood disorder (depression or bipolar) and also treat the psychotic symptoms with antipsychotic medication until they are controlled.

Psychosis associated with neurological/medical conditions

There are many medical problems that can manifest with psychotic symptoms. It is important to distinguish between these disorders and schizophrenia because the treatment will be different. When the psychosis is secondary to a medical condition it is important to address the underlying medical condition.

Examples of medical disorders that cause psychosis include:

  • Adrenal gland diseases
  • Brain tumors
  • Brain or spinal cord infections
  • Trauma to the brain
  • Alzheimer’s disease and other dementias
  • Folate deficiency
  • Huntington’s disease
  • Multiple Sclerosis
  • Thyroid disorders
  • B12 deficiency
  • Lupus

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