A symptom is a noticeable change showing that we’re not healthy or feeling good. In the case of mental disorders, it’s our feelings that are in disarray. A person might be anxious, deeply sad (depressed), lose appetite, sleep badly etc. It is not always easy for a person with a psychotic disorder or other psychiatric problems recognizing their own symptoms.
The core symptom of psychosis can be described as a gradual inability to distinguish oneself from one’s surroundings. Our psychological defences become overloaded by stress and we break down. In this phase it might be difficult distingushing your own thougts and experiences from your surroundings.
To function normally, all persons are dependent on being confident about who they are. Under pressure (what we have called “perceived stress”), this ability (self-perception) can break down and we can be more easily or more seriously confused. On this basis we can explain all the other symptoms in a logical manner: increased perceived stress breaks down our psychological defences, and our ordinary psychological mechanisms fall apart.
Common symptom of psychosis:
confused thinking
delusions
hallucinations
low motivation
emotional changes
In addition, the patient has other symptoms such as anxiety, depression, fatigue, etc., which are symptoms we all recognise when struggling with personal difficulties. The most important feeling and experience are suffering, pain and despair. The symptoms always develop gradually, in some more quickly than in others. This also means that, once we are aware of what is happening, we can prevent these symptoms from developing.
Early discovery and treatment
Psychosis is as a illness rare, but not uncommon in the general population. At some point in their lives, around 5–10 of 1,000 will be affected. The fact that psychosis is both rare and common appears to be a contradiction. Even though we see new cases each year, the sad fact is that in around 25% of them the condition becomes chronic. We believe that it’s because we are still too late with treatment. For young people in Norway today who are on the verge of developing psychosis, it takes up to three years before receiving treatment by a psychologist or psychiatrist. We know that if we manage to shorten the duration of untreated psychosis, i.e. the time it takes from the illness begins to manifest itself until treatment starts, the prognosis improves considerably. Sometimes we can prevent it from becoming psychosis. For that reason the big challenge for the mental health sector in coming years is this: trying to get people to seek treatment sooner.
Early signs of psychosis can be:
- Marked social isolation or withdrawal
- Marked failure in social roles, for example, by getting lower grades in school
- Markedly strange behaviour (e.g. the patient collects trash, hoards food or talks to himself in public)
- Failure to maintain personal hygiene
- Unusual or flat emotional affect
- Vague or elaborate speech, or marked reduction in speech
- Strange beliefs or magical thinking affecting behaviour and not in keeping with cultural norms, such as e.g. superstitions, belief in clairvoyance, telepathy, the feeling of having a “sixth sense” or that “other people can feel what I feel” or ideas or delusions of reference.
- Unusual sensory perceptions, e.g. repeated illusions, or feeling that a force or person that is not present is present
- Marked lack of initiative, interest or energy
We ordinarily divide all illnesses, physical as well as mental, into four stages. Stage I is the mildest, while stage IV is the most serious. Illnesses are always easier to treat in the initial stage. The prognosis improves the earlier we initiate treatment.
We are now beginning to understand that psychoses in their chronic form may be an expression of treatment having been inadequate at the onset of illness. We also think that it may be possible to prevent the development of a psychotic episode. Studies done in the past ten years support such a supposition, though the research on this is still in the initial stages.
At any given time, around three out of a thousand people will be having a psychotic episode – others will have made a complete recovery or be between episodes.
Close to 75% of those affected are young people aged 16–25.
Although both men and women are affected, it appears that men develop the illness earlier than women and that men are at a somewhat greater risk of developing a psychotic disorder (for example, schizophrenia, where men account for 60% of the cases).
The symptoms of psychosis appear to vary from person to person. However, most of those affected will have problems thinking clearly, and they will experience some of the symptoms described earlier. Symptoms such as delusions and hallucinations become more serious the longer the illness remains untreated.