Psychosis refers to an episode involving a cluster of symptoms or experiences, most frequently caused by a psychotic disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists several psychotic disorders, all connected by a “loss of contact with reality.”
Some warning signs that an individual might be experiencing psychosis because of a psychotic disorder may include:
If you suspect you are experiencing psychosis or might have a psychotic disorder, seek help from a licensed professional.
There are various causes of psychosis. While some are directly related to psychotic disorders like schizophrenia spectrum disorders or bipolar disorder, there are other types of psychosis as well, such as drug-induced psychosis or psychosis caused by medical ailments like a brain tumor or stroke. In bipolar disorder, psychosis is often linked to extreme mood states, such as mania or depression.
If you are struggling with substance use, contact the SAMHSA National Helpline at 1-800-662-HELP (4357) to receive support and resources. Support is available 24/7.
Due to the wide range of underlying factors that may cause psychosis, no concrete level of severity can be established. For example, those with a vitamin deficiency might find their psychosis dissipates easily, while those with psychotic disorders like schizophrenia might find their psychosis symptoms more difficult to manage.
For the above reasons, determining the duration of acute psychosis in any given individual can be difficult. Some forms of psychosis can be managed by ceasing the activity that caused the psychosis in the first place, such as getting adequate sleep and nutrition or ceasing the misuse of recreational drugs and alcohol.
Some people may experience a psychotic episode that lasts a few days, a few weeks, or more extended periods, depending on the severity of the underlying causes. Brief psychotic disorder lasts less time than psychosis connected to other conditions. However, each person experiences psychosis differently, and an acute phase may become prolonged.
Psychotic disorders and psychosis often manifest in individuals for as long as a year before treatment is sought. Seeking treatment early can help you receive support right away and may allow you to feel relief from your symptoms sooner. if you suspect you are experiencing delusions or a disconnect with reality, consider reaching out to a licensed mental health professional.
Certain types of psychosis, such as psychosis caused by long-term mental health conditions like schizophrenia and bipolar disorder, might benefit from pharmacotherapeutic methods like antipsychotic medication, as well as medications to manage coinciding symptoms like anxiety and depression.
Particular research has been done on coordinated specialty care for mental health issues like psychotic disorders. This support might include a combination of individual or group psychotherapy, case management for certain cases of psychosis, and medication management. Licensed medical and mental health professionals apply various methods simultaneously to support those experiencing psychosis in managing their symptoms and living healthy and productive lives.
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.
Psychosis and the mental illnesses that often cause this condition can be challenging to manage. In some cases, symptoms of a mental health disorder may lead to barriers that make it difficult to leave home for therapy appointments. If you relate, online therapy may be a beneficial and more convenient option.
Through a platform like BetterHelp, clients can choose between phone, video, or live chat sessions and attend therapy from home. These platforms also offer tools like worksheets and support groups that might not be available otherwise.
While online therapy might not directly address some of the major cases of psychosis, like those seen in long-term schizophrenia, research has shown that online CBT can be effective at treating some of the coexisting symptoms of these conditions, such as anxiety and depression.
Due to the wide range of causes and symptoms associated with psychosis and a relative inability to ascertain the duration of a psychotic episode, seeking medical support from a licensed professional when you first notice symptoms can be beneficial.
Through methods like coordinated specialty care, medication, and therapy, the symptoms of psychosis can often be effectively managed. Consider reaching out to a professional online or in your area to learn more about your options.
Psychotic symptoms may last anywhere from days to years depending on the underlying cause, whether the person experiencing psychosis is receiving ongoing treatment, and the severity of the psychosis and underlying conditions. The inclusion of the prodromal and recovery stages further complicates the issue of defining how long the average psychotic episode lasts. Prodromal symptoms appear before the onset of the psychotic episode, and it is not always clear when prodromal symptoms escalate to full psychosis. Similarly, a person might experience semi-psychotic symptoms as they recover from the episode.
Many things can trigger psychosis, but some of the most commonly reported include sleep deprivation and high stress. Genetics and other environmental factors can also play a role; those with a family history of psychotic illness are at a greater risk of experiencing a psychotic episode. Chronic alcohol and drug use can also induce psychotic episodes, but it is not yet possible to define who will be most adversely affected.
An underlying mental illness might also change how psychosis appears, as can a significant head injury. Those with conditions characterized by brief, recurrent psychotic episodes often learn to recognize triggers and stressors that are likely to induce psychosis. Those experiencing a first-episode psychosis may not be able to identify the specific trigger that led to the psychotic episode. Many people do not experience further episodes and do not need to learn what triggered their psychosis.
Evidence suggests that psychosis can be described in three phases: prodromal, acute, and recovery. The prodrome phase is a “ramp-up” of psychotic symptoms. A person might experience confused thinking, irritability, and sleep disturbances. The symptoms of the prodromal stage gradually worsen before peaking in the acute stage. The symptoms of psychosis begin to reach their highest severity. A person might hear voices, see things that no one else can see, or voice false beliefs that are obviously untrue, such as believing they have special powers like reading another person’s thoughts.
A gradual reduction of the psychosis episode symptoms characterizes the recovery stage. The recovery stage usually begins after a person receives treatment. They may require ongoing support or specific treatment to continue to recover. Generally, evaluation and treatment from medical and mental health professionals offer the greatest likelihood of preventing psychosis from returning.
Psychosis can induce severe symptoms that directly affect a person’s ability to reason logically and make decisions based on reality. Negative symptoms - or the absence of normally present healthy behaviors - may include reduced motivation, impaired emotional processing, and social withdrawal. Positive symptoms - characterized by the presence of unusual thoughts or behaviors - may include delusions, hallucinations, paranoia, and disorganized behaviors.
A person experiencing a psychotic episode typically requires professional attention to address the symptoms. By definition, those experiencing psychosis have trouble discerning fantasy from reality and will likely find it challenging to find the help they need independently. While some episodes might resolve spontaneously, others will require medical intervention. In rare cases, the psychosis might not end without medical intervention. A specific drug or other treatment may be required for the symptoms to resolve. Because of the severity of the condition and the necessity of treatment, it is typically unwise to try to manage psychosis naturally and without professional guidance.
Whether the brain goes back to normal after psychosis depends on the underlying cause of psychotic symptoms. Those with mental health conditions associated with psychosis, such as schizophrenia or delusional disorder, often demonstrate abnormal brain anatomy or function in neuroimaging studies. Their brain structure will not change after the psychosis resolves, and additional treatment will likely be required to prevent future episodes.
However, in other cases, the brain may change after psychosis or underlying conditions are treated. For example, substance-induced psychosis, often associated with chronic alcohol use, may lead to changes in the brain that resolve once the psychosis and underlying chronic use of alcohol and other substances are addressed. The withdrawal process might also induce symptoms similar to psychosis. Finally, a traumatic brain injury could possibly lead to psychosis or other symptoms, which may dissipate as the brain heals.
The first stage of psychosis is typically referred to as the prodromal stage. In the prodrome stage, a person begins to experience psychotic symptoms that do not rise to the severity of a full psychotic episode. Common symptoms include confusion, irritability, paranoia, and sleep disturbances. As symptoms progress, they might experience delusions, hallucinations, or other features of psychosis. The symptoms typically become more severe and have a greater impact on a person’s daily life as they progress from stage one to stage two.
Evidence suggests that the greatest predictor of psychosis is having a first-degree relative with a history of a psychotic disorder. Researchers have identified a significant genetic factor driving psychosis. Disruptions to brain development in childhood likely also play a role in the development of disorders with psychotic features. There is also evidence to support that drug use before a person’s late teens might increase the risk of psychosis. Environmental factors may also play a role, as research indicates that life stressors and the absence of adequate social support may increase the risk of psychotic episodes.
It may be possible to calm a psychotic episode for some, but most people will find it challenging to mitigate psychosis on their own, especially if they are experiencing their first episode. While many may want to help a friend or loved one calm their psychosis, it is typically unwise to try to interfere with a psychotic episode without the necessary training to do so.
Someone experiencing psychosis is, by definition, out of touch with reality and may not recognize a loved one’s attempts to help calm them. Likely, the person strongly believes the thoughts they experience while undergoing a psychotic episode. Combined with paranoia - a common feature of psychosis - helping a person calm their psychosis can be very challenging. While a person’s system of support can help them manage their psychosis, the most effective efforts usually involve helping the person access professional intervention and medical care.
Evidence indicates that severe sleep deprivation can induce psychotic symptoms. Typically, a person must go at least 72 hours without sleep before hallucinations and other common psychotic symptoms appear. The longer a person goes without sleep, the more severe the symptoms become. Symptoms typically begin as simple visual hallucinations and sensory misperceptions before progressing to complex hallucinations and delusions, ending in a condition that resembles acute psychosis. In most cases, a period of normal sleep completely resolved the psychotic symptoms.
It is not always clear if someone is experiencing psychosis, and only qualified medical and mental health professionals can accurately determine the presence of psychotic symptoms. However, it may be possible to recognize some of the more common positive symptoms of psychosis, such as hallucinations and delusions. If a person reports or interacts with people or objects that only they can see, psychosis is more likely. Similarly, if they express demonstrably untrue beliefs, such as believing they are a supervillain or believing they run a secret government organization, they may be expressing delusions commonly seen in psychosis.