Psychosis ~What is it?

[Quantum Quack]

The common definition found in a dictionary is something like this:

Main Entry: psy·cho·sis
Pronunciation: sI-'kO-s&s
Function: noun
Inflected Form(s): plural psy·cho·ses-"sEz/
Etymology: New Latin
: fundamental mental derangement (as schizophrenia) characterized by defective or lost contact with reality

One who can Not hold onto the Normal Boundaries Of Reality that most find appealing and acceptable.
A State in which the mind tricks itself through Delusions and or Hallucination to interpret things one does not understand.

Is this definition sufficient?

Can one define the "boudaries of reality'?

Is the term Psychosis more one of utility than describer or explanation?

I would think that most persons on the planet are in some way psychotic by this definition at some stages in their lives, but what gives this word so much power?
Does having a halucination automatically attract the label of psychosis?
Could having a dream be considered as a psychotic episode?

How would we determine that a person is psychotic? Is it just because of his beliefs or is it because of his actions based on those belief?

Many many questions seem to come to mind about this topic and would any one care to help in the understanding of it?

 

[PHPlatonica]

A LARGE Challenge!
Psychosis is stepping out of the "accepted" boundaries set by Persons in society.
it is neither Wrong, nor Untrue. We have learned through out the years that Experience plays many important roles on each person. And Each person will not Experience the same situation the Same way.
Then there are the "Group hallucinations" as they are called, that have been experienced around the world.
When one Takes into his/her body a hallucinogenic substance, the Neurons are rewired and the perception of things being perceived Changes. This is believed to be what happens to a Schizophrenic, or a Sleep Deprived, or Severe fever patient. They Claim many experiences that no one else could see... they are branded "Delusional".... It is up to the individual, and the faith in ones own self and standing, to accept the experience and act accordingly so as not to interfere with another persons existence. But Sharing these Experiences has brought about many more truths than not....
More in a Second!

 

[PHPlatonica]

http://gestalttheory.net/archive/wertspeech.html

very interesting!! Worth checking out !

 

[Hercules Rockefeller]

How would we determine that a person is psychotic?

Psychotic Disorders

Schizophrenia, manic-depressive illness, psychotic depression and organic psychoses of known etiology, such as the alcoholic and senile psychoses, are the major forms of psychotic disorders.

At some level of neural function, they share the ability to produce characteristic clinical features: (i) delusions or false beliefs; (ii) hallucinations or false perceptions, usually without insight into their pathological nature; and (iii) disorganization of thought, for example, incoherence. These are sometimes accompanied by bizarre behavior. Abnormalities in the structure or function of neurons are central to the various forms of psychosis.

<blockquote>From:
Basic Neurochemistry: molecular, cellular and medical aspects (6th ed)
editor-in-chief, George J. Siegel

American Society for Neurochemistry
ISBN 0-397-51820-X</blockquote>

 

[Light]

The common definition found in a dictionary is something like this:



Is this definition sufficient?

Can one define the "boudaries of reality'?

Is the term Psychosis more one of utility than describer or explanation?

I would think that most persons on the planet are in some way psychotic by this definition at some stages in their lives, but what gives this word so much power?
Does having a halucination automatically attract the label of psychosis?
Could having a dream be considered as a psychotic episode?

How would we determine that a person is psychotic? Is it just because of his beliefs or is it because of his actions based on those belief?

Many many questions seem to come to mind about this topic and would any one care to help in the understanding of it?

Quantum, there is one element missing in your description - persistence.

As you have correctly stated, anyone can have moments of irrationality. It is when those moments become hours and days that the diagnosis is warranted.

And no, dreams do not qualify. In most people dreams ARE irrational and bear little or no connection to reality.

Also, your question about beliefs vs actions is actually mute. Actions are based on beliefs. You will not find one without the other.

 

[Quantum Quack]

Quantum, there is one element missing in your description - persistence.

As you have correctly stated, anyone can have moments of irrationality. It is when those moments become hours and days that the diagnosis is warranted.

And no, dreams do not qualify. In most people dreams ARE irrational and bear little or no connection to reality.

Also, your question about beliefs vs actions is actually mute. Actions are based on beliefs. You will not find one without the other.

Light,
I find value in your post.
Especially reference to persistence.

However your comment about dreams poses an interesting irony.

If dreams are irrational then this is NOT psychosis, however if dreams are found to be rational this is deemed by many to be Psychosis....funny that.

Say a person has a scambled dream that makes no sense,,,ok this is not psychosis however when that same person has what may be considered to be a lucid dream and finds significant relevance to reality this is considered as what?

Sort of a strange turn around yes?

 

[Quantum Quack]

Psychotic Disorders

Schizophrenia, manic-depressive illness, psychotic depression and organic psychoses of known etiology, such as the alcoholic and senile psychoses, are the major forms of psychotic disorders.

At some level of neural function, they share the ability to produce characteristic clinical features: (i) delusions or false beliefs; (ii) hallucinations or false perceptions, usually without insight into their pathological nature; and (iii) disorganization of thought, for example, incoherence. These are sometimes accompanied by bizarre behavior. Abnormalities in the structure or function of neurons are central to the various forms of psychosis.

<blockquote>From:
Basic Neurochemistry: molecular, cellular and medical aspects (6th ed)
editor-in-chief, George J. Siegel

American Society for Neurochemistry
ISBN 0-397-51820-X</blockquote>

Thanks for that post, HR, most informative....

 

[Quantum Quack]

Also, your question about beliefs vs actions is actually mute. Actions are based on beliefs. You will not find one without the other.

say a person living in New Zealand believes he is being monitored by the CIA but decides to ignore "them" any way because of the "so what " attitude. [ I am assuming with this that this man is actually not being monitored by the CIA]

Is he psychotic or does he just have a strange belief?

The reaosn I ask this is that belief alone is not sufficient I feel. It is when that belief is fully believed and acted on that may be a problem.
I think most people hold their own beliefs with a certain loosness, being open to change, however when a person is so strong in their beliefs and acts upon them showing no doubts about the validity of those beliefs could this be a sign of psychosis.

For example some religious devotees seem a lttle psychotic ...[ reference to 70 virgins and suicide bombings etc]

 

[Light]

Light,
I find value in your post.
Especially reference to persistence.

Thank you, Quantum, that was most kind of you.

However your comment about dreams poses an interesting irony.

If dreams are irrational then this is NOT psychosis, however if dreams are found to be rational this is deemed by many to be Psychosis....funny that.

Say a person has a scambled dream that makes no sense,,,ok this is not psychosis however when that same person has what may be considered to be a lucid dream and finds significant relevance to reality this is considered as what?

Sort of a strange turn around yes?

Not really. In fact, most dreams are VERY irrational. The few, however, that are rational leaves the individual with much the same feeling as having watched a segment of a movie.Many times that kind is nothing more than a replay of some recent event though some of the details may change.

"Lucid dreams" are greatly misunderstood by most people. Actually, they are just normal dreams but the individual has a propensity for heightened sense of awareness to something that occurred in the dream. Also, dreams that are considered 'lucid' are usually those that were interrupted - individual still in REM mode - and thus are much clearer and easier to remember. I read the results of a sleep study in Psychology Today that found those two factors alone accounted for well over 90% of what people classed as lucid.

However, there actually IS one type of dream that is considered a symptom of disorder - recurrent. That class can come from different sources as well. A common one is nothing more than a harmless mild form of fixation/obsession on a certain series of events or a personal phobia. And here once again, persistence is key. If the same dream lasts for more than about a week, an evaluation is indicated.

 

[Quantum Quack]

A question that comes to mind that may seem contraversial is:

Could our extremely tight definition of psychosis actually heighten the amount of psychosis present.

For example if some one with mild forms of extreme beliefs and behaviour be considered as psychotic when in fact they are merely eccentric.

The reason I ask this is that by claiming so much as being beyond the boundaries of reality are we not forcing person to accept the psychotic label prematurely.

To explain a little more I am making a slight reference again to religious devotion of various forms and even most philosophies that people harbour.

By definition the building of a church is an act of psychosis.
The invasion of Irak looking for imaginary Weapons was and is an act of psychosis....and so on.

Is the definition of this word too tight do you think? or should it be tighter?

Is the definition itself in some ways responsible for the prevalence of psychosis.?

Possibly I am asking an impossible to answer question.

 

[Tnerb]

I would rather say his first post remains un-answered.....

 

[Light]

A question that comes to mind that may seem contraversial is:

Could our extremely tight definition of psychosis actually heighten the amount of psychosis present.

For example if some one with mild forms of extreme beliefs and behaviour be considered as psychotic when in fact they are merely eccentric.

The reason I ask this is that by claiming so much as being beyond the boundaries of reality are we not forcing person to accept the psychotic label prematurely.

To explain a little more I am making a slight reference again to religious devotion of various forms and even most philosophies that people harbour.

By definition the building of a church is an act of psychosis.
The invasion of Irak looking for imaginary Weapons was and is an act of psychosis....and so on.

Is the definition of this word too tight do you think? or should it be tighter?

Is the definition itself in some ways responsible for the prevalence of psychosis.?

Possibly I am asking an impossible to answer question.

No, Quantum, in the clinical sense it's not impossible to answer. A bit of the problem here is that you are using too wide a brush. There are other categories that cover some of the things you've listed above and they aren't considered clinical disorders. For example, the part about religion. There is an inherent 'something' in most humans that makes them want to believe in a higher power of some sort. It may be called God, it might be called Nature, it can even be called "wanting to be one with the Universe." That is not a psychosis. It actually falls within the realm of what's considered normal. And that's not to say that atheists are abnormal at all. Not a bit. They have chosen to not believe in such things. Actually, you might be quite surprised to discover just HOW broad the term normal really is.

And neither should the medical term be applied to what is generally called "religious fanatics" - people who go on suicide missions and the like. The proper therm in those cases is "conditioned" - or in the common vernacular "brainwashing."

 

[Light]

I would rather say his first post remains un-answered.....

Why do you say that? Besides my own professional ones, I believe he has received some excellent answers to it. What do you feel is missing?

 

[Quantum Quack]

Ok, lets try another approach.
I visit a clairvoyant, she or he talks of many things and many experiences, He/she practices soothe and tells me about the future that she he feels exists. he or she is in a shop that also sells books and crystals and various wiccan paraphenalia. His her belief in astral travelling and gods and demons is strong. I pay my bill and leave....

Is that person considered as psychotic?

The reason I am writing this is I am trying to draw an ability to get beyond the clinical definition yet relate that definition to the real world of the so called mystical fringe. Similar to the rationalisation of religion etc etc....

A person who professes calls auditory halucinations as claire audio and visual halucinations as clairvoyence. Why are they not considered as psychotic where as others are? What is the distinction that I am chasing here do you think?

 

[Light]

Ok, lets try another approach.
I visit a clairvoyant, she or he talks of many things and many experiences, He/she practices soothe and tells me about the future that she he feels exists. he or she is in a shop that also sells books and crystals and various wiccan paraphenalia. His her belief in astral travelling and gods and demons is strong. I pay my bill and leave....

Is that person considered as psychotic?

The reason I am writing this is I am trying to draw an ability to get beyond the clinical definition yet relate that definition to the real world of the so called mystical fringe. Similar to the rationalisation of religion etc etc....

A person who professes calls auditory halucinations as claire audio and visual halucinations as clairvoyence. Why are they not considered as psychotic where as others are? What is the distinction that I am chasing here do you think?

Ha-ha! Please believe me, Quantum, I'm not laughing at you - I'm laughing at memories nearly forgotten. I find you to be very bright and thoughtful. Someone with intelligence. It's just that all of this reminds me very much of the first week of Psychology-101. Many students - the ones brave enough to ask so early - have the exact same questions.

No, the term you're looking for this time around is "delusional." It also can be applied to some of those religious extremists we talked about a few minutes ago. And to several people on these forums, notably a certain British lady and a few others.

It looks like what we need is about four or five pages of definitions. That, or you could pick up a paperback on introductory or abnormal behavior. But don't misunderstand me, I'm more than happy to go through this with you. Even though I hung up my coat and tie long ago, I suppose there's a little war-horse left in every retired person.

One small thing to keep in mind is that many boundaries are blurred and a lot of these things have some major overlaps. Not only that but they change with times as subsets are developed. And it's not uncommon to see that "compartmentalization" go too far and the professionals sometimes have to pull on the reigns. The trend, though, is to keep on ever-narrowing every condition down - to the point that sometimes even the pros get a little lost. It actually changes MUCH more often than any other branch of science! So it can be tough to keep up once in a while.

 

[Quantum Quack]

Ha-ha! Please believe me, Quantum, I'm not laughing at you - I'm laughing at memories nearly forgotten. I find you to be very bright and thoughtful. Someone with intelligence. It's just that all of this reminds me very much of the first week of Psychology-101. Many students - the ones brave enough to ask so early - have the exact same questions.

No, the term you're looking for this time around is "delusional." It also can be applied to some of those religious extremists we talked about a few minutes ago. And to several people on these forums, notably a certain British lady and a few others.

It looks like what we need is about four or five pages of definitions. That, or you could pick up a paperback on introductory or abnormal behavior. But don't misunderstand me, I'm more than happy to go through this with you. Even though I hung up my coat and tie long ago, I suppose there's a little war-horse left in every retired person.

One small thing to keep in mind is that many boundaries are blurred and a lot of these things have some major overlaps. Not only that but they change with times as subsets are developed. And it's not uncommon to see that "compartmentalization" go too far and the professionals sometimes have to pull on the reigns. The trend, though, is to keep on ever-narrowing every condition down - to the point that sometimes even the pros get a little lost. It actually changes MUCH more often than any other branch of science! So it can be tough to keep up once in a while.

Fair comment. and I can enjoy the mirth with you....

In an attempt to answer my own qiuestion I would venture that the main difference apart form opinions such as delusional [ which of course is mere opinion....ha...couldn't help puting that in could I.... hey?] is that the clairvoyant has established in their psych a methodology and an understanding of their experiences that prevents the negative extremes that it often a part of psychosis.

They have generated a rational that allows their "hmmmm "gifts" to make sense to them and as their bank accounts show others as well.
Now you will have noticed I shifted perpsective with that last sentance and took the skeptics viewpoint of "fraud" con artist etc etc....However I am well aware of some clairvoyency that is far from fraudulent or designed to strip a person of their vast wealth.

That said, I tend to think that because the person experiencing those so called halucinations has a rational way of coping with them and learning from them they are no longer psychotic but merely delusional. [ notice my perspective shift again.]

Ahhh it's nice to know that I am considered only delusional and not psychotic.....ha.....phew!! I am glad about that...ha

So a patient comes to see a doctor with incredible stories to tell about his halucinations the doctor diagnoses a relative psychosis. The same person goes to see a clairvoyant and is given assistance to nurture their gift.
Two possible clinical results occur. [ of many possible]
The first usually is a continuous history of hospital admissions the other is a person who learns to rationalise their experience and lives on the mystical fringe.....hmmmmm... I wonder which is the best outcome, the hospital with all the cost and medications or the mystical fringe with the delusions of grandure......ha.....[ but less expensive to the community]

I guess where this is leading is that if a person suffering halucinations was able to be given assistance in rationalising their experiences better we would be able to minimise their hospital admissions and societal dysfunction. [ again notice the shift in perpspective here]

To tell you the truth I would rather have a son that took pleasure [ even if considered as delusional] in helping people with his clairvoyancy than to have a son who lived the perpetual nightmare of schizophrenia simply because we declared his halucinations as halucinations and has to deny his "truth" just because others say so.

Do you see my point?

 

[Quantum Quack]

I am just exploring a line of enquiry.....that has been buzzing around in my head for a long time

 

[Light]

Fair comment. and I can enjoy the mirth with you....

In an attempt to answer my own qiuestion I would venture that the main difference apart form opinions such as delusional [ which of course is mere opinion....ha...couldn't help puting that in could I.... hey?] is that the clairvoyant has established in their psych a methodology and an understanding of their experiences that prevents the negative extremes that it often a part of psychosis.

They have generated a rational that allows their "hmmmm "gifts" to make sense to them and as their bank accounts show others as well.
Now you will have noticed I shifted perpsective with that last sentance and took the skeptics viewpoint of "fraud" con artist etc etc....However I am well aware of some clairvoyency that is far from fraudulent or designed to strip a person of their vast wealth.

That said, I tend to think that because the person experiencing those so called halucinations has a rational way of coping with them and learning from them they are no longer psychotic but merely delusional. [ notice my perspective shift again.]

Ahhh it's nice to know that I am considered only delusional and not psychotic.....ha.....phew!! I am glad about that...ha

So a patient comes to see a doctor with incredible stories to tell about his halucinations the doctor diagnoses a relative psychosis. The same person goes to see a clairvoyant and is given assistance to nurture their gift.
Two possible clinical results occur. [ of many possible]
The first usually is a continuous history of hospital admissions the other is a person who learns to rationalise their experience and lives on the mystical fringe.....hmmmmm... I wonder which is the best outcome, the hospital with all the cost and medications or the mystical fringe with the delusions of grandure......ha.....[ but less expensive to the community]

I guess where this is leading is that if a person suffering halucinations was able to be given assistance in rationalising their experiences better we would be able to minimise their hospital admissions and societal dysfunction. [ again notice the shift in perpspective here]

To tell you the truth I would rather have a son that took pleasure [ even if considered as delusional] in helping people with his clairvoyancy than to have a son who lived the perpetual nightmare of schizophrenia simply because we declared his halucinations as halucinations and has to deny his "truth" just because others say so.

Do you see my point?

Absolutely! (And I only had to shift gears from forward to reverse and back again three times to keep up with you.)

Yes, and your rationale is quite straightforward and accurate. However it might surprise you just a bit to discover how often the approach is NOT to "cure" but rather to learn to deal with such things in a more rational and controlled way. With the person, rather than the problem, in control.

Also, please keep in mind that my training and expertise is NOT in treatment - that's the job of the psychiatrist. My specialty is in learning and understanding the what and the why of the human mind. Although the fields certainly overlap a great deal, nevertheless they are quite distinctive in purpose and practice.

Coming back to the subject of delusions once again, you should also know that there can be a thousand different degrees of it. It is almost fair to say that everyone has some very mild form of a delusion or two. Superstition is a VERY common one. Almost anyone who buys a lottery ticket has some sort of superstition about the numbers they pick. There's no logic at all in the idea that your birthday, for example, is any better than mine for a number.

The concept of "luck" is another clear one. In truth, there is no luck - there is only purposefully working toward something and random chance. Nothing else at all. Yet many people insist they are cursed with bad luck - and many, many of them actually believe it. What better example of delusion is there than that?

So... it's only when one's delusion(s) takes some degree of control in their lives that it becomes a clinical problem. Being afraid of walking under a ladder isn't going to hurt you, in fact, it may keep something from falling on your head. But on the other hand, tossing salt over your shoulder can cause a small problem if it happens to go into the eyes of a big, burly, belligerent person.

 

[Quantum Quack]

Absolutely! (And I only had to shift gears from forward to reverse and back again three times to keep up with you.)

Yes, and your rationale is quite straightforward and accurate. However it might surprise you just a bit to discover how often the approach is NOT to "cure" but rather to learn to deal with such things in a more rational and controlled way. With the person, rather than the problem, in control.

Also, please keep in mind that my training and expertise is NOT in treatment - that's the job of the psychiatrist. My specialty is in learning and understanding the what and the why of the human mind. Although the fields certainly overlap a great deal, nevertheless they are quite distinctive in purpose and practice.

Coming back to the subject of delusions once again, you should also know that there can be a thousand different degrees of it. It is almost fair to say that everyone has some very mild form of a delusion or two. Superstition is a VERY common one. Almost anyone who buys a lottery ticket has some sort of superstition about the numbers they pick. There's no logic at all in the idea that your birthday, for example, is any better than mine for a number.

The concept of "luck" is another clear one. In truth, there is no luck - there is only purposefully working toward something and random chance. Nothing else at all. Yet many people insist they are cursed with bad luck - and many, many of them actually believe it. What better example of delusion is there than that?

So... it's only when one's delusion(s) takes some degree of control in their lives that it becomes a clinical problem. Being afraid of walking under a ladder isn't going to hurt you, in fact, it may keep something from falling on your head. But on the other hand, tossing salt over your shoulder can cause a small problem if it happens to go into the eyes of a big, burly, belligerent person.

Luck.... a Myth!!! sheesh, a couple of billion Chinese are going to be awfully dis-appointed

Light, can I ask you a very tough question?

Do you know or have you studied what the effect of being diagnosed with paranoid schizophrenia has on a person just diagnosed?
Do you know how devastating such a diagnosis can be to a person?

Is it all that surprising that suicide is so common?
Do you think it is the condition that drives the suicide rate or the treatment and diagnosis?

I must admit in my research I have found that the greatest reason for the desire for suicide is the isolation that diagnosis generates for a person who is already suffering a huge amount of confusion due to sensory experiences of unknown value.

I remember one persons comments when asked about his feelings when diagnosed.
" My life was over " was all he said. 3 months after my interview it was.

I just feel that we are way to quick to claim psychosis and diagnosis in so many cases. That we can with the stroke of a pen and word from the mouth so thoroughly destroy a persons sense of future and optimism.

This is why I guess I am delving into definitions and the ramifications of those definitions.

I am not in any way accusing you or any one of malice or any lacking in the duty of care. This whole area is such a sad and tragic field. And we do what we can....so please forgive me if I have implied anything to the negative.

I also understand that diagnosis for so many is actually a last resort and usually the person is so confused about what is real and what he is told is not real that medications are very necessary to slow all that thinking down.

But I wonder is there a better way?

 

[Quantum Quack]

I remember chatting with a young psychiatrist who was of a more unconventional school of thought, he told me of his own personal philosophy about his job and who and what he was.

He said that he took the approach that he was unable to make the determinatiuon as to what was real and what wasn't. It was not with in his ability to make such judgements however what he did tell his patients upon diagnosis was that the main need for diagnosis was to allow the prescription of medications that would allow the patient to slow down a little and give the patient time to discover for themselves what was real and what wasn't.
His line of approach was that patients referred to him were all invariably suffering a form of post traumatic stress and that anti psychotic medications allowed the patient the ability to rest their over active minds.

I must admit I found his approach to be much better than most.

I would have loved to find out his patient success rate......