What Is the Difference Between Psychosis and Schizophrenia?

Psychosis itself is a symptom and not a mental illness that describes experiencing the world in a different way. Schizophrenia, on the other hand, is a serious, long-term mental illness of which there are five types.

Psychosis and schizophrenia are conditions that have similar symptoms and can greatly affect your mental health and well-being. Both conditions can cause you to have a break from reality or experience and perceive the world differently than others do. These symptoms can have a major impact on your thinking, mood, and behavior.

Both psychosis and schizophrenia can affect the way you interact with and experience the world.

What is psychosis?

Psychosis is a medical term that describes experiencing the world in a different way. This means that you might see, hear, or believe things that other people don’t. Some other words or phrases that are used to describe psychosis include:

• A break from reality
• Psychotic symptoms
• Psychotic episode
• Psychotic experience

Psychosis itself is a symptom, not a mental illness. It’s estimated that about 3% of people will have a psychotic episode during their lifetime. People who have experienced a psychotic episode say that it can be confusing or scary since it’s hard to distinguish what’s real and what isn’t.

What is schizophrenia?

While psychosis is a symptom, schizophrenia is a serious, long-term mental illness. Less than 1% of adults in the U.S. are diagnosed with schizophrenia. Often, doctors categorize schizophrenia as a type of psychosis or psychotic disorder.

Schizophrenia has many different symptoms associated with it. Depending upon your symptoms, you may have one of five different types of schizophrenia:

• Catatonic schizophrenia
• Paranoid schizophrenia
• Residual schizophrenia
• Disorganized/hebephrenic schizophrenia
• Undifferentiated schizophrenia

Symptoms can change over time. To help make diagnosing easier, doctors may categorize symptoms into three different schizophrenic spectrum disorders: 

• schizoaffective disorder
• schizophreniform disorder
• schizotypal personality disorder. 

The feelings associated with psychosis and schizophrenia can be very similar and can range in severity.

Symptoms of psychosis

The two main symptoms of psychosis are hallucinations and delusions. Hallucinations can cause you to see, hear, or experience things that may feel very real but only exist in your mind. This can include hearing voices or seeing glimpses or objects that aren’t really there. Hallucinations can also cause you to have strange or unexplained feelings.

Delusions are strong beliefs or feelings that are outside of the norm for your culture and are most likely untrue. These ideas are often seen as irrational or strange to people on the outside. Some common delusions are:

• Believing that you have powers, have a special mission, or might be a god
• Thinking that people are conspiring against you or following you
• Believing that outside forces are controlling your thoughts, behaviors, or feelings

These symptoms can have a serious effect on your behavior and can be very stressful. If you are having these symptoms, you are most likely experiencing a psychotic episode.

Symptoms of schizophrenia

Men with schizophrenia usually start developing symptoms either in their late teens or early 20s. Women usually start showing symptoms in their late 20s or early 30s. It’s rare for people to be diagnosed with this condition before age 12 or after age 40.

Hallucinations and delusions are also symptoms of schizophrenia. Other symptoms of schizophrenia are called negative symptoms. These are symptoms that change a person’s behavior or personality. These symptoms can sometimes be mistaken for clinical depression. Some examples include:

• Speaking in a dull, disconnected way
• Loss of interest in hobbies or everyday activities
• Feeling emotionally disconnected
• Not keeping up with personal hygiene
• Avoiding people, including friends and family
• Muddled and confused thoughts

It’s important to note that violence is not a symptom of schizophrenia. It also doesn’t cause someone to have a split personality.

Even though psychosis and schizophrenia have similar symptoms, the causes set them apart. In both cases, research is still being done to pinpoint the exact causes.

Causes of psychosis

There are several things that may cause psychosis or a psychotic episode. They fall into three categories: a psychological condition, medical condition, or the misuse of drugs and/or alcohol.

Some psychological conditions that are known to cause psychotic episodes are:

• Schizophrenia
• Bipolar disorder
• Severe stress and anxiety
• Trauma
• Depression

Medical conditions that may trigger psychosis include: 

• Parkinson’s disease
• Alzheimer’s 
• Multiple sclerosis (MS)
• Syphilis
• Malaria
• HIV and AIDS

Abusing drugs and alcohol can trigger a psychotic episode, along with suddenly stopping using them (withdrawal). You can experience psychosis if you’ve drunk a large amount of alcohol or consumed drugs. Drugs that can cause a psychotic episode include:

• Cocaine
• LSD
• Methamphetamine 
• Ketamine
• Amphetamine
• MDMA
• Cannabis

Causes of schizophrenia

It’s still not known exactly what causes schizophrenia, but researchers think it’s a combination of factors. Genetics are thought to play a part, as schizophrenia runs in families. You’re six times more likely to have schizophrenia if a close family member also has it.

Your environment may also be a cause, including complications at birth. Research shows that babies born prematurely, with low birth weight, or who were malnourished in the first two trimesters are more likely to develop schizophrenia.

People with schizophrenia have shown to have small differences in their brain structure. Certain brain chemicals, like dopamine and glutamine, may also contribute to schizophrenia.

Psychosis is a symptom, not an illness, so your doctor can help you to diagnose what has caused your psychotic episode. They will give you a physical exam and ask you about your family history to determine if the cause is medical.

If your doctor suspects a medical cause, they may order further testing to pinpoint the root of your psychosis. The cause could be a mental illness, in which case a mental health professional can provide treatment.

Diagnosing schizophrenia is more difficult since there is no single test to check for it. Many people who are diagnosed with schizophrenia refuse to believe that they have it, causing further problems with treatment. If you have two or more of the following symptoms, your doctor may diagnose you:

• Delusions
• Hallucinations
• Negative symptoms
• Disorganized speech and behavior

Identifying and treating psychosis and schizophrenia as early as possible usually leads to the best outcome.

The most successful method for treating psychotic episodes is Coordinated Specialty Care (CSC). This involves a team of mental health professionals working together to create a personalized treatment plan. Your CSC team will help meet your needs with therapy and medication.

Treatment for psychosis usually involves psychotherapy and antipsychotic medications. Together, these treatments can help to reduce the chances of further symptoms and psychotic episodes.

Schizophrenia is also treated with a tailored plan of therapy and medication. There is no cure, but your team of health care providers will work with you to provide a variety of therapies. In addition to therapy and medication, your plan should also include healthy eating and exercise.