Psychosis – spot signs and manage symptoms

A psychotic episode can be frightening, whether it’s affecting you or someone close to you – learn more about this and what to do.

What are the symptoms?

What causes psychosis?

How is psychosis diagnosed?

What are the treatments?

Self-care tips when you have psychosis

Where to get support

Psychosis is a collection of symptoms that make it difficult for someone to recognize what is and isn’t real. It can be scary and confusing – whether affecting you or someone close to you – but effective treatment is available, so don’t delay seeking help. 

Psychosis can be very distressing, both for you and those around you. It’s a group of symptoms affecting the mind, where a person loses some contact with reality. 

In a psychotic episode, you might see or hear things that others can’t, and believe things that aren’t true. 

Psychosis can be a symptom of other conditions, or triggered by an event, such as traumatic experience. Whatever the underlying cause, it’s important to get help as soon as possible. Early treatment is more effective, and in some people may even prevent future episodes. 


## What are the symptoms?

Psychosis affects everyone differently. You might live with it most of the time, only have it once or experience short episodes throughout your life. There are 2 main groups of symptoms: 

- __hallucinations__ – seeing, hearing (hearing voices is a common example) or sometimes feeling, smelling or tasting things that aren’t there, but feel very real 
- __delusions__ – having fixed false beliefs. For example, you may think you’re being controlled by an external force or that you have special powers. 

You may also experience disordered thinking and speaking, which means your thoughts come very quickly, your speech may be fast and confusing, and your behavior strange or inappropriate. 

Before someone develops full psychosis, there are often signs that their mental health is deteriorating, such as anxiety and low motivation, plus other symptoms, including:

- suspiciousness or paranoia
- difficulty thinking clearly
- becoming withdrawn and spending more time alone
- having intense, unusual ideas that may seem bizarre to others
- poor self-care or personal hygiene
- sleep disruption
- difficulty working out what is and isn’t real
- confused speech or other communication problems
- an unexpected decline in performance at work. 

When someone’s having a psychotic episode, they may behave in ways that are unpredictable, frightening, and potentially harmful for themselves or others. 

There’s also a higher risk of self-harm and suicide, so if you’re experiencing psychotic symptoms or someone close to you is, get help as soon as possible. 


Get help with this

## What causes psychosis?
There isn’t a single cause. Researchers think psychosis may be connected to a combination of genetics, differences in brain development, and being exposed to trauma. 

It can be a symptom of a mental health condition, such as:
- [schizophrenia](https://www.livehealthily.com/health-library/conditions/schizophrenia)
- [bipolar disorder](https://www.livehealthily.com/health-library/conditions/bipolar-disorder)
- [severe depression](https://www.livehealthily.com/health-library/conditions/depression), including [postpartum depression](https://www.livehealthily.com/health-library/conditions/postnataldepression)
- [severe anxiety](https://www.livehealthily.com/health-library/conditions/anxiety) or stress.

The underlying mental health condition can influence psychotic symptoms. For example, someone with bipolar disorder may have grandiose delusions, while someone with schizophrenia is more likely to experience strong irrational beliefs. 

Other causes of psychosis can include sleep deprivation, some prescription medications, and misuse of alcohol or other drugs.


## How is psychosis diagnosed?
Some research has found people often live with psychotic symptoms for over a year before they start treatment. But getting help early is key for a good recovery, so don’t hesitate to see a healthcare professional. 

They will usually ask you about your symptoms, your personal and family history of mental health conditions, and whether you’re taking any medicine, or using drugs or alcohol. 

They may also carry out a physical exam to rule out causes such as a brain tumor or epilepsy. 


## What are the treatments?
Treatment for psychosis isn’t straightforward, and it may take a little time for you and your healthcare team to work out what helps. 

Getting support quickly is important – early treatment can prevent some people ever having another episode, and if you continue to have some symptoms, you’ll learn ways to cope better with them and stop them interfering with your life.

The exact treatment you have depends partly on the underlying cause of the psychosis, but it’s likely to be a combination of:

- medication, usually with antipsychotics, which help reduce hallucinations or delusional thoughts. There are various types available, and your healthcare professional will work with you to find the one that’s most helpful, with the fewest side-effects. You may also be prescribed other medicines, such as antidepressants, depending on your symptoms
- specialized psychotherapy (talking therapy) for psychosis, aimed at helping you to understand your experiences and find ways to manage symptoms
- family support, so that those around you can cope better and understand how to help you 
- in cases of severe psychotic episodes, you may need to be cared for at a psychiatric hospital. 


## Self-care tips when you have psychosis
Looking after yourself is important too. Your healthcare professional can advise you and your loved ones about lifestyle steps that may be helpful for both managing symptoms when you have them, and preventing future episodes. 

These may include:
- joining a support group, where you can meet other people who’ve experienced psychosis
- understanding your triggers, so that you can avoid or manage them. Common triggers include major life events, mood and lack of sleep. Try keeping a journal, so it’s easier to spot patterns 
- practicing relaxation strategies to help you look after your wellbeing when you’re stressed
- taking care of your physical wellbeing, for example, by getting enough sleep, getting active and by spending time in nature. It’s also important to avoid alcohol and drugs, which can make your symptoms worse
- talking to those close to you about what helps you, so that they can give you the right support during a psychotic episode if you’re not able to explain what you need. 


## Where to get support
Organizations can give advice and guidance on psychosis and related conditions. Your healthcare team will be able to tell you about groups that can help – here are a few:

- [National Alliance on Mental Illness (US)](https://www.nami.org)
- [Early Assessment and Support Alliance (US)](https://easacommunity.org)
- [Mind (UK)](https://www.mind.org.uk/)


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References

Charlotte Haigh

Jo Wheatley

Dr Emily Blount

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