Psychotic disorders are a category of mental health condition that contains a number of different specific disorders.
There are a number of psychotic disorders and they don’t have the same symptoms for everyone. That said, most psychotic disorders involve hallucinations, delusions, and/or other forms of losing touch with reality.
People with psychotic disorders often find that their symptoms seriously disrupt day-to-day life. However, even severe psychotic disorders can often be treated effectively.
Prevalence of psychotic disorders
It’s somewhat difficult to know for sure exactly how common psychotic disorders are. However, research suggests that they are more common than many people may think.
Experts often agree that schizophrenia (one of the most common psychotic disorders) occurs in about 1% of the population. However, one large study found that the percentage of people who will be diagnosed with some kind of psychotic disorder during their lifetimes may actually be closer to 3%.
Psychotic disorders are most common in teenagers and young adults (roughly age eighteen through age thirty-five), and they appear to be about equally common for men and women.
Symptoms of psychotic disorders
There are five categories of symptoms that all psychotic disorders share:
- Delusions: A delusion is a belief that is not based in reality. Someone experiencing delusional thinking isn’t just mistaken; they will continue to believe the delusional thought even if they’re shown evidence that it’s false. Delusions can range from fairly commonplace ideas (like being convinced that someone else is in love with you or hates you) to more bizarre ideas (such as believing that you’ve been abducted by aliens).
- Hallucinations: A hallucination is a sensory experience that is not based in reality. Hallucinations feel completely real to the person experiencing them, and they can happen with any sense (sight, hearing, taste, touch or smell). Auditory hallucinations (hearing things that aren’t there) are especially common in psychotic disorders.
- Disorganized thinking and/or speech: Put simply, this means that a person isn’t thinking straight or is saying things that don’t make sense. This might mean stringing together thoughts that seem unrelated, switching topics frequently, or in extreme cases, speaking in a way that’s totally incomprehensible to others (this is called “word salad”).
- Disorganized motor behavior: This is physical behavior that is extremely abnormal in one way or another. For example, it might look like being very agitated or doing the same motion over and over again. In some cases, it could also mean becoming much less reactive to the outside world (this is called “catatonia”).
- Negative symptoms: Negative symptoms have to do with things a person with a psychotic disorder doesn’t do. Some common negative symptoms include expressing little emotion, speaking very little, and feeling unable to experience pleasure in reaction to things that used to be enjoyable.
It’s important to note that not everyone with a psychotic disorder experiences all five categories of symptoms. Symptoms can look very different for different people and different kinds of psychotic disorders.
Types of psychotic disorders
Not all symptoms of psychotic disorders feat neatly into one of the following categories. That said, the major types of psychotic disorder are:
- Schizophrenia: People with schizophrenia experience at least two of the five categories of psychotic symptoms within the same month-long span. These symptoms continue for at least six months, and they cause significant issues in at least one major area of the person’s life (such as work, school, or family life).
- Schizophreniform Disorder: Schizophreniform disorder looks almost exactly the same as schizophrenia, but the difference is that the symptoms are present for a span of time between one month and six months. If the symptoms last for six months or more, then the diagnosis would be schizophrenia instead.
- Schizoaffective Disorder: Schizoaffective disorder has the same pattern of symptoms as schizophrenia, but the difference is that people with this disorder also experience an episode of major depression and/or mania at the same time as the psychotic symptoms.
- Brief Psychotic Disorder: People with brief psychotic disorder experience one or more of the first four categories of psychotic symptoms (that is, delusions, hallucinations, disorganized thought/speech, and disorganized motor behavior). However, the symptoms do not last longer than one month, which is what makes this disorder different from schizophrenia and schizophreniform disorder.
- Delusional Disorder: People with delusional disorder experience one or more delusions for at least one month. However, they do not experience other psychotic symptoms, and their behavior is not otherwise odd or disruptive.
- Substance/Medication-Induced Psychotic Disorder: This disorder is diagnosed when a person experiences delusions or hallucinations in reaction to a drug, medication, or other substance. This might happen in reaction to alcohol, hallucinogens, inhalants, amphetamines, cocaine, or another of other substances.
- Psychotic Disorder Due to Another Medical Condition: This disorder is diagnosed when a person experiences delusions or hallucinations that result from a different medical condition. Some medical conditions that can cause psychotic symptoms include endocrine disorders, metabolic disorders, autoimmune disorders, and epilepsy.
What to do if you’re experiencing a psychotic disorder
In general, it’s very important to get psychiatric treatment for psychotic disorder. Especially if you seek treatment early, symptoms of psychotic disorders can often be managed successfully.
The following treatment options can be helpful for psychotic disorders:
- Therapy. Once your condition is stable, a therapist can work with you to process your experiences and manage any ongoing symptoms. (See more tips on finding a therapist below.)
- Check-ups: Because psychotic disorders can be linked medical conditions, it’s especially important to stay up-to-date with your medical appointments. Your medical doctor can help you rule out physical conditions that may contribute to your symptoms.
- Medication: Medication is often necessary for treating psychotic disorders. A psychiatric professional can help you assess your options and decide if medication is the right choice for you. They can also help you manage any side effects of your medication.
- Support groups. Once your symptoms are under control, a support group can give you perspective, understanding, and solidarity from other people who are also experiencing psychotic disorders. You can find support groups through your local chapter of the National Alliance on Mental Illness or by asking your doctor for recommendations.
- Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at 1-800-273-8255.
What to look for in a therapist for psychotic disorders
The most important thing is to seek treatment immediately from a medical or psychiatric professional. Psychotic disorders can sometimes require hospitalization or medication in the short term, so it’s important to get the support you need.
In the long term, you may also want to work with a therapist to process your experience and work through any ongoing symptoms. In this case, you’ll want to make sure that your therapist is qualified to treat people with psychotic disorders. This will usually involve:
- Advanced education in a field related to mental health, such as psychiatry, psychology, or social work;
- Licensure to practice in the state where you live;
- Additional training and/or experience in treating psychotic disorders specifically, which will usually also mean experience collaborating with your medical team.
Finally, as with any therapy, it’s important to make sure that your therapist is a good fit for your unique needs. Be sure to evaluate the following in your initial calls with therapists:
- How will you pay for therapy? Does the therapist take your insurance or otherwise offer rates that will work with your budget?
- When and where will you attend sessions? Does the therapist offer treatment at a location that is convenient for you and at times that work with your schedule?
- Most importantly, do you feel comfortable talking to this therapist and sense that you have the potential to develop a therapeutic alliance?