Understanding Psychosis: Symptoms, Causes, And Treatments

Due to media depictions, the word “psychosis” is often associated with a wide range of mental images and ideas. In general, however, psychosis is a medical term used to describe symptoms linked to a loss of contact with reality. It can affect anyone, but certain individuals may be at an increased risk depending on several factors. Psychosis and psychotic disorders can often be treated with therapy and medication, but inpatient treatment may sometimes be necessary. Healthy coping skills and self-care can be helpful as well. Individuals who aren’t currently experiencing acute psychosis may benefit from the insight and support offered by an online therapist.

Understanding psychosis

Psychosis isn’t usually seen as a diagnosable mental health condition. Instead, it tends to be categorized as a collection of psychological symptoms that signal a person has lost touch with reality. The primary indicators of psychosis are generally hallucinations, delusions, and confused or disorganized thoughts, speech, or behavior. 

The National Alliance on Mental Illness (NAMI) explains, “Psychosis is a symptom, not an illness, and it is more common than you may think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as 3 in 100 people will have an episode at some point in their lives.”

It can be crucial to note that when someone is experiencing a hallucination or delusion, it appears and feels real to them. They may be seeing, talking to, and hearing intrusive instructions from something or someone others can’t perceive. The symptoms of psychosis can cause a person to harm themselves or others in extreme situations and should be considered a mental health emergency. 

If you or someone you know is struggling or in crisis, help is available. Text or call 988 or chat 988lifeline.org. Support is available 24/7. If you are experiencing trauma, support is available.

Signs and symptoms of psychosis

While psychosis can look different for every individual who experiences it, some commonalities usually exist in the types of symptoms people report in psychological research. 

Early signs 

A psychotic break isn’t usually something that occurs with no warning. Many people exhibit a steady decline in their overall health and grip on reality before a psychotic episode. The early warning signs (also known as prodromal symptoms) can indicate a more significant incident is imminent. These might include the following:

• Difficulty concentrating or focusing
• Changes to how you think
• A sudden drop in school or work performance
• A decline in personal hygiene and self-care
• Loss of social interest or social isolation
• Severe mood swings or emotional reactions that don’t fit the situation
• Lack of emotion or response when it would make sense

Psychotic symptoms

Once psychosis sets in, it could involve the following symptoms: 

• Delusions — Unshakable beliefs in something untrue
• Hallucinations — Sensory experiences involving something that isn't there
• Disorganized thoughts — Trouble communicating rationally
• Negative symptoms — Loss or decline in regular function, often mistaken for depression
• Disorganized behavior — Unpredictable or inappropriate emotional responses
• Catatonia —Lack of awareness and response to surroundings and stimuli, or catatonic excitement with unpredictable behavioral responses 

What causes psychosis?

Although mental health experts can’t pinpoint a single cause for psychosis as it tends to be unique to the person experiencing it, the following explanations may be possibilities as to why someone might develop symptoms of the condition: 

An underlying mental health condition

Sometimes, underlying mental health disorders can contribute to psychosis. These may include schizophrenia, schizoaffective disorder, delusional disorder, bipolar depression, and extreme episodes of major depressive disorder. 

Psychosis can also develop from medical conditions or injuries, severe mental distress, and certain medications. It may also be substance-induced or occur after an individual gives birth (in what’s known as postpartum psychosis). 

Genetics

Some people have a genetic predisposition to psychosis, such as a family history of severe depression, bipolar disorder, or schizophrenia. 

Neurochemistry and physical brain differences

Imbalances in your personal neurochemistry or physical differences in how your brain produces and processes certain neurochemicals can influence whether and how severely you experience psychosis. 

Traumatic brain injury or head trauma

Traumatic brain injuries or various forms of head trauma, like a concussion, stroke, or other physical damage, can cause psychosis. 

Experiencing or witnessing a traumatic event

Sometimes, a person who witnesses or experiences a traumatic event may exhibit the signs of a psychotic episode as they process the emotional impact of the trauma and their reaction.

Substance use

Alcohol and other substances have frequently been linked with a higher likelihood of a psychotic break. 

Extreme or prolonged mental stress

Stress can affect humans in many unexpected ways, both mentally and physically. The effects can be cumulative, building up over time until an individual reaches the point of a psychotic break. 

Certain physical, neurological, or psychiatric medical conditions

Various medical conditions, like Alzheimer’s disease, can cause psychosis. For some people who are depressed, psychosis can occur as well. 

Mental health care for psychosis

It can be important for those experiencing psychosis to seek treatment. Depending on the symptoms present, their intensity, and how the individual is responding to them, different people might pursue various courses of treatment.

Inpatient mental health services

When an individual experiences severe symptoms and poses a danger to themselves or others, they may require supervised inpatient treatment until they are more stable. 

Antipsychotic medication

Pharmaceutical intervention can help manage neurochemical imbalances that create or worsen psychotic symptoms. Never start or stop taking medication unless instructed to do so by a licensed medical professional.

Ongoing psychotherapy

Whether online or face-to-face, therapy can help individuals get personalized access to mental health services. Many types of therapy may be recommended, depending on a person’s needs and preferences. 

Individual therapy can equip individuals with new coping skills and help them process their experiences. Family therapy generally enables the family members of someone with a psychotic disorder to work through their emotions with the guidance of a therapist. Couples therapy can help couples navigate the challenges posed by one partner’s psychosis and aid them in developing strategies to move forward together. 

Therapists may use approaches like cognitive behavioral therapy (CBT) to treat their clients. CBT typically examines the link between a person’s thoughts and feelings, making it possible to recognize and reshape harmful thought and behavior patterns. Early treatment can help individuals find more success in managing symptoms and recognizing unhealthy habits. 

Coping techniques for symptoms of psychosis

While consistent adherence to a comprehensive treatment plan developed by a licensed mental health professional is usually one of the most effective ways to manage psychosis or a psychotic disorder, there are some coping skills you can use to complement this process. 

Creating a crisis plan and sharing it with loved ones

Someone in the midst of a psychotic episode has generally lost touch with reality and is often unaware of their own words and behavior. It can be helpful to develop a crisis plan with your mental healthcare provider, including information like what your psychosis symptoms might look like, what the right course of action is, and contact information for critical members of your support network. You may consider distributing copies to your friends and family so that they know how to help you. It could also be helpful to offer a copy to your employer, but you may want to discuss this with your therapist first. 

Understanding psychosis triggers and how to avoid them 

Keeping a daily journal about your feelings and experiences can be a therapeutic tool all on its own, but it might help you manage your psychotic disorder symptoms as well. Try keeping track of what triggers a psychotic episode and how you react to episodes. You can also write down when you became aware of hallucinations and delusions or note any other psychosis symptoms you experienced. 

Observing which coping skills helped you get through the situation can also be helpful. Over time, you can become more aware of your triggers and symptoms and how they affect you. While psychosis-related disorders like schizophrenia and bipolar disorder currently have no known cure, their effects can be managed with time, treatment, and consistency. 

Avoiding maladaptive coping skills

While negative coping skills, such as consuming alcohol or engaging in other forms of substance use, can seem like an ideal solution for the temporary relief they provide, they are usually considered maladaptive because they do not help you cope with your symptoms in healthy, productive ways. You may feel worse after indulging in this form of escapism and could potentially develop an alcohol or substance use disorder.

Implementing self-care tips

Though self-care can be recommended for any health condition, it may offer some benefits that specifically apply to psychosis, and it can help you build the resilience and awareness to recognize and manage your symptoms and stressors. Consider the following tips:

• Get plenty of sleep. When your brain is well-rested, it may help you recognize and manage your symptoms more successfully. 
• Eat a balanced, nutritious diet and get your recommended vitamin content. When your brain and body have everything they need to function correctly, you may be less likely to experience problems related to a deficiency. 
• Maintain regular physical activity. When your body is healthy, you may have more energy to care for yourself and your mental health. 
• Join a support group to learn healthy, practical coping skills from other people experiencing similar symptoms. 

Benefits of online therapy

Living with and managing psychosis or a psychotic disorder can be challenging to do on your own. If you or a loved one are experiencing psychotic episodes or symptoms of psychosis, consider working with a licensed therapist online through a virtual therapy platform like BetterHelp. The symptoms of psychosis may make it difficult to function as usual, which could increase your barriers to traditional mental health care. With online therapy, you can remain in the security of your own home while participating in sessions, allowing you to get the support you need on your own schedule and according to your comfort levels. 

Effectiveness of online therapy for symptoms of psychosis

While some severe cases of psychosis may require inpatient treatment, for some people, symptoms can be addressed with regular online therapy sessions. In one study, researchers explored the efficacy of a web-based mindfulness intervention for those living with psychosis. They found that the participants who completed the program usually experienced a significant reduction in anxiety, beliefs about voices, and voice‐related negative affect. In each outcome, there were typically individuals who showed improvements, while none of them showed deterioration. These results may speak to the effectiveness of online therapy for people experiencing symptoms of psychosis. However, in-person therapy may be a better treatment method for acute psychosis as BetterHelp is not a crisis-supported platform.