Psychotic Disorders

When reality and imagination become one

Do you know the feeling of "drifting off”? When your surroundings disappear, and you get a little lost in your imagination or your present task? A daydream can sometimes be beautiful, sometimes weird, or negative, when we just want to shake them off and keep going with our day.

Do you know the feeling of "drifting off”? When your surroundings disappear, and you get a little lost in your imagination or your present task? A daydream can sometimes be beautiful, sometimes weird, or negative, when we just want to shake them off and keep going with our day.
When imagined things, like the contents of a daydream or voices that speak to us, become indistinguishable from reality, then we could be dealing with the first signs of a psychotic disorder. People who suffer from a psychosis oftentimes do not realize they do so – after all, imagined things seem as real as anything else, so why question it? –, and can easily seem weird to the people around them without understanding why. That is why it is very important to treat these affected people with respect, and for friends and family to be there for them, help them, and encourage them to deal with their disorder in an adequate way.

 

Overview

In the beginning of a psychosis, the affected person will oftentimes realize later than others that they act differently than they would normally. This is due to the fact that a psychosis means an indistinguishable line between what is real and what is imagined. People who suffer from a psychosis might feel like they are being followed, or that nobody seems to want to understand them – even though what they experience is as real to them as day and night. Imagine how you would feel if you were reading this text, and someone comes along and tells you that what you are holding in your hand is not a mobile device or a laptop, but an empty piece of paper and that you are not reading anything and being crazy and imagining things. Yet here you are, knowing for a fact that you have just read all the information above and gotten to know a little bit about psychotic disorders – clear memories in your head from just a few moments ago. You would not believe the other person and probably be very suspicious of why they would want to make you believe things that you clearly know are not as they say they are. This is why people who suffer from a psychosis are sometimes quite difficult to reach and why they might resist talking about their actions and problems.

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Beim Beginn einer Psychose bemerken die betroffenen Personen meist erst später als ihre Angehörigen, dass sie sich anders verhalten als zuvor. Das liegt daran, dass für die betroffene Person Wirklichkeit und Einbildung oft nicht mehr zu unterscheiden sind. Menschen, die an einer Psychose erkrankt sind, haben auch häufig das Gefühl, dass sie verfolgt werden oder niemand sie versteht – sie sind schwieriger zu erreichen und wehren sich gegen Gespräche über ihr Verhalten.

 

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Hallucinations

The affected person perceives something that is not actually there. It could be hearing a voice, or music, without someone actually speaking, or without the radio being turned on. It could also be visual – meaning the person sees things or people that are also not there. Sometimes hallucinations can also be in the forms of smells and even touch – like feeling like insects are crawling over one’s skin.

Delusions

The affected person is deeply convinced of a fact that is factually not possible, or that can even be easily proven as wrong, or as only existing in the imagination of the person. It could be the thought that friends are constantly watching and wishing evil upon the affected person. It could also be the thought that something that is said on TV is directly intended towards the affected person and will lead to other people now chasing him or her.

Ego-disorder

The affected person loses touch with what is the self and what is the environment. This can lead to the feeling of being controlled by others, or that someone has planted thoughts into the mind of the affected person. Or it could be that the person is sure that reality and the self is something unrealistic and that others are able to read their minds.

Seemingly weird movements or speech

The affected person is moving differently to how she or he would normally move or is speaking in unfinished sentences that do not make sense.

Strong difficulties to concentrate

Quick to be distracted, jumping from one topic to the next.

These symptoms are called positive symptomsLike in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way.Plus“ in der Mathematik 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

Not everyone who seems or feels “weird” or distanced for a while is automatically subject to a psychotic disorder. But when the symptoms prevail and start to sincerely disturb daily life and social interactions it is important to look closer. Especially in the case of a psychotic disorder, the symptoms can seem very destructive and limiting. People who suffer from a psychotic disorder are easily be seen as “crazy” – this is why you should be sensitive when approaching someone you are worried about. Characteristically for a psychotic disorder, it might be very difficult to reach or talk to the affected person. If someone is convinced that even friends and family are conspiring against her or him, helping will probably be rejected and resisted. This is not to be taken personally but understood as part of the disorder and not to be worked against. Don’t be afraid to observe and recognize any changes in behaviour in yourself and people who are close to you. Take them seriously if they become significant. Talking and helping is always better than looking away! Feeling confused, or anxious, or losing grasp of what is real and what is not is not easy, nor particularly pleasant – whether this is due to an illness or not. There are ways to deal with these sorts of problems.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide

These symptoms are called positive symptoms this means something is added to the person’s perception or the way she or he acts, which was not there before the psychotic disorder. Like in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way. 

 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

 

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

 

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

 

Nicht bei jedem Menschen, der mal für eine Weile „seltsam“ wirkt oder sich zurückzieht, muss man sich Sorgen über eine psychotische Erkrankung machen. Allerdings sind besonders die Symptome einer psychotischen Erkrankung dadurch geprägt, dass sie die Lebensqualität, den Alltag und die sozialen Beziehungen der betroffenen Person stark einschränken. Menschen, die an einer Psychose leiden, werden schnell als „verrückt“ verurteilt – deswegen solltest du sensibel auf die Person zugehen, um die du dir Sorgen machst. Besonders bei Menschen mit einer psychotischen Erkrankung kann es schwierig sein, an sie heran zu kommen. Wenn eine dir nahestehende Person davon überzeugt ist, dass sich Freundinnen, Freunde und Familie gegen sie verschworen haben, dann wird sie sich wahrscheinlich nicht von euch helfen lassen wollen. Das solltest du nicht persönlich nehmen, sondern verstehen, dass diese Wahnvorstellung Teil der Krankheit ist. Beobachte dich selbst, deine Freundinnen, Freunde und Familienmitglieder, und nimm Verhaltensveränderungen ernst. Reden und helfen ist immer besser als wegschauen! Sich durcheinander zu fühlen, ängstlich zu sein oder sich in eingebildeten Realitäten zu verlieren, ist für niemanden schön – ob es nun mit einer Erkrankung zu tun hat oder nicht. Doch es gibt sicherlich eine Möglichkeit, das Problem anzugehen.

 

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide

A psychosis is a mental illness. Just like with a bodily sickness, the affected person does not really have an influence on whether or not she or he suffers from a psychosis. Oftentimes, the occurrence of a psychosis can be linked to a traumatic experience, or a difficult phase in life. The misuse of drugs can also be the cause of a psychosis – sometimes the single use of a drug will cause it.

This could be due to increasingly high dosage of dangerous substances within drugs – also those that are said to be harmless.

Caution: As with any psychological disorder, people who suffer from a psychosis are never to blame for being ill – even if they, for example, misused drugs. It is never that easy. Some people are just predisposed to a psychosis by their genes and by people in their family having suffered from a psychosis. For others, the disorder comes “out of the blue”. A psychosis is subject to the transmitting and communicating substances in our brain – a complex interaction that we can’t see or influence from the outside. So, what can be said for sure is: There are different causes and influences for the occurrence of a psychosis, or that work against a psychosis; some of which we can work on, some of which we cannot. For many people, a psychosis starts with a phase that is often accompanied by a depression. Oftentimes, first signs of a psychosis are already visible in the teenage years, although this is often labelled as “just being teenagers”. This is why help often arrives late for the people who need it – although especially in the case of a psychosis, early treatment would be very helpful.

Dass wir täglichen Herausforderungen und Schwierigkeiten unterschiedlich begegnen, hängt von unserer persönlichen Widerstandskraft ab – der sogenannten Resilienz. Sie wird zum Beispiel dadurch gestärkt, dass wir ein Gefühl von Sicherheit und allgemeiner Zufriedenheit verspüren, unsere sozialen Kontakte pflegen und uns angemessen um uns selbst kümmern. Weitere Informationen findest du unter Psyche and resilience.

Experts often describe the onset of a psychosis as a vicious cycle. Especially people who often feel uncomfortable and do not get much support by friends and family are susceptible to psychoses. But exactly these vital things – social contacts and the well-being – are the first to break off in the beginning of a psychotic disorder. So, if a person who is susceptible to a psychotic disorder is exposed to a lot of stress, needs to tackle a difficult phase in life alone, or when social contacts start breaking away, the point can be reached where she or he just can’t deal with these challenges anymore – at least not alone. Sudden changes, like the loss of an important person or a loved one getting sick, can also become such a heavy burden to carry, that they trigger the first symptoms of a psychosis.

Experts often describe the onset of a psychosis as a vicious cycle. Especially people who often feel uncomfortable and do not get much support by friends and family are susceptible to psychoses. But exactly these vital things – social contacts and the well-being – are the first to break off in the beginning of a psychotic disorder. So, if a person who is susceptible to a psychotic disorder is exposed to a lot of stress, needs to tackle a difficult phase in life alone, or when social contacts start breaking away, the point can be reached where she or he just can’t deal with these challenges anymore – at least not alone. Sudden changes, like the loss of an important person or a loved one getting sick, can also become such a heavy burden to carry, that they trigger the first symptoms of a psychosis.

For example, there is the delusional disorder, in which the affected person experiences a new reality. She or he is absolutely certain that their subjective and imagined reality is the true reality. It could be paired with an understanding of others not seeing the same things and having a different reality – but such drastic misunderstandings can also lead to anger and aggression.
An example of delusions is a delusion of love, in which the affected person is certain that a specific person is in love with him or her – this goes so far that, even if the other person is in a relationship and told the affected person that she or he is not interested and happily married, the affected person will simply believe this to be a lie. Another widespread example is the delusion of prosecution, whereby the affected people feel watched and followed, even in their most private spaces.

Another form is schizophrenia, whereby affected people experience hallucinations and delusions over a longer period of time. Their speech and actions might seem blurred or disconnected. This may lead to them feeling uncomfortable or making others feel uncomfortable, often leading to unacceptance and distance in their usual social environment. A person with schizophrenia might experience fluctuations in the symptoms – sometimes weaker, sometimes stronger symptoms –, but in the long run schizophrenia will probably cause great changes in the affected person’s life: She or he is not able to keep up with the work of school or a job, the person falls behind with social contacts and family, and stops taking care of daily tasks and her or his own human needs - like eating, movement, and hygiene.

These two forms of psychotic disorders are just examples of the wide range of directions this illness can take. As with many other psychological disorders, a psychotic disorder can appear in combination or linked to another mental disorder – psychologists speak of a schizo-affective disorder.

Which type of psychotic disorder you or the person close to you deals with is impossible to simply say and poses a question to be answered with the help of a professional contact person. Such a professional can make a diagnosis and find out, in cooperation with you or the affected person, which therapy suits the individual needs and would lead to the regaining of the desired quality of daily life.

A person with a psychotic disorder will often feel like no one understands her or him. Oftentimes, she or he will not understand that there is a problem at all, since the perceived realities and convictions are unmistakably taken for the “right ones”, even if contradicting evidence exists. But it is important to take affected people and their views seriously, to treat them with respect, and support them as best as friends and family can to get the help that they might need.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

What does a psychosis feel like?

In the beginning of a psychosis, the affected person will oftentimes realize later than others that they act differently than they would normally. This is due to the fact that a psychosis means an indistinguishable line between what is real and what is imagined. People who suffer from a psychosis might feel like they are being followed, or that nobody seems to want to understand them – even though what they experience is as real to them as day and night. Imagine how you would feel if you were reading this text, and someone comes along and tells you that what you are holding in your hand is not a mobile device or a laptop, but an empty piece of paper and that you are not reading anything and being crazy and imagining things. Yet here you are, knowing for a fact that you have just read all the information above and gotten to know a little bit about psychotic disorders – clear memories in your head from just a few moments ago. You would not believe the other person and probably be very suspicious of why they would want to make you believe things that you clearly know are not as they say they are. This is why people who suffer from a psychosis are sometimes quite difficult to reach and why they might resist talking about their actions and problems.

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Beim Beginn einer Psychose bemerken die betroffenen Personen meist erst später als ihre Angehörigen, dass sie sich anders verhalten als zuvor. Das liegt daran, dass für die betroffene Person Wirklichkeit und Einbildung oft nicht mehr zu unterscheiden sind. Menschen, die an einer Psychose erkrankt sind, haben auch häufig das Gefühl, dass sie verfolgt werden oder niemand sie versteht – sie sind schwieriger zu erreichen und wehren sich gegen Gespräche über ihr Verhalten.

 

Psychotic disorders can take different shapes and forms and are therefore classified along a wide range of illnesses – like schizophrenia, or delusional disorders. However, the symptoms that point toward any such psychotic disorder are largely the same in the beginning:

Hallucinations

The affected person perceives something that is not actually there. It could be hearing a voice, or music, without someone actually speaking, or without the radio being turned on. It could also be visual – meaning the person sees things or people that are also not there. Sometimes hallucinations can also be in the forms of smells and even touch – like feeling like insects are crawling over one’s skin.

Delusions

The affected person is deeply convinced of a fact that is factually not possible, or that can even be easily proven as wrong, or as only existing in the imagination of the person. It could be the thought that friends are constantly watching and wishing evil upon the affected person. It could also be the thought that something that is said on TV is directly intended towards the affected person and will lead to other people now chasing him or her.

Ego-disorder

The affected person loses touch with what is the self and what is the environment. This can lead to the feeling of being controlled by others, or that someone has planted thoughts into the mind of the affected person. Or it could be that the person is sure that reality and the self is something unrealistic and that others are able to read their minds.

Seemingly weird movements or speech

The affected person is moving differently to how she or he would normally move or is speaking in unfinished sentences that do not make sense.

Strong difficulties to concentrate

Quick to be distracted, jumping from one topic to the next.

These symptoms are called positive symptomsLike in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way.Plus“ in der Mathematik 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

Not everyone who seems or feels “weird” or distanced for a while is automatically subject to a psychotic disorder. But when the symptoms prevail and start to sincerely disturb daily life and social interactions it is important to look closer. Especially in the case of a psychotic disorder, the symptoms can seem very destructive and limiting. People who suffer from a psychotic disorder are easily be seen as “crazy” – this is why you should be sensitive when approaching someone you are worried about. Characteristically for a psychotic disorder, it might be very difficult to reach or talk to the affected person. If someone is convinced that even friends and family are conspiring against her or him, helping will probably be rejected and resisted. This is not to be taken personally but understood as part of the disorder and not to be worked against. Don’t be afraid to observe and recognize any changes in behaviour in yourself and people who are close to you. Take them seriously if they become significant. Talking and helping is always better than looking away! Feeling confused, or anxious, or losing grasp of what is real and what is not is not easy, nor particularly pleasant – whether this is due to an illness or not. There are ways to deal with these sorts of problems.

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide

These symptoms are called positive symptoms this means something is added to the person’s perception or the way she or he acts, which was not there before the psychotic disorder. Like in mathematics, positive as a quality means adding to something, rather than being good or feeling any special way. 

 

Positive symptoms are new behaviors or abnormalities that are not part of the person's previous nature, they are new additions.

 

Other symptoms can be:

    • Loss of interest in things and activity that used to be very important to the affected person.
    • Lack of motivation and a subsequent withdrawal from the social environment.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.
    • Speech and movement in general become less and less – the affected person could, for example, only answer with the fewest necessary words and move significantly slower than before.

These symptoms are called negative symptoms – Like in mathematics, negative means something becomes less, rather than negative being an emotional quality of something.

 

Negative symptoms mean that normal characteristics and behavioural habits start to decline and become less.

 

Nicht bei jedem Menschen, der mal für eine Weile „seltsam“ wirkt oder sich zurückzieht, muss man sich Sorgen über eine psychotische Erkrankung machen. Allerdings sind besonders die Symptome einer psychotischen Erkrankung dadurch geprägt, dass sie die Lebensqualität, den Alltag und die sozialen Beziehungen der betroffenen Person stark einschränken. Menschen, die an einer Psychose leiden, werden schnell als „verrückt“ verurteilt – deswegen solltest du sensibel auf die Person zugehen, um die du dir Sorgen machst. Besonders bei Menschen mit einer psychotischen Erkrankung kann es schwierig sein, an sie heran zu kommen. Wenn eine dir nahestehende Person davon überzeugt ist, dass sich Freundinnen, Freunde und Familie gegen sie verschworen haben, dann wird sie sich wahrscheinlich nicht von euch helfen lassen wollen. Das solltest du nicht persönlich nehmen, sondern verstehen, dass diese Wahnvorstellung Teil der Krankheit ist. Beobachte dich selbst, deine Freundinnen, Freunde und Familienmitglieder, und nimm Verhaltensveränderungen ernst. Reden und helfen ist immer besser als wegschauen! Sich durcheinander zu fühlen, ängstlich zu sein oder sich in eingebildeten Realitäten zu verlieren, ist für niemanden schön – ob es nun mit einer Erkrankung zu tun hat oder nicht. Doch es gibt sicherlich eine Möglichkeit, das Problem anzugehen.

 

If you observe one or more of the following symptoms in your own behaviour or in someone around you, it is important to take them seriously and try to take action.

    • Occurrence of delusional thoughts that feel threatening or dangerous
    • Reluctance toward friends or family, maybe even in the form of anger or breaking contact completely
    • Threats to use violence against oneself or others (perhaps even strangers)
    • Recurring thoughts and talks about death and suicide
Where does a psychosis come from?

Eine Psychose ist eine seelische, also psychische Krankheit. Wie bei einer körperlichen Krankheit haben wir keinen Einfluss darauf, ob wir an einer Psychose erkranken oder nicht. Oft hängt der Ausbruch einer psychotischen Krankheit mit einem besonders belastenden Ereignis oder einer schwierigen Lebensphase zusammen. Bei psychotischen Erkrankungen kann allerdings auch der Missbrauch von Drogen eine Rolle spielen – manchmal reicht der einmalige Konsum von Drogen aus, um eine Psychose auszulösen.

Das liegt zum Beispiel an immer stärkeren Dosen gefährlicher Stoffe in Drogen – auch in denen, die als „harmlos“ gelten. Einen Überblick darüber, welchen Einfluss Drogen auf unsere Psyche haben, bekommst du here.

Aber Vorsicht: Wie bei allen anderen psychischen Erkrankungen auch, hat eine an einer Psychose erkrankte Person nicht „selbst Schuld“ daran, dass sie erkrankt ist – auch nicht, wenn sie zum Beispiel Drogen konsumiert hat. Manche von uns sind vorbelastet, zum Beispiel dadurch, dass jemand in der Familie bereits an einer Psychose erkrankt ist. Für andere kommt die Erkrankung wie „aus dem Nichts“.

Auch eine Psychose hängt mit den Botenstoffen im Gehirn zusammen – ein komplexes Zusammenspiel, das wir von außen weder sehen oder steuern können.

Fest steht also: Es gibt einige Ursachen und Einflüsse, die den Ausbruch einer Psychose begünstigen oder ihm entgegenwirken, und an manchen können wir selbst arbeiten, während wir auf andere keinen Einfluss haben.

Bei vielen Menschen beginnt eine psychotische Krankheit mit einer Phase, die von Depressionen geprägt ist. Häufig sind erste Anzeichen einer Psychose bereits im Jugendalter erkennbar, werden dann aber als „typisches Teenagerverhalten“ abgestempelt. Deswegen suchen sich leider viele betroffene Personen erst sehr spät Hilfe – doch gerade bei einer Psychose sind die Erfolgschancen einer Therapie dann am größten, wenn diese frühzeitig begonnen wird.

Dass wir täglichen Herausforderungen und Schwierigkeiten unterschiedlich begegnen, hängt von unserer persönlichen Widerstandskraft ab – der sogenannten Resilienz. Sie wird zum Beispiel dadurch gestärkt, dass wir ein Gefühl von Sicherheit und allgemeiner Zufriedenheit verspüren, unsere sozialen Kontakte pflegen und uns angemessen um uns selbst kümmern. Weitere Informationen findest du unter Psyche and resilience.

What happens during a psychosis?

Experten vergleichen den Ausbruch einer Psychose häufig mit einem „Teufelskreis“. Denn besonders Menschen, die sich nicht wohl fühlen oder Unterstützung von der Familie, Freundinnen und Freunden bekommen, sind anfällig für Psychosen. Genau diese Dinge – das Wohlbefinden und die sozialen Kontakte – nehmen beim Ausbruch einer psychotischen Erkrankung meist als erstes ab. Wenn also ein Mensch, der anfällig für eine psychotische Krankheit ist, über einen längeren Zeitraum extremem Stress ausgesetzt ist, eine schwierige Phase durchstehen muss oder seine sozialen Kontakte wegbrechen, kann irgendwann der Punkt erreicht sein, an dem er nicht mehr aus eigener Kraft mit diesen Herausforderungen umgehen kann. Auch plötzliche Veränderungen können einen zu stark belasten, wie zum Beispiel der Verlust einer wichtigen Person oder wenn eine Freundin, ein Freund oder Familienmitglied erkrankt. Diese zu große Belastung kann der Auslöser für die ersten Symptome einer Psychose sein.

Es gibt unterschiedliche Formen psychotischer Erkrankungen, die zwar meist ähnlich beginnen, sich dann aber in unterschiedliche Richtungen entwickeln. Die Formen unterscheiden sich auch in der Dauer, die die Symptome anhalten. Manche Formen sind davon geprägt, dass die Symptome wiederholt und für kurze Zeiträume auftreten, andere davon, dass eine Person über einen langen Zeitraum hinweg immer stärker ausgeprägte Symptome aufzeigt.

For example, there is the delusional disorder, in which the affected person experiences a new reality. She or he is absolutely certain that their subjective and imagined reality is the true reality. It could be paired with an understanding of others not seeing the same things and having a different reality – but such drastic misunderstandings can also lead to anger and aggression.

Zu der Wahnhaften Störung gehört unter anderem der Liebeswahn, bei dem die betroffene Person davon überzeugt ist, dass eine bestimmte Person in sie verliebt ist. Oder der Verfolgungswahn: Hier ist die betroffene Person davon überzeugt, ständig beobachtet zu werden – zum Beispiel von den Nachbarn oder sogar im eigenen Badezimmer.

Another form is schizophrenia, whereby affected people experience hallucinations and delusions over a longer period of time. Their speech and actions might seem blurred or disconnected. This may lead to them feeling uncomfortable or making others feel uncomfortable, often leading to unacceptance and distance in their usual social environment. A person with schizophrenia might experience fluctuations in the symptoms – sometimes weaker, sometimes stronger symptoms –, but in the long run schizophrenia will probably cause great changes in the affected person’s life: She or he is not able to keep up with the work of school or a job, the person falls behind with social contacts and family, and stops taking care of daily tasks and her or his own human needs - like eating, movement, and hygiene.

These two forms of psychotic disorders are just examples of the wide range of directions this illness can take. As with many other psychological disorders, a psychotic disorder can appear in combination or linked to another mental disorder – psychologists speak of a schizo-affective disorder.

Um welche Form einer psychotischen Erkrankung es sich bei dir oder einer nahestehenden Person handelt, das ist eine Frage, mit der ihr am besten bei einer professionellen Ansprechperson aufgehoben seid. Neben der richtigen Diagnose kann sie mit euch zusammen herausfinden, welche Therapie am besten funktionieren kann, damit die Lebensqualität im Alltag zurückgewonnen wird.

Help with psychotic disorders

A person with a psychotic disorder will often feel like no one understands her or him. Oftentimes, she or he will not understand that there is a problem at all, since the perceived realities and convictions are unmistakably taken for the “right ones”, even if contradicting evidence exists. But it is important to take affected people and their views seriously, to treat them with respect, and support them as best as friends and family can to get the help that they might need.

Do you need help with the first step? Whether you are affected yourself and need to entrust your feelings to someone, or if you want to help a friend or a family member: here you will find tips on how to start a conversation about these difficult topics.

And then: Therapy? How a therapy looks like, how much time it needs, and what it does to help you or the person you are concerned about you will find here

Who can I talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

 

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

 

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