Can Severe Anxiety Cause Psychosis

When Anxiety Disorders Spiral Out of Control

Anxiety disorders represent the most diagnosed mental health disorders in the nation, with an estimated 40 million individuals affected. Within the spectrum of anxiety-related disorders exist various manifestations of anxiety, each with their own unique features. However, the common thread that connects each anxiety disorder is intense worry or fear. But can severe anxiety cause psychosis?

When someone with extreme anxiety, such as panic disorder, experiences a psychotic break it can be highly unsettling. As the anxiety creates a condition where the connection to reality becomes untethered, the individual may experience hallucinations and delusions, only aggravating the existing symptoms.

When this condition occurs it may be referred to as a psychotic break or a nervous breakdown. The symptoms are clearly related to the anxiety disorder, rather than a psychotic disorder such as schizophrenia. Stabilizing the individual should be the first step in care, followed by enhanced treatment for the core anxiety disorder.

Types of Anxiety Disorders

When speaking about anxiety it is important to know that there are various forms of this common mental health disorder. These include:

• Generalized Anxiety Disorder. GAD features exaggerated worry that can consume the individual’s time and energy. The level of worry is irrational and has the potential to disrupt normal daily functioning.
• Panic Disorder. Panic disorder features sudden, unpredictable feelings of terror that can cause symptoms similar to a heart attack, such as heart palpitations, racing heart, shortness of breath, chest pain, and dizziness. These attacks can result in social isolation as the individual seeks to avoid the attacks at all costs.
• Social Anxiety Disorder. Social anxiety features intense discomfort in social situations due to the irrational worry of being judged or rejected. The disorder can result in avoidance of any social events or gatherings, impacting career and personal relationships.
• Phobia. Specific phobias involve intense fear of an object, place, or situation that causes them to avoid any possible contact with it or potential triggers. Attempts to avoid the object of fear can result in isolating behavior.
• Trauma Disorder. After experiencing or witnessing a traumatic event, individuals may continue to relive the event in their mind, have nightmares and flashbacks, and avoid any situations or places that might trigger intense emotional reactions. When the trauma doesn’t resolve after a month, it is called post-traumatic stress disorder, or PTSD.
• Obsessive-Compulsive Disorder. OCD features both obsessive worries and fears that result in compulsive actions in an attempt to reduce the anxiety caused by the obsessions.

Symptoms of Psychosis

The primary feature of psychosis is a loss of touch with reality. Psychotic disorders, such as schizophrenia, schizoaffective disorder, and delusional disorder, are characterized by:

• Increasingly disorganized thinking
• Mental confusion
• Auditory and visual hallucinations
• Delusional thoughts

Generally, psychosis comes on gradually, with signs that indicate a developing mental illness. Those might include inappropriate emotions, a decline in personal hygiene, difficulty thinking straight or concentrating, a decline in job or academic performance, emotional detachment, and being highly suspicious. When wondering can severe anxiety cause psychosis, the answer should be framed around psychotic features, not a psychotic disorder.

Can Severe Anxiety Cause Psychosis

Research suggests that symptoms of psychosis may be preceded by an extreme even, such as a panic attack or trauma. The intense emotional distress suffered as a result of anxiety can trigger psychotic symptoms. According to a study published in the Journal of Clinical Psychiatry, anxiety disorders, such as panic disorder, OCD, or PTSD can result in psychotic symptomology. These symptoms resolved with treatment involving both benzodiazepines and antidepressants.

Another study published in the Schizophrenia Bulletin noted that it isn’t only anxiety, but also individuals with depression as well that may exhibit psychotic features. This was found particularly among younger males with a family history of mental illness. The authors of the study comment that while in the past there were clear lines drawn between anxiety and depressive disorders and psychosis but that this assumption is in need of updating.

Treating Anxiety Disorders with Psychotic Features

Arriving at an accurate diagnosis is the first step in determining how to treat someone who has both severe anxiety disorder and exhibits psychotic features. Taking all aspects of the illness into consideration will assist clinicians in arriving at a specific diagnosis. Because different types of anxiety require slightly different treatment approaches, this initial assessment phase is key.

Treatment for the condition will likely involve an integrated approach, including:

Psychotherapy: Psychotherapy will include both individual therapy and group therapy. The individual cognitive behavioral therapy sessions allow the therapist to help the individual identify irrational thoughts and fears and maladaptive emotional responses. CBT is highly effective for treating PTSD, OCD, generalized anxiety disorder, and phobias. A recent study published in Dialogues in Clinical Neuroscience concluded with the statement, “the research on CBT in anxiety disorders supports the efficacy and effectiveness of these methods, with most of the current research demonstrating the usefulness of providing exposure therapy in the treatment of anxiety disorders.” 

Group therapy: Group sessions provide opportunities for small groups to discuss and share their anxiety issues while being facilitate by a therapist who guides the topics. These intimate group settings provide a safe environment for sharing and foster peer support in the process.

Medication: Medication will be prescribed depending on the specific diagnosis. In many cases medication will include benzodiazepines for reducing anxiety symptoms, antidepressants, and antipsychotics.

Adjunctive therapies: If the individual is struggling with panic disorder or trauma disorder, the use of exposure-based therapies and eye movement desensitization and reprocessing will be very useful as a treatment element. These types of adjunctive therapies help the individual by reducing the potency of the object, person, memory, trauma, etc. that elicits intense fear.

Holistic therapies: Increasingly, holistic therapies, most of which are derivative of Eastern practices, are utilized for the treatment of anxiety. Activities such as yoga, mindfulness training, guided meditation, acupuncture, and massage therapy are helpful in controlling stress and promoting relaxation. Patients can learn how to initiate mindfulness exercises on their own at any time of day, which is helpful when sudden symptoms emerge.

Helping Individuals With Anxiety Disorder and Psychosis

The Treatment Specialist provides an in-depth library of information and treatment options for mental health conditions, including severe anxiety. If you or a loved one suffer from intense panic attacks or another anxiety disorder that has resulted in psychotic features, you may wonder can severe anxiety causes psychosis. Our specialists can provide important information about your symptoms and guide you toward treatment options. Mental health programs include both residential and outpatient, as well as dual diagnosis treatment if there is a co-occurring substance use disorder. Reach out to our highly trained specialists today at (866) 644-7911.