PTSD Psychotic Symptoms: Symptoms, Triggers, and Effective Treatments

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Due to current events including war and natural disasters, much of the world community is aware of Post Ttraumatic Stress Disorder, or PTSD. However, the psychotic symptoms that can sometimes be associated with PTSD are not as well known. Nonetheless, these symptoms are often prevalent in people with more severe cases of the trauma disorder.

People who suffer from PTSD are the ones who experienced a major natural disaster, were threatened by personal death, or witnessed an attempted murder on someone else. Other causes of PTSD include rape, being mugged, and a variety of other events that can happen to a person to cause them mental and emotional trauma.

Initially the trauma may cause Acute Stress Disorder and if this disorder is not treated properly or successfully within 30 days, then the disorder evolves into PTSD and for many; according to research, it can involve psychotic symptoms. There are two different categories of psychotic symptoms. The first category is labeled positive psychotic and the second is negative psychotic. Each category of these symptoms can have the same trigger and cause, but positive psychotic symptoms are known to be more prominent than the negative ones.

Positive Psychotic Symptoms of PTSD

When a person with post-traumatic stress disorder has psychotic symptoms they are usually in the positive category. This does not mean that the symptoms are positive in nature, in fact it is quite the opposite. People with this type of psychotic symptoms of PTSD often complain of having a very unusual feeling, their thoughts are abnormal as are their behaviors. Often they will have hallucinations as well as delusions.

Negative PTSD Psychotic Symptoms

The psychotic symptoms of a person with PTSD are characterized by the patient losing abilities. The person may have trouble talking and may even stop speaking for days on end and having an utter inability to dress themselves or partake in feeding, bathing and other activities of daily living on their own fall into the negative psychotic symptoms category.

Psychotic Symptoms with PTSD

A study conducted by the University of Manitoba, Columbia University, and the University of Regina found that out of the 5,877 PTSD patient files they examined that nearly half (52%) had had at least one experience of positive psychotic symptoms. The study went on to find that over a quarter of the patient files studied had noted to their physician they had beliefs they were being followed and other paranoid instances. More than 10% of the 5, 877 had episodes of thinking they could read someone’s mind, felt as if someone was touching them when they were completely alone, could smell odd scents that nobody else could smell, and believed that a higher power was controlling every aspect of their life. More facts about PTSD can be found here.

Cause of Psychotic Symptoms

The psychotic symptoms of PTSD, whether positive or negative, are generally brought on by the same reasons; it is how the patients brain decides to react-either with the positive symptoms or negative ones. Generally an onset of psychotic symptoms of PTSD are caused by being exposed to something exactly or similar to what induced the PTSD in the first place or re-experiencing another traumatic type situation and also by not being treated for the trauma disorder. Untreated people with PTSD and those with more severe symptoms of PTSD are more likely than others to develop psychotic symptoms.

How to Treat PTSD Psychotic Symptoms

The base treatment of the psychotic symptoms of PTSD are similar to the basic treatment of post-traumatic stress disorder. Medications are often used and can include anti-depressants, anti-anxiety medications, anti-psychotic medications, and various off-label prescriptions. Severe depression can also cause psychotic symptoms.New studies are underway on various medications to test their ability to better help patients with PTSD. Along with medication, talk therapy, biofeedback, education about PTSD and psychotic symptoms of PTSD are also used. The reasoning behind educating the patient is to help them keep themselves balanced and to hopefully understand that they are experiencing these symptoms due to their PTSD and hopefully will not succumb to believing what their symptoms are telling them. Not all patients with post-traumatic stress disorder will experience PTSD psychotic symptoms. To help avoid triggering episodes of psychosis it is important for the person with PTSD to be under the care of a psychology specialist and maintain a treatment regiemine of medication and/or therapy sessions.



Sareen, J., Cox, B.J., Goodwin, R.D., & Asmundson, G.J.G. (2005). Co-occurrence of posttraumatic stress disorder with positive psychotic symptoms in a nationally representative sample. Journal of Traumatic Stress, 18, 313-322.

Kilcommons, A.M., & Morrison, A.P. (2005). Relationships between trauma and psychosis: An exploration of cognitive and dissociative factors. Acta Psychiatrica Scandinavica, 112, 351-359.

American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: Author.