What Is Psychosis?

When you lose touch with reality and see, hear, or believe things that aren’t real, doctors call that psychosis.

You may have delusions. That means you hold on to untrue or strange beliefs. You might also have hallucinations. That’s when you imagine you hear or see something that doesn’t exist.

Psychosis is a symptom, not an illness. A mental or physical illness, substance abuse, or extreme stress or trauma can cause it.

Psychotic disorders, like schizophrenia, are mental illnesses that involve psychosis that usually happens for the first time in the late teen years or early adulthood. Young people are especially vulnerable for reasons doctors don’t fully understand. Even before the first episode psychosis (FEP), they may also show subtle signs of behavioral changes. This is called the prodromal period and could last days, weeks, months.or even years.

What It's Like

You can’t tell the difference between what’s real psychosis and what’s not. Also, your speech might be unclear and your behavior disorganized.

You may have depression, anxiety, and sleep problems, too. It could be a struggle just to get through your day.

There are often warning signs leading up to psychosis. You may start to act differently. Your work or school performance could start to slip. You might also isolate yourself from others.  

You might also feel paranoid, experience hallucinations, have trouble expressing ideas, or slack off in your personal hygiene.

Causes

Doctors do not know exactly what causes psychosis, but there are many theories. In some people who have a biological vulnerability to developing psychosis, it may be triggered by too little sleep, some prescription medications, and abuse of alcohol or drugs like marijuana and LSD.

Traumatic events, like the death of a loved one or a sexual assault, can lead to psychosis in people who are vulnerable to it. So can traumatic brain injuries, brain tumors, strokes, Parkinson’s disease, and Alzheimer’s disease.

Psychosis can also be a symptom of a mental illness, like schizophrenia or bipolar disorder.

Diagnosis

You can see a psychologist, psychiatrist, or a social worker. If you or a loved one are concerned that you have had unexplained changes in your thinking and perception. They’ll find out what might have caused it and uncover any related conditions. Doctors diagnose mental illnesses after ruling out other things that could be causing psychotic symptoms.

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Treatment

It’s important to get treated early, after the first episode of psychosis. That will help keep the symptoms from affecting your relationships, work, or school. It may also help you avoid more problems down the road.

You doctor may recommend Coordinated Specialty Care (CSC). This is a team approach towards treating schizophrenia when the first symptoms appear. It combines medicine and therapy along with social services and employment and educational interventions. The family is involved as much as possible.

Just what your doctor recommends will depend on the cause of your psychosis.

Your doctor will prescribe antipsychotic drugs -- in pills, liquids, or shots -- to lessen your symptoms. He will also recommend that you stop using drugs and alcohol.

You might need to get treated in a hospital if you’re at risk of harming yourself or others, or if you can't control your behavior or do your daily activities. Your doctor will check your symptoms, look for causes, and suggest the best treatment for you.

Some clinics and programs offer help just for young people.

Psychotherapy

Counseling can also help manage psychosis.

Cognitive behavioral therapy (CBT) can help you recognize when you have psychotic episodes. It also helps you know whether what you see and hear is real or imagined. This kind of therapy also stresses the importance of antipsychotic medications and sticking with your treatment.

Supportive psychotherapy helps you learn to live with and manage psychosis. It reinforces healthy ways of thinking.

Cognitive enhancement therapy (CET) uses computer exercises and group work.

Family psychoeducation and support involves your loved ones. It helps you bond and improves the way you solve problems together.

Coordinated Specialty Care (CSC) implements a team approach in treating psychosis when it is first diagnosed. CSC combines medication and psychotherapy with social services and employment and educational intervention.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on July 17, 2018

Sources

SOURCES:

National Alliance on Mental Health: “Psychosis.”

U.S. National Library of Medicine Medline Plus: “Psychotic Disorders.”

National Institute of Mental Health: “Recovery After an Initial Schizophrenia Episode (RAISE) Questions & Answers.”

Compton, M. and Broussard, B. The First Episode of Psychosis: A Guide for Patients and Their Families, published online 2009.

Cleveland Clinic: “Diseases and Conditions: Schizophrenia.”

National Institute of Mental Health: “What is Psychosis?”

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