Psychosis

What is psychosis?

Psychosis can affect people in different ways. For some, it's a one-off experience, but many people have regular 'psychotic episodes' for short periods. In other cases, it can be present most of the time.

Psychotic experiences usually involve seeing or hearing things that aren't there, believing things that aren't true or having confused, disorganised thoughts. These experiences can be described as losing touch with reality.

Psychosis symptoms

Psychotic experiences are different for everyone, but the three most common symptoms are:

• Hallucinations – seeing, hearing or feeling things that others don't. This might include hearing voices, seeing people or shapes, feeling someone touching you when no one is there or even smelling or tasting things that don't exist.

• Delusions – firmly believing things that aren't true. For example, you may be convinced that someone is following you or trying to hurt you or that you're invincible with special powers and authority.

• Confusing thoughts – you might process thoughts in a disorganised way, making you talk rapidly, quickly change subjects and lose your train of thought.

Other symptoms can include:

• Difficulty concentrating

• Memory problems

• Difficulty taking in information

• Problems with decision making

What causes psychosis?

Psychosis is often a symptom of another mental health condition, although it's possible to experience psychosis independently. Doctors usually describe psychosis as an 'experience' rather than diagnosing it as an actual mental health condition.

Psychotic experiences can be linked to mental health conditions like:

• Schizophrenia

• Bipolar disorder

• Depression

Other things that can trigger psychotic episodes include:

• Traumatic experiences

• Taking drugs, drinking alcohol or withdrawing from them

• The side effects of medication

• Brain injury

• A neurological condition, like dementia, Alzheimer's or Parkinson's

• Stress

Psychotic experiences after giving birth

If you have psychotic experiences shortly after giving birth, it's called postnatal psychosis or postpartum psychosis. It's a rare condition, but it can come on suddenly and needs to be treated as a medical emergency.

Psychosis treatment and support

The first step is to talk to a doctor about the symptoms you're experiencing. They'll give you an initial assessment to look at any medication you're taking and your family's mental health history.

The doctor will want to know about your moods and emotions. They will ask you to describe any symptoms, like hallucinations or delusions. People who experience psychosis are at greater risk of self-harming and feeling suicidal. If you have self-harmed or had the urge to harm yourself, or had suicidal thoughts, it's important to tell your doctor.
If your doctor thinks you're experiencing psychosis, they will refer you to a team of mental health professionals who will give you a full assessment and decide on the best course of treatment and support.

Usually, psychosis treatment includes a combination of:

Medication

The most common medication recommended to treat psychosis is an antipsychotic medicine. This helps to reduce symptoms by causing changes in your brain chemistry. It can be very effective, but it isn't suitable for everyone.

If you experience symptoms that affect your moods, you could also be offered antidepressants or mood stabilisers.

Therapy

Cognitive behavioural therapy (CBT) can help you understand your experiences better and develop ways to cope. You may be offered CBTp, which is a CBT-therapy designed specially to help with psychosis.

Family therapy can be useful if you have relatives caring for you or supporting you through the psychotic episodes. You'll be able to discuss your experiences as a family and find practical ways to cope together.

Support

Psychotic experiences can be disorientating, confusing and frightening, and talking to others who understand what you're going through can be a huge help.

Self-help groups are a safe, private place where you can share your thoughts and feelings without judgement. Talk to your doctor about what's available in your area.

Hospital

When psychotic episodes are severe, especially if doctors are concerned about yourself or others' safety, you may need treatment in a psychiatric hospital.

Emergency help for psychosis

If someone you know is experiencing a psychotic episode, it can be challenging to understand how to help them. If you're concerned that they need medical help, try one of these options:

• Contact their mental health team if they're registered with one

• Call their doctor

• Take them to an A&E if you can, and they are willing

• Call 999 and ask for an ambulance

Recovery

It can take time to find the best form of treatment and support for psychosis, but it's usually possible to manage the symptoms when you do.