Female Psychosis Symptoms: Exploring The Stigma Around Mental Illness

Medically reviewed by Nikki Ciletti, M.Ed, LPC and Corey Pitts, MA, LCMHC, LCAS, CCS

Updated January 16th, 2025 by BetterHelp Editorial Team

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Psychosis can be defined as a mental state characterized by a detachment from reality. It can manifest through various symptoms, including hallucinations, delusions, disorganized thinking, and impaired social function. While psychosis can affect individuals of all genders, research suggests that there may be differences in how symptoms present between men and women. For example, women tend to develop schizophrenia later than men, and they may experience more side effects from antipsychotic medication. It can be important to tailor psychosis treatment to the individual, and most treatment plans include a combination of therapy and medication.

A woman in a white shirt gazes out of a window in her home while holding a coffee mug near her face while deep in thought. — Getty/Viktoria Korobova

What is psychosis?

Before delving into biological sex-based differences, it can be helpful to understand common psychotic symptoms. Psychotic symptoms can be seen as those characterized by an overall loss of touch with reality.

Though psychosis typically occurs as a symptom of an existing psychotic disorder, other physiological and environmental factors can play a role as well. For example, substance use, medical conditions, hospitalization, traumatic experiences, and childbirth can contribute to the manifestation of a psychotic episode. Additionally, mood disorders like bipolar disorder and severe depression can lead to symptoms of psychosis in some individuals.

General psychotic symptoms

Hallucinations
Delusions
Confused speech
Social isolation
Lack of emotion
Having trouble focusing and being easily distracted
Being overly suspicious or paranoid
Acting hostile or distrustful
Strange thoughts and behaviors

While these signs and symptoms may be apparent to others, the person experiencing psychosis might not realize they're disconnected from reality.

What causes psychosis?

Psychosis is a complex mental state that can stem from a wide variety of causes, often intertwining genetic and environmental factors. Psychosis can occur in many disorders, such as brief psychotic disorder, postpartum psychosis, and substance- or medication-induced psychotic disorder, among others.

Postnatal psychosis, also called puerperal psychosis or postpartum psychosis, is a rare but severe mental health condition that typically occurs within the first few weeks after childbirth. It is usually characterized by the rapid onset of psychotic symptoms, including hallucinations, delusions, severe mood disturbances, and disorganized thinking. Someone who has developed postnatal psychosis may exhibit profound changes in behavior, such as agitation, paranoia, or confusion, which can pose serious risks to both the mother and her infant.

Brief psychotic disorder is a temporary and sudden onset of psychotic symptoms that typically lasts for less than a month.

Meanwhile, substance- or medication-induced psychotic disorder can describe the emergence of psychotic symptoms directly caused by the use of substances or certain medications.

Some potential causes of psychosis may include the following:

1. Genetic factors: Like many mental health conditions, psychosis can have a genetic component. Individuals with a family history of psychosis or related disorders may be at increased risk.

2. Hormonal changes: Fluctuations in hormone levels, such as those experienced during menstruation, pregnancy, childbirth, and menopause, can impact brain chemistry and contribute to the onset or exacerbation of psychotic symptoms.

A woman in a white button down shirt sits at a table with her computer and looks at the screen with a serious expression while holding a pen in her hands. — Getty/stefanamer

3. Stress and trauma: Exposure to traumatic events, chronic stress, or adverse childhood experiences can increase the risk of developing psychosis. Trauma-related disorders like post-traumatic stress disorder (PTSD) may co-occur with psychosis.

4. Substance use: Substance use, including the use of alcohol, cannabis, stimulants, and hallucinogens, can precipitate psychotic symptoms in susceptible individuals. Women may be particularly vulnerable to the effects of substance use due to differences in metabolism and hormonal influences.

5. Psychological factors: Certain personality traits, such as high levels of neuroticism or low resilience, may predispose an individual to psychosis. Additionally, maladaptive coping strategies or difficulty with emotion regulation can contribute to the development of psychotic symptoms.

6. Medical conditions: Certain medical conditions and neurological disorders can increase the risk of psychosis in women and people of other genders. These may include autoimmune disorders, brain injuries, epilepsy, and neurodegenerative diseases.

7. Sleep disorders: Disrupted sleep patterns, insomnia, and other sleep disorders are often linked to an increased risk of psychosis. Women may be more susceptible to sleep disturbances due to hormonal fluctuations and caregiving responsibilities.

8. Social and environmental factors: Socioeconomic disadvantage, discrimination, social isolation, and lack of access to mental health care can contribute to the development of psychosis. Gender-specific stressors, such as gender-based violence or discrimination, may also play a role.

9. Psychiatric comorbidities: Those with pre-existing mental health conditions, such as depression, bipolar disorder, or an anxiety disorder, may be at higher risk of experiencing psychosis. Psychiatric comorbidities can interact with psychosis symptoms, potentially complicating diagnosis and treatment.

10. Medication side effects: Certain medications used to treat medical or psychiatric conditions may induce psychosis as a side effect. Women may be more susceptible to medication-related psychosis due to differences in metabolism or hormonal interactions.

While people of all genders can experience psychosis, identifying the specific causes and contributing factors for psychosis in women typically requires a comprehensive assessment by mental health professionals. Early intervention and personalized treatment approaches can be helpful for managing psychosis and improving long-term outcomes for women affected by this condition.

How male and female psychosis symptoms differ

While updated research may be necessary, differences in the experience of psychosis between males and females have been observed in various aspects, including the age of onset and symptom presentation. Research indicates that schizophrenia, a disorder involving psychosis, often appears earlier in males, typically during their teens to early twenties, while females tend to develop symptoms later, usually in their late twenties to early thirties.

However, studies suggest that schizophrenia prevalence in females might increase after the age of 40, possibly due to hormonal changes related to menopause. Females may experience two peaks of onset, with one between the ages of 20 and 39 and another during the postmenopausal period.

When it comes to symptom presentation, females with psychosis may initially appear to function more effectively, but they may also face more mood-related symptoms, potentially leading to misdiagnosis and treatment delays.

Another study suggested that women may be more likely to encounter side effects of some antipsychotic medications. While these studies tend to emphasize the importance of tailored treatment plans that consider gender-specific needs, further research may be required for a better understanding of how biological sex and gender can influence the development and treatment of female psychosis symptoms.

A woman in a yellow shirt sits at a table with her laptop openinfront of her while she gazes off deep in thought. — Getty/Jajah-sireenut

Psychosis treatment

Regardless of gender, diagnosing the cause of psychosis typically involves careful observation and assessment by a qualified medical or mental health professional. Psychosis treatment approaches often involve antipsychotic medication, which must be prescribed and monitored by a doctor or psychiatrist, along with non-pharmacological interventions, like cognitive behavioral therapy (CBT). Coordinated specialty care, which integrates psychotherapy with pharmacology, can be effective in managing psychosis.

Furthermore, exploring online therapy options can offer affordability, flexibility, and effectiveness, particularly in addressing associated symptoms like anxiety and depression. While online therapy may not directly address severe cases of psychosis, seeking professional assistance remains crucial for comprehensive support, symptom management, and overall well-being and quality of life.

During the prodromal and recovery phases of a psychotic episode, attending therapy online rather than in person may offer a more convenient and accessible mode of seeking professional support. Users can switch therapists as needed to find the right fit and schedule sessions that coordinate with their existing routines.

Takeaway

Psychosis is generally characterized by a detachment from reality, encompassing symptoms like hallucinations, delusions, and disorganized thinking. While psychosis can affect individuals of all genders, research suggests that there may be differences in how symptoms present between men and women. While further research is likely needed to better understand how biological sex and gender may influence the development and treatment of psychosis, tailored treatment plans that consider gender-specific needs are often helpful for effective symptom management. Therapy can play a vital role in psychosis treatment, and outside of the acute phase of psychosis, individuals may benefit from attending sessions online.

Frequently asked questions

Read more below for answers to questions commonly asked about this topic.

What are psychotic symptoms in women?

Women and men both have the same basic types of psychosis symptoms, but women and men’s delusions and hallucinations may differ in content. The National Alliance for Mental Health describes psychosis in more detail and offers additional resources.

How does psychosis affect mental health?

Psychosis affects mental health by disconnecting a person from reality. This can cause problems at work, home, and school, which can further exacerbate mental health issues.

What is the stigma of a person with mental illness?

A stigma, a negative belief attached to a group of people, has persisted around mental illness, often labeling those experiencing mental illness as “crazy,” useless, or frightening. Education around causes of and treatments for mental illness, as well as humanizing those who live with mental illness, is critical for combatting stigma.

How do I know if I'm in psychosis?

Early signs of psychosis include changes in behavior and mood such as inability to sleep, irritability or depression, social withdrawal, stopping speech mid sentence, or inability to concentrate. Experiencing hallucinations (seeing or hearing things that other people don’t see or hear, such as hearing voices) and delusions (false beliefs such as persecutory delusions, grandiose delusions, and believing you have special powers or are controlled by outside forces) are other signs of psychosis.

What can be mistaken for psychosis?

A number of medical conditions can create symptoms that can be mistaken for psychosis. These include toxicity, vitamin deficiency, head trauma, stroke, seizure, Alzheimer’s, and encephalitis, among others.

What are the early warning signs of psychosis?

Some of the warning signs of a first episode of psychosis include confused thinking, less emotion, social withdrawal, and sleep problems. Other symptoms can include dangerous behavior or thoughts of self harm. Psychosis due to schizophrenia typically appears in a person's late teens or early twenties.

According to Assistant Professor Brian Keane at the University of Rochester Medical Center, his research shows that brain differences exist in people with psychosis, and an MRI can help detect them.

If you have an initial schizophrenia episode, it is important to seek immediate help, as psychosis treated early can be managed more effectively, perhaps preventing further episodes. Typical treatment comprises therapy and medication, and educating family members also has positive outcomes.

What is the best drug for psychosis?

There is no one best drug to treat a person experiencing psychosis, although a psychiatrist will typically prescribe some form of antipsychotic medication.

What is hormonal psychosis?

Hormonal psychosis can affect women and those who menstruate and is a psychosis that appears around a person’s menstrual cycle. The disorder is fairly rare and is believed to be involved with a drop in estrogen.

What are the three stages of psychosis?

The three main stages of psychosis are the prodromal stage (early psychosis), acute stage, and recovery stage.

What is menopausal psychosis?

Not only women experience menopausal psychosis, but any person who is undergoing hormonal changes due to menopause may have this type of psychosis. Menopausal psychosis is a psychosis that first appears in a person’s life when they are in menopause.

If you are experiencing any symptoms of psychosis, reach out to your primary care provider or a general psychiatry department who can assess your mental and physical condition and create a treatment plan. Any severe form requires ongoing treatment.