"It was like I was having a million thoughts all at once and yet I was so disorganized, nothing was getting done. I was frightened and anxious because I felt someone was trying to harm me. Increasingly, I spent most of my time alone in my room doing nothing. I didn't want to be bothered with friends and family. The television started having special messages meant only for me and I was hearing voices commenting on what I was doing. Looking back, I realize things just weren't making sense anymore. At the time though, it seemed normal and I didn't mention what was happening to me to anyone."
                      From the Canadian Mental Health Association

This person is experiencing psychosis, a serious but treatable medical condition where the individual loses contact with reality. When the individual can't tell the difference between what is real and was it not, it is called a psychotic episode. A first episode is very frightening, confusing and distressing, both to the person experiencing it and to their family and friends.
 
Psychosis is characterized by severe disturbances in thinking, emotion and behavior, and it profoundly disrupts a person's relationships, ability to work and self-care. Psychosis can happen to anyone, affecting both genders and all races. About three percent of the population suffers from psychosis. Symptoms tend to first appear between ages 16 and 30. In most cases, it is unclear what brings on a first episode, but current research indicates that brain chemistry and biological and genetic factors may play a role in the development of psychosis.
 
Symptoms may occur gradually or come on very suddenly. A person with psychosis may:

• Experience changes in thinking patterns (difficulty concentrating, loss of memory, disconnected and confused thoughts).
• Have delusions (fixed, false beliefs that have no basis in fact, often delusions of grandeur such as being descended from royalty).
• Have hallucinations (hearing, seeing, tasting, smelling and feeling something that does not exist). For the individual experiencing them, hallucinations are very real.
  
• Experience changes in mood (finding it hard to express feelings, feeling inappropriate or intense burst of emotion, feeling empty of any emotions, depression).
• Have very disorganized behavior (may not be able to conduct every day tasks such as bathing, dressing and preparing meals).
• Believe that others can manipulate their thoughts or that they can manipulate the thoughts of others.
• Have thoughts of death or suicide.  

 
Psychosis includes these illnesses:

• Schizophrenia. This is perhaps the mental illness that gets the most play in the media and movies because it can have dramatic symptoms such as visual and auditory hallucinations and delusions. The name means "fractured mind": it does not mean "split personality," as is commonly thought. There is a common misconception that people with schizophrenia are more violent than the general population. That is not correct. They are no more likely to be violent than people without the disease. Rather than looking for trouble, most withdraw and prefer to be left alone. It should be noted, however, that when individuals with schizophrenia self medicate with drugs and alcohol the incidence of violent behavior rises significantly (as it does with people without schizophrenia).
  
• Bipolar disorder. Also called manic-depression, it is characterized by extreme mood swings between depression and mania. In the mania phase of the illness, the person will feel high, happy and full of energy. They may not sleep for days at a time, be irritable, think and talk rapidly and exhibit lack of inhibitions. In the depressive phases, they may find it extremely difficult to function.  
  
• Schizoaffective disorder. This is a combination of schizophrenia symptoms and a mood disorder.
• Depression with psychotic features. A person has severe depression and symptoms of psychosis but without the mania associated with bipolar disorder.
• Drug-induced psychosis. The use of drugs such as marijuana, cocaine, LSD, amphetamines and alcohol can cause psychotic symptoms to appear.
• Post traumatic stress disorder. Psychosis may occur with flashbacks and hallucinations.  

 
Suicide is a serious risk in people who have schizophrenia and other psychotic disorders. About ten percent complete suicide. Always take a suicide threat seriously. If an individual tells you that he/she plans to kill themselves take them to a hospital or call 911 immediately.
 
Although psychosis is a serious illness, the good news is that it can be treated. A number of antipsychotic drugs are available that have shown significant effectiveness in treating some of the symptoms and new drugs are coming on the market that hold promise. One of the biggest challenges with medication is that once the individual feels better and experiences relief of the symptoms, he/she tends to stop taking it which leads to relapse. It is vital that the person remain on their medication. Cognitive behavior therapy (a form of talk therapy that emphasizes the important role of thinking in how we feel and what we do) is also beneficial.
 
If you or someone close to you is experiencing symptoms of psychosis:

• Get help. Don't wait. Don't ignore it. Recovery is more difficult when effective treatment is delayed.
• Talk to a counselor.
• Talk to your doctor. He/she can make a referral to a specialist for a full assessment. 
• Ask questions and get informed. 
• Keep hope alive. People who get proper treatment can lead productive, fulfilling lives.
  

 
Want to know more about psychotic illnesses? Visit:

• The National Institute of Mental Health at www.nimh.nih.gov
• The Mayo Clinic at www.mayoclinic.com
• U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration at
  www.mentalhealth.samhsa.gov/publications
• National Alliance on Mental Illness at www.nami.org