It is not uncommon for those with PTSD to experience symptoms related to psychosis, such as hallucinations. Sometimes, these symptoms can indicate trauma that is unresolved and in need of addressing. PTSD is a complex diagnosis, and it is important to consider all the ways it can impact you. However, this is a condition that can be managed with effective treatment.
What Is Post Traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) is a mental health condition that results from experiencing a traumatic event, or being in a situation with prolonged exposure to traumatic events. Examples of this include being in active war zones, experiencing abuse, and surviving natural disasters or traumatic accidents.
PTSD symptoms are composed of four clusters:
- Hypervigilance
- Avoidance behaviors
- Intrusive memories and reliving the trauma
- Negative changes in thinking and mood
What Is Psychosis?
Psychotic disorders (psychosis) are mental health conditions in which people lose touch with reality. Episodes can involve hearing or seeing things that aren’t there, and can lead to high levels of distress.6
Positive Symptoms
During a psychotic episode, a person will experience positive symptoms (new, abnormal symptoms), which include uncomfortable feelings, intrusive thoughts, and risky or unusual behavior.
The positive symptoms of psychosis include:
- Delusions: These are ideas one develops and believes are true, even if there is a very high likelihood of these ideas being completely false.
- Hallucinations: Hallucinations are false experiences that affect a person’s senses. This may include hearing, seeing, smelling, or tasting things that aren’t real.
- Disorganized behaviors: One may be incoherent, use made-up words or sentence patterns that don’t make any sense, or act in unusual and bizarre ways.6
Negative Symptoms
Negative symptoms refer to the absence of normal behaviors. This can be hard to characterize–understanding negative symptoms as the absence of emotional response is the best way to imagine them. It can be challenging for people with negative symptoms to express an emotion, because they may not be in touch with such. In these cases, a person may display flat affect, blunted affect, or seem generally withdrawn.6
Psychosis Symptoms in PTSD
PTSD can be a precursor to psychosis. Some symptoms of PTSD can overlap with the occurrence of positive psychosis symptoms, such as visual hallucinations and hearing voices that are not there. Experiencing severe shock or violent and sudden death, such as in a war zone or domestic violence, are contributing factors.6
Hallucinations in PTSD
Those with PTSD can experience hallucinations due to the psychopathology of how trauma changes the brain. The brain is impacted in a way that might cause it to create new pathways to process information. Certain parts of the brain become more or less activated, which is why some individuals may experience hallucinations.6
Flashbacks & Dissociation in PTSD
Flashbacks and dissociation tend to go hand-in-hand for many who have experienced trauma. Adverse childhood events, such as abuse or neglect, are a huge risk factor for developing a dissociative disorder–children and adults who’ve experienced this type of trauma make up a large portion of those with dissociative disorders, which can be indicative of PTSD.
Due to ongoing childhood trauma, children might be conditioned to function in dysfunction. Thus, mild dissociation as a coping strategy could become chronic, causing someone to disconnect from their body. Children may also develop ongoing flashbacks into adulthood, and trauma related symptoms can lead to PTSD or C-PTSD over time.2
Can PTSD Cause Psychosis?
If left untreated, PTSD symptoms may increase a person’s risk of experiencing psychosis. It is estimated that half of those diagnosed with PTSD also experience psychosis at some point in their life. Those who have been subjected to combat or domestic violence are more at risk for psychosis symptoms.4
However, having this condition doesn’t necessarily mean a person will suffer psychosis.
There are other factors unrelated to one’s PTSD that can influence a psychotic episode. For example, psychosis may indicate an underlying mental health condition, such as bipolar disorder, dissociative disorder, schizophrenia, or delusional disorder.
PTSD & Schizophrenia
PTSD cannot directly cause schizophrenia, but those who have experienced extreme trauma are more at risk of developing the disorder. Moreover, schizophrenia and PTSD can occur comorbidly. Luckily, there are treatment options fit for those who struggle with both conditions.3
PTSD Treatment
Seeking professional help may be the best first step in your PTSD recovery, especially if you are dealing with hallucinations and psychosis. Signs that you may want to speak with a therapist or counselor include general insecurities being exacerbated, anxiety, depression, anger, rage, and any other kind of distress.
Therapy
Therapy can be beneficial for those living with PTSD. Finding the right therapist will also help you deal with emotional blunting. Working to understand where this lack of emotion stems from, and how to respond to it, can allow you to ensure your important relationships and connections stay intact. Couples or family therapy may also be considered, depending on individual situations. If you’re wondering where to begin, you can start by using an online therapist directory, with which you can locate a professional who can assist you with PTSD symptoms.
Some common therapy options for PTSD include:
- Dialectical behavioral therapy (DBT): DBT sessions focus on teaching a person mindfulness, distress tolerance, emotional regulation, and interpersonal skills. These skills help people learn how to accept themselves without judgment, acknowledge their emotions, improve communication, and better manage complex situations.1
- Cognitive behavioral therapy (CBT): CBT aims to help people identify patterns of negative thoughts, and how these thoughts lead to actions. The goal of CBT is to challenge people to identify their thoughts and feelings, and replace the negative ones with positive ones.2
Medications
Medications can be effective in treating psychosis related to trauma. Many times, these experiences are indicative of a larger issue. Therefore, taking medications in conjunction with talk therapy is a common approach to PTSD treatment. It’s important to consider all your options before pursuing a medication regimen. Be sure to discuss this with your medical team before starting or stopping any medications.
Final Thoughts
What you’re struggling with may seem unique to you, but remember that you’re not alone. Living with hallucinations and flashbacks can be scary and frustrating, but there are ways to heal and experience relief. Talking to a therapist who specializes in PTSD psychosis will make a big difference in how you feel. Together, you and your therapist will develop a plan to help you better regulate these difficult emotions.
For Further Reading
PTSD Hallucinations & Psychosis Infographics
