Does Psychosis Go Away? Understanding Psychosis Stages And Support Options
Psychosis can involve a cluster of symptoms that are often scary and confusing for those impacted and the people around them. Experiencing an episode of psychosis can cause one to believe they’ve lost control of themselves and their reality. This may incite questions about whether psychosis can be treated and fully go away. In some cases, psychosis is not recurrent. However, this factor is often dependent on the causes and stage of psychosis. Understanding the episodic nature of psychosis can be a step toward receiving appropriate treatment, which usually involves prescription antipsychotic medication and therapy.
What is psychosis?
The National Health Service (NHS) reports that psychosis is a cluster of symptoms that occur when an individual loses contact with reality. A person experiencing psychosis may encounter confusing symptoms that don’t align with their usual personality. For example, they might experience the following psychotic symptoms:
- Hallucinations: Hallucinations generally involve sensory perceptions of sights, smells, sounds, tastes, and feelings that are not truly occurring.
- Delusions: Delusions can be seen as false beliefs that are difficult to sway. An individual experiencing delusions might think they are a reincarnation of a celebrity or that people are following them everywhere they go.
- Disorganized behavior, thoughts, and speech: Disorganized thoughts, speech, and behavior can be common in psychosis, causing individuals to struggle to put words together in a way that makes sense to themselves and others.
Psychosis symptoms may also include social withdrawal, paranoia, suspicion, difficulty sleeping, and anxiety. In people experiencing mania associated with bipolar disorder, psychosis might be accompanied by delusions of grandeur and manic behavior.
Understanding psychotic episodes and stages
In mental illnesses like schizophrenia spectrum disorders and psychotic disorders, psychosis might occur in the following three stages.
Prodromal phase
According to a study in HHS Public Access, the prodromal phase of psychosis is the “period of subclinical signs and symptoms that precedes the onset of psychosis. This prodromal period can last from weeks to several years, and comorbid disorders are very common during this period.”
Prodromal symptoms can mimic other mental illnesses, so getting a screening when any new symptoms or mental health challenges arise can be helpful. Below are some of the symptoms associated with the prodromal phase:
- Anhedonia (Emotional numbness and a lack of pleasure)
- Difficulty sleeping or sleeping too often
- Difficulty eating or eating more than usual
- Restlessness and irritability
- Difficulty trusting and connecting with others
- Anxiety and depression
- Social withdrawal and staying at home more often
- A lack of self-care and hygiene practices
- Difficulty performing daily responsibilities at work or school
- Changes in personality or speech patterns
- Cognitive challenges, confusion, and memory loss
- Dissociation or a sense of having lost time
If you are experiencing new or concerning mental health symptoms, talk to your primary care physician about getting a psychosis screening. Other mental health screenings, such as those for depression or anxiety, may also be beneficial.
Active phase
The active phase of psychosis generally occurs when an individual is actively experiencing severe symptoms like hallucinations, delusions, and disorganized behavior. In an active episode, it can be difficult for others to talk to the individual, as they may not be connected or responsive to external stimuli.
Residual phase
The residual or recovery phase of psychosis normally occurs after an active phase has ended. The residual phase is often associated with similar symptoms to the prodromal phase, which can include social withdrawal, irritation, mood swings, and emotional apathy. In the residual phase, seeking therapy to discuss what occurred in the psychotic episode and build a safety plan for the future can be helpful.
Does psychosis go away?
Psychosis often occurs in episodes. Psychosis does not last forever in most people who develop the condition. However, the amount of time an episode lasts can vary based on its cause, whether the person is seeking treatment, and their diagnosis. For example, people with schizophrenia may have more severe and prolonged episodes without medical support.
Some people may experience brief psychotic disorder, which can be defined as an acute episode of psychosis that lasts less than a month and results in complete remission. However, all people who experience psychosis may be at risk of a future episode. People who have situational psychosis, such as postpartum psychosis or psychosis related to stress or grief, may be less likely to experience a future episode.
For some people, treatment diminishes or completely eliminates symptoms. Medication can help individuals manage symptoms like hallucinations and delusions, which can disrupt their sense of reality. Support and early psychosis treatment often enable individuals to live productive, fulfilling lives by managing their symptoms.
Mental health treatment options for psychosis
While psychosis may sometimes go away on its own, treatment is often required to experience relief. Below are some of the most common psychosis treatment options, along with tips for locating them.
Medication management
Medication management services are often offered by mental health clinics. In these locations, clients can be prescribed medications and work with a case manager to adhere to their medication schedule. Some clients may take their medication daily at the center or through an inpatient facility. Others may have their medication delivered to them in bubble packs to make it easier to take. Medication management can help with treatment adherence, as people with schizophrenia spectrum disorders tend to be 50% more likely not to take their medications without this form of support, although updated research may be needed.
Antipsychotic medications are usually the first line of treatment for psychosis. However, always consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
Crisis support
Crisis support services are typically put in place to support people with active psychosis who may be at risk of harming themselves or others. In some cities, these services can be received through a hospital emergency department. However, other cities may have crisis mental health centers or separate psychiatric hospitals that offer more intensive care. Consider calling a crisis hotline to learn more about your area's resources. You might also talk to your primary care doctor for recommendations.
Support groups for people living with mental illness
Support groups may be helpful alongside other treatment options as a way to meet others with similar experiences. After a psychotic episode, it can be scary to navigate life and wonder whether another might occur. Expressing these feelings and thoughts to others may allow you to receive peer support. In addition, support groups are often free and available to all. The Schizophrenia & Psychosis Action Alliance (S&PAA) offers two support groups for people with psychosis and their loved ones.
Inpatient mental health care
Inpatient care might be recommended for long-term psychotic episodes. In these cases, an individual may live in a group home, hospital psychiatric ward, or inpatient facility. These locations may offer around-the-clock care, medication management, nursing, therapy, and mental health check-ins. In some cases, hospitalization may be an option for stabilizing individuals with the goal of returning home and going back to their usual everyday lives.
Therapy
Therapy with a mental health professional may be a beneficial option for those who have experienced a psychotic episode and are worried about future episodes occurring. Therapy can also be helpful for caregivers and family members of people with psychosis. However, in-person therapy may sometimes be challenging to reach, as it can involve time and financial barriers. In these cases, online therapy through a platform like BetterHelp may be a more convenient option.
Studies suggest that online therapy can be an effective form of treatment for psychosis, although acute psychotic symptoms may need to be addressed in person. A clinical trial published in 2017 found that an online cognitive behavioral therapy program typically reduced the incidence and severity of hallucinations while improving social function in individuals with psychosis.
Takeaway
What are the most common symptoms of psychosis?
The characteristic symptoms of psychosis include delusions and hallucinations. Delusions are false beliefs that are often demonstrably untrue. For example, a person expressing how they could defeat the entire United States Army single-handedly is likely experiencing a delusion. Hallucinations are sensory aberrations that can involve any sense, although auditory and visual hallucinations are most common. Auditory hallucinations might include hearing voices or speech that no one else can hear, while visual hallucinations might include seeing persons or objects that no one else can see.
Other symptoms might include confused thinking, impaired problem-solving skills, paranoia, impaired emotional processing, and sleep disturbances. The acute phase of psychosis may last for days or weeks and may require coordinated specialty care to resolve in severe cases. While some people do see their symptoms spontaneously reduce, especially during their first psychotic episode, psychosis often requires therapy and prescription medications to resolve completely.
Does bipolar disorder cause psychosis?
Bipolar disorder can sometimes involve psychosis. It is more common in bipolar disorder type I compared to bipolar type II and typically appears during manic episodes. Those with bipolar disorder who have previously experienced a psychotic episode are at a substantially greater risk of experiencing another. Those who have not experienced a psychotic episode are at a higher risk of experiencing psychosis if they have a family member who previously experienced a psychotic episode.
What percentage of people with bipolar disorder experience symptoms of psychosis?
Research suggests that not everyone who is diagnosed with bipolar disorder will develop psychosis. A recent meta-analysis indicated that around half of all people with bipolar disorder will experience a psychotic episode during their lifetime. The data further showed that approximately 61% of those with bipolar disorder type I and 22% of those with bipolar type II will experience a psychotic episode. However, if symptoms are treated early and the person with bipolar disorder adheres to their treatment regimen, it is possible that psychosis can be avoided entirely.
Can anxiety lead to psychosis?
Anxiety doesn’t typically lead to psychosis in the same way as a psychotic disorder or other mental health conditions. However, the stress of anxiety might influence other mental health or medical conditions, which may be an underlying cause of a possible condition that can induce psychosis. Similarly, anxiety might lead to severe sleep deprivation, which can increase the likelihood that a person might experience delusions or hallucinations. Psychosis develops differently from person to person, and anxiety may be an underlying factor that allows untreated psychosis to emerge.
Is psychosis a mental illness?
Psychosis is not considered a mental illness itself but rather a collection of symptoms that appear in many mental health conditions, most notably schizophrenia and bipolar disorder. It can also appear following a brain injury or in various forms of dementia, such as Alzheimer’s disease. Mental health professionals often prioritize strategies to treat psychosis symptoms, as psychosis can have a severe adverse effect on a person’s life.
For example, after a person experiences an initial schizophrenia episode, they will probably work closely with mental health and medical professionals to address psychotic symptoms before moving on to strategies that focus on other aspects of the person’s well-being. Generally, if an underlying mental health condition is treated early and the person sees a professional to manage their care, it is possible to manage the impact of a psychotic episode.
Does psychosis go away on its own?
It is possible for a psychotic episode to end spontaneously, but it is not possible to predict whether that will occur. Generally, psychosis requires assessment and evaluation by health professionals to determine the underlying factors. It is a severe mental health concern that can adversely affect a person’s life, and early treatment often improves a person’s well-being considerably. Psychotic disorders that appear in adolescence or young adulthood are typically easiest to treat and may be more likely to resolve on their own.
Some people experience their first episode of psychosis and no further symptoms after it resolves. However, clinical trials suggest that once someone has experienced one psychotic episode, the likelihood of experiencing another rises drastically. If treatment begins early, future psychotic episodes can likely be prevented. Older adults are more likely to experience psychotic symptoms that do not resolve without treatment.
How long does it take to come out of psychosis?
For those receiving treatment, a psychotic episode usually begins to resolve within hours or days. However, untreated psychosis can last anywhere from days to years. Early signs of an oncoming psychotic episode might be present long before acute psychosis begins, representing a critical period where only some psychotic symptoms are present. Similarly, the recovery phase of psychosis also features sporadic or low-severity psychotic symptoms, making it challenging to define exactly when psychosis begins and ends.
What is the most effective treatment for psychosis?
The most effective treatment for psychosis depends on the underlying factors causing it. For example, psychosis caused by sleep deprivation can, in most cases, be resolved simply by helping the person sleep. In contrast, psychosis due to schizophrenia typically requires antipsychotic medication and psychotherapy to manage.
A person experiencing psychosis may have trouble solving practical problems and managing their own care. They might also hear voices telling them to engage in self-harm or other activities that could harm themselves or others. In those cases, treatment may require hospitalization or residential care to ensure the person remains safe until symptoms abate. In other cases, especially for young people, a person must work closely with a therapist or social worker to ensure they have the resources necessary for effective treatment.
What are the warning signs of psychosis?
According to the National Institute of Health, the greatest single predictor of psychosis is a family history of psychotic disorders. Minor to moderate changes to thoughts and behaviors typically occur before an acute psychotic episode. Some of those warning signs include:
- Suspiciousness or paranoia.
- Confusion and difficulty thinking clearly.
- Social withdrawal.
- Strange or unusual feelings, or the absence of feelings.
- Sleep disturbances.
- Confusing or disorganized speech.
- Suddenly unable to complete necessary tasks at home, work, or school.
What happens if psychosis is left untreated?
Untreated psychosis can lead to many adverse impacts on a person's life, especially for young adults, who are most likely to be diagnosed but may struggle to find the resources necessary for appropriate management. Psychosis can lead to major behavioral changes. A person might stop eating, stop going to work, engage in reckless behavior, or demonstrate behavior inconsistent with reality. The brain changes associated with psychosis can make it hard for a person experiencing psychosis to recognize how the condition impacts them. Self-care is often abandoned, and the person may engage in dangerous behaviors without recognizing the potential lack of safety.
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