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| Severe Wingnut Psychosis: The sudden and uncontrollable impulse, and or urge to bash in my television set with a large, metal object due to the exposure of CNN, MSNBC, and FOX News. | |||
| '''Psychosis''' is a ] classification for a ] in which the perception of ] is distorted. Persons experiencing a psychotic episode may experience ]s (often ] or ] hallucinations), hold ] or ] beliefs, experience ] changes and exhibit disorganized thinking (see ]). This is sometimes accompanied by features such as a ] into the unusual or bizarre nature of their behavior, difficulties with social interaction and impairments in carrying out the activities of daily living. | |||
| ==Overview== | |||
| Psychosis is usually considered by mainstream ] to be a symptom of severe ]. Although it is not exclusively linked to any particular psychological or physical state, it is particularly associated with ], ] (manic depression) and severe ]. | |||
| It is not uncommon in cases of ] and may occur after ] use, particularly after ] or chronic use, although certain compounds may be more likely to induce psychosis, and some individuals may show greater sensitivity than others. The direct effects of ]s are not usually classified as psychosis, as long as they abate when the drug is metabolised from the body. | |||
| Chronic ] is also known to cause psychotic states, however the exact mechanism is uncertain. Psychosis triggered by stress in the absence of any other mental illness is known as ]. | |||
| Psychosis is a descriptive term for a complex group of behaviours and experiences and as such is not a medical ] in itself. Perhaps because of this, it is often confused with syndromes which may seem similar on the surface, or with words which may suggest, or seem to suggest a likeness. | |||
| The term ''psychosis'' should be distinguished from the concept of ], which is a legal term denoting that a person should not be criminally responsible for his actions. Similarly, it should be distinguished from ], a ] often associated with violence, lack of ] and socially manipulative behaviour. Despite the fact that both are colloquially abbreviated to 'psycho', psychosis bears little similarity to psychopathy's core features, particularly with regard to violence, which rarely occurs in psychosis, and the distortion of perceived reality, which rarely occurs in psychopathy. | |||
| It should also be distinguished from the state of ], in that a psychotic individual may be able to perform actions that require a high level of intellectual effort in clear consciousness. Finally, it should be distinguished from mental illness. Psychosis may be regarded as a symptom of other mental illnesses, but as a descriptive concept it is not considered an illness in its own right. For example, persons with ] can have long periods without psychosis and persons with ] and depression can have mood symptoms without psychosis. Conversely, psychosis can occur in persons without chronic mental illness as a result of an adverse drug reaction or extreme stress. | |||
| Psychosis has been of particular interest to critics of mainstream psychiatric practice who argue that it may simply be another way of constructing reality and is not necessarily a sign of illness. For example, ] has argued that psychosis is a symbolic way of expressing concerns in situations where such views may be unwelcome or uncomfortable to the recipients. ] has focused on the social implications of labelling people as psychotic, a label which he argues unjustly medicalises different views of reality so such unorthodox people can be controlled by society. | |||
| ]: The word ''psychosis'' was first used by Ernst von Feuchtersleben in ] as an alternative to ] and ] and stems from the Greek ''psykhe'' (mind) and ''osis'' (diseased or abnormal condition). The word was used to distinguish disorders which were thought to be disorders of the mind, as opposed to ], which was thought to stem from a disorder of the nerves. | |||
| ==Psychotic experience== | |||
| A psychotic episode can be significantly coloured by mood. For example, people experiencing a psychotic episode in the context of depression may experience persecutory or self-blaming delusions or hallucinations, whilst people experiencing a psychotic episode in the context of ] may form grandiose delusions or have an experience of deep religious significance. | |||
| Although usually distressing and regarded as an illness process, some people who experience psychosis find beneficial aspects and value the experience or revelations that stem from it. | |||
| ===Hallucinations=== | |||
| ] are defined as sensory perception in the absence of external stimuli. Psychotic hallucinations may occur in any of the five senses and take on almost any form, which may include simple sensations (such as lights, colours, tastes, smells) to more meaningful experiences such as seeing and interacting with fully formed animals and people, hearing voices and complex tactile sensations. | |||
| Auditory hallucinations, particularly the experience of hearing voices, is a common and often prominent feature of psychosis. Hallucinated voices may talk about, or to the person, and may involve several speakers with distinct personas. Auditory hallucinations tend to be particularly distressing when they are derogatory, commanding or preoccupying. | |||
| ===Delusions and paranoia=== | |||
| Psychosis may involve ] or ] beliefs. ] classified psychotic delusions into ''primary'' and ''secondary'' types. Primary delusions are defined as arising out-of-the-blue and not being comprehensible in terms of normal mental processes, whereas secondary delusions may be understood as being influenced by the person's background or current situation. | |||
| ===Thought disorder=== | |||
| ] describes an underlying disturbance to conscious thought and is classified largely by its effects on speech and writing. Affected persons may show pressure of speech (speaking incessantly and quickly), derailment or flight of ideas (switching topic mid-sentence or inappropriately), thought blocking, rhyming or punning. | |||
| ===Lack of insight=== | |||
| One important and puzzling feature of psychosis is usually an accompanying lack of insight into the unusual, strange or bizarre nature of the person's experience or behaviour. Even in the case of an acute psychosis, the sufferer may seem completely unaware that their vivid hallucinations and impossible delusions are in any way unrealistic. This is not an absolute, however; insight can vary between individuals and throughout the duration of the psychotic episode. | |||
| In some cases, particularly with auditory and visual hallucinations, the patient has good insight and this makes the psychotic experience even more terrifying in that the patient realizes that he should not be hearing voices, but does. | |||
| ==Medical understanding of psychosis== | |||
| There are a number of possible causes for psychosis. Psychosis may be the result of an underlying mental illness such as ] (also known as manic depression), and ]. Psychosis may also be triggered or exacerbated by severe mental stress and high doses or chronic use of drugs such as ], ], ], ] or ]. However, incidence of psychosis resulting from a single administration of any drug is rare, although cases have been reported in the medical literature suggesting a person's sensitivities to new compounds can be unpredictable. As can be seen from the wide variety of illnesses and conditions in which psychosis has been reported to arise (including for example, ], ], ] and even ]) there is no singular cause of a psychotic episode. | |||
| The division of the major psychoses into ] (now called ]) and dementia praecox (now called ]) was made by ], who attempted to create a synthesis of the various mental disorders identified by ] ], by grouping diseases together based on classification of common symptoms. Kraepelin used the term 'manic depressive insanity' to describe the whole spectrum of ]s, in a far wider sense than it is usually used today. In Kraepelin's classification this would include 'unipolar' ], as well as ] and other mood disorders such as ]. These are characterised by problems with mood control and the psychotic episodes appear associated with disturbances in mood, and patients will often have periods of normal functioning between psychotic episodes even without medication. Schizophrenia is characterized by psychotic episodes which appear to be unrelated to disturbances in mood, and most non-medicated patients will show signs of disturbance between psychotic episodes. | |||
| Psychotic episodes may vary in duration between individuals. In ], the psychotic episode is related directly to a specific stressful life event so patients may spontaneously recover normal functioning within two weeks. In some rare cases, individuals may remain in a state of full blown psychosis for many years, or perhaps have attenuated psychotic symptoms (such as low intensity hallucinations) present at most times. | |||
| Patients who are undergoing a brief psychotic episode may have many of the same symptoms as a person who is psychotic as a result of (for example) schizophrenia, and this fact has been used to support the notion that psychosis is primarily a breakdown in some specific biological system in the brain. The ] was an early, and still popular, example of a theory based on this assumption. However, it is controversial how much weight should be given to such exclusively biological theories as it has become clearer that a wide range of influences (including environmental, social and childhood development factors) may contribute to the final experience of psychosis. | |||
| It has also been argued that psychosis exists on a continuum as everybody may have some unusual and potentially reality-distorting experiences in their life. This has been backed up by research showing that experiences such as hallucinations have been experienced by large numbers of the population who may never be impaired or even distressed by their experiences]. In this view, people who are diagnosed with a psychotic illness may simply be one end of a spectrum where the experiences become particularly intense or distressing (see ]). | |||
| ===Psychosis and brain function=== | |||
| The first brain image of person with psychosis was completed as far back as ] using a technique called ]] (a painful and now obsolete procedure where ] is drained from around the brain and replaced with air to allow the structure of the brain to show up more clearly on an ] picture). | |||
| ] | |||
| Modern brain imaging studies, investigating both changes in brain structure and changes in brain function of people undergoing psychotic episodes have shown mixed results. | |||
| A ] study investigating structural changes in the brains of people with psychosis showed there was significant ] reduction in the ] of people before and after they became psychotic]. Findings such as these have led to debate about whether psychosis is itself ] and whether potentially damaging changes to the brain are related to the length of psychotic episode. Recent research has suggested that this is not the case] although further investigation is still ongoing. | |||
| Functional brain scans have revealed that the areas of the brain that reacts to sensory perceptions are active during psychosis. For example, a ] or ] scan of a person who claims to be hearing voices may show activation in the auditory cortex, or parts of the brain involved in the perception and understanding of speech. | |||
| On the other hand, there is not a clear enough psychological definition of ] to make a comparison between different people particularly valid. Brain imaging studies on delusions have typically relied on correlations of brain activation patterns with the presence of delusional beliefs. | |||
| One clear finding is that persons with a tendency to have psychotic experiences seem to show increased activation in the right hemisphere of the brain]. This increased level of right hemisphere activation has also been found in healthy people who have high levels of ] beliefs] or in people who report ] experiences]. It also seems to be the case that people who are more creative are also more likely to show a similar pattern of brain activation]. Some researchers have been quick to point out that this in no way suggests that paranormal, mystical or creative experiences are in any way ''by themselves'' a symptom of mental illness, as it is still not clear what makes some such experiences beneficial whilst others lead to the impairment or distress of diagnosable mental pathology. However, people who have profoundly different experiences of reality or hold unusual views or opinions have traditonally held a complex role in society, with some being viewed as ]s, whilst others are lauded as ]s or visionaries. | |||
| Psychosis has been traditionally linked to the ] ]. In particular, the ] has been influential and states that psychosis results from an overactivity of dopamine function in the brain, particularly in the ]. The two major sources of evidence given to support this theory are that dopamine blocking drugs (i.e. ]s) tend to reduce the intensity of psychotic symptoms, and that drugs which boost dopamine activity (such as ] and ]) can trigger psychosis in some people (see ]). | |||
| Nevertheless, the connection between dopamine and psychosis is generally believed to be complex. First of all, while anti-psychotic drugs immediately block dopamine receptors, they usually take a week or two to reduce the symptoms of psychosis. Moreover, newer and equally as effective antipsychotic drugs actually block slightly less dopamine in the brain than older drugs whilst also affecting ] function, suggesting the 'dopamine hypothesis' is vastly oversimplified. | |||
| Psychiatrist ] has criticised pharmaceutical companies for promoting simplified biological theories of mental illness that seem to imply the primacy of pharmaceutical treatments while ignoring social and developmental factors which are known to be important influences in the aetiology of psychosis]. | |||
| Some theories regard many psychotic symptoms to be a problem with the perception | |||
| of ownership of internally generated thoughts and experiences]. For example, the experience of hearing voices may arise from internally generated speech that is mislabelled by the psychotic person as coming from an external source. | |||
| ===Cannabis and psychosis=== | |||
| There is now growing evidence for a small but significant link between ] use and vulnerability to psychosis]. Some studies indicate that cannabis use correlates with a slight increase in psychotic experience, which may trigger full-blown psychosis in some people. Early studies have been criticized for failing to consider other drugs (such as LSD) that the participants may also have used before or during the study, as well as other factors such as possible pre-existing mental health issues. However, more recent studies with better controls have still found a small increase in risk for psychosis in cannabis users. It is still not clear whether this is a causal link, and it may be that cannabis use only increases the chance of psychosis in people already predisposed to it. The fact that cannabis use has increased over the past few decades, whereas the rate of psychosis has not, suggests that a direct causal link is unlikely for all users. | |||
| ===Non-psychiatric conditions and psychosis=== | |||
| Psychosis can be a feature of several diseases, often when the ] or ] is directly affected. However, the fact that psychosis can occasionally arise in parallel with number of ailments (including diseases such as ] or ] for example) suggests that a variety of nervous system stressors can lead to a psychotic reaction. Psychosis arising from non-psychiatric conditions is sometimes known as 'secondary psychosis'. The mechanisms by which this happens is still not clear, but the non-specificity of psychosis has led Tsuang and colleagues to argue that "psychosis is the 'fever' of mental illness - a serious but nonspecific indicator"]. | |||
| There are some non-psychiatric conditions which are linked particularly to psychosis, which may include: | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] (it is one of the 19 types of nervous system involvement in SLE). | |||
| * ] | |||
| <!--* Etc looking for a good resource on secondary psychosis--> | |||
| ==See also== | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| ==Further reading== | |||
| ===Medicine=== | |||
| *Sims, A. (2002) ''Symptoms in the mind: An introduction to descriptive psychopathology (3rd edition)''. Edinburgh: Elsevier Science Ltd. ISBN 0702026271 | |||
| ===Personal accounts=== | |||
| *] (1981) '']''. London: Gollancz. ISBN 0679734465 | |||
| *] (1995) ''An Unquiet Mind: A Memoir of Moods and Madness''. London: Picador.<br> ISBN 0679763309 | |||
| * Misplaced Pages entry for ] | |||
| *Schreber, D.P. (2000) ''Memoirs of My Nervous Illness''. New York: New York Review of Books. ISBN 094032220X | |||
| == External links == | |||
| * | |||
| * - paintings and drawings about and during psychotic experiences | |||
| * Research: On being sane in insane places | |||
| ==References== | |||
| <sup>1</sup>Moore, MT, Nathan, D, Elliot, AR & Laubach, C. (1935) Encephalographic studies in mental disease. ''American Journal of Psychiatry'', 92 (1), 43-67.<br> | |||
| <sup>2</sup> Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. ''Lancet'', 25, 361 (9354), 281-8.<br> | |||
| <sup>3</sup> Untreated initial psychosis: relation to cognitive deficits and brain morphology in first-episode schizophrenia. ''American Journal of Psychiatry'', 160(1), 142-148.<br> | |||
| <sup>4</sup> Lateralized hemispheric dysfunction in the major psychotic disorders: historical perspectives and findings from a study of motor asymmetry in older patients. ''Schizophrophrenia Research'', 30, 27(2-3), 191-8. <br> | |||
| <sup>5</sup> Brain electric correlates of strong belief in paranormal phenomena: intracerebral EEG source and regional Omega complexity analyses. ''Psychiatry Research'', 100(3), 139-154.<br> | |||
| <sup>6</sup> Temporal lobe signs: electroencephalographic validity and enhanced scores in special populations. ''Perceptual and Motor Skills'', 60(3), 831-842.<br> | |||
| <sup>7</sup> Are creativity and schizotypy products of a right hemisphere bias? ''Brain and Cognition'', 49(1), 138-151.<br> | |||
| <sup>8</sup>] (2002) ''The Creation of Psychopharmacology''. Cambridge, MA: Harvard University Press. ISBN 0674006194<br> | |||
| <sup>9</sup> The perception of self-produced sensory stimuli in patients with auditory hallucinations and passivity experiences: evidence for a breakdown in self-monitoring. ''Psychological Medicine'', 30 (5), 1131-9.<br> | |||
| <sup>10</sup> The continuity of psychotic experiences in the general population. ''Clinical Psychology Review'', 21 (8), 1125-41.<br> | |||
| <sup>11</sup> Editorial: The link between cannabis use and psychosis: furthering the debate. ''Psychological Medicine'', 33, 3-6.<br> | |||
| <sup>12</sup> Toward reformulating the diagnosis of schizophrenia. ''American Journal of Psychiatry'', 157(7), 1041-1050.<br> | |||
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Revision as of 04:59, 12 April 2005
Severe Wingnut Psychosis: The sudden and uncontrollable impulse, and or urge to bash in my television set with a large, metal object due to the exposure of CNN, MSNBC, and FOX News.