Psychosis can be triggered by severe stress or trauma. The symptoms of stress-induced psychosis include hallucinations and delusions.
Stress is a natural part of everyday life, but extreme stress can take its toll on your mental health. In severe cases, stress can trigger psychosis.
Psychosis isn’t a mental health condition in itself but a group of symptoms. It’s relatively rare. According to the National Institute of Mental Health,
Stress may trigger psychosis in people living with lifelong mental health conditions like bipolar disorder and schizophrenia.
But individual episodes of psychosis — particularly those called brief psychotic disorder — can also be triggered by severe stress.
The main symptoms of psychosis are:
- Hallucinations: These involve seeing, hearing, tasting, smelling, or feeling things that don’t exist outside of your mind (for example, you may hear the voice of someone who isn’t there).
- Delusions: These involve believing in something untrue (for example, you may believe someone wants to hurt or kill you, or you may believe you have power, magical abilities, or authority you don’t actually have).
- Confused and disturbed thoughts: These may cause you to speak rapidly or to change conversational topics abruptly.
During psychosis, you may also experience:
- impulsive behavior or behavior that’s reckless or disorganized
- negative symptoms, such as a lack of interest in regular activities, an ungroomed appearance, not participating in usual routines, or not showing emotion
- catatonia, which is where you may seem “frozen” and be unable to move or speak much
Episodes are usually accompanied by a lack of self-awareness. You may be unable to recognize that you’re experiencing delusions or hallucinations.
Some people may realize that they need mental health help during an episode of psychosis, but they may be afraid to get help, or their delusions might stop them.
For example, a person may believe that doctors and nurses are conspiring against them and might avoid calling emergency services.
This is why it’s important to intervene if you think your loved one is experiencing an episode of psychosis.
Typically, stress-induced psychosis is triggered by extremely stressful or traumatic events.
For example, stress-induced psychosis can be caused by:
- the death of a loved one
- witnessing or experiencing an act of violence or abuse
- car accidents
- natural disaster
Because there can be multiple possible causes of psychosis, it isn’t always easy for clinicians to determine what triggered an episode. Multiple stressors or contributing factors may play a role.
Genetics may play a role in whether or not someone develops a psychotic disorder. But not everybody who experiences stress-induced psychosis has a psychotic disorder.
For example, stress can lead to brief psychotic disorder, which is where an episode lasts between 1 and 30 days. Your symptoms will resolve after this period but may return in the future.
You may be
- are female
- are in your 20s, 30s, or 40s
- have a personality disorder or mood disorder
- are an immigrant or refugee
- live in a developing country
Brief psychotic disorder isn’t always caused by stress or trauma — and not all stress-induced psychosis fits the diagnostic criteria for brief psychotic disorder.
For example, stress might play a role in triggering episodes of psychosis in people living with schizophrenia.
A genetic component may also determine who experiences stress-induced psychosis and who doesn’t. One
A healthcare professional will conduct a psychiatric evaluation, asking questions about your thoughts and experiences and observing your behavior, to assess your symptoms.
The clinician may also run tests to determine whether your symptoms are associated with an underlying health condition or substance use.
The diagnosis ultimately depends on the duration of your symptoms:
- Brief psychotic disorder: 1 to 30 days
- Schizophreniform disorder: 1 to 6 months
- Schizophrenia: longer than 6 months
Psychosis may also be a symptom of:
Your treatment will depend on the cause of psychosis. Brief psychotic disorder, for example, is treated differently from schizophrenia.
Psychosis treatment may include:
- antipsychotic medications
- talk therapy, which can include individual or group therapy
In some cases, inpatient treatment — where you stay overnight in a psychiatric facility to receive ongoing observation and support — may be necessary.
Inpatient treatment can be especially helpful if your home environment is adding to your stress levels or if you’re at risk of self-harm.
Psychosis can be a complication of a number of underlying conditions, some lifelong and some short term. Your outlook will depend on your underlying condition.
- Brief psychotic disorder: Brief psychotic disorder may occur once only. But once you experience it, it’s possible for it to occur again.
- Bipolar disorder: Bipolar disorder can sometimes include episodes of psychosis. Although bipolar disorder is a chronic condition that can’t be cured, it can be managed through medication and therapy.
- Postpartum psychosis: Postpartum psychosis eventually goes away when treated with medication and therapy, but it’s possible to experience psychosis again, especially if you give birth again.
- Schizophrenia: Schizophrenia is also a chronic condition that can’t be cured, but medication and therapy may help you manage the symptoms.
- Schizophreniform disorder: Schizophreniform disorder is a type of schizophrenia where you experience schizophrenia symptoms briefly and recover fully. You may continue medication to prevent a relapse for up to a year.
In general, a combination of medication and therapy can reduce your chances of experiencing psychosis again.
Therapy for psychosis often includes learning stress-reduction techniques so that you build skills that enable you to cope with anxiety-inducing situations.
Can a panic attack feel like an episode of psychosis?
In the midst of a panic attack, you might worry that you’re experiencing psychosis or a mental breakdown.
During a panic attack, you might experience difficulty thinking clearly or talking in coherent sentences. You may also experience dissociation, depersonalization, or derealization.
This might make you feel like nothing around you is real, or like you’re detached from reality. But hallucinations and delusions aren’t typical symptoms of panic attacks.
What else can cause psychosis?
Brief psychotic disorder can occur without a major stressor or traumatic event. Sometimes, it occurs without a particular trigger.
Psychosis may also occur because of mental health conditions like schizophrenia, postpartum psychosis, and bipolar disorder.
Psychosis can also be triggered by:
Is psychosis the same as depersonalization, derealization, or dissociation?
No. With psychosis, you firmly believe that your delusions are real. With depersonalization, derealization, or dissociation, you feel disconnected from the world and as if your actions and surroundings are surreal. But you’re not questioning reality.
Depersonalization is where you feel disconnected from your thoughts and feelings, like they aren’t real or like they don’t really belong to you. You might feel like you’re outside your body, watching yourself like you’re watching a movie.
Derealization is where you feel disconnected from your surroundings. The people and environment around you might not feel real. They might feel foggy, distorted, or artificial.
Dissociation, on the other hand, is a broader term that refers to feeling disconnected from your own feelings, thoughts, and surroundings. Dissociation might include depersonalization and derealization.
Although dissociation may be a symptom of a mental health condition, it isn’t a mental health condition in itself.
What mental health conditions are associated with psychosis?
Psychosis is associated with a range of mental health conditions, including:
- bipolar disorder
- delusional disorder
- postpartum psychosis
- psychotic depression
- schizophreniform disorder
But having an episode of psychosis doesn’t necessarily mean that you have a chronic mental health condition.
Psychosis may be triggered by traumatic events and extreme stress. Your genetics, mental health, and environment may play a role in whether you develop stress-induced psychosis.
Psychosis can also be a complication of a chronic mental health condition, like schizophrenia and postpartum psychosis.
Stress-induced psychosis can be a difficult and scary experience for you and your loved ones, but recovery is possible. You may benefit from a combination of therapy, medication, and self-care strategies.
If you think you’re experiencing psychosis, or if a loved one is displaying the symptoms of psychosis, call 911 or local emergency medical services as soon as possible.
Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.