According to news reports earlier today, the Kony 2012 director Jason Russell, 33, was “hospitalized last week in San Diego after witnesses saw him running through streets in his underwear, screaming incoherently and banging his fists on the pavement.” His wife now says he’s been diagnosed with brief reactive psychosis, which is technically called “brief psychotic disorder.”
Brief psychotic disorder could be most simply thought of as a form of short-term schizophrenia, since many of the symptoms of the disorders are exactly the same. The primary difference is that in a brief psychotic disorder, the psychosis is less than 30 days.
Let’s delve more into brief reactive psychosis and talk about how one “gets it” (don’t worry, it’s not catching).
Brief Psychotic Disorder is characterized by the presence of one or more of the following symptoms:
- Delusions
- Hallucinations
- Disorganized speech (e.g., frequent derailment or incoherence)
- Grossly disorganized or catatonic behavior
The duration of an episode of brief psychosis is at least one day but less than one month, with eventual full return to previous level of functioning. It is most often found in adults in their late 20s or early 30s.
Generally, you might make this diagnosis over a diagnosis of schizophrenia because the psychosis hasn’t yet reached 30 days. Once you get past that one month mark, however, a diagnosis of schizophrenia would usually be more appropriate.
The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) is silent on the causes of this disorder (as it is generally for all mental disorders). But the article claims that “extreme stress” was the cause of it in Russell:
“The preliminary diagnosis he received is called brief reactive psychosis, an acute state brought on by extreme exhaustion, stress and dehydration,” Danica Russell said. “Though new to us, the doctors say this is a common experience given the great mental, emotional and physical shock his body has gone through in these last two weeks.
“Even for us, it’s hard to understand the sudden transition from relative anonymity to worldwide attention — both raves and ridicules, in a matter of days.”
While I don’t discount Danica Russell’s beliefs, nor the explanation she was given by his doctors, the truth is that — like most mental disorders — we really don’t know what causes brief reactive psychosis. After examining the research on the causes of brief psychotic disorder, I have to say there’s just not a whole lot there, because it’s such a rare and uncommon disorder. There are no lab tests for it, nor other medical procedures that can tell you with any certainty that X has caused it.
I believe that Jason Russell’s doctors do a disservice to the complexity of mental disorders and the people who suffer them by suggesting a cause is readily known when, in truth, there’s no way they could make such a determination. I know doctors don’t like to say, “We don’t know what caused it, but it might’ve been…” or, “We don’t know what caused it, but the good news is that we have a lot of treatments that seem to work in most people…” Yes, these are more nuanced and complex explanations, yet they are so vitally important to ensuring we don’t “dumb down” mental disorders to the point of repeating ignorance.
We don’t really know what causes brief psychotic disorder — in Jason Russell or anyone else.
But we do wish him a speedy and complete recovery.
Read the news story: Wife: ‘Kony 2012’ director suffers from psychosis
8 comments
I worked as a Clinical Team Leader on an Inpatient Psychiatric ICU for nine years. During the period greater than one month but less than six months the provisional diagnosis of Schizophreniform disorder was given. If necessary criteria were met after six months the diagnosis was changed to Schizophrenia.
This six month period is significant because some patients resolve enough of their symptoms to qualify for a different psychotic disorder or in some cases a mood disorder (often bipolar) qualified as “with psychotic features.”
On a practical basis, when working with families the schizophreniform diagnosis allows them a bit of hope and a longer time to begin to accept that their loved one has schizophrenia.
People with schizophrenia today sometimes can cope well on the newer atypical antipsychotics. Two of my patients are in their third year of college but still have episodes of recurring symptoms. They know the psychiatrist can briefly increase their medications. The treatment team helps the patient to reexamine their stress levels that can be a contributing cause of the recurrence.
As more and more of these patients perform well in the real world, I hope we will begin to change the face of schizophrenia as a diagnosis with the potential for a good prognosis.
Hi John, What is the difference between a “psychotic disorder†and a “manic episodeâ€. What do they have in common?
DSM-IV Criteria for a manic episode.
A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
1. inflated self-esteem or grandiosity
2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3. more talkative than usual or pressure to keep talking
4. flight of ideas or subjective experience that thoughts are racing
5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
C. The symptoms do not meet criteria for a Mixed Episode.
D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatments) or a general medical condition (e.g., hyperthyroidism).
How interesting. That’s all I have to say. They said he’ll be in there for a few weeks…in the hospital. Wondering how this will play out with the evidence played on the news, too. No one wants to be called psychotic, and theres the evidence from TMZ. Video, not just roaming words.
What are the chances that this is the convenient cover story for drug usage? My first reaction to the story was that he might have taken ecstasy, LSC, mushrooms, or peyote. I’d love to hear a professionals take on this possibility. Is it common that people don’t believe in this diagnosis? I had never heard of it before.
Also, frankly illicit drug use is less stigmatised than mental illness unfortunately, so I think someone covering up drug use with psychosis would be highly unlikely.
Cynic,
The reality I have observed is that it more then likely it wasn’t an illegal drug he was on. The DSM-IV description of a manic episode I listed above has a note at the end of it stating,
“Note: A full manic episode emerging during antidepressant treatment (medication, ECT, etc) and persisting beyond the physiological effect of that treatment is sufficient evidence for a manic episode diagnosis.”
Fear not the illegal drugs, but rather the ones people are making $10 billion dollars off of.
Catch the Wind
(a poem about Jason Russell of Invisible Children on the occasion of his reactionary psychosis after his Kony 2012 video went viral)
Useless lawyer waste of people
Mrs. Spring.
And they tease you.
Can you hold your hand out
With the world wind some
With the run of your life?
You turn away.
Pornography,
Your poetic form is finished.
Boring daddy
Hear you play their thoughts.
Go back to work.
I give up.
So much bigger than me.
You’re supposed to send it in.
Your country a track record
Gettin’ into our country.
You can say anything.
I’m not so sure about that.
No response.
I’m serious,
I need this.
Mass movement organization,
Experienced donations so far.
Star into city.
Can somebody give me a donation?
Fresh start,
I will always almost happen.
Translation:
And you fold the world.
Anonymous, mysterious
(Let me get my glasses.
That’s strange.)
We talk to you
Earth activated.
Look at your gymnastics.
Wide horses,
It is good to see yah.
That’s right on
The movie
We Have a World in View.
Pardon me,
What does it mean to yah?
All of it sink in?
Tryin’ to explain to yah
A whole wide world
Movement.
As much as you can
You don’t stop and think
How many are in movements.
All of that’s threatening you.
There remains something important
Over there
Deep
Would benefit your discovery program:
Hear what we think
All the time.
Find the key inside.
Have you been in bed before?
And you’re layin’ there in their scrap,
Who’ve you’ve crossed their minds.
Their hands
Definitely on this.
I’m talkin’ about
A mural
With all these signatures.
Well I bet you
Couldn’t handle the delivery.
I hand it of you
Tasted enemy.
It’s a systems failure.
Know what I mean?
A rising forward movement
In which hundreds connected with deep were slain.
You’re going to go to school,
Examine ideas,
If you let me
Give you something to do.
Sterling Abbot
Your wife’s concentration,
Another wife
You’re gonna live
In the very bones of yourself.
This is not flesh and blood.
It’s your waistcoat
Of ruling ideas
And guarding passions.
Get out;
I don’t want to.
Ruling passions can be difficult
I understand.
Play come on.
In making a very sharp objection
Present myself.
I’m a licensed teacher.
I’ll be conceiving of no reply.
Just a truthful father shooting.
I damage your report to everybody.
I throw it off.
I’m so bombard your home.
Even flying the hammer and sickle you find me.
I’m business news.
Man I’m sitting
Where you put your feet,
What you stand on.
There you are
In our rosebushes.
What you’re looking for
Is a door:
Can we just solve here?
You pick ole Major Warrant,
The simplicity minor that was just talkin’ to yah.
Not him.
Comin’:
Deny it –
Somethin’ eating everybody,
Runnin’ through a whole population.
All the locals come down with it.
They got manifestors runnin’ around.
Not everybody tweaks.
Tommy
You’re no good:
Opportunity
Show some lime in everyone.
Shut the door.
The article
Won’t come out in your paper will it?
If it don’t
Your foolish pride
In front of
Jason.
I’ll explain
That American.
Did Rock Hudson throw a popular fit outside or anything else?
Oops, you got mad at me.
Upended
It,
Piano.
You’re not gonna like this.
Go get your prize:
I’m the man;
That’s me on the spotlight.
Cut that burrito,
Spanish book,
America is beautiful
Machismo.
The same
War bond
In your hunted fugitive.
Almost everywhere
Apparently.
It’s the Earth;
It’s all mankind
Got the problem.
What’s the solution?
You put out fires for sure.
The arson
Don’t make a scapegoat.
Every arson
You make propaganda
Immune from hospital.
Is that the smartest thing to do?
How do you get
The manifestor
To come to terms?
Alienate him further
(Giving that launch infamy)
Increase his fuel,
That stuff inside him bombing children.
He needs to feel
The community.
Stick around:
Man that’s a good question
The community.
Look after One
Is this opera house,
Wire at the top.
Wire specialist
I’ll give him a hug.
We’re gonna go over there.
A very big
Change in identity
So we’re there.
That’s included.
The weathering ride to help,
That’s why you went,
Just to get something
(I’ve dropped this so many times it ain’t funny.):
Enlightenment.
This is not a Buddhist sutra.
We’re lookin’ beyond escape.
This is just phase one.
There’s three.
How much room on spaceships?
The Earth we stay
Planetary and all grown up
If that keeps up:
Darn it,
I should could do better can’t I?
I’ve given you your healing song.
Happy birthday.