The Difference between Psychosis and Neurosis

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"The Difference between Psychosis and Neurosis"
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There were few occasions in the past when I heard some people used the terms neurosis and psychosis interchangeably.  In fact only recently, a group of young men, sitting in a table next to ours (my wife, our two kids and I) in a restaurant, were raucously poking fun at one of them, calling him neurotic at one time and psychotic the next.  But do the terms neurosis and psychosis really mean the same thing?

The answer is no, they don't.  The terms neurosis and psychosis actually refer to certain symptoms and behavior that cut across several diagnostic categories.  They may refer to difficulties of personal adjustment to an accepted or agreeable way of life.  People who suffer from neurosis exhibit an excessive reaction to what others would deem minor stresses.  This means that a neurotic individual worries over things that are of little importance or substance.

In spite of this distinguishing characteristic, however, neurotic persons have not lost touch with reality; they can usually function normally despite experiencing distressing feelings, such as depression or anxiety.  The problems associated with neurosis, as psychological theory suggests, are products of the individual's unconscious attempts to guard against an overwhelming sense of fear and apprehension brought about by conflicts between desires and prohibitions.

It is the aim of psychotherapy to resolve such conflicts.  Of course, antidepressants are sometimes prescribed for neurosis; but this mental disorder implies an illness that is psychological in origin.

In a more restricted sense, the term psychosis refers to an illness of a disintegrated personality; it may be biologically triggered.  The individual's inability to distinguish the real from the unreal is a distinguishing characteristic of psychosis.  As a consequence, it becomes impossible for the psychotic patient to relate acceptably to other people and to life's responsibilities.

Apart from often being delusional, a person suffering from psychosis may experience confusion (is unable to think logically), disorientation (loses awareness of place and time), and hallucinations (has false perceptions of things).  Being unable to correctly perceive and interpret the things around him/her, the psychotic patient may act incongruously, becoming afraid, confused and isolated.

There are other factors, aside from mental illness, that can affect the brain and result to psychosis.  These include such physical illnesses as infections, tumors, and diabetes.  The use of drugs and alcohol are likewise possible contributing factors.  Treatment of psychosis may be difficult; the use of neuroleptics (powerful tranquilizers) is a usual form.  In some cases, hospitalization may be required.  While psychotherapy may not be of much help in treating symptoms of psychosis, it can help a patient who is in remission.


1. "A Bio-Social Theory of Neurosis" by Dr. C. George Boeree, Shippensburg University -

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