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Psychotic Episodes
Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them. This might involve hallucinations or delusions.

Experiencing the symptoms of psychosis is often referred to as having a psychotic episode. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion and behaviour.

Psychosis isn't a condition in itself – it's triggered by other conditions. It's sometimes possible to identify the cause of psychosis as a specific mental health condition, such as:

• schizophrenia – a condition that causes a range of psychological symptoms, including hallucinations and delusions
• bipolar disorder – a mental health condition that affects mood; a person with bipolar disorder can have episodes of depression (lows) and mania (highs)
• severe depression – some people with depression also have symptoms of psychosis when they're very depressed

Psychosis can also be triggered by traumatic experiences, stress or physical conditions, such as Parkinson's disease, a brain tumour, or as a result of drug misuse or alcohol misuse.

How often a psychotic episode occurs and how long it lasts can depend on the underlying cause. For example, schizophrenia can be long-term, but most people can make a good recovery, and about a quarter only have a single psychotic episode. Episodes related to bipolar disorder usually resolve, but may reoccur.

Someone who develops psychosis will have their own unique set of symptoms and experiences, according to their particular circumstances.

However, four main symptoms are associated with a psychotic episode. They are:

• hallucinations
• delusions
• confused and disturbed thoughts
• lack of insight and self-awareness

These are outlined in more detail below.

Hallucinations
Hallucinations are where a person perceives something that doesn't exist in reality. They can occur in all five of the senses:

• sight – someone with psychosis may see colours and shapes, or people or animals that aren't there
• sounds – someone with psychosis may hear voices that are angry, unpleasant or sarcastic
• touch – a common psychotic hallucination is that you are being touched when there is no-one there
• smell – usually a strange or unpleasant odour
• taste – some people with psychosis have complained of having a constant unpleasant taste in their mouth

Delusions
A delusion is where a person has an unshakeable belief in something implausible, bizarre or obviously untrue.

Paranoid delusion and delusions of grandeur are two examples of psychotic delusions.

A person with psychosis will often believe that an individual or organisation is making plans to hurt or kill them. This can lead to unusual behaviour. For example, a person with psychosis may refuse to be in the same room as a mobile phone because they believe they are mind-control devices.

Someone with psychosis may also have delusions of grandeur. This is where they believe they have some imaginary power or authority. For example, they may think that they're the president of a country or that they have the power to bring people back from the dead.

Confused and disturbed thoughts
People with psychosis often have disturbed, confused and disrupted patterns of thought.

Signs of this include:

• rapid and constant speech
• random speech – for example, they may switch from one topic to another mid-sentence
• a sudden loss in their train of thought, resulting in an abrupt pause in conversation or activity

Lack of insight
People who have psychotic episodes are often totally unaware their behaviour is in any way strange, or that their delusions or hallucinations are not real.

They may recognise delusional or bizarre behaviour in others, but lack the self-awareness to recognise it in themselves. For example, a person with psychosis being treated in a psychiatric ward may complain that their fellow patients are mentally unwell, while they're perfectly normal.

You should see your GP immediately if you're experiencing psychotic episodes. It's important that psychosis is treated as soon as possible, because early treatment usually has better long-term outcomes.

Treatment for psychosis involves using a combination of:

• antipsychotic medication – which can help relieve the symptoms of psychosis
• psychological therapies – the one-to-one talking therapy cognitive behavioural therapy (CBT) has proved successful in helping people with schizophrenia and, in appropriate cases, family therapy has been shown to reduce the need for hospital treatment in people with psychosis
• social support – support with social needs, such as education, employment or accommodation

Most people with psychosis who get better with medication need to continue taking it for at least a year. Some people need to take medication long term to prevent symptoms reoccurring.

If a person's psychotic episodes are severe, they may need to be admitted to a psychiatric hospital.

Getting help for others
People with psychosis often have a lack of insight. They're unaware that they're thinking and acting strangely.

Due to their lack of insight, it's often down to the friends, relatives or carers of a person affected by psychosis to seek help for them.

If you're concerned about someone you know and think they may have psychosis, you could contact their social worker or community mental health nurse if they've previously been diagnosed with a mental health condition.

If you think the person’s symptoms are placing them at possible risk of harm you can:

• take them to the nearest accident and emergency (A&E) department, if they agree
• call their GP or local out-of-hours GP
• call 999 and ask for an ambulance

In addition to seeking help from your GP, if you are hearing voices or experiencing other kinds of hallucinations, or you are experiencing other symptoms such as paranoia or have problems with drugs or alcohol, the Sheffield Mental Health Guide has information about local support groups and organisations who may be able to help you.

The Sheffield Mental Health Guide has information about support groups, counselling services and other organisations in the Directory of Services. To search the Directory for services and resources about psychosis, click here.

The Sheffield Help Yourself Guide also has information about local support groups and services that may be able to help you. To visit the Help Yourself website click here.

Source: NHS Choices Website

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Artwork generously donated for use by Caroline Appleyard - www.appleyard-art.co.uk