Psychosis vs. Schizophrenia: What’s the Difference?

“Psychosis refers to a set of symptoms [with multiple potential causes], whereas schizophrenia is a chronic mental health disorder that includes psychosis as one of its core features,” says Karla Molinero, MD, medical director of child and adolescent residential services at Brattleboro Retreat, a mental health treatment facility in Vermont.

It’s essential to know the difference in order to get effective treatment, says Harold Hong, MD, a psychiatrist and the medical director of New Waters Recovery, a mental health and substance abuse treatment facility in Raleigh, North Carolina. “While both conditions need attention, the treatment approaches can vary significantly,” he says. “Misdiagnosing someone can lead to ineffective treatments and further complications, so accurate identification by mental health professionals is crucial.”

Here’s what to know about the symptoms of psychosis versus schizophrenia, the differences between the two, and treatment options for each.

Psychosis Symptoms

• Hallucinations This refers to seeing or hearing things that aren’t actually there.
• Delusions This refers to having strongly held yet clearly false beliefs that often seem irrational to others, such as the belief that someone else is controlling one’s thoughts.

“This disconnection from reality can happen for several reasons, including many different mental and physical conditions,” Dr. Ghassemi says.

Schizophrenia Symptoms

• Positive Symptoms (Also Known as Psychotic Symptoms) These are unusual thoughts or behaviors caused by schizophrenia. They include symptoms of psychosis like hallucinations and delusions.
• Negative Symptoms These are the absence of expected ways that an individual usually interacts with their surroundings. They can include reduced emotional expression, speaking in a flat or monotonous tone of voice, speaking little even when forced to interact, a lack of interest in social interactions and daily activities, and extreme fatigue.
• Disorganized Symptoms These symptoms apply to thoughts, speech, and movements. A person with schizophrenia may struggle to organize their thoughts when speaking or may speak in jumbled ways or with words that have no meaning (sometimes known as “word salad”). They may also have unusual movements, such as spinning around a lot for no obvious reason.
• Cognitive Symptoms These include difficulty focusing, memory problems, issues with decision-making, and problems with processing information, as well as a lack of awareness that they have the condition.

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Psychosis and schizophrenia have several things in common. As mentioned above, both psychosis and schizophrenia involve psychotic symptoms like hallucinations and delusions, says Dr. Molinero.

“Duration of experiences and functioning or behaviors are where psychosis and schizophrenia differ,” says Molinero.

Schizophrenia is a more complex and long-term condition than psychosis, says Dr. Hong. “It includes many of the same symptoms as psychosis, like hallucinations and delusions, but also features ‘negative’ symptoms [unlike psychosis],” he says.

Schizophrenia impacts all areas of life, including work, relationships, education, and mood in the long term. Psychosis may also affect those same areas but to a lesser degree, because it’s often a shorter-term experience than schizophrenia, Molinero says.

“Early intervention and a multidisciplinary approach help enhance long-term outcomes and empower individuals to lead fulfilling lives,” says Ghassemi.

• Treatment of any underlying medical condition that may be responsible for psychosis symptoms
• Medications, such as antipsychotic drugs, antidepressants, or lithium
• Cognitive behavioral therapy, a type of therapy that can help treat certain mental health conditions that cause or exacerbate psychosis
• Hospitalization, which can be necessary if psychosis is severe or if the person may pose a danger to themselves or others
• Support programs, such as inpatient substance use disorder programs or outpatient support groups, especially if one’s psychosis was caused by a substance use disorder

• Antipsychotic drugs
• Psychotherapy, which can help people with the condition learn how to cope with it and manage their symptoms in the long term
• Hospitalization, especially if the person is experiencing psychotic symptoms
• Electroconvulsive therapy, which your provider may recommend if other treatments aren’t effective for you
• Rehabilitative services, such as resilience training, family therapy, cognitive support, or help with work or school, which can help people develop coping skills, and strengthen communication and thinking abilities to set someone up for long-term success

“Many people with psychosis or schizophrenia lead fulfilling lives with the proper support and treatment,” says Hong. “Remember, seeking help is a sign of strength, and with time and the right resources, individuals can effectively manage their symptoms.”

• Talking about wanting to die
• Feeling shame, guilt, or like a burden to others
• Emotional or physical pain that feels like it’s too much to overcome
• Feelings of hopelessness, emptiness, being trapped, or without a purpose
• Intense sadness, agitation, anxiety, rage, or mood swings
• Changes in usual sleeping or eating habits
• Increased alcohol or drug use
• Taking risks, such as driving too fast
• Withdrawing from loved ones or saying goodbye to people around them with no other logical reason for doing so
• Giving away belongings or making a will
• Looking up ways to die or having a plan