Mental health conditions come with serious stigma. That stigma can hold people back from getting treatment, because they're worried they're going to be branded as "crazy." Anxiety is a mental health issue characterized by a lot of unusual symptoms and behavioral changes, and some people worry that they are showing signs of psychotic behavior.
Anxiety is Not Psychosis
The truth is that while anxiety can cause a lot of different changes and behaviors, psychotic behavior is not one of them. Psychosis is characterized by a dangerous loss of reality. Anxiety can cause a break from reality, but that break isn't dangerous and doesn't cause any noticeable, permanent changes.
Extreme anxiety can lead to what's known as "derealization." Derealization is a temporary loss of the feeling of reality. Those that suffer from it during the peak of an anxiety attack feel like the world around them isn't real. But that feeling fades away when the anxiety decreases.
Anxiety can also cause some unusual behaviors and thoughts. In fact, obsessive compulsive disorder is sometimes associated with "disturbing thoughts" that have some people worried that they may be going crazy. These thoughts include:
- Thoughts about violence against another person.
- Thoughts about extreme sexual acts against another person.
- Thoughts about death or gore.
These thoughts can occur as a result of anxiety.
But none of these are necessarily a sign of psychosis.
The difference between psychosis and anxiety is pronounced. The first thing to remember is one of the reasons that you (potentially) have this fear that you're becoming psychotic is because you have anxiety.
Those that are struggling with psychosis are usually not aware that they are losing touch with reality - they believe that their thoughts and hallucinations are real rather than imagined experiences. The fact that you're worried you're losing touch with reality is evidence that you are still largely connected to reality and aware of the distinction between what’s real and what isn’t.
With obsessive compulsive disorder (and to a lesser extent, other forms of anxiety), the thoughts are triggered or worsened by the fact that you really don’t want them to occur in the first place. It's a phenomenon known as thought suppression, where the brain causes you to think about things you don't want to think about more often specifically because you try to avoid the thoughts.
But with psychosis, the thoughts simply occur. They do not cause a rush of anxiety and the person doesn't try to push them away. They simply occur like any other thought. The loss of touch with reality tends to make the thought more real and something the person doesn't see a problem with. The person with anxiety doesn't experience that.
How to Tell the Difference Between Anxiety and Psychosis
There are similarities between anxiety and psychosis, and if you're concerned you should see a psychologist, doctor or psychiatrist. But there are also very clear differences between them. Anxiety is also far more common than psychosis, so the likelihood is that you are simply struggling with an extreme level of anxiety.
If someone you know is displaying signs of psychosis and you think they are in danger of harming themselves or someone else, it’s incredibly important that you get them the help that they need. Try to escort them to a hospital, or else contact 911 if necessary.