Psychosis is a combination of symptoms resulting in an impaired relationship with reality. It can be a symptom of serious mental health disorders. People who are experiencing psychosis may have either hallucinations or delusions.

Hallucinations are sensory experiences that occur within the absence of an actual stimulus. For example, a person having an auditory hallucination may hear their mother yelling at them when their mother isn’t around. Or someone having a visual hallucination may see something, like a person in front of them, who isn’t actually there.

The person experiencing psychosis may also have thoughts that are contrary to actual evidence. These thoughts are known as delusions. Some people with psychosis may also experience loss of motivation and social withdrawal.

These experiences can be frightening. They may also cause people who are experiencing psychosis to hurt themselves or others.

It’s important to get medical help right away if you or someone else is experiencing symptoms of psychosis.

According to the National Institute for Mental Health (NIMH), there are warning signs that may appear before psychosis develops. These can include:

  • a sudden drop in school work or job performance
  • trouble thinking clearly
  • difficulty concentrating
  • feeling paranoid or suspicious of others
  • withdrawing from friends and loved ones
  • an influx of strange, new feelings, or no feeling at all
  • a disinterest in personal grooming
  • difficulty separating reality from non-reality
  • trouble communicating

If someone is experiencing an episode of psychosis, the main symptoms include:

  • hallucinations
  • delusions
  • disorganized behavior (behavior that does not seem to make sense, or that is impulsive)
  • negative symptoms (seemingly having no emotion, lack of interest in activities previously enjoyed, an ungroomed appearance, etc.)
  • catatonia (a “frozen” appearance)

A person who is experiencing psychosis may often have confusing and disrupted thoughts. Some examples of this include:

  • constant talking with rapid speech patterns
  • switching topics mid-sentence with no explanation
  • a sudden loss of their train of thought, causing them to pause or freeze abruptly

Delusions and hallucinations are two very different symptoms that are both often experienced by people with psychosis. Delusions and hallucinations seem real to the person who is experiencing them.

Delusions

A delusion is a false belief or impression that is firmly held even though it’s contradicted by reality and what is commonly considered true. There are delusions of paranoia, grandiose delusions, and somatic delusions.

People who are experiencing a delusion of paranoia might think that they are being followed when they’re not, or that secret messages are being sent to them.

Someone with a grandiose delusion will have an exaggerated sense of importance.

Somatic delusion is when a person believes they have a terminal illness, but in reality they’re healthy.

Hallucinations

A hallucination is a sensory perception in the absence of outside stimuli. That means seeing, hearing, feeling, or smelling something that isn’t present.

A person who is hallucinating might see things that don’t exist or hear people talking when they’re alone.

Each case of psychosis is different, and the exact cause isn’t always clear. There are certain illnesses that cause psychosis. There are also triggers like drug use, lack of sleep, and other environmental factors. In addition, certain situations can lead to specific types of psychosis developing.

In general, some of the factors involved in psychosis are:

  • genetics
  • trauma (such as a death, sexual assault, or living through a war)
  • substance use (drugs like LSD and amphetamines have been linked to instances of psychosis in some people)
  • mental health conditions (like schizophrenia)

It’s not currently possible to precisely identify who is likely to develop psychosis. However, research has shown that genetics may play a role.

People are more likely to develop a psychotic disorder if they have a close family member, such as a parent or sibling, who has a psychotic disorder.

Children born with the genetic mutation known as 22q11.2 deletion syndrome are at risk of developing a psychotic disorder, especially schizophrenia.

Some kinds of psychosis are brought on by specific conditions or circumstances.

Brief psychotic disorder

Brief psychotic disorder, sometimes called brief reactive psychosis, can occur during periods of extreme personal stress like the death of a family member.

Someone experiencing brief reactive psychosis will generally recover in a few days to a few weeks, depending on the source of the stress.

Drug- or alcohol-related psychosis

Psychosis can sometimes be triggered by the use of alcohol or drugs, including stimulants such as methamphetamine.

Hallucinogenic drugs like LSD often cause users to see things that aren’t really there, but this effect is temporary. Some prescription drugs like steroids and stimulants can also cause symptoms of psychosis.

People who have an alcohol or substance use disorder can experience symptoms of psychosis if they suddenly stop drinking or taking those drugs.

Organic psychosis

A head injury, illness, or infection that affects the brain can cause symptoms of psychosis.

Psychotic disorders can be triggered by stress, drug or alcohol use, injury, or illness. They can also appear on their own. The following types of disorders may have symptoms of psychosis:

Bipolar disorder

When someone is living with bipolar disorder, they experience extreme mood changes. When their mood is high and positive, they may have symptoms of psychosis. They may feel extremely happy or grandiose.

When their mood is more depressed, the person may have symptoms of psychosis that make them feel angry, sad, or frightened. These symptoms can include thinking someone is trying to harm them.

Delusional disorder

A person experiencing delusional disorder strongly believes in things that aren’t real, even when presented with opposing evidence.

Psychotic depression

This is major depression with symptoms of psychosis.

Schizophrenia

Symptoms of psychosis generally appear in schizophrenia.

Psychosis is diagnosed through a psychiatric evaluation. That means a doctor will watch the person’s behavior and ask questions about what they’re experiencing.

Medical tests and X-rays may be used to determine whether there is an underlying illness causing the symptoms.

Diagnosing psychosis in children and teenagers

Many of the symptoms of psychosis in adults aren’t symptoms of psychosis in young people. For example, small children often have imaginary friends with whom they talk. This just represents imaginative play, which is completely normal for children.

But if you’re worried about psychosis in a child or adolescent, it’s best to describe their behavior to a doctor.

Treating psychosis may involve a combination of medications and therapy. Most people will experience an improvement in their symptoms with treatment.

Rapid tranquilization

Sometimes people experiencing psychosis can become agitated and be at risk of hurting themselves or others. In these cases, it may be necessary to calm them down quickly.

This method is called rapid tranquilization. A doctor or emergency response personnel will administer a fast-acting injection or liquid medication to quickly relax the person.

Medication

Symptoms of psychosis can be managed with medications called antipsychotics. They reduce hallucinations and delusions, and help people think more clearly. The type of antipsychotic a doctor prescribes will depend on the symptoms.

In many cases, people only need to take antipsychotics for a short time until their symptoms are more manageable. Others may need to take them more long term.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of mental health therapy. Its goal is to change thinking and behaviors. CBT involves regular meetings with a mental health counselor.

CBT has been shown to be effective in helping people better manage their mental health conditions.

It’s often most helpful for symptoms of psychosis that medications don’t fully address.

Experiencing psychosis can be extremely frightening, but many people who experience it don’t always talk about it initially.

If you believe someone you know may be experiencing psychosis or may soon experience symptoms, contact their healthcare team right away if they have one. If they don’t, reach out to a local hospital.

If you believe they may be a danger to themselves or others, you can call 911 or take them to the emergency room.

If you feel unsure or nervous about their behavior or what they might do, get a professional involved as soon as you can.

Psychosis doesn’t have many medical complications. However, if left untreated, it can be challenging for people experiencing psychosis to maintain quality of life. This could cause other conditions to go untreated.

Most people who experience psychosis, even severe cases, will recover with the proper treatment, such as therapy and medication.