Most people think of psychosis as a break with reality— in a way it is. Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. These disruptions are often experienced as seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. While everyone’s experience is different, most people say psychosis is frightening and confusing.

What is Psychosis?

The word psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. When someone becomes ill in this way it is called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficulty understanding what is real and what is not.

If you are diagnosed with one or more of these conditions then you may experience psychosis. Alternatively, if you experience psychosis (and you have other symptoms too), then you may be given one of these diagnoses:

  • severe depression
  • schizophrenia
  • bipolar disorder
  • schizoaffective disorder
  • paranoid personality disorder or schizotypal personality disorder
  • postpartum psychosis
  • delusional disorder
From the DSM-5

What causes Psychosis?

We are still learning about how and why psychosis develops, but several factors are likely involved. We do know that teenagers and young adults are at increased risk of experiencing an episode of psychosis because of hormonal changes in their brain during puberty.

Risk Factors

Several factors that can contribute to psychosis:

    • Genetics. Many genes can contribute to the development of psychosis, but just because a person has a gene doesn’t mean they will experience psychosis. Ongoing studies will help us better understand which genes play a role in psychosis.
    • Trauma. A traumatic event such as a death, war or sexual assault can trigger a psychotic episode. The type of trauma—and a person’s age—affects whether a traumatic event will result in psychosis.
    • Substance use. The use of marijuana, LSD, amphetamines and other substances can increase the risk of psychosis in people who are already vulnerable.
    • Physical illness or injury. Traumatic brain injuries, brain tumors, strokes, HIV and some brain diseases such as Parkinson’s, Alzheimer’s and dementia can sometimes cause psychosis.
    • Mental health conditions. Sometimes psychosis is a symptom of a condition like schizophrenia, schizoaffective disorder, bipolar disorder or depression.

    How to Recognize Psychosis

    Typically, a person will show changes in his or her behavior before psychosis develops. Behavioral warning signs for psychosis include:

    Sudden drop in grades or job performance
    New trouble thinking clearly or concentrating
    Suspiciousness, paranoid ideas, or uneasiness with others
    Withdrawing socially, spending a lot more time alone than usual
    Unusual, overly intense new ideas, strange feelings, or no feelings at all
    Decline in self-care or personal hygiene
    Difficulty telling reality from fantasy
    Confused speech or trouble communicating

    Know the Facts

    3 out of 10

    3 out of 100 people will experience psychosis at some time in their lives.

    About 100,000 adolescents and young adults in the US experience first episode psychosis each year.


    Having an episode of psychosis does not mean someone will suffer from a psychotic disorder, like schizophrenia. 

    Less than 1% of the U.S. population lives with a psychotic disorder.


    Treatment Options

    Studies have shown that it is common for a person to have psychotic symptoms for more than a year before receiving treatment. Reducing this duration of untreated psychosis is critical because early treatment often means a better recovery. 

    • Individual or group psychotherapy is typically based on principles of cognitive behavior therapy. This therapy is tailored to each patient’s needs and emphasizes resilience training, illness and wellness management, and building coping skills.
    • Family support and education teach family members about psychosis, coping, communication, and problem-solving skills.
    • Medication management helps reduce psychosis symptoms. Medication selection and dosing are tailored to patients with early psychosis and their individual needs. 
    • Supported employment and education services help patients return to work or school and achieve their personal goals. Emphasis is on rapid placement in a work or school setting, combined with coaching and support, to ensure success.
    • Case management helps patients with problem-solving. The case manager may offer solutions to address practical problems and coordinate social services across multiple areas of need.

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