Psychosis is a state in which one loses contact with reality. Originating from either mental or physical conditions, its symptoms include delusions, hallucinations, disorganized speech or behavior, and a decrease or loss of normal functions. A hallucination can be hearing a voice that is not actually there, while a delusion is a fixed false belief that is not true. A decrease or loss of normal functioning may mean difficulties speaking and expressing emotions. Mental and physical disorders associated with psychoses include schizophrenia, psychotic depression, bipolar disorder, delusional disorder, and druginduced psychosis. Those dealing with a psychotic episode often experience social withdrawal. In addition, they may not realize that they have a mental illness and go for years without treatment. At the same time, their mental state may affect their education, employment, and relations with friends and family.

Denial, stigma, and fear are barriers to seeking treatment. Psychosis can cause feelings of shame and stigma not only to those individuals but also to family and friends. In 1963, Erving Goffman described stigma as "deeply discrediting" attributes that are normally undesirable. Manifestations of stigmatization are embarrassment, anger, avoidance, fear, stereotyping distrust, and bias, any of which can reduce patients' access to resources and opportunities, leading to low self-esteem, isolation, and a sense of hopelessness. Many people with serious mental illness deal with both internal and external challenges. That is, the disabilities and symptoms stemming from psychosis challenge them, as does dealing with the discrimination, assumptions, and stigma that result from misunderstandings about mental illness.

Fear and stigma about the mentally ill abound in society. Those experiencing psychosis often experience myths and misunderstandings about their illness. While societal understanding about different forms of mental illness has increased, the belief continues among many that people with psychosis are more violent now than they were in the past. Perceptions and misconceptions that people with psychosis are dangerous are a critical factor in others keeping or desiring social distance from them. As a result of these misunderstandings, people with mental illness often experience discrimination and lack access to the full range of opportunities such as employment, adequate health care, safe housing, and integration and/or socialization with diverse groups.

References:

1) Corrigan Patrick W. and Amy C. Watson. 2002. "Understanding the Impact of Stigma on People with Mental Illness." World Psychiatry 1:16-20.

2) Goffman, Erving. 1963. Stigma. Englewood Cliffs, NJ: Prentice Hall.

3) Phelan, Jo C., Bruce G. Link, Ann Stueve, and Bernice A. Pescosolido. 2000. "Public Conceptions of Mental Illness in 1950 and 1996: What Is Mental Illness and Is It to Be Feared?" Journal of Health and Social Behavior 41(2):188-207.

4) U.S. Surgeon General. 2007. "Mental Health: A Report of the U.S. Surgeon General."

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