Psychosis Overview

When someone loses their grasp on reality, the psychiatric symptoms they experience—mainly hallucinations, delusions, confused thinking, and disorganized thoughts—are called psychosis. These psychiatric symptoms may indicate an initial schizophrenia episode or other conditions that involve psychosis. Therefore, it may be helpful to understand these experiences to better support yourself or other people with psychosis. Read on to learn more about this mental health emergency and how online therapy can help you manage symptoms in yourself or practical ways to support a loved one through a psychotic episode.   

What is psychosis?

Psychosis develops across a diverse range of individuals, affecting anyone regardless of age, race, gender, sex, or other factors. It is a common symptom associated with many psychiatric, medical, and neurological conditions. Many people with psychosis are living with a psychotic disorder, a type of mental illness in which the loss of touch with reality is a primary feature. Psychosis can also be associated with mental health conditions like bipolar disorder, depression, and post-traumatic stress disorder. The main signs of psychosis are hallucinations, disorganized thoughts, and delusions as one loses connection with reality. 

Psychologists may define psychosis as a group of symptoms that occurs when a person experiences challenges in determining what’s real and what’s not. This disconnection from reality causes distortions in how a person thinks and perceives the world around them. 

A person experiencing it may encounter severe disruptions in their perception of reality, influencing the person's thoughts and sensory experiences in ways that can cause severe distress. Someone experiencing a psychotic episode may hear, see, feel, smell, or taste things that aren’t there, cling to firmly held bizarre or disorganized ideas, or act in a confused, erratic manner. These main signs can be accompanied by other symptoms of mental health conditions, such as severe anxiety and depression.

The symptoms can be disruptive and distressing, sometimes causing a person to harm themselves or, in rare cases, someone else. It can be essential to note that the signs feel and appear real to the person experiencing them. If you or someone you love is concerned about self-harming thoughts or behavior, you can reach out anytime to the Suicide & Crisis Hotline, where professionals can guide you to essential resources.

Who can experience psychosis?

Anyone can experience psychosis. Psychosis usually presents during young adulthood, in the late teens to mid-20s. Although rare, children can also experience it, often as a symptom of a non-psychotic disorder. While young people are most at risk of developing psychotic symptoms, older adults may also have a psychotic episode as a result of injury or neurological disorders. Studies have estimated postnatal psychosis affects approximately one in 500 mothers shortly after giving birth. In some cases, when someone with major depressive disorder is depressed, psychosis can develop. 

How to recognize the symptoms of psychosis

Finding early treatment might be easier when you know how to recognize the signs in yourself or your family members. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, psychosis involves symptoms in at least one of the following categories: 

• Hallucinations: Experiencing sights, sounds, smells, tastes, or touches perceived as real despite the lack of stimulus. 

• Delusions: False beliefs a person refuses to let go of despite lack of proof or even when presented with evidence disproving their ideas.   

• Disorganized thoughts or speech: Unrelated, illogical, or loosely connected thoughts. Speech may not make sense to others and jump from one topic to the next without finishing an idea.

• Catatonia: Becoming unresponsive or unaware of the world around you. Catatonia may present as a lack of response or unusual, unsafe, or unexpected behaviors.

• Disorganized behavior: Inappropriate or unpredictable emotional responses that don’t fit the circumstances. 

• Negative symptoms: Decline in speech, movement, emotional reactions, energy, motivation, social contact, or interest, also called anhedonia.   

There are sometimes early warning signs, called prodromal symptoms, which may appear before psychotic episodes, usually in people between their late teens and mid-20s:

• A substantial drop in school or work performance and effort

• A sudden reduction in personal hygiene and self-care

• Trouble thinking clearly or concentrating

• Social withdrawal

• Being uneasy or suspicious around others

• Either showing intense, inappropriate emotions or a lack of feeling

Generally, the length of a psychotic episode depends on the type of psychosis. If the signs are related to substance or medication use, they often resolve when it clears your system. Brief psychotic disorder lasts less than a month, but for someone to be diagnosed with schizophrenia and many other psychotic disorders, symptoms must occur for a month or longer. With mood disorders like bipolar disorder, psychosis symptoms usually occur during a manic phase, lasting from one week to multiple months if left untreated. 

Recognizing the symptoms of psychosis is crucial for the well-being of those affected by mental health conditions with psychotic signs. An early diagnosis can lead to interventions that may help improve outcomes for individuals.

What causes psychosis?

Several genes are linked to psychosis, such as certain ones that may increase the risk of schizophrenia, though the presence of those genes doesn't guarantee that you will experience it. Experiencing a traumatic event can also trigger a psychotic episode, though the type of trauma and the person’s age can influence whether or not someone develops it after a traumatic incident. 

Consuming LSD, amphetamines, cocaine, cannabis, alcohol, and other substances can increase the risk of psychosis. In some cases, psychosis develops due to taking certain prescription medications like stimulants and sedatives that may carry a risk of causing a psychotic episode. Some physical injuries and illnesses can cause psychosis, such as head trauma, stroke, Alzheimer’s, and other conditions. 

Psychosis is not a mental health condition by itself. However, it is a primary symptom related to many psychiatric disorders, including (but not limited to):

• Schizophrenia

• Schizoaffective disorder

• Delusional disorder

• Brief psychotic disorder

• Shared psychotic disorder

• Postpartum psychosis

• Medication-induced psychotic disorder

• Substance use disorders

• Bipolar disorder

• Severe depression

• Severe anxiety disorders

In addition, postnatal psychosis, also called puerperal psychosis, can affect women who have recently given birth. It is a severe mental health condition characterized by signs such as hallucinations, grandiose delusions, mood swings, and confusion. Postnatal psychosis can develop rapidly within the first few weeks after childbirth and requires immediate medical attention for proper diagnosis and treatment. Understanding how it affects mothers can be key to getting timely support and treatment.

Exploring how psychotic symptoms can vary 

Depending on the type of psychosis and the individual, symptoms can affect people differently. While hallucinations can affect any of the five senses, the most common type is auditory, often in the form of hearing voices or incoherent sounds, according to the American Academy of Child and Adolescent Psychiatry. Delusions involve holding false beliefs despite evidence to the contrary and can be categorized into various types:

• Erotomanic delusions: Believing that someone else is in love with them. 

• Delusions of grandeur: Strong conviction that they have an extraordinary power or authority or are destined to do something momentous. 

• Thought broadcasting: Believing they are broadcasting their thoughts and others can perceive them, often leading to paranoia. 

• Persecutory delusions: Believing that one is being targeted, harassed, or conspired against by others.

In addition to the primary indicators, as someone develops psychosis, they may also experience non-psychotic signs like depression, anxiety, social withdrawal, sleep problems, lack of motivation, trouble focusing, and functional impairment in one or more areas of their life. 

Is psychosis treatable?

Depending on the cause of psychosis, there are several available methods of treating it. Treatment generally involves a combination of psychotherapy, medication, and a versatile support network. 

Cognitive behavioral therapy (CBT) helps identify and reshape harmful or delusional thought patterns and behavioral habits. Various psychotherapy approaches can help support emotional intelligence, awareness, and literacy. Antipsychotic drugs or other medications may work to balance chemicals in the brain and treat symptoms, while inpatient treatment at a hospital or psychiatric facility may be more appropriate for severe or sudden cases.

Support programs 

Available support programs can also help teach skills at work, socially, or with family. Programs may be available to offer emotional support to the family members of a person with it. If you are concerned that you or someone you love is experiencing a disconnection from reality, seek help immediately. Psychosis is a mental health emergency. 

How is psychosis diagnosed?

After identifying signs of psychosis or experiencing a psychotic episode, you can speak to your physician or a mental health specialist for a proper diagnosis. 

A complete mental, physical, and family history will help determine if an underlying condition is causing it rather than a psychotic disorder. You may be asked to complete blood tests, brain imaging, or other diagnostic testing to rule out comorbid health issues. Your therapist will likely ask many questions about your emotional state and have you complete questionnaires to help evaluate your reactions and how you react in a given situation. 

Moving forward with a treatment plan

After reviewing all the available information, your mental healthcare provider will form a diagnosis, develop a comprehensive treatment program, and establish a crisis plan to give you resources during psychotic episodes. They may also work with other healthcare providers to provide coordinated specialty care depending on the psychotic symptoms and other problems you may be experiencing. 

How online therapy can help you manage mental illness

While a single instance of psychosis can be caused by an underlying condition that can be treated and eliminated, such as head injury or encephalitis, it could also indicate the presence of a psychotic disorder. With treatment through a combination of psychotherapy, medication, and continuous care, individuals can develop strategies to manage their condition.

Consider working with a licensed therapist online through a virtual teletherapy platform like BetterHelp for the support and guidance of a mental health professional as you learn to understand and manage symptoms. Signs of several psychotic disorders often emerge during the late teen and early adult years. If you are a parent or guardian seeking support for your child, contact TeenCounseling for online therapy for children from 12 to 19. 

Many forms of psychosis can be treated by working with a licensed therapist online. Studies from the American Psychological Association indicate that virtual and face-to-face CBT treatments provide comparable outcomes. Patients often reported shorter wait times, more cost-effective programs, and a comprehensive network of licensed providers with teletherapy platforms.