Psychosis vs. Schizophrenia: What's the Difference?

Psychosis and schizophrenia are both associated with mental health but they have some important differences. The terms are sometimes used interchangeably, but psychosis and schizophrenia are not the same.

Psychosis is a symptom that's defined as "losing touch with reality." Signs can include hallucinations, delusions, and agitation. It may be caused by substance use, sleep deprivation, or conditions like schizophrenia.

Schizophrenia is a mental health condition that can cause psychosis. People living with schizophrenia can experience symptoms of psychosis but not all people experiencing psychosis have schizophrenia.

This article explains the differences between psychosis and schizophrenia and addresses how they are linked. It will also cover the symptoms of psychosis and schizophrenia, how they are diagnosed, and how they are treated.

What Is Psychosis?

Psychosis means a person is feeling a loss of contact with reality. A period of psychosis is called a psychotic episode. Psychosis is not an illness by itself. Instead, it is a possible symptom of a number of different conditions.

Psychosis is a defining symptom of schizophrenia, but not everyone who experiences psychosis has schizophrenia. Around three out of every 100 young adults will experience an episode of psychosis.

Psychosis can happen to anyone. It can be caused by:

• Mental health conditions like schizophrenia, bipolar disorder, or delusional disorder
• Traumatic brain injury
• Neurological conditions like epilepsy
• Neurodegenerative conditions like Alzheimer's disease or Parkinson's disease
• Other medical conditions such as HIV, brain tumor, or stroke

A psychotic episode can also occur on its own.

It's possible for someone to experience psychosis temporarily. For example, sleep deprivation, going through a traumatic event, being under extreme stress, taking certain prescription medications, or using substances (such as hallucinogens like LSD) can lead to psychosis. In these cases, the symptom will go away with time as a person recovers from the event or stress, or when they stop using the medication or substance.

What Is Schizophrenia?

Schizophrenia is a long-term mental health condition that affects a person's thought processes, emotions, and behavior. About one in 300 people have schizophrenia worldwide.

Psychotic symptoms can be part of living with schizophrenia. Cognitive symptoms such as trouble processing information or loss of motivation that makes it hard to do everyday activities can also occur with the condition.

Schizophrenia occurs in stages. The length of each stage differs from person to person, but the phases tend to occur in sequence and may recur throughout a person's life.

1. Prodromal phase: This phase can last from weeks to years. The symptoms during this phase develop gradually and include the loss of interest in activities, social withdrawal, or difficulty concentrating. A person may also have an intense fixation on certain ideas or subjects.
2. Active phase: The acute stage of schizophrenia is when psychotic symptoms occur. The symptoms can come on gradually after a prodromal phase or appear suddenly.
3. Residual phase: During this period, a person's symptoms have reduced, but they may still feel withdrawn and have trouble focusing.
   

Once a person develops schizophrenia, they will have schizophrenia for the rest of their lives.

Symptoms

Psychosis is itself a symptom of a mental health condition, including schizophrenia. Psychosis can also occur along with other symptoms that usually come on gradually.

Psychosis

Other symptoms associated with psychosis include:

• Agitation: This describes an excessive physical movement or verbal activity. Symptoms of agitation can also include emotional distress, restlessness, or pacing.
• Delusions: Delusions are false beliefs that are not based on reality. A person having delusions will not change their beliefs even when given evidence that a belief is false. For example, believing that a famous person is in love with them despite never meeting that person.
• Disorganized thinking or behavior: Disorganized symptoms of schizophrenia are things like jumbled or hard-to-understand speech, writing, or thinking. These symptoms can make it difficult for someone to communicate with others and keep their thoughts straight.
• Hallucinations: Hallucinations occur when a person senses things that are not really there. This can include hearing, seeing, smelling, tasting, and feeling things that feel real to them, but are not.
  
  

Schizophrenia

The symptoms of schizophrenia are important to making a diagnosis of the condition. A person living with schizophrenia may experience:

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized or catatonic behavior (e.g., restlessness, lack of movement, and/or erratic movement)
• Negative symptoms (e.g., minimal or no emotional expression and lack of motivation)

People living with schizophrenia can experience psychotic symptoms, such as:

• Paranoia (for example, believing that they are being spied on or being controlled by outside forces)
• A belief that others can read their thoughts
• Believing that ordinary events hold special meaning specifically to them (e.g., that a person is sending them messages through the television)
• Delusions of grandeur (e.g., believing they are of great importance, are very powerful, or have special powers)
• Hearing noises or voices that are not there (e.g., hearing voices telling them to do certain things)
• Switching quickly from subject to subject when speaking
• Making up words
• Discussing ideas that seem unrelated
• Having difficulty performing everyday tasks such as self-care and hygiene
• Difficulty planning
• Experiencing symptoms of catatonia (e.g., physical rigidity, repetitive movements, or lack of a response to their environment)

Treatment

Psychosis can be a symptom of schizophrenia. Therefore, some of the treatments for schizophrenia and psychosis can overlap. Your provider will help you decide which treatment options are best for you.

Psychosis

Early treatment for psychosis is very important to help someone recover. Treatment for psychosis depends on the cause but often involves antipsychotic medications and psychotherapy.

Antipsychotics might work by blocking the effects of the overactivity of a brain chemical called dopamine. This chemical affects emotions, planning, and memory. The overactivity of dopamine is thought to contribute to psychotic symptoms.

Antipsychotic drugs generally fall into one of two categories: atypical or typical.

• Atypical, or second-generation, antipsychotics: These medications inhibit dopamine action and affect levels of serotonin (a chemical related to mood). They are usually the first choice to treat schizophrenia.
• Typical, or first-generation, antipsychotics: These antipsychotics inhibit dopamine activity but do not affect serotonin.

Antipsychotic medications work differently for each person and may cause side effects. It's important that you discuss the risks and benefits with your provider.

You should also know that antipsychotic medications can take up to six weeks to reach their full effect. However, they may start to reduce symptoms of psychosis within hours or days. When taken long-term, antipsychotics can help prevent future psychotic episodes.

Psychotherapy can also be used to help people who are experiencing psychosis. Therapy can be done individually or in a group, and may involve building coping skills, wellness management, and resilience training.

Schizophrenia

Treatments for schizophrenia will also likely include both medications and psychotherapy.

Common schizophrenia treatments include:

• Antipsychotic drugs: These medications are used to treat psychosis, which includes symptoms like hallucinations and delusions. Providers will prescribe the best medication combination and dosage for each person.
• Psychosocial treatments: Therapy is used alongside medication to help a person living with schizophrenia manage symptoms and handle activities at school, work, and home. One type of therapy is cognitive-behavioral therapy (CBT), which helps a person learn to modify their behaviors by recognizing and changing thought patterns.
• Coordinated specialty care: In these programs, a person living with schizophrenia works with healthcare providers to make a plan of treatment, usually when they are still in the early stages of the condition. The treatment plan may include medication, psychotherapy, case management, education support, employment support, and family education.
• Drug and alcohol treatment: Misusing substances like drugs and alcohol is common in people living with schizophrenia. A drug or alcohol rehabilitation program that's designed specifically for people with mental health conditions might be recommended.
  

Summary

Psychosis is a symptom that refers to a loss of touch with reality. Schizophrenia is a mental health condition that has many symptoms, and psychosis can be one of them.

People living with schizophrenia often have psychotic symptoms. However, all people experiencing psychotic symptoms do not necessarily have schizophrenia.

Treatment for both psychosis and schizophrenia usually includes antipsychotic medication and psychotherapy. The combination of treatments will be based on what's best for each person.