Difference Between Neurosis and Psychosis, Practice Problems and FAQs

Do you know when is the World Mental Health day? It’s celebrated on October 10 to educate people and raise awareness for mental health and advocate against the social stigma associated with mental health disorders. There used to be a time when terms such as anxiety, depression and mental health were a social taboo and people were scared of acknowledging any association with these conditions, lest they be considered ‘mad’ or ‘mentally challenged’.

But, nowadays people have grown more aware and tolerant towards each other’s mental health and any challenge associated with it. In fact, mental health and development is given equal significance when compared to physical health and development. You must have noticed that every school, college and office now has psychological counsellors to help the students and employees with stress, anxiety, depression or any mental challenge that they might be facing.

Often the thin line between different mental disorders is hard to place, except for professionals. Two such conditions are neurosis and psychosis which are often misunderstood to be very similar to each other. In this article, we will try to understand what these disorders are and the differences between them.

Table of Content:

• Neurosis
• Psychosis
• Difference between neurosis and psychosis
• Practice Problems
• FAQs

Neurosis

Neurosis, psychoneurosis or neurotic disorder is a condition of mild mental disorder. It might be triggered by inner struggles, mental as well as physical disturbances and might result in irrational reactions to any situation. Affected individuals suffer from irritability, anxiety, sadness or depression, anger, confusion, self-consciousness, etc. and experience an unconscious emotional conflict which might lead to mental problems.

Fig: Some common symptoms of neurosis

Causes:

Neurotic diseases are caused due to disruptions in the metabolism of biologically active chemicals such as neurotransmitters, vitamins, hormones, etc that are involved with proper functioning of the nervous system.

This disorder may originate from chronic stress, be it mental or physical, due to excessive workload, insufficient rest, traumatic experiences and the unconscious ego defence strategies that help an individual to deal with the stress of such experiences.

Fig: Some common causes of neurosis

A neurotic person gets over absorbed and obsessed with his or her own emotions, failures, etc. However, the person does not lose touch with reality and neurosis does not involve hallucinations and delusions. Few examples of neurosis disorders are -

• Panic disorder
• Post-traumatic stress disorder
• Hysteria
• Obsessive-compulsive disorder
• Generalised anxiety disorder
• Depression
• Impulse control disorder

Fig: Some common disorders associated with neurosis

Diagnosis

An interview with the person suspected to have neurosis is set up by the psychologist or psychiatrist and his or her mental status is clinically assessed with the help of a Sixteen Personality Factor Questionnaire (16PF).

Treatment

Psychologists and psychiatrists take different approaches towards treating neurosis. Making their patients aware of the feelings, traumatic memories or repressed impulses that might lead to neurotic behaviour is one of the first steps towards a successful treatment. The next step involves helping the patients have a better understanding of themselves and then help them heal and develop a better personality.

Another approach is to discuss the thoughts that might trigger the neurotic symptoms and help the patients replace such thoughts with more positive thoughts and better interpretation of situations and surroundings. Often patients are made to learn from examples. All these approaches can be supplemented with the conventional way of administering medicines such that a joint approach helps in curing the individual.

However, not every person suffering from neurotic disorder is in immediate need of professional help. In preliminary stages, self-management procedures can help to reduce neurotic behaviour.

A healthy meal, regular exercise, sufficient sleep, avoiding caffeine, alcohol and nicotine and healthy conversations with friends and family can also help in dealing with mild neurosis. However, one must seek professional help whenever required.

Psychosis

Psychosis is a severely abnormal condition of the mind that causes an individual to lose touch with reality. Psychotic individuals suffer from delusions, hallucinations and various types of mental and psychological disruptions. Such individuals develop an imaginary world in which they perceive themselves to be living and are incapable of differentiating between reality and their own imagination.

Fig: Hallucinations and delusions in psychosis

Apart from hallucinations and delusions, psychosis also manifests other symptoms such as depression, insomnia or hypersomnia, impaired speech, anxiety, inability to express emotions and suicidal thoughts and actions. If these symptoms last for more than six months then a person’s normal life is entirely disrupted. However, the duration of this disorder is not constant and cannot be generalised for all.

Fig: Other symptoms associated with psychosis

Causes

Psychosis can be caused due to a range of different factors. Some of the common factors leading to psychotic hallucinations can be extreme stress, sleep deprivation, grief over the loss of loved ones, etc.

Organic psychosis is caused due to medical conditions that affect the brain, which include neurodegenerative diseases (such as Alzheimer’s disease, Parkinson’s disease, etc.), malignant brain tumours, delirium and dementia, neurodevelopmental disorders due to chromosomal abnormalities, endocrine disorders, autoimmune disorders, vitamin deficiencies, etc.

Fig: Neurodegenerative diseases which cause psychosis

It can also be triggered by abuse of alcohol and psychoactive drugs such as cannabis, cocaine, psychedelic drugs (LSD), amphetamines, etc. Withdrawal or administration of certain medicinal drugs can also lead to psychosis.

Fig: Abusing drugs and alcohol can cause psychosis

Functional psychosis occurs due to psychiatric disorders such as schizophrenia, bipolar disorder, schizoaffective disorder, psychotic depression, delusional disorder, post traumatic stress disorder, obsessive compulsive disorder, etc.

Fig: Some psychiatric disorders which cause psychosis

Diagnosis

Studying the medical, behavioural as well as family history of the individual along with clinical tests and physical exams can be helpful in diagnosing psychosis in a patient. Observing the patient and enquiring the family about behavioural changes can help in diagnosis. Early diagnosis can help in alleviating symptoms and improving the mental condition of a patient. But, the condition worsens with time and may result in acute psychosis if diagnosed too late.

Treatment

Traditionally psychosis is treated with antipsychotic drugs and psychotherapy. Love and support from near and dear ones goes a long way in treating psychotic patients. The patients are required to stay in mental health facilities for their own as well as their family’s safety. Rapid tranquilisation may be needed in case of an uncontrollable psychotic episode. At other times, the person might just continue with therapy and medications.

If the individual suffering from psychosis is in the phase of maintenance (a period during which the affected person works towards consolidating the progress made during therapy and preventing relapse), then friends and family should ensure proper intervention in case of any abnormal behaviour or psychotic episode.

Differences between neurosis and psychosis

Let’s have a look at the differences between neurosis and psychosis.

Practice Problems

1. Which of the following is not a symptom associated with neurosis?

1. Anxiety
2. Hallucination
3. Depression
4. Irritability.

Solution: Individuals affected with neurosis suffer from irritability, anxiety, sadness or depression, anger, confusion, self-consciousness, etc. and experience an unconscious emotional conflict which might lead to mental problems.

Hallucinations and delusions are not experienced by neurotic individuals. These are symptoms of psychosis. Thus, the correct option is b.

2. Neurosis may be triggered by

1. Alzheimer’s disease
2. Vitamin deficiency
3. Ego defence mechanisms
4. Drug abuse

Solution: Neurosis may originate from chronic stress, be it mental or physical, due to excessive workload, insufficient rest, traumatic experiences and the unconscious ego defence strategies that help an individual to deal with the stress of such experiences. A neurotic person gets over absorbed and obsessed with his or her own emotions, failures, etc.

Psychosis may be caused due to medical conditions such as Alzheimer’s disease, vitamin deficiencies and drug and alcohol abuse. Thus, the correct option is c.

3. Which of the following statements is not true for psychosis?

1. The affected individuals have a high risk of harming themselves.
2. It may result in insomnia or hypersomnia, impaired speech, anxiety and inability to express emotions in patients.
3. The affected person loses touch with reality.
4. Patients need not be hospitalised.

Solution: Psychosis is a severe mental disorder that causes an individual to lose touch with reality. Apart from hallucinations and delusions, psychosis also manifests other symptoms such as depression, insomnia or hypersomnia, impaired speech, anxiety, inability to express emotions and suicidal thoughts and may inflict harm to themselves.

Such individuals can be treated with antipsychotic drugs and psychotherapy and should be kept in a well equipped mental health facility during the course of the treatment.

Thus, the correct option is d.

4. How can one diagnose psychosis?

Answer: Studying the medical, behavioural as well as family history of the individual along with clinical tests and physical exams can be helpful in diagnosing psychosis in a patient. Observing the patient and enquiring the family about behavioural changes can help in diagnosis.

FAQs

1. What is Horney’s theory of neurosis?

Answer: Karen Horney’s theory on the origin and dynamics of neurosis was laid down in her last and final book, Neurosis and Human Growth. According to her theory, neurosis is a distorted view of one’s self and the world which is driven by compulsive needs and not by a genuine interest in the world in a way that it exists.

2. What is Neurotics Anonymous?

Answer: Neurotics Anonymous, abbreviated as N/A[1] or NAIL to distinguish it from Narcotics Anonymous (NA), is a twelve step program founded in 1964 that helps in recovery from emotional and mental illness.

3. What is catatonia?

Answer: Catatonia is a highly agitated state of psychotic episode characterised by complete impairment of one’s experience of the real world.

4. What is cognitive behavioural therapy?

Answer: Cognitive behavioural therapy (CBT) focusses on the distortions in thoughts, attitudes and beliefs of an individual and the behaviour associated with such distorted cognition. It aims at reducing the symptoms of mental health disorders such as depression and anxiety by improving emotional regulation and enabling a person to develop coping strategies to deal with these problems.