How to differentiate between psychosis and neurosis

Psychosis and neurosis are two psychological terms that are often used incorrectly in contemporary society. It is not uncommon to hear a young person exclaim, “My mother is so neurotic! She just doesn’t know when to stop harping.” “Going all psychotic” is an equally familiar expression frequently used incorrectly to describe an individual’s out-of-control anger. Yet neither psychosis nor neurosis is simply a label to describe unreasonable behavior or parental nagging. They are real mental health conditions that are painful for those who struggle with them. Because of the misuse of these two terms, both conditions are often misunderstood by friends and family.

Exaggerated statements that randomly use diagnostic terms incorrectly add to the already challenging complexity of understanding the distinctions between their various symptoms involved in poor mental health.  In reality, there is a vast difference between being neurotic and psychotic. In fact, many functional individuals have some form of mild neurosis. Psychosis is much more serious and those who are diagnosed as psychotic have a severe psychiatric disorder and may pose a danger to themselves or others.

“Psychosis” is a term that comes from the field of psychiatry. It is a state of mind in which an individual experiences a break with reality. It is not a mental illness by itself, but it a descriptor that is often applied to more severe forms of mental illness. A schizophrenic may experience psychotic episodes in which he hears and sees things that are not real. “Psychosis” can also be used to describe the mental state of an individual who experiences a severe drug reaction that causes auditory and visual hallucinations. The elderly sometimes experience psychosis as a part of mental illnesses like Alzheimer’s or Parkinson’s disease.

Psychosis can be a temporary state of mind or a permanent feature of mental illness. Although society sometimes uses the word “psychotic” loosely, in the same way it might use the phrase “losing it,” it is not a term that should be applied to an individual just because he is extremely angry or unwilling to listen to reason. Psychosis is a serious form of psychological distress during which an individual is incapable of acting on his own behalf. Psychotic individuals are hospitalized and treated with antipsychotics to help control irrational thoughts and hallucinations that generally are a part of their mental status. In a court of law, psychosis can result in a ruling of incompetency and either temporary or permanent insanity.

“Neurosis” is a term that is being scrutinized closely by the current psychological community. Once believed to be a form of mental illness, it is now looked at as an unhealthy aspect of a certain spectrum of personalities. An individual who is commonly thought of as “neurotic” is best described as a personality type that has moved beyond its natural tendencies toward introspection and worry, into an obsessive thought process. When under a great deal of stress, a neurotic personality usually experiences symptoms of depression and/or anxiety. The term “neurotic” is rarely used in today’s psychological community. Individuals with significant neuroses are often diagnosed with Generalized Anxiety Disorder. In reality, almost everyone experiences some form of transient neurotic behavior, whether it be fixating about an upcoming routine medical screening or anxiously lying awake on the night before an airline flight.

Sigmund Freud, often viewed as the “father” of modern psychology, was the first to clarify the distinctions between “neurosis” and “psychosis.” He said that the vast majority of neurotics would continue to function fairly normally in spite of increased emotional discomfort from time to time. “Psychotics,” however, were regarded as individuals who were out of touch with reality and very emotionally disturbed. The field of modern psychology has adopted his definitions of these two mental states, but has further clarified them with a new understanding of how neurosis can be an unhealthy coping mechanism that emanates from a certain type of personality.

Is an individual psychotic or neurotic? Neither of these terms should be applied loosely and certainly not within the context of frustrations that arise out of dealing with difficult people. Before flippantly slapping either label on an acquaintance or co-worker, remember that while a majority of people will never experience a psychotic episode, most will, at some time, exhibit neurotic behavior.  Real neurosis, however, is a pattern of behavior characterized by obsessive worry and anxiety that can be emotionally crippling. Neurotics need help learning how to handle their excessive fear and anxiety over everyday circumstances of life.