Psychology question: Is someone "psychotic" if they recognize their symptoms aren't "real"?

If the psychosis manifests in the form of delusions (outrageous beliefs that could not reasonably be true), by definition the psychotic person would not recognize them as such. If the symptoms are hallucinations, such as hearing voices, it is possible that the person experiencing then can recognize that they aren't real.

Exercise Specialist wrote:

If the psychosis manifests in the form of delusions (outrageous beliefs that could not reasonably be true), by definition the psychotic person would not recognize them as such. If the symptoms are hallucinations, such as hearing voices, it is possible that the person experiencing then can recognize that they aren't real.

Thanks for the response.

So, for a delusion, the person must believe that the idea is definitely true, is that right? For instance, someone who has an obsessive/intrusive thought that causes anxiety but RECOGNIZES that's it's irrational/untrue would not really be "delusional" per se? The person would have to wholeheartedly believe in the idea as a certainty, am I right?

Someone is considered psychotic if they are bothered by things that aren't "real." You can have an interesting discussion about what actually is "real" but that's another topic. If the person is severely anxious about something the question hinges on whether they're anxious about something that would generally be considered real or not.

In my mental health clinic days I had a patient who was terribly worried about being pregnant. The idea/fear was a true obsession. In a 17 year old girl who'd been having sex this would not be a psychotic issue but this particular client was a 43 year old man. So yeah, that was considered psychotic. You're probably in a gray area if this guy had been as plagued and obsessed by that fear as he was but then added, "But I know I can't be pregnant but still worry about it all the time" but most likely such a person would not be considered psychotic.

If they stab women to death in the shower and pretend their long dead mother is still alive, they may be psychotic.

It is not quite as simple as other people are saying. Self-awareness does not prevent someone being psychotic. It is not uncommon that someone will be aware of their condition and it is actually a major risk factor for suicide in schizophrenics.

But, from the small amount that you said I would say that it sounds more likely that you are describing an anxiety disorder. Obviously there is not enough information to go though. You would need to describe the symptoms in some detail. I would recommend going or getting the person to go to a professional.

I don't have much time but here are two examples,

Person A: Presented with a fear that if they left the house they might end up molesting the neighbors children. Final diagnosis: Agoraphobia which was successfully treated.

Person B: Presented with anxiety that their friends were being deceitful. Final diagnosis: Schizophrenia the treatment for which is ongoing.

All I am trying to say is that how crazy it seems or even how crazy the person says it is is not a great indicator on its own.

Sorry, the last sentence is a mess... in a hurry!

Well, for instance, if a person had an intrusive, unwanted thought that their friends were "plotting against them", yet recognized that the thought was ridiculous and wanted desperately to get rid of the thought -- I assume that would be more like an anxiety disorder? As opposed to actually thinking, "yes, I know all about their little scheme!" which I assume would be more on the psychotic side of things.

Yes, that sounds about right. I was not too sure if the OP was dealing with a real or a hypothetical situation and I wanted to make it clear that it can be tricky to make a judgment on these things.

HRE wrote:

You can have an interesting discussion about what actually is "real"

That could include whether many of psychology's basic concepts are real. Belief in psychology might itself qualify as psychotic.

It's not a psychology question; it's a psychiatric problem for psychosis.

The majority of psychologists/psychiatrists are delusional psychotics themselves.

Can a delusional psychotic accurately render a diagnosis? I think not.

Havent read the other responses ... Sounds like you have the right idea. "Neurotic" might be the better choice of words to describe severe anxiety or similar.Psychotic really describes someone who is living in a different reality.

questioner of this wrote:

I just need to clarify something.

If someone has severe anxiety over something and experiences troubling, intrusive thoughts on the matter, am I correct in saying that that's NOT psychotic?

My understanding is that psychotic individuals tend not to question their strange symptoms/beliefs, but rather readily accept them as being reality.

Thank you for the complements, Bad Wigins.

To try to answer the original question. First, nearly all diagnosis in psychiatry is at the syndromal level. In other words, a collection of symptoms and signs co-aggregate often enough to be recognised as an entity. Therefore, it is an approximation of a deeper biological truth, which we don't know that much about.

Secondly, the term psychosis implies the presence of characteristic symptoms such as delusions, hallucinations (usually auditory), thought disorder (a breakdown in language), and generally disorganised and/or bizarre behaviour.

Thirdly, psychosis can be a part of conditions such as schizophrenia, bipolar, drug addiction, medical illnesses, or, indeed, flare up in times of extreme stress.

Fourthly, with regard to delusions, definitions vary, but there are some useful guidelines. They do not have to be bizarre, but if something is completely 'crazy' and far out, then it's likely to be delusional, especially if the content is well out of keeping with their background, culture, and current situation. If it is stuff that could happen, even if unlikely, it gets trickier. A good clue is that their explanations for the odd stuff don't make any sense either. If you keep asking 'why', or 'what was that all about', or 'how come that happened' etc, you will often unearth strange and illogical/irrational answers that confirm their not in touch with reasonable, consensual reality.

Psychotic people often have a strange and intense demeanour, look and act weird, say things that leave you thinking 'and?', and their general function in various domains of life tends to be going downhill. Generally, they have little or no insight into the

In OCD, people may be fixated on certain obsessions, classically germs, stuff being turned off/locked, harm coming to people by their actions or inactions, order and symmetry. The compulsions arise to neutralise the obsessional content-handwashing, checking, avoiding certain people, situations or places, ordering things in a particular way, counting in a set pattern etc. However, they usually have insight into it being excessive, unusual and interfering with their life. In other words it is incongruent to them, and seen as an anomaly=insight.

Bad Wigins wrote:

HRE wrote:

You can have an interesting discussion about what actually is "real"

That could include whether many of psychology's basic concepts are real. Belief in psychology might itself qualify as psychotic.

As I said, that's another discussion and it's one I've had many times.