Psychosis is a troublesome symptom that is seen in many different types of mental conditions. One of these tends to be PTSD abbreviated from post-traumatic stress disorder. Basically, neither of these are not mutually exclusive. But does that mean PTSD with psychosis is a thing? Will it come as a symptom of it or vice versa? Or can PTSD cause psychosis? These are the types of questions we will try to answer in the words below:
Defining PTSD
Before we answer anything about PTSD with psychosis or questions like, “Is PTSD a psychotic disorder”, we should talk more about psychosis first. As mentioned before, psychosis is a prominent symptom for many of the different mental conditions but it is a symptom nonetheless. PTSD on the other hand is a full-fledged mental condition, which can have many different symptoms including psychosis.
PTSD stems from experiencing a traumatic event. Usually, a traumatic event leads to a stress reaction. The type of stress reaction that arises decides if one is going to be affected by PTSD or not. If the stress response to a traumatic event is acute, it comes shortly after the said event and its symptoms go away within 3 to 4 weeks at most. But if it is the case, you have been feeling symptoms such as the ones mentioned below, which are also found in acute stress reactions but persist for a longer period then it likely will be PTSD(1).
- Excessive anxiety or debilitating stress
- Depressive mood, or feelings of guilt or shame.
- Having recurring flashbacks or nightmares.
- Avoidance behavior for situations, places, and activities related to the traumatic event.
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These symptoms become persistent over time frequently due to trauma becoming sort of a habit by virtue of being long-term. Examples of these long-term traumatic events include (but aren’t limited to)(1):
- Serious accidents, like a car collision or a plane crash (although not long-term, these are capable of inducing long-term effects)
- Severe physical injury
- Severe illness such as cancer
- War and military combat
- Natural disasters, such as a tornado, earthquake, fire or flood
- Excessive physical abuse or verbal abuse, especially by an authoritative figure
- Sexual assault or abuse, especially the one that has been going on for a long-term
- Bullying and cyber-bullying
- Spontaneous bereavement
How Trauma-induced Psychosis Symptoms Come Into Play
Psychosis, which is a literal break from reality, also sometimes arises as one of those prominent trauma-induced psychosis symptoms in PTSD and sometimes can come into existence as a comorbidity of PTSD(2).
PTSD with psychosis, whose former part is all about losing touch with reality through hallucinations, which is seeing, feeling, and hearing things that are not there and delusion, which is believing in grandiose and irrational constructs, and thought processes, with some other symptoms like disgruntled speech thrown in-between, can be debilitating. It can cause an affected individual to act or feel as if they are reliving the triggering traumatic event again and again through PTSD with psychotic features(2). It is not PTSD from psychosis but more of a PTSD with psychosis type of thing. Hell, it’s more like the traumatic event that led to the development of PTSD is more likely the cause of psychotic symptoms(3).
PTSD Psychosis Symptoms
There are different ways PTSD with psychosis comes into motion. However, it has positive and negative symptoms. Positive symptoms add to the “experience” of the affected individual rather than make it debilitating. Negative symptoms are those kinds of PTSD psychosis symptoms that noticeably make important functions in you “absent” and hurt the executive functioning of the affected individual. Both of these symptom types can become comorbid in PTSD with psychosis(4) while might also be seen in other subtypes of psychosis.
Read More: The Most Common Stages Of Psychosis
Positive PTSD Psychosis Symptoms
These are usually hallucinations and delusions, which were mentioned before. But there is also paranoia, disorganized behavior, and dissociation. Paranoia is an extreme anxiety, fear, and distrust of others about perceived danger that transforms into hypervigilance, defensiveness, and the constant worry of being harmed by others(5). Disorganized behavior is all about bizarre actions and disgruntled speech(6). In dissociation, there are instances in which you feel disconnected from your identity and have symptoms like an out-of-body experience(7).
Negative PTSD Psychosis Symptoms
This is part of the PTSD psychosis phase, where affected individuals start to dwell in avoidance behavior like not going out with friends, or for work. In addition to that, they often display a reduced ability to be expressive, speak less, and tend to have difficulty articulating thoughts or ideas properly. A reduced level of motivation is often seen as well, which makes it extremely difficult to start even trivial tasks like getting dressed or going for a bath(8).
Treatment Even for Complex PTSD and Psychosis Not Just The Usual One
When PTSD with psychosis gets to extreme levels, it becomes complex PTSD and psychosis due to extremely prolonged exposure to trauma-related events, such as repetitive exposure to sexual abuse. Even that can be treated with the help of treatment methods such as psychotherapy and medication as these can not only improve functioning but can also reduce the risk of developing psychotic symptoms linked to untreated PTSD(9).
Psychotherapy is capable of addressing PTSD symptoms head on and it can also result in a reduction of psychotic symptoms. Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis(10).
While positive symptoms can easily be treated with medication, for negative symptoms, research suggests that not enough evidence exists for experts to recommend the usage of second-generation antipsychotics (SGA) to treat PTSD with psychotic features(11).
Read More: Facts About PTSD: Understanding The Hidden Struggles Behind Trauma
Summary
PTSD with psychosis is a debilitating disease and it is indeed real. Treatment though can help in resolving it, even complex PTSD and psychosis. Treatment such as the ones mentioned above and alternative ones like psychiatric medication management or telehealth psychiatry are available for treating problems like PTSD or psychosis and other mental conditions such as schizophrenia, depression, insomnia, or ADHD with the help of Solid Foundation Psychiatry.