Psychosis vs. Schizophrenia
Psychosis and schizophrenia are terms that are often used together, or even interchangeably. But while psychosis and schizophrenia are related, they are not identical.
Psychosis is a group of symptoms. Schizophrenia is a mental health disorder. While psychosis is often one of the symptoms of schizophrenia, an individual can experience a psychotic episode without ever being diagnosed with schizophrenia. Drug-induced psychosis is one example of this.
For people struggling with schizophrenia and/or psychosis—and for their loved ones—this page provides detailed information about the differences between these two conditions, and also how they are related.
What Is Psychosis?
Psychosis is a cluster of mental-emotional symptoms that indicate a loss of touch with reality, but not a complete break from reality. When a person experiences such symptoms, they’re said to be having a psychotic episode or a psychotic break.
There are about 100,000 new cases of psychosis in the United States each year. 1
There is often confusion between “psychosis”—a group of symptoms—and “psychotic disorders”—which is an official category of mental illnesses as listed in the DSM-5. Schizophrenia is one of the mental illnesses that is a subcategory of psychotic disorders. A substance/medication-induced psychotic disorder is another subcategory of psychotic disorders.
But the term “psychosis,” on its own, typically refers only to a group of symptoms. The two main symptoms of psychosis are hallucinations and delusions.
Hallucinations are the apparent perception of something that’s not happening. It’s when an individual sees, hears, feels, smells, or tastes things that aren’t occurring outside of their own mind. In the person’s own subjective experience, the hallucinations are often as clear and vivid as normal perceptions. A person who is having a psychotic episode, for instance, might hear voices when no one else is around; see an object that isn’t there; or perceive a scent that has no actual source in a shared reality.
Delusions are strongly held beliefs or judgments that aren’t shared by most others and are very likely to be untrue. Such beliefs are often deeply irrational: maintained even in the face of nearly incontrovertible evidence to the contrary. Even though they are based on a mistaken or strange or unrealistic view, the delusions are held with utter conviction. An individual can be so convinced of the reality of their delusion that no amount of logical argument can persuade them otherwise.
A person experiencing delusions may, for instance:
Warning Signs of Psychosis
A person who is on the verge of a psychotic episode will often experience changes in their thoughts, feelings, and/or behavior before the psychosis develops fully. Such warning signs of a psychotic break may include:
Psychosis Risk Factors
Conditions that can increase the risk of a psychotic break include:
The Three Phases of Psychosis
Mental health professionals often speak of psychosis in terms of three distinct phases, corresponding to early signs, the acute phase of the psychotic episode, and the recovery process. 2
Phase 1: Prodome (aka Psychosis Syndrome)
The early signs of a psychotic break are often vague and may be barely noticeable. While each individual’s experience will be unique, some of the common signs associated with the prodome phase include:
Phase 2: Acute
The acute phase of psychosis—aka the critical period—is when the actual symptoms begin to appear. As mentioned above, the primary symptoms of psychosis are hallucinations and delusions.
During the acute phase of a psychotic break, the person may become extremely distressed by what is happening to them. They might also behave in a way that’s so out of character that their friends and family members become extremely concerned and decide that it’s time to seek professional help.
Phase 3: Recovery
It’s important to understand that psychosis is a treatable condition. With effective treatment, most people can recover fully from their first episode of psychosis—and may never experience another one.
Some of the symptoms of the acute phase of a psychotic break may linger in the recovery phase. But with appropriate treatment—supervised by mental health professionals—most people successfully recover and can return to their everyday lives.
Misusing drugs or alcohol—or the sudden withdrawal from them—can trigger a psychotic episode. Drug-induced toxicity affects brain chemistry. So a person who has consumed a large amount of alcohol or drugs may experience psychosis which is the result, at least in part, of such biochemical changes. If such episodes recur, the individual may be diagnosed with a substance/medication-induced psychotic disorder.
Like other forms of psychosis, the primary symptoms of substance-induced psychosis are hallucinations and delusions. People experiencing psychosis may experience a variety of other symptoms as well. Early treatment can be essential for a person’s well-being and mental health.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), an official diagnosis of substance/medication-induced psychotic disorder also requires:
There is no single drug that necessarily causes drug-induced psychosis. Understanding a drug’s side effects and addiction potential before taking it are effective ways to reduce the risk of substance-induced psychosis. But the only fool-proof way to prevent drug-induced psychosis is by abstaining from drug use.
Alcohol is one of the substances whose misuse can trigger substance-induced psychosis. Acute alcohol intoxication, alcohol withdrawal, as well as chronic alcoholism can all trigger alcohol-related psychosis, which is also known as alcohol hallucinosis. 3
In this form of psychosis, hallucinations, delusions, and other psychotic symptoms (e.g., paranoia, fear, confusion, aggression) appear during or shortly after heavy alcohol intake—or during the withdrawal process. While alcohol-related psychosis is similar to schizophrenia, it is considered to be a unique condition.
Methamphetamines are potent psychostimulants that may cause psychotic episodes in recreational or chronic users. Psychotic symptoms and syndromes are experienced in approximately 40% of individuals who use methamphetamine. 4
Acute symptoms of meth-induced psychosis can include agitation, violence, and delusions. For some meth users, psychotic episodes may recur and be difficult to distinguish from a primary psychotic disorder such as schizophrenia.
Researchers have established a correlation between cannabis consumption and a variety of mental health disorders, including cannabis-induced psychosis. Cannabis use is considered a risk factor—an environmental stressor—that increases the odds of having a psychotic episode. And long-term use is associated with a greater risk of psychosis. 5
The psychoactive effects of Delta 9-THC in cannabis include feelings of dreaminess, disinhibition, and heightened awareness of sounds (e.g., music), colors, or tastes. The effects of this drug may also induce psychotic symptoms such as visual hallucinations, paranoid ideation, and mood instability. Other possible symptoms of marijuana-induced psychosis include isolation and agitation.
Acute episodes of cannabis-induced psychosis can last from a few days to several months.
What is Schizophrenia?
Movies such as A Beautiful Mind and The Soloist portray the real-life stories of people (mathematician John Nash and musician Nathanial Ayers) who have suffered from schizophrenia. But what exactly is schizophrenia, and how is it related to or different from psychosis?
Schizophrenia is a severe and chronic mental illness that affects how a person thinks, feels, and behaves—and creates the impression that people who suffer from the disease are “out of touch with reality.” 6
According to the National Institute of Mental Health, schizophrenia affects less than one percent of the U.S. population: The prevalence of schizophrenia and related disorders is between 0.25 and 0.64 percent.
Men with schizophrenia typically develop the first symptoms of the disease in their late teens or early-20s. Women usually begin showing symptoms in their late-20s or early-30s. It’s unusual for people to be diagnosed with schizophrenia before age 12 or after age 40.
The exact cause of schizophrenia is unknown. However, experts believe that genetics; environmental factors; and irregularities in the functioning of neurotransmitters (chemicals in the brain)—particularly dopamine—likely play a role.
As an officially diagnosed mental health disorder, schizophrenia belongs to the larger category of “psychotic disorders.” The full list of psychotic disorders includes:
As mentioned above, this diagnostic category of “psychotic disorders” should not be confused with the cluster of symptoms known as “psychosis.”
People diagnosed with the psychotic disorder schizophrenia often experience psychosis as one of their symptoms. But not everyone who experiences psychosis has a schizophrenia diagnosis.
Five Types of Schizophrenia
There are different subtypes of schizophrenia—distinguished according to their primary symptoms.
Symptoms of Schizophrenia
Mental health professionals use the criteria described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose schizophrenia.
General Types of Schizophrenia Symptoms
Schizophrenia Spectrum Disorders
Schizophrenia symptoms can change over time. To reflect these differences—and how they occur along a spectrum—psychiatrists often categorize symptoms into three different schizophrenic spectrum disorders.
Other Psychotic Disorders
Along with the three schizophrenia spectrum disorders, there are five other psychotic disorders. These include:
Psychosis vs Schizophrenia
Both psychosis and schizophrenia can negatively affect a person’s mental health and well-being. Both are associated with a break from reality—with perceiving and experiencing the world in ways that are dramatically different from how others do.
The difference, once again, is that psychosis is a collection of symptoms that demonstrate a loss of touch with reality. A psychotic episode can be catalyzed by alcohol or drug abuse, a medical condition, sleep deprivation, trauma, or certain prescription medications—as well as by various mental health disorders.
Schizophrenia, on the other hand, is a mental health disorder that often has psychosis as one of its symptoms. But there are additional symptoms and diagnostic criteria for schizophrenia.
How Is Psychosis Related To Schizophrenia?
An individual with schizophrenia can experience periods of psychosis, known as psychotic episodes. During these episodes, they may experience hallucinations and delusions—so-called “positive symptoms” of schizophrenia.
But a person can also experience psychosis without having schizophrenia or another mental health disorder.
Treatment for Psychosis
Treatment for psychosis is most effective when it’s identified and treated early. The standard treatment for psychosis typically includes:
Treatment for Schizophrenia
Begin Your Healing Journey at SoCal Mental Health
SoCal Mental Health is a short-term residential treatment option for those struggling with schizophrenia and other mental health disorders. They specialize in crisis stabilization and are located in Orange County, California. They also offer personalized treatment for both schizoprenia disorder and psychotic disorder.
A skilled team of mental health professionals combines science and cutting-edge therapy with human compassion and understanding. In addition to medication management, they utilize therapeutic modalities such as:
Complementary therapies employed to enhance healing include:
The caring staff at SoCal Mental Health are here to ease the transition from inpatient psychiatric hospitalization to long-term residential or outpatient programs. They provide the best care in a small, home-like setting where clients feel comfortable and supported through the healing process.
For more information about SoCal treatment for mental health disorders, such as schizophrenia or psychotic disorders, contact us today.
References and Resources
- Understanding Psychosis. National Institute of Mental Health.
- What Is Psychosis. Yale School of Medicine.
- Stankewicz HA, Richards JR, Salen P. Alcohol Related Psychosis. 2022 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29083782.
- Glasner-Edwards S, Mooney LJ. Methamphetamine psychosis: epidemiology and management. CNS Drugs. 2014 Dec;28(12):1115-26.
- Grewal, Ruby S. and Tony P. George (July 14, 2017). Cannabis-Induced Psychosis: A Review. Psychiatric Times Vol 34 No 7.
- Schizophrenia. National Institute of Mental Health.
- What Is Schizophrenia? American Psychiatric Association.
- Symptoms of Schizophrenia. National Health Service UK.
- Miller, Caroline. How Does CBT Help People With Psychosis? Child Mind Institute.
- Schizophrenia Treatment. National Alliance on Mental Illness.