Psychosis is a set of psychological symptoms which have an impact on the way a person understands their reality, such as seeing, hearing or believing things that others don’t. When people experience these symptoms, mental health professionals say they are having a psychotic episode. Psychotic episodes can vary in length: they can last for a few days; they can continue indefinitely until they are treated or they can come and go.

There is no one cause of psychosis. It can be a symptom of a serious mental health problem such as bipolar, schizophrenia, personality disorder or severe depression, it can also be triggered by using recreational drugs, a side effect of some prescription medications, or from experiencing trauma, abuse, extreme stress or lack of sleep. Sometimes psychosis runs in families and is thought to have genetic link.

A first episode of psychosis often happens in late adolescence or young adulthood, it can be very frightening  but it’s important to remember that psychosis can be treated and it’s best to get advice and treatment early, as soon as people start experiencing symptoms.

Psychosis is rare, and just because you experience some of the symptoms below doesn’t mean you definitely have psychosis, only trained professionals can make a diagnosis so if you are worried then see your GP as soon as possible, they will refer you to a specialist service if necessary.

Symptoms

Unusual ideas or false beliefs, that are often very frightening – sometimes people with psychosis will believe that other people or organisations are out to get them, are spying on them and want to hurt them or even kill them. Others believe they have a special power  – that they are able to control other people’s thoughts, for example, or that they are someone important such as the son of God, the prime minister or a celebrity. These sort of beliefs can make people feel more cheerful and are not always distressing in themselves. However, the fact that no one else recognises how important they are may make the person feel distressed or angry.

Hallucinationsseeing, hearing, smelling or feeling things that aren’t there or that others don’t see. Auditory hallucinations such as hearing voices are a common symptom of psychosis, these voices are entirely real to the person who is hearing them, so they may talk back or hold a conversation with them. Voices might say upsetting, critical, cruel and frightening things and this can be very distressing. Some voices tell people what to do and can sometimes cause them to take risks or harm themselves. However, not all people who hear voices have psychosis.

Confused and jumbled thinking – people with psychosis may find it hard to concentrate or understand things and feel muddled and confused. They might feel that their mind is full of random ideas and their thinking is faster or slower than normal. This is sometimes reflected in the way they speak, they might speak very quickly or say things that don’t make sense.

Changes in feelings – experiencing mood swings or feeling isolated and cut off from the world for example. Sometimes people feel low or depressed, or they may feel unusually excited or ‘high’ for no reason.

Changes in behaviour – people might start to behave in odd or unusual ways as a result of their beliefs and hallucinations, and may seem very different to how they were before they experienced these symptoms. Sometimes people have lots of energy and are very active at night for example, or they may have no energy, isolate themselves and struggle to do normal activities. They might laugh at things that don’t seem funny, become upset without an obvious cause or talk to people others can’t see or hear. Their school work and grades might drop in standard or they may stop going to school, work or social activities. They might struggle to sleep at night, lose their appetite or interest in food, or stop taking care of themselves – neglecting to have a shower or clean teeth or hair for example.

If you are worried that you or someone else is experiencing symptoms of psychosis it is important to get professional help as soon as possible. Psychosis is a treatable condition, but it is unlikely to go away by itself without treatment.

Talk to your parents/carers, a teacher, youth worker or someone you trust straight away. You should also see your GP who can refer you to the right specialist services if they feel you need this. In Cornwall you might be referred to CAMHS or the Early Intervention Team – they work with young people who are experiencing psychosis for the first time, or who are having symptoms that could be a precursor to a psychotic episode.

Treating psychosis

Treatment for psychosis might include information and education about the condition and how to manage symptoms, counselling or therapy such as CBT (Cognitive Behavioural Therapy), and medication. Medication can be very effective in treating psychosis – see Headmeds for more information about antipsychotic medications.

Making lifestyle changes such as learning to manage stress, looking after your diet and exercise and avoiding drugs and alcohol can also help you to recover and may help to prevent symptoms returning.

When people have a psychotic episode, they are often unaware that they are unwell. They believe what they are experiencing is actually happening to them – that they really are being followed, that their life is at risk, or that they are being threatened for instance.

If the symptoms are severe, people can find it impossible to tell the difference between the experiences they are having and reality, to think logically, or talk about how they are feeling or to put their strange thoughts, emotions and fears in context. This means that psychosis can be very frightening and distressing for the person who is experiencing the symptoms.

If you are worried about a friend or family member try to be as calm, supportive and understanding as possible. Don’t panic or argue with their beliefs, this will just make them feel more distressed. Try to encourage them to talk to someone and to see their GP or a mental health professional as soon as possible.

You can also offer comfort and practical help, such as cooking them a meal, making an appointment for them or helping them to calm down.

You can contact your GP or the Early Help Hub in Cornwall for advice on 01872 322277.

Supporting someone with psychosis can be a stressful experience, make sure you get some help and support yourself, or contact the Young Minds Parent/Carer Helpline on 0808 802 5544.

If you think someone needs immediate medical attention or is at risk of harm then take them to the GP straight away. Alternatively contact the out of hours GP, take them to A&E or in an emergency call 999.

Myth buster #1

Myth: people with psychosis are often violent or dangerous.

Fact: While this is how psychosis is often portrayed in films and TV shows, actually people with psychosis are often very frightened and it is more likely that they will be the victim of violence or of harm to themselves than to anyone else.

Myth buster #2

Myth: a person with psychosis has a ‘split personality’

Fact: this is a myth created in popular culture. Having an episode of psychosis might mean that someone behaves strangely; sees, hears or smells things that aren’t really there (hallucinations); or has unusual beliefs and ideas about themselves or the world (delusions) – which are sometimes very frightening and confusing. Psychosis is a treatable illness and it is important that people are encouraged to get help as soon as possible

Useful resources

Rpsych

Detailed information for young people about psychosis, from the Royal College of Psychiatrists website

Headmeds

Everything you want to know about medication for mental health problems – app and website

Need help now?

If you need to speak to someone urgently call your GP or family doctor!

or

Childline up to 19yrs : 0800 1111
The Samaritans: 116 123
In an emergency go to A&E or call 999

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