Psychosis In Teens: Signs, Effects, And Mental Health Care Options

Medically reviewed by Melissa Guarnaccia, LCSW
Updated March 5th, 2025 by BetterHelp Editorial Team

Psychosis is a state in which an individual struggles to grasp reality. A psychotic episode may involve delusions, hallucinations, and disorganized thought—all of which can significantly affect a person’s life. Teenagers who experience psychotic symptoms may be uniquely impacted by them due to the emotional and cognitive challenges that adolescent life can present. For teens or parents concerned about psychosis, it can help to understand how psychotic symptoms can present and how they can be treated. Below, we’re providing an overview of psychosis, discussing the signs of psychotic episodes in teens, and outlining options for receiving treatment. 

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What is psychosis?

Psychosis is marked by an individual’s loss of connection with reality. It can manifest as false beliefs, sensory stimuli that aren’t experienced by other people, and/or confused speech or thought. Psychosis is associated with several different mental health conditions and can present in numerous ways, often seriously impacting an individual’s well-being, relationships, and ability to function. 

Symptoms of psychosis

Psychotic episodes can be characterized by a range of cognitive, emotional, and physical symptoms. The following are some of the most common psychotic symptoms:

  • Delusions (false beliefs that persist despite evidence to the contrary)
  • Hallucinations (hearing voices or seeing things that others cannot hear or see)
  • Disorganized speech (nonsensical or confusing communication patterns)
  • Mood swings
  • Paranoia
  • Sleep disturbances

If you believe you or your teen may be living with psychosis, it can be critical to consult with a healthcare provider as soon as possible. A medical or mental health professional can provide you or your teen with a screening and determine whether further testing, a diagnosis, and treatment may be necessary.

Causes of psychosis

While the exact cause of psychosis is unknown, several factors are thought to contribute to the development of psychotic symptoms. Genetics are considered a primary cause of psychosis, as are alterations in the structure and function of the brain. Certain risk factors—including traumatic experiences, the use of certain medications, and sleep deprivation—can also contribute to the development of psychosis. Psychotic disorders, mood disorders, and other psychological conditions can cause psychosis as well. 

Types of psychotic disorders

There are several mental health conditions that are primarily characterized by psychosis. The following are descriptions of the psychotic disorders outlined in the DSM-5:

  • Schizophrenia: a condition marked by positive symptoms (delusions, hallucinations, etc.) and negative symptoms (flat affect, lack of motivation) that cause significant impairment
  • Schizophreniform disorder: a schizophrenia spectrum disorder in which symptoms of schizophrenia do not persist beyond six months
  • Schizoaffective disorder: a condition in which symptoms of psychosis arise alongside symptoms of a mood episode, such as mania or depression
  • Delusional disorder: a disorder primarily characterized by false beliefs that persist despite evidence to the contrary
  • Brief psychotic disorder: a condition in which symptoms of psychosis are present for less than one month

There are several other psychiatric disorders that can cause psychosis, though they are not considered psychotic disorders. For example, major depressive disorder with psychotic features is a form of depression in which hallucinations, delusions, or other symptoms accompany low mood and related depressive symptoms. Some other conditions that can sometimes cause psychotic symptoms include severe post-traumatic stress disorder, bipolar disorder, anxiety disorders, substance use disorder, or obsessive-compulsive disorder.

How the symptoms of psychosis can affect teens

Psychosis typically develops when an individual is in their twenties; however, in some cases, psychotic symptoms may begin in adolescence or even childhood. The signs of psychosis in teens may sometimes be subtle, which could make them even harder to detect. In adolescents, the symptoms of psychosis are typically prodromal, meaning they signal the potential onset of a condition.   

It is estimated that 7.5% of adolescents experience psychotic symptoms. A psychotic episode may also exacerbate many of the mental health concerns that can arise during adolescence. Psychosis can lead to emotional distress, functional impairment, isolation, physical health challenges, and a range of other impacts that may negatively affect teenagers who experience it. 

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Common challenges of adolescence

Teenagers are already navigating a challenging period in life, taking on new responsibilities, undergoing physical changes, and preparing for their future. As they make the transition to adulthood, they may begin thinking about their eventual career path as well. Teens can experience significant pressure to succeed academically, leading to stress and, in some cases, anxiety. They might be gaining independence from their parents for the first time as well, leading to a changing family life. 

Adolescents may be either going through puberty or just completing it, which can lead to an altered voice, the development of sex organs, and a surge of hormones. Teens’ changing bodies are often the source of self-consciousness and difficulty with self-image. Additionally, teens can experience mental health challenges related to their gender identity or sexuality or how they’re perceived, which they may be exploring more as they approach adulthood. Psychosis could exacerbate any of these existing challenges that are common in adolescence.

How psychosis can exacerbate the challenges teens face

Teens who may already be questioning certain aspects of life can be especially vulnerable to the effects of psychosis. Adolescents experiencing psychotic symptoms like delusions or hallucinations may begin to feel that they can’t trust their reality or that they’re unable to connect with friends and family members. Additionally, the teenage years are crucial to an individual’s development of their sense of self, and research suggests that psychosis is connected with disturbances in self-identity—which can impact a teenager’s confidence, self-awareness, and understanding of their place in the world.

An adolescent’s academic performance can be significantly affected by symptoms like trouble focusing, impaired memory, difficulty with problem solving, and reduced reasoning abilities. Teens often experience pressure to get good grades so they can gain entry into college and eventually enter the workforce. Academic challenges caused by disorganized thought, delusions, or other challenges can impact a teen’s future and cause emotional distress. 

Teenagers who are experiencing an influx of hormones often have mood swings that can be challenging to manage. During this time, if they also begin questioning their reality, struggling to communicate, and withdrawing from social life, they may experience further emotional challenges.

Additionally, psychosis-related mental health resources may not be as readily available to or understood by teens and their parents. Schizophrenia and related mental health disorders are typically less common than conditions like depression and anxiety, which means they may be less frequently discussed in school mental health initiatives or other contexts.

Untreated psychosis may also lead to more severe mental health concerns in teens. Adolescents who have prodromal symptoms may experience worsening symptoms and the eventual development of a psychotic disorder, particularly without prompt mental health care. 

Signs of psychosis in teens

Identifying the early warning signs of psychosis can be a crucial first step in helping a teen get the help they need to manage a psychotic episode. Signs of psychosis can vary depending on the disorder an adolescent is experiencing (if applicable) and several other factors. Additionally, prodromal psychotic symptoms can be harder to detect, as they are typically less severe than the symptoms of a full psychotic episode. 

That said, the following are some potential signs of psychosis in teens:

  • Desire to isolate from friends and family members
  • Trouble communicating or organizing their thoughts
  • Sleep disruptions
  • Changes in appetite
  • Lack of interest in activities once enjoyed
  • Beliefs or statements that are out of the ordinary
  • Notable changes in behavior or personality
  • Abnormal experiences with sensory stimuli

Treatment for psychosis

While psychotic symptoms may be distressing to experience, they can typically be managed with the right approach. Early psychosis treatment may help reduce the chances that prodromal symptoms will turn into a serious mental illness. For those already living with a psychotic illness, treatment may help alleviate associated cognitive, emotional, and physical challenges. 

Mental health care 

Typically, treatment for psychosis involves medication and psychotherapy. Antipsychotic medication may reduce the severity and frequency of symptoms like hallucinations and delusions. Always consult with a healthcare professional prior to starting, stopping, or changing any medication. 

Psychotherapy, or talk therapy, can help teens with psychosis address the emotional challenges of their symptoms. A therapist can provide a teen with emotional support, help them develop coping strategies, and address potential comorbidities. 

Lifestyle changes

While medication and therapy are the primary forms of treatment for psychotic symptoms, certain complementary approaches may also help alleviate the emotional, physical, and cognitive challenges of psychosis. 

For example, research suggests that physical activity can have several potential benefits for people with psychosis. Regular cardiovascular exercise may help reduce cognitive impairment, enhance social and occupational functioning, and improve quality of life in people with psychotic symptoms. 

There is also evidence of a connection between nutrition and psychosis. For example, many studies suggest that deficiencies in certain B and D vitamins may be linked to schizophrenia. A nutritional plan that involves eating nutrient-dense foods at each meal may help reduce the likelihood that an adolescent will develop a psychotic disorder. 

Additionally, sleep disturbances are common symptoms of psychosis as well as a potential cause of psychotic symptoms. Maintaining a consistent sleep schedule may help teens reduce their risk of experiencing a psychotic episode. 

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How online therapy can help

While online therapy is not recommended as a first-line treatment for psychosis, it can sometimes be used as an adjunct, alongside primary forms of care. Online therapy can be a convenient and affordable way of addressing the various life challenges that psychotic symptoms can present for teens or their caregivers. 

Addressing the emotional effects of psychosis in teens with online therapy

Using an online therapy platform like BetterHelp (for adults) or TeenCounseling (for adolescents aged 13–19), you or your teen can work through certain emotional or cognitive symptoms of psychosis remotely, through video call, voice call, or in-app messaging with a licensed therapist. Online therapy can also be a more affordable option in many cases, as it typically costs less than in-person therapy without insurance.

The efficacy of mental health care through online therapy

Research suggests that online therapy may help alleviate the emotional and cognitive challenges adolescents can experience after episodes of psychosis, particularly in combination with in-person treatment as needed. For example, in one study, researchers suggest that young people with schizophrenia experienced increased motivation, reduced negative thoughts, and enhanced self-efficacy after virtual treatment. The study notes that these improvements in symptoms were sustained at a three-month follow-up. 

Takeaway

Psychosis is a serious mental health challenge that can impact a teen’s perception of reality, potentially affecting their social, academic, and family life and overall well-being. Knowing how to identify and get support for psychotic symptoms can help teens and caregivers foster emotional wellness and live healthy, productive lives. If you’re seeking support for psychological concerns as a parent or teen, consider working with a licensed professional online or in person.

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