Psychosis is a poorly understood condition surrounded by myths, stigma, and misinformation. But what actually is psychosis? And what treatments are available?

7 minute read 

What is psychosis?

Rather than a disease in itself, psychosis is a symptom of several mental health conditions where the affected person has lost touch with reality. It may also be described as a psychotic experience, or psychotic episode. You may experience a single episode of psychosis in your lifetime, or multiple episodes throughout your life. An estimated 0.7% of people over the age of 16 have been diagnosed with a psychotic disorder in the UK.

There are three stages of psychosis: prodrome, acute and recovery.

Prodrome phase 

The first stage of psychosis is characterised by subtle changes in behaviour such as difficulty focusing, feeling easily overwhelmed, sleep problems, social isolation and wanting to spend more time alone.

Acute phase

In the acute stage of psychosis, symptoms such as hallucinations, delusions, and disordered thinking begin. The affected person may begin to exhibit unusual behaviour during this stage. How long this stage lasts varies depending on the cause. A brief, one-off episode of psychosis typically lasts for around a month, whereas psychosis caused by a mental health condition like schizophrenia may continue for six months or more.

Recovery

The last stage of psychosis is recovery. During this stage, the symptoms of psychosis improve, and the affected person will gradually return to their normal routine. Recovery usually occurs after treatment for an underlying mental health disorder or stopping whatever triggered the psychosis such as substance abuse or stress.

Psychosis symptoms

Psychosis usually develops in the late teens or early twenties but can occur at any age secondary to another condition such as a head injury or dementia.

There are three main symptoms of psychosis:

• Hallucinations — hearing seeing, feeling, tasting, or smelling something that isn’t there, but feel very real to the person experiencing them

• Delusions — strong beliefs not based in reality, such as conspiracy theories, believing someone wants to harm you, or that you have exceptional attributes or talents that you don’t have

• Disordered thinking and speaking — racing, disorganised thoughts and fast, incoherent, or jumbled speech

Psychosis behaviours

Somebody experiencing an episode of psychosis may exhibit behaviour including:

• Suspicion or mistrust of others

• Paranoid ideas

• Social withdrawal and spending more time alone

• Expressing unusual ideas, thoughts, or feelings

• Difficulty differentiating between what is real and what isn’t

• A lack of feelings

• Difficulty thinking clearly and logically

• Confused or jumbled speech or difficulty communicating

• Loss of interest in self-care and personal hygiene

• Sudden deterioration in grades or job performance

• Sleep problems including difficulty falling asleep, disrupted sleep, or reduced quality of sleep  

• Anxiety

• Lack of motivation

• Threats or violence towards themselves or others

What causes psychosis?

There is no single cause of psychosis, and the condition is thought to develop due to a combination of factors including genetics, abnormal brain development, and external influences like stress, trauma, or recreational drug use.

Psychosis may be related to another mental health condition such as schizophrenia, bipolar disorder, or severe depression.

Psychosis may also be triggered by:

• A traumatic event or experience

• Stress

• Drug or alcohol misuse

• Certain medical conditions, such as a brain tumour, dementia or Parkinson’s disease

• Childbirth

• Head injury

• Certain prescription medications

When to see a doctor

See a doctor if you, or a loved one is experiencing symptoms of psychosis. One of the main components of psychosis is difficulty telling the difference between what is real, and what isn’t. As such, many people showing signs of psychosis are unaware of their condition. If your loved one is showing symptoms of psychosis, you may need to reach out to the necessary services on their behalf.

How is psychosis diagnosed?

There is no simple test for psychosis, and a diagnosis is made by evaluating your symptoms, thought patterns and behaviour. Your GP may ask you some questions about what you are feeling and experiencing. If psychosis is suspected, you will be referred to a specialist for further evaluation and treatment.

Your GP may order some tests such as blood tests, or diagnostic scans like a CT or MRI to check for any underlying medical conditions.

Psychosis treatment

Treatment for psychosis depends on the cause, but commonly involves a combination of medication, and talking therapies. In addition, family and social support are essential in treating psychosis. If an episode of psychosis is severe, hospitalisation may be needed to stabilise and reduce symptoms.

Medication

Medication for psychosis is usually with a type of drug called an antipsychotic. You may also be prescribed antidepressants or mood stabilisers. These medications don’t offer a cure but can help to reduce symptoms such as hallucinations, delusions, and disordered thinking. Depending on the cause and severity of your condition, you may need to take medication short or long-term.

Talking therapy  

The most common  therapy for psychosis is a type of cognitive behavioural therapy (CBT) specially designed for people with psychosis. This is sometimes known as CBTp.

CBTp may be individual or group therapy and aims to help people with psychosis cope with their symptoms and offer strategies to improve their overall function. CBTp may also prevent or delay the worsening of symptoms during the early stages of a psychotic episode.

FAQs

Can someone with psychosis live a normal life?

Depending on the cause, most people make a full recovery from an episode of psychosis and go on to live a normal life. If psychotic episodes do reoccur, early diagnosis and treatment are essential in ensuring a quick and full recovery.

Can psychosis go away on its own?

Some types of psychosis, such as drug-induced psychosis, or psychosis due to stress or medication can resolve on their own once the trigger is removed. Psychosis due to a mental health condition such as schizophrenia is unlikely to go away without treatment.

Can someone go back to normal after an episode of psychosis?

Most people make a full recovery from an episode of psychosis and many people never experience another episode.

How long does psychosis last?

How long an episode of psychosis lasts depends on various factors including what caused the psychosis, how severe the psychotic episode is, and how quickly they receive treatment. A single psychotic episode can last for a month or less and never reoccur, while psychosis linked to a mental health condition may last for around six months and may come back throughout the person’s life.

Can drugs trigger psychosis?

Many recreational drugs including cannabis, cocaine, amphetamines, ecstasy and MBMA may trigger a type of psychosis known as drug-induced psychosis. In some cases, this can trigger or exacerbate symptoms of a long-term mental health condition like schizophrenia or bipolar disorder.

Further support

Psychosis is a mental health condition where a person loses touch with reality. It can be a brief, single episode triggered by an external event, or a long-term symptom of an underlying mental health condition. Though frightening to experience, with the right treatment and support, most people with psychosis make a full recovery.

For more information and support, contact:

• Mind provides information and support for those dealing with mental illness by phone and email.

• Bipolar.UK provides information and support to people with bipolar disorder, hypomania, and mania

• Hearing Voices Network offers information and support to people experiencing hallucinations or altered perceptions

• Hub of Hope  A database that provides access to local and national mental health support across the UK.

• National Paranoia Network Offers support to people experiencing paranoid thoughts

• Rethink Mental Illness Offers information and support to those experiencing mental illness

• CarersUK Advice and support for caregivers