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Psychosis and Confabulation Disorder: Causes, Symptoms, and Management

Introduction

The behaviour described in case scenario 2 is a clear case of psychosis. Jack gets agitated and appears to have a serious feeling of nervousness. He appears to be so disoriented and does not allow anyone to touch or cool him down. However, amidst being caught in the feeling of agitation, he still recognizes some people and the purpose for which they are present at the restaurant. He decides to speak at times and get quiet after a while. My attempt as a psychologist to perform observation of vital signs on him fails as he gets more agitated.

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Psychosis is a combination of mental related symptoms, which include hallucinations and delusions. With delusions, the patients develop the feeling that certain people who are unknown to them want to hurt them (Compton & Broussard 2009, p. 4). The patients also become confused and at times suffer from disturbed thinking. Psychotic conditions vary greatly but these discrepancies depend on each patient. For some patients, the conditions can last for a short time while for others the conditions can stay for as long as they do not seek medical attention (Freudenreich 2008, p. 3).

On the other hand, confabulation disorder refers to a problem of behaviour that is mainly characterized by production of false memories. Memories that are confabulated may also be characterized by a confused combination of events, which may be real. Unlike psychosis, confabulated minds have some elements of truth in them. People with confabulated memories require close attention from caregivers, who can understand and assist them in whatever they do (Schnider 2008, p. 45).

In most cases, people who suffer from psychosis do not know that they have the condition. Most psychotic patients believe that the delusions they experience are factual (Freudenreich 2008, p. 3). For instance, they believe and feel that it is real that unknown people are after hurting them. Psychosis is a sign that an individual is suffering from schizoaffective disorder, bipolar disorder, and/or schizophrenia. Psychotic conditions may be triggered by substance abuse, sleep deprivation, severe depression or severe anxiety. It is recommended that people who experience symptoms of psychosis seek medical assistance as soon as they begin to see such indications (Compton & Broussard 2009, p. 9).

Mental State Assessment and Symptoms of Psychosis

There are several mental assessments that can be performed to determine if an individual may be suffering from psychosis like in the case of Jack. Firstly, these individuals are always confused and they show an aspect of disturbed thoughts. They will appear to have in their minds different and mixed ideas; their minds appear to be speeding up at times and speeding down at other times (Compton & Broussard 2009, p. 11). In the case of Jack, he seems to be having mixed ideas; for example, his mind speeds up as he stands to pace up and down while in the restaurant.

It is easier to notice that someone is suffering from psychosis by studying the way they think, which may be reflected by the way they speak. For instance, these individuals may find themselves talking very fast without stopping to listen to anyone. Sometimes, they can stop talking abruptly without completing their statements (Wallace 2008, p. 62). Individuals with serious psychotic conditions may say senseless things. As a result of the senseless statements they make and their unwillingness to converse, it may be difficult to engage psychotic people in any meaningful conversation (Capps 2010, p. 161). All these are evident in Jack’s case as he speaks so many words and suddenly goes into silence. He cannot coherently answer the questions that he is asked by the psychologist.

Another major characteristic of psychosis is delusion; people who suffer from psychosis normally have strong beliefs, which in most cases are neither true nor provable. They strongly believe that the delusions are true, which is clear in the way they behave or speak (Larkin & Morrison 2007, p. 105). The delusions may become worse when these people believe that some other people are after their lives and are conspiring to hurt or to kill them. In the case scenario 2, Jack’s behaviour shows that he is likely to be suffering from psychosis (Capps 2010, p. 166). At the incident where he refuses to be touched by anyone, maybe he feels that the people in the restaurant are against him and could be planning evil things against him.

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In other cases, people with psychosis believe that they possess strong power and are able to rule the people around them (Freudenreich 2008, p. 7). For instance, people with religious delusions have a feeling that they are very close to God and should be considered very important in the society. The problem comes when other people fail to notice the role played by the victims suffering from delusions; they regard themselves as celebrities (Larkin & Morrison 2007, p. 108). As a result, they may become angry or agitated as witnessed in the case of Jack.

The unexplained sudden change of behaviour is also considered a symptom of psychosis. People who suffer from psychosis may suddenly become overwhelmed by things that others do not understand (Wallace 2008, p. 67). For instance, people who were initially unwell may suddenly become excited when they begin experiencing psychosis. They may refuse to associate with other people and may not want anyone to get close to them as witnessed in Jack’s case. They may also experience mixed feelings of loneliness and begin withdrawing from people around them (Wallace 2008, p. 69).

Lastly, people suffering from advanced psychosis may be so frightened and agitated that they may fail to differentiate whatever they feel from reality. At this point, the patients may fail to think sensibly and are never in a position to explain how they feel. They may come up with funny things and insist on carrying them out (Capps 2010, p. 174). For instance, in the case scenario Jack insists on calling his sister but is unable to explain why he wants to talk to her. He gets so confused and eventually becomes disoriented.

Causes of Psychosis

Psychosis as a mental disorder is caused by combined forces of social and biological factors. However, in some cases, psychosis may be caused purely by one of the factors without interacting with the others (Cardinal & Bullmore 2011, p. 64). In the case of schizophrenia, the disorder is known to come up as a result of impaired chemical composure of the brain. However, the condition in the case of schizophrenia can be worsened by social factors such as lack of family love and support or severe stress (First & Tasman 2010, p. 134).

Social factors such as stress, depression and trauma are known to bring about brief psychotic disorder, which is a short-term type of psychosis. These social factors may be caused by major life changing events such as floods, death of a family member and poor work conditions. The social conditions are known to trigger brief psychotic disorder in most patients, even in those without history of any psychological disorder (Love 2009, p. 48).

In the case of a delusional condition, both hereditary and biological factors are among the main causes. Specifically, a sudden change in brain chemistry and neurological abnormalities are known to cause delusional disorders (Cardinal & Bullmore 2011, p. 66). In most cases, the psychological disorder is triggered by abnormalities in the limbic system. Limbic system is a part of the brain, which is located in the inner edge of the cerebral cortex, and is responsible for regulation of emotions (Love 2009, p. 51).

Psychosis may also be caused by misuse of drugs especially the strong ones. Other people who are also vulnerable to suffering from psychosis are the drug abusers. The most common drugs in this category are recreational drugs, which include PCP, cocaine, alcohol and marijuana. They can make the users experience psychosis when they use or withdraw from using them. There are some drugs that are known to cause the disorder; these substances are mainly steroids and chemotherapeutic medicines (First & Tasman 2010, p. 136).

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Lastly, psychosis may also be stimulated by organic and environmental factors. Some of the organic causes include metabolic conditions such as porphyria, neurological factors, endocrine factors such as hypothyroidism, improper balance of body electrolytes, and renal malfunction. Substance-induced psychosis is another type of psychotic disorder that comes up as a result of environmental pollution (Cardinal & Bullmore 2011, p. 68).

How to Deal with Psychosis

There are several interventions that can be put in place to deal with or to treat psychosis. The first intervention is medication, which is mostly used to assuage psychotic symptoms. The difficulty involved in medication prescription is that it is not easy to determine the kind of medicine that suits an individual (Lauriello & Pallanti 2012, p. 92). For that reason, a number of medication adjustments may be done until the patient begins showing positive response. Unfortunately, some of the medications may have adverse side effects such as restlessness, dry mouth, and drowsiness. However, most of the side effects have been taken care of by the newer generation of medications, which have less of such outcomes (Rothschild 2009, p. 78).

The families of the individuals who suffer from psychosis can also be encouraged to form self or join self help groups through which they can devise ways to assist their patients. For instance, through the help groups they can establish supportive strategies and push for establishment of public education and other community based programs. Through the help groups, people who have suffered from psychosis can provide consultation services, advice and peer support to the current patients of psychosis (Rothschild 2009, p. 81).

The conditions of people with psychosis may also be improved by putting them on healthy nutrition, adequate rest and proper physical exercise. Healthy nutrition with a well balanced diet is good particularly for the patients who are suffering from other complications besides psychosis. A psychotic condition that is triggered by stress and sleep deprivation can be corrected by adequate rest. Daily exercises may also assist in treating psychosis especially when it is stimulated by trauma and stress (Rothschild 2009, p. 84).

For serious conditions of psychosis, the patients need to be hospitalised and regular checkups done on them to monitor their progress. It is only in hospital that proper observations and assessments can be done to determine the correct medication prescriptions for an individual who has acute psychosis (Lauriello & Pallanti 2012, p. 93). The trained nurses and psychologists found in hospitals are able to provide proper medical attention and protection for the serious cases. After recovery and discharge of the patient, he or she should be subjected to regular checkups offered by a professional to minimise the probability of a relapse (Lauriello & Pallanti 2012, p. 94).

All the cases of psychosis require psychological therapy and counselling to improve the condition of the patients and to lessen the chances of a relapse. People with psychosis require people who understand their conditions. The type of therapy administered to a patient depends on the level of the psychotic episode experienced by him or her. During such therapies and counselling sessions, patients get an opportunity to learn practical ways of improving their psychological wellbeing such as stress management, which can be used to prevent a relapse (Love 2009, p. 53).

Summary and Conclusion

The behaviour, moods, and conduct described in case scenario 2 are symptoms of psychosis. Jack, the patient in the case scenario, is without a doubt suffering from psychosis. Psychosis is a combination of mental related symptoms, which mainly include hallucinations and delusions. Psychotic conditions interfere with the way someone behaves, talks, and the way he associates with people around him. Some of the factors that cause psychosis include sleep deprivation, stress, trauma, and abnormalities in the chemistry of brain. The most effective measures that can be used to treat psychosis include family support, rehabilitation programs, medication, hospitalisation, counselling and therapy.

References

Capps, D 2010, Understanding psychosis: issues and challenges for sufferers, families, and friends, Rowman & Littlefield, Lanham, MD.

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Cardinal, RN & Bullmore, E 2011, The diagnosis of psychosis, Cambridge University Press, Cambridge.

Compton, MT & Broussard, B 2009, The first episode of psychosis: a guide for patients and their families, Oxford University Press, Oxford.

First, MB & Tasman, A 2010, Clinical guide to the diagnosis and treatment of mental disorders, Wiley-Blackwell, Hoboken, NJ.

Freudenreich, O 2008, Psychotic disorders: a practical guide, Wolters Kluwer Health, Philadelphia, PA.

Larkin, W & Morrison, AP 2007, Trauma and psychosis: new directions for theory and therapy, Taylor & Francis Group, New York, NY.

Lauriello, J & Pallanti, S 2012, Clinical manual for treatment of schizophrenia, American Psychiatric Pub., Washington, DC.

Love, JC 2009, Psychosis in the family: the journey of a psychotherapist and mother, Karnac Books, London.

Rothschild, AJ 2009, Clinical manual for the diagnosis and treatment of psychotic depression, American Psychiatric Pub., Washington, DC.

Schnider, A 2008, The confabulating mind: how the brain creates reality, Oxford University Press, Oxford.

Wallace, HJ 2008, Inner signs and symptoms in psychosis, Pen Publisher, Oxford.

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