Could you have psychosis, schizophrenia, or both?

Psychosis occurs when someone loses contact with reality. It often involves hallucinations (seeing or hearing things that aren’t there) and/or delusions (objectively false beliefs). This experience is a core symptom of psychotic disorders like schizophrenia. But it’s not a stand-alone mental health condition. 

Distinguishing between psychosis and schizophrenia is an important part of ensuring that a person gets the right support for their needs. With the right treatment — such as therapy, medication, and/or social support — many people can learn to manage their symptoms and improve their quality of life.

Difference between psychosis and schizophrenia

Psychosis and schizophrenia are often confused for one another because they have overlapping symptoms. However, they’re not the same. The main difference between the two is that schizophrenia is a mental health condition that involves psychosis, while psychosis itself is a symptom that can occur in schizophrenia and other conditions. 

One of the main distinctions between psychosis and schizophrenia is how long the symptoms last. It’s possible to experience a single psychotic episode (that may last days or weeks) without having schizophrenia or another mental health condition. However, a person can’t be diagnosed with schizophrenia without the presence of ongoing psychosis — which must persist for at least one month, with overall disturbances lasting at least six months.  

Here are some other important differences between psychosis and schizophrenia:

Signs of psychosis

Psychosis can be a one-time event or a chronic, recurrent experience, depending on the person. It can stem from a variety of medical and mental health conditions. 

Some of the most common signs of psychosis include:

• Increased paranoia or suspiciousness
• Trouble with concentration, focus, and logical thinking
• Isolation and social withdrawal
• Unusual, intense, or strange feelings
• Not feeling much emotionally
• Decrease in self-care (i.e. hygiene)
• Sleep problems
• Intense or rapidly shifting emotions
• Loss of motivation 
• Decline in overall functioning 
• Trouble communicating clearly
• Sudden decline in occupational or academic performance
• Seeing, hearing, smelling, or feeling things that others cannot detect (hallucinations)
• Odd or objectively false beliefs (delusions)

Diagnostic criteria for schizophrenia

To be diagnosed with schizophrenia, a person must experience two (or more) of the following symptoms (but either delusions, hallucinations, or disorganized speech must be present). Without treatment, these symptoms must be present most of the time for at least a month: 

• Delusions
• Hallucinations
• Disorganized speech 
• Highly disorganized or catatonic behavior (odd or unusual movements or nonresponsiveness)
• Symptoms that affect emotional and social functioning (like feeling disconnected from people or emotions, social withdrawal, or inability to take care of one’s basic needs)

Does psychosis always mean schizophrenia?

It’s possible to have psychosis without schizophrenia. This is because, in addition to being a core symptom of psychotic disorders, psychosis can result from other factors, like:

• Borderline personality disorder (BPD) 
• Bipolar disorder 
• Severe depression
• Parkinson’s disease
• Alzheimer’s disease
• Dementia
• Sleep deprivation
• Certain prescription medications
• Harmful or excessive substance use

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Can psychosis be a symptom of schizophrenia?

Psychotic disorders, like schizophrenia, are one of the main causes of psychosis. And, in this context, most people will require professional help to manage their symptoms. Like other mental health conditions, early detection is key for schizophrenia-induced psychosis. 

Without treatment, symptoms of schizophrenia may worsen over time. This can lead to poorer outcomes and greater interruptions in overall functioning. 

Treatment for psychosis and schizophrenia

With early intervention, people who experience psychosis without having schizophrenia may never have another episode. However, if a person’s psychosis is caused by schizophrenia or another psychotic disorder, they’ll likely need lifelong support to manage their mental health. So, if you or someone you care about is showing signs of psychosis, don’t hesitate to seek professional help.

If a loved one is experiencing active psychosis, hospitalization may be necessary to ensure their safety before engaging with other forms of care. Once they achieve stability, the following supports can be used to help people experiencing stand-alone psychosis or psychosis brought on by schizophrenia:

• Medication: Medications are frequently used to manage psychosis and other symptoms of schizophrenia. You can ask your provider which medication might be best for you.
• Therapy: CBTp — a modified form of cognitive behavioral therapy (CBT) designed to treat psychosis — can help people manage symptoms of schizophrenia that don’t respond to medication. 
• Complementary supports: There are a variety of other supports that can help people overcome barriers caused by schizophrenia or psychosis. These could include peer groups, occupational or academic services, community-based programming, or case management.
• Coordinated care: Research shows that people experiencing psychosis may benefit from coordinated specialty care (CSC). This approach promotes communication and shared decision making among everyone involved in the treatment plan, including the person experiencing psychosis and their family (if appropriate).

Find care with Rula

If you’ve ever been confused about the difference between schizophrenia and psychosis, you’re not alone. These experiences share some common features, but there are also some important differences between them. Psychosis is a symptom of schizophrenia. It causes a detachment from reality due to hallucinations or delusions. While a person can have a psychotic episode without meeting the diagnostic criteria for schizophrenia, they can’t have schizophrenia without experiencing psychosis. 

But whether you’re living with psychosis due to schizophrenia or another concern, know that help is available. With the right support, you can learn to manage psychotic episodes, strengthen your mental health, and improve your quality of life. 

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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