Teen Psychotic Disorder

A group of severe mental disorders that cause abnormal thinking and perceptions.

What Is Teen Psychotic Disorder?

Psychosis is a serious mental disorder characterized by thinking and emotions that are so impaired, that they indicate that the person experiencing them has lost contact with reality.

People who are psychotic have false thoughts (delusions) and/or see or hear things that are not there (hallucinations). These are referred to as “positive” symptoms; “negative” symptoms like loss of motivation and social withdrawal can also occur.

These experiences can be frightening and may cause people who are suffering from psychosis to hurt themselves or others. It is important to see a doctor right away if you or someone you know is experiencing symptoms of psychosis.

Psychosis affects three out of every 100 people. It is most likely to be diagnosed in young adults, but psychosis can happen to anyone.

What is Psychosis?

Psychosis is a serious mental disorder characterized by thinking and emotions that are so impaired, that they indicate that the person experiencing them has lost contact with reality.

People who are psychotic have false thoughts (delusions) and/or see or hear things that are not there (hallucinations). These are referred to as “positive” symptoms; “negative” symptoms like loss of motivation and social withdrawal can also occur.

These experiences can be frightening and may cause people who are suffering from psychosis to hurt themselves or others. It is important to see a doctor right away if you or someone you know is experiencing symptoms of psychosis.

Psychosis affects three out of every 100 people. It is most likely to be diagnosed in young adults, but psychosis can happen to anyone.

Recognizing The Signs of Psychosis

Early stage psychosis:

  • Difficulty concentrating
  • Depressed mood
  • Sleep changes—sleeping too much or not enough
  • Anxiety
  • Suspiciousness
  • Withdrawal from family and friends
  • Ongoing unusual thoughts and beliefs

Later stage psychosis:

  • Delusions
  • Hallucinations
  • Disorganized speech—switching topics erratically
  • Depression
  • Anxiety
  • Suicidal thoughts or actions
  • Difficulty functioning

What Are Delusions & Hallucinations?

Delusions

A delusion is a false belief or impression that is firmly held even though it is contradicted by reality and what is commonly held as true. There are delusions of paranoia, grandiose delusions, and somatic delusions.

People who are experiencing a delusion of paranoia might think that they are being followed when they are not or that secret messages are being sent only to them through media. Someone with a grandiose delusion will have an exaggerated sense of his or her importance. Somatic delusions are the belief that you have a terminal illness when you are healthy.

Hallucinations

A hallucination is a sensory perception in the absence of outside stimulus. That means seeing, hearing, feeling, or smelling something that isn’t present. A person who is hallucinating might see things that don’t exist or hear people talking when he or she is alone.

Delusions and hallucinations seem real to the person who is experiencing them.

Causes of Psychosis

Each case of psychosis is different, and the exact cause is not always entirely clear. There are, however, certain illnesses that cause psychosis. There are also triggers like drug use, lack of sleep, and other environmental factors. In addition, certain situations can lead to specific types of psychosis to develop (see “Types of Psychosis” below).

Illnesses

Illnesses that can cause psychosis:

  • Brain diseases such as Parkinson’s disease, Huntington’s disease, and some chromosomal disorders
  • Brain tumors or cysts
  • Dementia (including Alzheimer’s disease)
  • HIV, syphilis, and other infections that attack the brain
  • Some types of epilepsy
  • Stroke
Environmental Causes

Psychosis can be triggered by the use of alcohol and illegal drugs, including stimulants such as methamphetamine (meth) and cocaine. Hallucinogenic drugs like LSD (acid) often cause users to see things that are not really there, but this effect is temporary. People who do not get enough sleep for long periods of time can experience symptoms of psychosis. Some prescription drugs like steroids and stimulants can cause symptoms of psychosis.

Risk Factors For Developing Psychosis

It is not currently possible to precisely identify individuals who are likely to develop a psychotic disorder. However, research has shown that genetics may play a role.

If one identical twin develops psychosis, there is a 50 percent chance the other twin will as well. Individuals with a close family member (parent or sibling) who has a psychotic disorder are more likely to develop a psychotic disorder.

Children born with the genetic mutation known as 22q11 deletion syndrome are at risk for developing a psychotic disorder, especially schizophrenia.

Types of Psychosis

Some kinds of psychosis are brought on by specific conditions or circumstances.

Brief Reactive Psychosis

Extreme personal stress like the death of a family member can bring on symptoms of psychosis. Someone experiencing brief reactive psychosis will recover in a few days.

Drug or Alcohol Related Psychosis

Use of alcohol and drugs can sometimes cause symptoms of psychosis. These symptoms might go away immediately when the effect of the alcohol or drug wears off, but this is not always the case. People who are addicted to alcohol and certain drugs can experience psychotic symptoms if they suddenly stop drinking or taking the drug to which they are addicted.

Organic Psychosis

A head injury or an illness that affects the brain like Parkinson’s disease can cause symptoms of psychosis.

Psychotic Disorders

The following types of psychoses are called psychotic disorders. They can be triggered by stress, drug or alcohol use, injury or illness, or they can appear on their own.

Bipolar Disorder

When someone has bipolar disorder, his or her moods swing from very high to very low. When his or her mood is high and positive, he or she may have symptoms of psychosis. The individual may feel extremely good and believe he or she has special powers. When his or her mood is depressed, the individual may have psychotic symptoms that make him or her feel angry, sad, or frightened. These symptoms include thinking someone is trying to harm him or her.

Delusional Disorder

A person suffering from delusional disorder strongly believes in things that are not real.

Psychotic Depression

This is major depression with psychotic symptoms.

Schizophrenia

Schizophrenia is psychosis that lasts longer than six months. Schizophrenia is a lifelong disease.

How is Psychosis Diagnosed

Psychosis is diagnosed through a psychiatric evaluation. That means a doctor will watch the person’s behavior and ask questions about what he or she is experiencing. Medical tests and X-rays may be used to determine whether there is an underlying illness causing the symptoms.

Diagnosing Psychosis in Children & Teenagers

Many of the symptoms of psychosis are perfectly normal in young people. For example, a teenager may suddenly need more sleep in response to changes in their body. Small children often have imaginary friends with whom they talk. If you are worried about psychosis in a child or adolescent, describe the individual’s behavior to a doctor.

Treatment of Psychosis

Treating psychosis may involve a combination of medications and therapy. Most people recover from psychosis with treatment.

Rapid Tranquilization

Sometimes people suffering from psychosis can become agitated and be at risk of hurting themselves or others. In those cases, it may be necessary to calm them down quickly. This method is called rapid tranquilization. A doctor or emergency response personnel will administer a fast-acting shot or liquid medicine to relax the patient right away.

Drugs & Medication

Symptoms of psychosis can be controlled with medications called antipsychotics. These medicines reduce hallucinations and delusions and help people think more clearly. The type of medicine you are prescribed will depend on which symptoms you are experiencing. In many cases, people only need to take antipsychotics for a short time to get their symptoms under control. People with schizophrenia may have to stay on medications for life.

Cognitive Behavioral Therapy

Cognitive behavioral therapy means meeting regularly to talk with a mental health counselor with the goal of changing thinking and behaviors. This approach has been shown to be effective in helping patients make permanent changes and more effectively manage their illness.

Psychotherapy

Therapy is essential to treating psychosis. Some more common therapies include:

  • Cognitive behavioral therapy (CBT), which teaches people to observe and then change ineffective patterns of thinking. For psychosis, CBT teaches someone to critically evaluate their experience to determine whether or not the experience is real or not.
  • Supportive psychotherapy teaches a person to cope with the experience of developing and living with psychosis. The therapist attempts to reinforce a person's healthy ways of thinking and reduce internal conflict.
  • Cognitive enhancement therapy (CET), which seeks to build brain capacity through the use of computer exercises and group work. Increasing cognitive functions, such as the ability to organize thoughts, is the ultimate goal.
  • Family psychoeducation and support, which helps individuals who are living with psychosis and their families work on bonding, collaborating, problem solving and learning from each other. NAMI’s Family-to-Family program is available across the nation and has been shown to improve family functioning and outcomes in key measures. Family-to-Family is an evidence-based practice where the positive results were still seen 9 months after taking the class.

Medication

Once a diagnosed has been made, a health care provider may work to select a medication that can help to reduce these symptoms. Antipsychotics fall into two classes:

  • First generation, or typical, antipsychotics. These medications can cause movement problems that can be short (dystonia) or long term (called tardive dyskinesia), and also muscle stiffness. Other side effects can also occur.
  • Second generation, or atypical, antipsychotics. These medications are called atypical because they are less likely to block dopamine and cause movement disorders. They do, however, increase the risk of weight gain and diabetes. Changes in nutrition and exercise, and possibly medication intervention, can help address these side effects.

Some of the most common medications prescribed for psychotic disorders include:

  • Quetiapine (Serequel)
  • Clozapine (Clozaril)
  • Olanzapine (Zyprexa)
  • Risperidone (Risperdal)

The literature on the utility and effectiveness of the use of antispychotics early in the course of psychosis and emerging schizophrenia is evolving. Check with a doctor to see progress on the research studies in this important and evolving area.

Complementary Health Approaches

In one small study, omega-3 fatty acids, commonly found in fish oil, were found to decrease the risk of developing psychosis in young adults and teens who demonstrated early symptoms. Researchers believe that omega-3s may help by replenishing neurons and connections in the brain.

Hospitalization

For acute safety issues, people experiencing psychosis may need to be hospitalized during an episode, and may sometimes require sedation in order to be evaluated. Hospital staff will run tests to rule out any other potential causes for a psychotic episode, such as drugs and alcohol or another illness. Based on what they find, they will suggest a course of treatment. This can include medication, outpatient therapy or an extended inpatient stay.

Cultural Considerations

Different cultures have different needs, so working with a professional who is sensitive to cultural interpretations of illness can help improve recovery outcomes. For example, visual or auditory hallucinations with a religious content, such as hearing God’s voice, may be viewed as a normal part of religious experience.

Complications of Psychosis

Psychosis does not have many medical complications. However, if left untreated, it can make it hard for the people with this disorder to take good care of themselves. That could cause other illnesses to go untreated.

Is it Possible to Recover From Psychosis?

Most people who experience psychosis will recover with proper treatment. Even in severe cases, medication and therapy can help people live normal lives.

Residential Teen Treatment

Treatment for teens with a Psychotic Disorder varies, according to the nature of the disorder as well as the severity. In most cases, antipsychotic medication will be prescribed to help treat the delusional symptoms which the teen is experiencing. And in all cases, talk therapy will take place in combination with the medication.

Talk therapy for the teens in treatment will incorporate a number of different approaches, including group sessions and family sessions. Some of the most important aspects of this therapy is recognizing and addressing any potentially dangerous hallucinations or delusions, in order to protect the teen, and possibly others, from any harm. Then, therapists work with teens to discuss what the teens are experiencing, provide a safe environment with which to evaluate the falsity of these experiences, and then implement behaviors and techniques toward the teen’s holistic treatment plan.

Questions

What Causes a Teen Psychotic Disorder?

While there is not one known cause for Psychotic Disorders, there are several factors known to contribute: they tend to be hereditary, more likely in people who have experienced severe stress over a lasting amount of time, and be linked to an imbalance of brain chemicals.

What if I've Only Had One Hallucination or Delusion, So I'm Not Ready to be Diagnosed or Get Treatment?

Experiencing a hallucination or delusion can be very scary, and we understand it can also be scary to face that you may have a mental illness. However, even if you may not feel ready to be told what’s going on, or to get treatment, you’re probably also not “ready” for more similar experiences, and the symptoms of psychotic illnesses tend to increase with time. So we recommend talking to a therapist early on, and just take it a step at a time. If you do have a Psychotic Disorder and you got treatment as early as possible, you’re going to be glad and it’s going to be much easier on you.

Source: Paradigm Malibu, Healthline, NAMI