Psychotic disorders are a bit of a grey area for most of us. In fact, if you know more about psychotic disorders than what you learnt from Russell Crowe in A Beautiful Mind, you’re a long way ahead of most. Sadly, the stories we get from movies and the media aren't always spot-on, so we've decided to debunk 7 of the biggest tall stories about psychosis.
1. Having a psychotic disorder means you’re crazy
Rubbish. This is like saying that having a fever means your whole body doesn’t work. People with psychotic disorders aren’t crazy, they just experience reality in a different way to others, often only temporarily. This might involve seeing or hearing things that aren’t really there, believing things that most people think are false, or speaking or acting in a confused or unusual way.
2. “Psychotic disorder” is just a fancy name for schizophrenia
Nope! While schizophrenia is the most common psychotic disorder, there are a handful of others, which differ in length, severity and nature. These include delusional disorder, brief psychotic disorder, schizoaffective disorder and schizophreniform disorder. Additionally, while other conditions like depression and bipolar may not technically be psychotic disorders, they can also involve aspects of psychosis.
3. It won’t happen to me - only drug users develop psychotic disorders
Roughly 1 in every 100 people will experience a psychotic disorder in their lifetime. For about half these people, this will occur before the age of 25, with young adulthood the most likely time of onset. While substance misuse is a risk factor for psychotic illness, so is family history, pregnancy and birth complications, stressful experiences, differences in brain structure and function and some medications. Good habits can minimise your risk, but sometimes it’s beyond our control.
4. Psychotic disorders can’t be treated
This is nonsense. Effective medical and psychological treatments exist which can help prevent the development of psychotic symptoms and minimise how bad they are and how often they occur.
Medication: Anti psychotic medication can be effective at treating symptoms like delusions and hallucinations, while anti depressant medication can help with feelings of low mood which often accompany psychosis.
Psychological treatment: Psycho-education, Cognitive Behavioural Therapy (CBT) and group or family therapy can help people understand their experience, reduce feelings of distress and improve their ability to cope with and manage their disorder.
5. People with psychotic disorders have split or multiple personalities
This is a popular myth glorified in the media and movies. However the only split in psychotic disorders is from reality, and this is usually brief and partial. People with these conditions do not shift between multiple personalities. The closest concept to split personality is Dissociative Identity Disorder, but this diagnosis is rare and there is debate among experts about whether it exists at all.
6. People snap and become psychotic with no warning
The onset of psychotic illness can occasionally be sudden, as with cases brought on by medication, substance use or a medical condition. In the majority of cases however a variety of symptoms develop slowly and gradually, in what is known as a prodromal period, prior to the full experience of the disorder. These can include psychotic symptoms such as hallucinations and delusions, along with depressive symptoms and mental difficulties such as problems with memory, language and attention.
7. I can’t talk to someone with a psychotic disorder
Sure you can! Most people with psychotic disorders will participate in and benefit from a good old chat. Often you’ll find that the conversation is no different to normal, as the person’s symptoms may not be affecting them, or may not be apparent.
Even if symptoms are evident though, this may make conversation more interesting! People experiencing psychosis may make up new words, connect ideas in a unique way or tell you about fantastical hallucinations. Both of you may well enjoy this, but it could also help reduce stigma about these kinds of conditions and you might even be able to point them in the direction of treatment.