Differences between psychosis and neurosis

Psychosis and neurosis are terms used in psychology to describe psychological disorders. The symptoms of a psychotic condition are not the same as those of a neurotic one and identifying them can be useful in seeking timely help. Therefore, knowing the differences between psychosis and neurosis is essential when making differential diagnoses.

Furthermore, by learning more about it, we can become aware of some problems. In this way, we avoid prejudices about mental health and help create a more empathetic society.

The territory of psychosis and neurosis

In 1796, William Cullen introduced the word neurosis to refer to alterations of the nervous system that cause sensory and motor dysfunctions. For example, hemiplegia, a condition that causes paralysis in half of the body, would be a type of neurosis.

Later, the term is applied in the field of psychology to describe certain clinical conditions. In the case of Sigmund Freud, father of psychoanalysis, understood neurosis as a structure of psychic function. “Neurotic” people would have symptoms such as anxiety, hysteria, obsessions, compulsions and sexual dysfunctions.

On the other hand, in the XIX century, Ernst von Feuchtersleben used the term “psychosis” for the first time. At first, this word included the Greco-Roman definition of “madness”, an umbrella under which those mental conditions were encompassed in which there was considerable confusion between internal and external reality. Some time later, the concept began to be enriched as the different psychotic illnesses were studied.

However, before that happened, the differences between psychosis and neurosis were not entirely clear. There were alterations that were defined as neuroses, although they also had psychotic features. For this reason, even today, there is still some confusion in this regard. Next, we will look at both terms separately to understand them better.

In neurosis, errors occur in the perception of reality.

Neurosis

Neurosis refers to a group of psychological disorders that are associated with emotional imbalances and errors in the perception of reality. A typical example would be anxiety, a condition that causes physical and emotional symptoms in those who suffer from it. Similarly, obsessive-compulsive disorders and stress reactions can be considered neuroses.

Continuing with this, in his book Anxiety and Neurosis, Rycroft and Carstairs (2018) speak of neurosis as a pathological exaggeration of natural experiences. In principle, anxiety is a normal emotion that arises in some situations, and can be truly adaptive. However, for different reasons, it could become a chronic emotion that appears in contexts where it is not positive.

In this same sense, the reasons why an emotion can become pathological are several. From the cognitive-behavioral model, it is usually associated with errors when processing reality. To better illustrate this, let’s imagine a person with low self-esteem who has recurring invalidating thoughts, such as “I’m worthless.”

If this person is asked to do a task, they may feel anxiety because they believe they are not capable. Such a belief or perception of herself would be related to his low self-esteem and frequent thoughts about his worthlessness.

Other conditions that we can classify as neuroses are post-traumatic stress disorders and phobias. In these cases, irrational beliefs and problems are also observed in the person’s learning history.

Psychosis

Continuing with the differences between psychosis and neurosis, we will delve deeper into the former. As with neurosis, psychosis refers to a group of mental disorders. Nevertheless, These are characterized because the symptoms directly affect the judgment of reality. Consequently, the patient perceives the world in an altered way.

Common conditions in cases of psychosis are hallucinations and delusions. One of the most common examples is persecutory delusions, in which the person believes that others want to hurt them for some reason. However, this belief has no objective basis in reality and could even blame non-existent beings.

Along these same lines, to understand the differences between psychosis and neurosis, we can cite other conditions. For example, Schizophrenia is one of the most common conditions, There is also acute psychotic disorder and delusional disorder.

In psychosis there is a loss of the sense of reality.

Aspects to consider about the differences between psychosis and neurosis

To summarize, it is possible to affirm that psychosis and neurosis have similar elements and differences. On the one hand, Both terms are used to categorize mental illnesses, but they are distinguished by the type of conditions they encompass.

In the case of psychosis, these are pathologies whose symptoms cause the loss of the sense of reality. Therefore, it generates problems in the functioning of those who suffer from them, since they adjust reality according to their delusions and hallucinations. Additionally, psychotic disorders can be degenerative and cause other symptoms such as cognitive impairment.

For its part, In neurosis we find alterations of thought and affect, but they do not distort reality completely. If we take the example of anxiety, many of the thoughts that cause it can have their origin in objective negative experiences. The problem appears when the context changes and those thought patterns are maintained.

It should be noted that there are diseases that are classified within neurosis, but that may present psychotic features. Such is the case of depression, which in some cases presents with psychotic symptoms such as hallucinations or delusions. The same happens with borderline personality disorder, in which there are usually delusional ideas, but not complete delusions. So, it is possible to say that they border on the edge of psychosis without actually being one.

To conclude, due to the above, the differences between psychosis and neurosis still tend to be debated in the scientific community. Perhaps it would be possible to define a new classification that integrates these conditions in which both types of symptoms are present.

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