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What is the Difference Between Neurotic and Psychotic?

By J. Beam
Updated Mar 03, 2024
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The terms neurotic and psychotic are both used to describe conditions or illnesses that affect mental health. Though neurotic and psychotic are both relative to mental health, there are differences between neurotic and psychotic conditions. The terms neurosis and psychosis are sometimes used interchangeably with neurotic and psychotic disorders.

A neurotic disorder can be any mental imbalance that causes or results in distress. In general, neurotic conditions do not impair or interfere with normal day to day functions, but rather create the very common symptoms of depression, anxiety, or stress. It is believed that most people suffer from some sort of neurosis as a part of human nature.

As an example, some people are afraid or unable to speak in front of large crowds. As a result, any situation that might warrant public speaking can cause symptoms from nervous nausea to vomiting, or from trembling to excessive perspiration. Some people suffer more severe symptoms of neurosis than others, and some forms of neurosis are more marked, such as obsessive-compulsive disorder. However, neurosis is not as severe as psychosis.

Psychosis, or a psychotic disorder, is believed to be more of a symptom than a diagnosis. As a psychiatric term, psychosis refers to any mental state that impairs thought, perception, and judgment. Psychotic episodes might affect a person with or without a mental disease. A person experiencing a psychotic episode might hallucinate, become paranoid, or experience a change in personality.

Generally speaking, the psychotic state is not permanent. Psychotic behavior differs from psychopathic behavior, and psychotic episodes rarely involve the violence associated with psychopathic behavior. Psychotic is also not the same as insane, which is both a medical and a legal description for a person who cannot be held accountable for his or her actions.

In essence, the primary difference between neurotic and psychotic is the manner in which they affect mental health. Neurotic behavior can be naturally present in any person and linked to a developed personality. Psychotic behavior can come and go as a result of various influences. The effects of some drugs can cause psychotic episodes, or a traumatic situation that affects a person’s psychological well-being might trigger the episode. Distinguishing between neurotic and psychotic conditions or disorders is accomplished through an evaluation by a psychiatrist or psychologist, who may treat symptoms with medication or therapy.

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Discussion Comments
By anon344344 — On Aug 08, 2013

Rational (fear, hypervigilance) v. irrational fears (paranoia).

By anon253634 — On Mar 10, 2012

Paranoia is rooted in arrogance. Fear is an emotional reaction based on reality.

By anon214312 — On Sep 14, 2011

@happy uk: You are wrong in associating psychosis automatically with a criminal personality.

I have had psychosis - which has been mainly in the form of delusions, paranoia and hearing voices - but am definitely not criminal.

By anon202906 — On Aug 03, 2011

There is plenty of grey area between the two! And one can cause the other. The stress of living with a long term neurotic fear can cause a psychotic break (eg.paranoia).

For example, a drug induced paranoid state can cause long term neurotic fears (eg. social phobia).

I once asked a psych doctor where does fear end and paranoia begin, but got no answer. So if they don't know, who does?

By anon157040 — On Mar 01, 2011

you might say forms of alcoholism (there are more than one) are indeed neurotic with grave psychological side-effects which can induce psychosis. Ultimately it is a form of self-harm and i guess self-harm is somewhere on a sliding scale that ends in suicide. As alcohol is a depressant drug then depression has to figure high in any analysis of this illness.

But there are many grey areas and we are also faced with 'dual-diagnosis' cases where individuals are both mentally ill and possibly psychotic as well as addicted physically to alcohol or other drugs. Pass me the root beer, please.

By anon155025 — On Feb 22, 2011

Do people with ever-growing and consuming neurotic tendencies, commonly/eventually have psychotic episodes? Leading to another question, that if neurotics get successful treatment to diminish or eliminate many of their neuroses, does it avoid/prevent the likelihood of a psychotic break?

By anon86658 — On May 26, 2010

To happyuk:

Psychotic = criminal personality = X

Psychopath = criminal personality = +

Psychotic = illogical, delusional, disorganized.

Psychopath = logical, rational, methodical, organized, no neurosis/emotional distress for most part.

By anon64931 — On Feb 10, 2010

Is there a grey area between neurosis and psychosis?

By anon59540 — On Jan 09, 2010

I want to know the difference between religious delusion in psychosis and hysteria?

By anon48069 — On Oct 09, 2009

i have recently realized i am neurotic. when i'm at work i can't have a real conversation with certain people without feeling uneasy and paranoid and i think everyone is out to get me. is there a treatment?

By anon45621 — On Sep 18, 2009

Trish - Either or Both! Look up the term "Pervasive". Psychosis: I have suffered three episodes this summer. I am 38 and have suffered from schizophrenia since the fourth grade. I can be "suspicious." I have become psychotic while psychotic - but if you look at that a little closer you will see the condition defines itself. With more evidence I can accept being psychotic *while* psychotic but the evidence has to be shown by someone other then me. The psych floor is usually a good indication! :-) Neither schizophrenia nor psychosis is hopeless, just stay honest.

By anon43377 — On Aug 28, 2009

While I agree in most cases psychotics are not aware of their own illness, this is not the rule for all. Daniel Paul Schreber for example, suffered from psychoses, but was aware of his own illness.

By anon39642 — On Aug 03, 2009

I was once told that a neurotic personality is one in which the person is walking a fence always afraid of falling on one side or the other. I think of neurosis as a form of control, in which other person actively engages in doing things a certain way over and over again in order to achieve a certain result. The neurotic seeks to control his environment.-- JGM

By Yve — On May 22, 2009

New to this site, but so needing help to distinguish the following. Partner suddenly 1 day 10 weeks ago left as he declared he was in fear of himself and who his 'whole' being was. Said he could not live with anyone for some unknown period of time. He has reclused and hidden away all this time with a midnight shift job only on weekends. Says he lives in great fear of the rest of him that is hidden away. Says I have only had the loving part of him and he is attempting to discover the rest of him before he can even consider returning.

Is 56 years old, totally isolated, avoiding people, studying obsessively for High Distinctions at Distance Uni, cycling obsessively daily up to 100kms/day, attempts to text me, usually 1 or 2 words, then nothing, then a loving gush, then silent for days...weeks..

This is the most bizarre I have ever seen him as he has been the complete reverse to all these behaviors for the whole time we have been together.

A psychologist today wondered if he is having neurotic episode after not coping with my 2 children at Christmas time and I am totally confused but also wonder can this be 'psychotic'. He is a total stranger to me and believes he does not need help...just to find the 'whole' of him...that also frightens him...he seems to be making no active attempts to do anything except recluse...I so desperately want to at least understand him...ta for any insights.

By anon31270 — On May 02, 2009

Regarding Psychosis--psychosis can be a delusion that is mood congruent. In the coding notes for the DSM IV TR is an example: someone who is depressed can feel extremely guilty or that punishment is deserved in reaction to a traumatic event. The thought pattern is consistent with depression, but extreme to the point that it qualifies as a psychosis.

By anon29493 — On Apr 03, 2009

Psychosis: "If I mow my lawn today it will cause North Korea to launch a nuclear warhead into Florida. I must refrain from mowing the lawn. I also must notify the FBI and Homeland Security about North Korea's plans."

Neurosis: "The lawn looks hideous. No matter how many times I mow it, it is just never perfect."

anon25030 is correct. A psychotic person is not aware of reality. A neurotic person is very much aware of reality--just has strange feelings about it.

By anon26511 — On Feb 14, 2009

I was a 747 pilot and got a compulsion to carry out an emergency procedure which entailed shutting down all engines in flight.

The CASA rule said that you can't fly with a diagnosis of a psychosis and the two psychiatrists reports on me said that I had a neurotic phobic anxiety reaction and a phobic anxiety state.

Should I have been cleared to fly?

By anon25030 — On Jan 22, 2009

Another way of saying it is that a psychotic person thinks 2 and 2 make 5 but a neurotic person knows it's 4 and hates it.

By trishbaby — On Nov 16, 2008

hey, my question is, is alcoholism considered neurotic or psychotic ?

By anon11531 — On Apr 18, 2008

what are the best treatment for neurosis symptoms?

By happyuk — On Mar 02, 2008

Surely the neurotic is the worrier, somebody that lets society impose itself upon him, and hence suffers stress, anxiety etc accordingly.

The psychotic, the criminal personality would be the opposite: somebody who imposes himself on society.

The healthy personality would lie somewhere in between.

By anon5394 — On Nov 23, 2007

It was my belief that neuroses do affect your day to day functionings. If we look at depression, for example, this disorder can impair social and occupational functioning; the person loses the desire to perform everyday tasks and engage himself/herself in things that he/she once enjoyed (anhedonia). The main difference between neuroses and psychoses, therefore, lies in the fact that a psychosis is generally associated with a loss of contact with reality, while a neurosis is not.

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