In general, people with PTSD exhibit intrusive thoughts and memories, avoidance of trauma reminders, emotional numbing, and high levels of anxious arousal. These are all cardinal symptoms of PTSD. However, some people with PTSD also experience odd perceptual experiences, or symptoms that generally would be considered to be part of a psychosis. You might be surprised to find that many people with PTSD experience some psychotic symptoms. In fact, this co-occurrence is common enough that some mental health professionals have developed specialized treatments for people with both PTSD and psychotic symptoms.
As indicated above, a substantial percentage of people with PTSD may also experience some psychotic symptoms. However, it is important to remember that just because you experience psychotic symptoms does not necessarily mean that you have a psychotic disorder, such as schizophrenia. In fact, studies of PTSD and psychotic symptoms have generally found that people with PTSD only experience a subset of psychotic symptoms.
Many people with PTSD experience flashbacks and periods of dissociation, particularly when under high levels of distress. Although these are not considered psychotic symptoms, they may share some features with psychotic symptoms. In particular, during a severe flashback, a person may see, hear, or smell things that other people cannot experience -- consistent with a hallucination. Flashbacks and dissociation can be very frightening experiences. They may make a person feel as though they do not have control over their body and experiences, and the unpredictable nature of these symptoms can be frightening. This article presents information on and some ways of coping with dissociation and flashbacks.
Many people are hesitant to treat someone with PTSD with traditional PTSD treatments (for example, exposure therapy) when that person also is experiencing psychotic symptoms. This may stem from a lack of training on the part of the therapist when it comes to dealing with the co-occurrence of PTSD and psychotic symptoms or from concerns that exposure therapy may actually make the psychotic symptoms worse. However, some mental health professionals have recognized the need for treatments that take into account both PTSD and psychotic symptoms.