Episode 4: What is Psychosis?

Psychosis is a word that gets spoken a lot, but that gets discussed very little.

About 1 of every 11 people will experience psychosis at some point in their lives. But even though it’s a common experience, we hardly ever talk about it.

In this episode of Ask A Psychiatrist, Dr. Erik Messamore and Melissa Xenophontos discuss psychosis.

Dr. Messamore explains what psychosis is, how it happens, and what to do about it.

We learn that it’s easier to understand – and probably more accurate – to think of psychosis as a misperception syndrome.

Psychosis by itself is not a standalone diagnosis. Rather, it’s a symptom that can have many different causes.

It’s important that anyone experiencing psychosis have a thorough medical and neurological evaluation to look for the cause. A medical explanation needs to be ruled out before viewing psychosis as a symptom of a mental illness.

Mental Health America has an online questionnaire that can help someone determine if they are experiencing psychosis.

Dr. Mesamore’s website has a blog post that lists the recommended medical tests to rule out medical causes of psychosis.

Click here if you’d like to ask a question or suggest a topic to address in a future episode.

If you’ve found this information helpful, please share it with your network!

KEY TAKEAWAYS:

• (02:00) – No standardized definition of psychosis, introduced in medical literature around 1843
• (03:04) – Psychosis should be thought of as misperception syndrome
• (04:45) – The brain receives about 11 million bits of information per second but conscious awareness works at about 50 bits per second. The necessary “information editing” is where a lot of misperceptions can develop.
• (09:00) – Misperceived significance can lead to the unusual ideas that often arise in psychosis
• (13:23) – Psychosis has many possible causes
• (15:00) – Progression of how to treat psychosis
• (18:56) – Medications can be a helpful piece of treatment, but should usually not be the only kind of treatment
• (21:04) – The goal of treatment is to get unquestionably better
• (22:39) – It’s important to talk about side effects in order to avoid or reduce them
• (25:12) – Specific symptoms of psychosis

QUOTABLE:

• “The accurate way to think about psychosis is a misperception syndrome or a phenomenon, technically and realistically it is best to think about psychosis as a neurological symptom.”
• “Conscious awareness is kind of like the dashboard of the entire brain processing.”
• “Psychosis is fairly easy to recognize, but once it’s recognized, the next step should not be an assumption that there’s a mental illness. The next step should be the assumption that there’s a medical disease going on that needs to be figured out and treated quickly.”
• “There are about 50 different diseases that can cause psychosis as a symptom… about 100 different medications or drugs which can cause psychosis as a side effect.”
• “Nobody should assume that psychosis means schizophrenia at all – it could be many other things.”
• “The goal of treatment is to restore a person’s function – the treatment should work; the treatment should make somebody better.”
• “Any clinician who is worth having should be extremely interested in hearing side effects, and should work with you to prevent, reduce, or eliminate them.”

About the Host:

Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He’s a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate.