Time to continue my new series on #psychwords - psychiatric words sometimes misused in everyday speech. It's time to #EndTheStigma by ensuring we use our words and the meanings behind them correctly.

Last time: "depressed" was the word (link at end)

Today: "Psychotic"

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In its earliest forms, and still perpetuating today, the word "psychotic" is used to mean "crazy" or "insane" (two deprecated, demeaning words that psychiatry no longer uses for important reasons).

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In common use, it can trivial:
"Dude just chugged 3 beers and 2 shots - he's psychotic!"

It can be used in place of "angry":
"She got so mad at me, she was freaking psychotic."

It can be used in place of "intense":
"Coach is psychotic - we ran practice for hours!"

All of these uses stigmatize "psychosis" and "psychotic" - but none worse than the associated with *dangerousness*. Popularized by movies like "Psycho", the "crazy" killer is now a lazy thriller trope that further perpetuates the idea that people with psychosis are dangerous.
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In fact, mental illness is associated with a *very small percentage* of violent crime (~4%), and people with psychosis and schizophrenia are far more often to be manipulated, abused, victimized, or otherwise harmed.

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So what is psychosis anyway? Well, as a word, it comes from the greek roots of "psyche" (the soul) and "-osis" or abnormal. It has always been associated with symptoms of psychological distress and bizarre bewhaviour.

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In modern usage, psychosis describes symptoms that show a lack of contact with reality:
* having sensations that aren't real (hallucinations)
* being convinced of things that aren't real (delusions)
* saying, doing, or thinking things that dont make sense (disorganization)

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There are other symptoms of psychosis
- "negative symptoms" like less movement, motivation, emotion, social withdrawal
- "cognitive symptoms" like problems with working memory

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Someone who is "psychotic" is experiencing the symptoms of psychosis, and there can be many reasons:
* fevers, infections, tumors, endocrine disorders
* severe depression or bipolar disorder
* drug use
* high anxiety or agitation states
* PTSD
* schizophrenia
* etc.

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In general, the main factors associated w/psychosis:

Biological (not exhaustive):
* fevers
* infections
* tumors and cysts
* drug and alcohol use
* brain injury
* hormone problems
* dementia
* epilepsy
* neurological disorders (HD, PD, etc)
* steroids

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Psychological/Psychiatric (again, not exhaustive)
* depression (often severe)
* postpartum
* bipolar disorder
* severe trauma
* personality disorders
* high anxiety state / extreme agitation

Social: (NE)
* isolation, victimization
* homelessness & poverty ("downward drift")

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And there are the group of disorders in the DSM:

"Psychotic Disorders"
- Schizophrenia - psychotic symptoms >6mon
- Schizoaffective - above with severe mood probs
- Schizophreniform Disorder - <6mon
- Brief Psychotic Disorder - <1mon
- Delusional Disorder - just that

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I personally have worked with MANY people with psychosis. They are capable of kindness, love, anger, resentment, humour, sadness, motivation, career... they are humans with significant suffering.

To here media and public speak about "psychotic" as dangerous is so hurtful.

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It is absolutely true that people who are psychotic can have symptoms that increase the risk of violence, but most often, the violence is self directed, and the lack or neglect of self-care can lead to significant health problems.

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If you want to read more about psychosis, my jurisdiction has an *amazing resource* called "Here to Help" - i cannot overstate how amazingly well it is written and how comprehensive, caring, and multi-factored its approach to psychosis is.

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https://www.heretohelp.bc.ca/workbook/dealing-with-psychosis-a-toolkit-for-moving-forward-with-your-life

A final tip:
The word "psychotic" is OFTEN confused with the word "psychopathic" (which I'll get to probably later in this series!), or someone who doesn't care about others.

"Psychotic" has NOTHING to do with psychopathic. Please don't make this mistake.

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Previous #psychword: "depressed"
https://twitter.com/tylerblack32/status/1316416342812053506

Google drive link to a quick summary :)

https://docs.google.com/document/d/1N5dwp55vtAEYq2u3N4rvhx-3LPLJwAgGHAcehiA3IK0/edit?usp=sharing