Psychosis Guides & Articles

Imogen Sharma
Last updated:
Brindusa Vanta, MD, DHMHS
Medical Editor

What Is Psychosis?

Someone experiencing psychosis has either hallucinations (they see or hear things that other people can't see or hear) or delusions (they believe things that aren't actually true), or both. 1

The reality in their mind and external reality no longer align, and disorganized thought and speech frequently occur alongside psychosis. Psychosis occurs in a variety of mental illnesses, as well as in physical disorders.

Per the National Institute of Mental Health, there are approximately 100,000 new cases of psychosis in the United States each year. 2

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Hallucinations

Hallucinations can involve: 3

  • Seeing things other people can't see, such as religious figures, animals, and faces
  • Experiencing sensations, smells, or tastes with no external cause
  • Seeing objects move or distort in unusual ways
  • Hearing voices others can't hear

For a hallucination to be considered a symptom of psychosis, the individual must be unaware they're hallucinating.

Delusions

It's normal for people to have beliefs that aren't based on fact or shared by others, but delusions are more extreme. They're characterized by unusual beliefs that no one else shares and that are easily disproved—but they feel completely real to the person experiencing them.

Types of delusions include: 4

  • Paranoid delusions: Feeling like people or organizations are mistreating, spying, pursuing, or plotting harm against them, despite firm evidence to the contrary
  • Delusions of grandeur: When someone believes they have extraordinary abilities, power, knowledge, or influence without evidence

Disorganized Thoughts and Speech

Below are examples of the types of disorganized thoughts and speech associated with psychosis:

  • Racing thoughts that go so fast they feel beyond a person's control
  • Flights of ideas, when someone moves quickly between concepts and makes connections between thoughts that someone else wouldn't understand
  • Speaking quickly and incoherently
  • Linking words together because of their sound rather than their meaning

What Causes Psychosis?

Mental health conditions, physical illness, trauma, genetics, environment, and injury can contribute to the onset of psychosis. It impacts the way the brain processes information, which is at least partly caused by stress overload. 5 The brain struggles to work through emotions and thoughts, and the way a patient with psychosis perceives the outside world shifts.

Disorders with psychosis as a symptom include: 6

  • Schizophrenia
  • Schizophreniform disorder
  • Schizoaffective disorder
  • Delusional disorder
  • Brief psychotic disorder
  • Bipolar disorder
  • Major depression with psychotic features
  • Post-traumatic stress disorder (PTSD)
  • Schizotypal personality disorder and some other personality disorders
  • Dementia
  • Brain tumors and other brain diseases
  • HIV
  • Some types of epilepsy
  • Stroke
  • Some prescription drugs
  • Substance use disorders (including during withdrawal)

Life experiences, brain chemicals, and genetics play a role in the development of psychotic disorders. In many cases, psychosis can be managed with medication and help from a mental health professional.

How Long Does Psychosis Last?

Psychosis can last for minutes, hours, days, or, in severe cases, months. Duration depends on an array of factors, including the cause and type of psychotic episode. For example, with schizophrenia, symptoms may last for 6 months or more. On the other hand, a brief psychotic episode tends to last for a month or less.

What Are the Early Warning Signs of Psychosis?

There are three phases of psychosis, with the length of each varying based on the individual and their condition. 7 Early signs can be mild and go unnoticed, but many people describe finding it increasingly hard to describe their perceptions, thoughts, and feelings.

Other early (prodome) symptoms of psychosis are:

  • Decreased motivation
  • Decreased concentration
  • Depressed mood
  • Sleep disturbances
  • Suspicion
  • Anxiety
  • Social withdrawal
  • Odd beliefs or magical thinking
  • Withdrawal from family and friends
  • Deterioration in functioning

Acute Stage

During the acute stage of psychosis, patients experience prominent psychotic symptoms—whether they're delusions, hallucinations, or both. The person going through psychosis might become extremely distressed and confused and act in a way that's completely out of character. While the prodome stage of psychosis is marked by a gradual decline in functioning, the acute stage sees a rapid onset of symptoms and a swift break with reality.

Recovery Stage

Many people recover following their first break with reality and never experience symptoms again. Experts agree that seeking professional help early is one of the best ways to prevent future episodes. 8 Following psychosis treatment, most people are able to make a full recovery and return to their daily life.

How Is Psychosis Diagnosed?

To diagnose psychosis, a doctor asks about the patient's symptoms and medical history. Questions might be about:

  • Prescription medication
  • Substance use
  • Mood
  • Daily functioning
  • Family background of mental illness
  • Details about the specific delusions and/or hallucinations the patient's experiencing
  • Other symptoms

If the doctor suspects psychosis, they'll urgently refer the patient to a team of specialists. This team carries out a full assessment to diagnose the cause of psychosis and creates a comprehensive treatment plan.

Best Treatment for Psychosis

Many people with psychosis have symptoms for a year before seeking help—but early intervention can significantly improve outcomes. The best treatment requires a coordinated approach from a team of specialists, the individual experiencing psychosis, and their support network.

Components of psychosis treatment include: 9

  • Individual therapy
  • Group therapy
  • Medication management
  • Supported employment and education services
  • Case management

Recommended talk therapies for psychosis include:

  • Cognitive behavioral therapy adapted for psychosis (CBTp)
  • Family intervention
  • Psychosocial therapy

A doctor may prescribe antipsychotic medication to someone with psychosis, such as: 10

  • Clozapine
  • Quetiapine
  • Risperidone
  • Olanzapine

How to Cope With a Psychosis Diagnosis

Getting a mental health diagnosis can be frightening, but there are steps someone with psychosis can take to help themselves, such as:

  • Learning about triggers, which may be related to life events, moods, or lifestyle
  • Taking steps to manage stress, such as using meditation, music, or art therapy to unwind
  • Being extra careful about getting enough sleep, eating healthily, getting regular exercise, spending time outdoors, and avoiding substances
  • Optimizing the environment by implementing a structured routine and minimizing stressors and triggers

How to Help Someone With Psychosis

Seeking help can be challenging for someone with psychosis who's likely highly distressed and lacking insight into the cause of their symptoms. If they're experiencing paranoia, they might be afraid that a doctor won't have their best interests at heart. As such, loved ones can play an important role in helping the patient get the treatment they need.

This could involve speaking to friends, family members, or their wider community for more insights, and it may require gentle persistence when it comes to encouraging them to see a doctor. If you or someone you love is suffering from symptoms of psychosis, get help treating psychosis today.

Sources

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455840
  2. https://www.nimh.nih.gov/health/publications/understanding-psychosis
  3. https://medlineplus.gov/ency/article/003258.htm
  4. https://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/types-of-psychosis
  5. https://www.nami.org/Blogs/NAMI-Blog/March-2017/Understanding-Psychotic-Breaks
  6. https://medlineplus.gov/ency/article/001553.htm
  7. https://medicine.yale.edu/psychiatry/step/psychosis
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2559918
  9. https://www.nimh.nih.gov/research/research-funded-by-nimh/research-initiatives/recovery-after-an-initial-schizophrenia-episode-raise
  10. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/antipsychotic-medication