Psychotic disorders are among the most misunderstood mental health conditions, often portrayed in ways that don’t reflect the real experiences of those who live with them. In reality, these disorders involve serious but treatable disruptions in perception, thinking, and behavior that can make it difficult to tell what’s real from what isn’t. Military veterans are at higher risk of psychotic disorders, making this an issue when it comes to care for veterans.
What Are Psychotic Disorders?
Psychotic disorders are a group of severe mental health conditions that affect the way a person thinks, perceives reality, and interacts with the world around them. They constitute a break with reality, featuring distressing symptoms such as hallucinations and delusions.
These disorders can also cause disorganized thinking, unusual behavior, and difficulty communicating clearly or maintaining relationships. Psychotic disorders vary in severity and duration—some may occur briefly in response to stress or substance use; others, like schizophrenia, are chronic and require long-term treatment.
With proper medical care, therapy, and support, many people with psychotic disorders can manage their symptoms and lead fulfilling lives.
Who Is at Risk for Psychotic Disorders?
Anyone can develop a psychotic disorder, but certain factors can increase the likelihood of experiencing one. Genetics play a significant role—having a family member with schizophrenia or another psychotic disorder raises the risk. However, environmental and psychological influences are also important contributors.
Risk factors for psychotic disorders may include:
- Genetics: A family history of schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features.
- Brain chemistry and structure: Imbalances in neurotransmitters like dopamine or abnormalities in brain development.
- Trauma and stress: Experiencing severe stress, abuse, or trauma—especially during childhood or adolescence.
- Substance use: Using drugs such as cannabis, LSD, methamphetamine, or cocaine can trigger or worsen psychotic symptoms. Syd Barrett is a great example of someone who had a psychotic break due to drug abuse.
- Medical conditions: Certain neurological disorders, infections, or hormonal imbalances can sometimes lead to psychosis.
It’s important to note that having one or more of these risk factors does not mean a person will develop a psychotic disorder—only that their vulnerability may be higher. Early recognition and intervention can greatly improve outcomes and reduce the impact of symptoms.
Types of Psychotic Disorders
Psychotic disorders encompass a range of mental health conditions that share similar features, such as hallucinations, delusions, and disorganized thinking. However, each disorder differs in its duration, severity, and underlying causes. Understanding the distinctions between these conditions helps guide effective diagnosis and treatment.
Schizophrenia
Schizophrenia is one of the most well-known and severe psychotic disorders. It is a chronic mental health condition that affects how a person thinks, feels, and behaves. People with schizophrenia often struggle to distinguish reality from their own thoughts or perceptions. The condition typically develops in late adolescence or early adulthood and requires ongoing treatment. Schizophrenia can sometimes co-occur with PTSD, a condition many veterans are vulnerable to.
Symptoms of Schizophreniform Disorder
Symptoms include:
- Hallucinations and delusions
- Disorganized speech or thought patterns
- Decreased emotional expression
- Social or occupational difficulties
- Poor insight into one’s condition
Paraphrenia
Paraphrenia is similar to late-onset schizophrenia, typically developing in older adults. It involves persistent delusions and hallucinations but often without the significant personality changes or cognitive decline seen in other psychotic disorders.
Symptoms of Paraphrenia
Symptoms include:
- Persecutory delusions (believing others are plotting against them)
- Auditory hallucinations
- Suspiciousness or paranoia
- Intact memory and intelligence despite psychotic symptoms
- Withdrawal from social situations
Brief Psychotic Disorder
Brief psychotic disorder is a short-term condition in which an individual suddenly develops psychotic symptoms following a stressful or traumatic event. Symptoms appear abruptly and last for less than one month, after which the person typically recovers fully.
Symptoms of Brief Psychotic Disorder
Symptoms include:
- Sudden onset of delusions or hallucinations
- Disorganized or catatonic behavior
- Intense emotional turmoil or confusion
- Rapid recovery once symptoms subside
Delusional Disorder
Delusional disorder involves the presence of one or more persistent delusions without the other prominent symptoms of schizophrenia. Despite these false beliefs, individuals often maintain normal functioning in most areas of life.
Symptoms of Delusional Disorder
Symptoms include:
- Fixed false beliefs (e.g., being followed, loved from afar, or conspired against)
- No major hallucinations or disorganized speech
- Stable mood and personality outside delusional episodes
- Preoccupation with the delusion despite evidence to the contrary
Substance-induced Psychosis
Substance-induced psychosis occurs when drug or alcohol use triggers psychotic symptoms. This can happen during intoxication, withdrawal, or after long-term substance misuse. Common substances associated with psychosis include stimulants, hallucinogens, and alcohol.
Symptoms of Substance-induced Psychosis
Symptoms include:
- Hallucinations or delusions during or after substance use
- Agitation, paranoia, or extreme fear
- Confusion or disorganized thoughts
- Symptoms that subside after the substance leaves the body
How Are Psychotic Disorders Diagnosed?
Diagnosing a psychotic disorder involves a comprehensive evaluation by a mental health professional. Because many conditions can cause psychotic symptoms, accurate diagnosis is essential to determine the best treatment plan.
The diagnostic process typically includes:
- A clinical interview: A psychiatrist or psychologist assesses symptoms, behavior, and thought patterns.
- Medical evaluation: Blood tests or imaging may be used to rule out underlying medical or neurological causes.
- Psychiatric history: Information about family history, substance use, and previous mental health issues helps identify possible risk factors.
- Observation: Clinicians may monitor the person’s speech, affect, and ability to differentiate reality from delusion.
Psychotic disorder symptoms require prompt diagnosis and treatment. Delays in treatment can have a profound impact on a person’s life.
DSM5 Criteria for Psychotic Disorders
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides specific criteria for diagnosing psychotic disorders.
According to the DSM-5, a diagnosis typically requires the presence of one or more of the following core symptoms:
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms (such as flat affect or lack of motivation)
The duration and combination of symptoms help determine the specific disorder. For instance, schizophrenia requires continuous symptoms for at least six months, while brief psychotic disorder lasts less than one month.
Treatment for Psychotic Disorders
Treatment for psychotic disorders focuses on managing symptoms, improving functioning, and preventing relapse. Most people benefit from a combination of medication, psychotherapy, and supportive care. Early intervention is especially important, as prompt treatment can lead to better long-term outcomes.
Medications
Medications are often the cornerstone of psychotic disorder treatment. They help balance brain chemistry, reduce hallucinations or delusions, and stabilize mood.
Mood Stabilizers
Mood stabilizers, such as lithium or valproate, are commonly used when mood symptoms (like depression or mania) accompany psychosis—particularly in schizoaffective or bipolar-related psychotic disorders. These medications help reduce mood swings and improve emotional regulation.
Antipsychotic medications
Antipsychotic drugs are the primary treatment for schizophrenia and other psychotic disorders. They work by blocking dopamine receptors in the brain to reduce hallucinations, delusions, and disorganized thinking.
There are two different types of antipsychotics: first and second-generation. First-generation antipsychotics include haloperidol and chlorpromazine. Second-generation antipsychotics, which are obviously newer, include drugs such as risperidone, olanzapine, quetiapine, and aripiprazole, and tend to have fewer side effects and are commonly prescribed today.
Psychotherapy
Psychotherapy plays a key role in helping individuals manage symptoms, build coping skills, and improve quality of life. It’s often used alongside medication for the best outcomes.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy, or CBT, helps individuals recognize and challenge distorted thoughts or beliefs related to their psychosis. It also teaches coping strategies for managing anxiety, paranoia, or hallucinations. Over time, CBT can help patients gain better insight into their condition and reduce distress associated with symptoms.
Tips for Coping with a Psychotic Disorder
Living with a psychotic disorder can be challenging, but consistent treatment, strong support, and healthy habits can make a meaningful difference. Some helpful coping strategies include:
- Stick to your treatment plan: Take prescribed medications and attend therapy sessions regularly.
- Build a support network: Stay connected with friends, family, or support groups that understand your experiences.
- Reduce stress: Practice mindfulness, meditation, or gentle exercise to manage anxiety.
- Avoid drugs and alcohol: Substance use can worsen or trigger psychotic symptoms.
- Maintain structure: Create a daily routine to promote stability and focus.
Professional Help for Psychotic Disorder
If you or someone you love is experiencing psychosis, it’s important to know that effective help is available. Psychosis and related disorders—including psychosis and schizophrenia—can cause distressing symptoms of psychosis such as visual hallucinations, hearing voices, or believing in types of delusions that feel completely real. These symptoms can make daily life overwhelming, but you don’t have to face them alone.
At Footprints to Recovery, our compassionate team provides specialized mental health care focused on the treatment of psychosis. Through research-based therapies like talking therapy, medication, and supportive interventions, we’ve helped people regain control, stability, and confidence. We understand the causes of psychosis can vary—from trauma and substance use to genetics—and we tailor every treatment for psychosis to the individual. Aliya Veterans employs mental health treatment experts, including veterans and former first-responders, on staff to provide such treatment to veterans such as yourself.
Whether you’ve begun to develop psychosis, are in the midst of psychotic episodes, or are supporting a person with psychosis, early intervention is key. People with psychosis can recover and live fulfilling lives with the right support. Reach out to Footprints to Recovery today to learn more about understanding psychosis and how to get psychosis treated through compassionate, personalized care.
Your path to healing from mental illness starts here—contact us today and take the first step toward recovery.