Substance-Induced Psychotic Disorder

If there’s anything worse than being addicted to drugs or having a severe mental illness, it’s being addicted to drugs and having a severe mental illness. And they do often go together, sometimes by direct cause and effect. Many people turn to addictive substances to numb the pain of mental health concerns. And many people develop such conditions after using drugs to the point of brain damage. A person who takes a mood-altering substance, and then behaves erratically long after the effects should have worn off, may have substance-induced psychotic disorder: a condition characterized by mental disconnect from reality.

Symptoms of Substance-Induced Psychotic Disorder

In medical vocabulary, psychosis means a mental condition that distorts thoughts and emotions to the point a person can no longer accurately process reality. Substance-induced psychotic disorder symptoms (similar to those of schizophrenia) include:

• Hallucinations: seeing, hearing, or otherwise perceiving things that aren’t really there
• Hypersensitive reactions to sensory input
• Paranoid or inexplicably defensive behavior
• Believing that one is being contacted, observed, or controlled by outside entities
• Delusions of grandeur
• Physical agitation
• Disordered or rambling speech
• Inability to express emotions
• Withdrawal from others (also a common symptom of substance use disorder)
• Forgetting to eat or practice other basic self-care

Psychosis has many possible causes besides substance use/drug abuse. A diagnosis of specifically substance-induced psychotic disorder requires that symptoms appear within a month of using drugs, in someone not known to have experienced psychosis before. 

When Substance Use Induces Psychotic Disorder

It’s well known that drug use can trigger individual psychotic episodes. Psychotic disorder means that psychotic effects linger or recur after the substance’s direct physical effects wear off—or, sometimes, that psychotic symptoms appear for the first time during addiction withdrawal. As many as one in four people treated for psychosis may have substance-induced psychotic disorder.

The question of whether any individual will develop psychosis from substance use depends more on physical and mental predispositions than on the specific substance involved (even non-addictive drugs such as antidepressants have been implemented in some cases). Males, people under 30, and people with preexisting mental conditions (of any type) are considered at higher risk.

Treatment and Recovery

Psychosis can be frightening and often leads to dangerous behavior, but contrary to popular stereotype, it is not necessarily continuous or permanent. With substance-induced psychotic disorder, treating underlying substance addiction may be enough: many psychosis cases clear up on their own within a month of full detox.

That said, substance misuse often does do lasting damage to the brain—and, as already noted, many cases of substance use disorder (addiction) co-occur with preexisting mental conditions. Treatment for substance-induced psychotic disorder and/or substance use disorder should always include a full psychiatric evaluation and a full physical-health examination, to uncover any additional problems.

There is also much that people can do to help themselves recover from addiction and associated substance-induced psychotic disorder.

• Eat healthy and get plenty of rest.
• Practice relaxation and mindfulness exercises to stay grounded in reality. (Spending time outdoors is also helpful.)
• Cultivate thorough understanding of your condition and the underlying issues. Build a clear and strong picture of reality in your mind.
• Make a relapse prevention plan to keep addiction in check. Know how to avoid circumstances that tempt you to drug use.
• Stay alert, also, for possible signs of a new psychotic episode developing (straining to concentrate, feeling unusually stressed/irritable/depressed/suspicious). Know in advance whom you will call for help if this happens.
• Arrange for long-term therapy.
• Join a peer support group.
• Stay busy with activities you find personally meaningful. When the real world feels worth your time, your brain has built-in incentive to resist retreating into drug use or psychosis.

Help for Substance Use and Mental Disorders

Whether or not mental problems are directly substance-induced, half of people struggling with addiction also battle psychosis or another mental health disorder—meaning that both conditions need treatment before the whole person can recover.

If you or anyone in your family has this problem, consider the Dual Diagnosis Treatment program at Beach House. We provide in-depth psychiatric assessments, with individualized treatment plans that cover every need. Contact us to learn more.

Recommended articles:

• “Brain and Addiction.” (National Institute on Drug Abuse)
• “Community Drug Alert Bulletin—Stress & Substance Abuse.” (National Institute on Drug Abuse)
• “An Overview of Brief Psychotic Disorder.” (VeryWellMind)
• “Schizophrenia Myths and Facts.” (WebMD.com)
• “Tips for Dealing with Triggers in Recovery from Substance Use Disorders.” (PsychCentral)
• “What Is Substance/Medication-Induced Psychotic Disorder?” (VeryWellMind)
• “What Is the Difference Between Psychosis and Schizophrenia?” (VeryWellHealth)