Psychosis 

Introduction 

Psychosis: Sarah's story

Sarah, 19, describes her experience of psychosis. Find out how early help from local services can help young people who live with mental illness.

Media last reviewed: 24/04/2013

Next review due: 24/04/2015

Who's affected by psychosis?

Psychosis is more common than most people realise, with schizophrenia being the most commonly associated mental health condition.

Recent research found that in England in any given year, one new case of psychosis is diagnosed for every 2,000 people.

Another study estimated that around 3 in 100 people will have at least one episode of psychosis at some point during their life.

Psychosis can develop at any age, but is rare in children under 15.

Depression

Depression is more than feeling unhappy or fed up for a few days. However, most people can make a full recovery with the right treatment and support

Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them. This might involve hallucinations or delusions.

The two main symptoms of psychosis are:

  • hallucinations  where a person hears, sees and, in some cases, feels, smells or tastes things that aren't there; a common hallucination is hearing voices
  • delusions  where a person believes things that, when examined rationally, are obviously untrue  for example, thinking your next door neighbour is planning to kill you

The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion and behaviour.

Experiencing the symptoms of psychosis is often referred to as having a psychotic episode.

What causes psychosis?

Psychosis isn't a condition in itself  it's triggered by other conditions.

It's sometimes possible to identify the cause of psychosis as a specific mental health condition, such as:

  • schizophrenia  a condition that causes a range of psychological symptoms, including hallucinations and delusions
  • bipolar disorder  a mental health condition that affects mood; a person with bipolar disorder can have episodes of depression (lows) and mania (highs)
  • severe depression  some people with depression also have symptoms of psychosis when they're very depressed

Psychosis can also be triggered by traumatic experiences, stress or physical conditions, such as Parkinson's disease, a brain tumour, or as a result of drug misuse or alcohol misuse.

How often a psychotic episode occurs and how long it lasts can depend on the underlying cause.

For example, schizophrenia can be long-term, but most people can make a good recovery, and about a quarter only have a single psychotic episode. Episodes related to bipolar disorder usually resolve, but may reoccur.

Read more about the causes of psychosis.

Diagnosing psychosis

You should see your GP immediately if you're experiencing psychotic episodes. It's important that psychosis is treated as soon as possible, because early treatment usually has better long-term outcomes.

Your GP will look at your symptoms and rule out short-term causes, such as drug misuse. They may ask you some questions to help determine what's causing your psychosis. For example, they may ask you:

  • whether you're taking any medication
  • whether you've been taking illegal substances
  • how your mood has been  for example, whether you've been depressed
  • how you've been functioning day-to-day  for example, whether you're still working
  • whether you have a family history of mental health conditions – such as schizophrenia
  • about your hallucinations – such as whether you've heard voices
  • about your delusions – such as whether you feel people are controlling you
  • whether you have any other symptoms

Your GP should refer you to a mental health specialist for further assessment and treatment.

Read more about diagnosing psychosis.

Treating psychosis

Treatment for psychosis involves using a combination of:

  • antipsychotic medication  which can help relieve the symptoms of psychosis
  • psychological therapies  the one-to-one talking therapy cognitive behavioural therapy (CBT) has proved successful in helping people with schizophrenia and, in appropriate cases, family therapy has been shown to reduce the need for hospital treatment in people with psychosis
  • social support  support with social needs, such as education, employment or accommodation

Most people with psychosis who get better with medication need to continue taking it for at least a year. Some people need to take medication long term to prevent symptoms reoccurring.

If a person's psychotic episodes are severe, they may need to be admitted to a psychiatric hospital.

Read more about the treatment of psychosis.

Getting help for others

People with psychosis often have a lack of insight. They're unaware that they're thinking and acting strangely.

Due to their lack of insight, it's often down to the friends, relatives or carers of a person affected by psychosis to seek help for them.

If you're concerned about someone you know and think they may have psychosis, you could contact their social worker or community mental health nurse if they've previously been diagnosed with a mental health condition.

If you think the person’s symptoms are placing them at possible risk of harm you can:

Read more about how to get help for others.

Complications

People with a history of psychosis are much more likely to have drug and/or alcohol misuse problems.

This may be because such substances can provide short-term symptom relief, although they usually make symptoms worse in the long term.

People with psychosis also have a higher than average risk of suicide. It's estimated that 1 in 5 people with psychosis will attempt to commit suicide at some point in their life, and 1 in 25 people with psychosis will kill themselves.

Side effects can also occur if taking antipsychotics on a long-term basis. Weight gain is a common side effect. In rare cases, a person with psychosis may also develop type 2 diabetes.

Read more about the complications of psychosis.

Page last reviewed: 31/07/2014

Next review due: 31/07/2016

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Comments

The 12 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Jbrlycorn said on 04 November 2013

I developed Psychosis through Complex Partial seizures with secondary Generalisation (Epilepsy) and they think I was getting side effects from Leviteracetam, they have now changed my medication to Epicenta and I have not had a seizure since, but every time I had a seizure I had delusions and Hallucinations with extreme paranoia after coming out of the Psychosis. I was usually hospitalised for 1 week and my psychosis happened for days. but for now everything is okay and Im hoping that it was just a side effect, so now I'll just have to wait and see. I have had multiple Hallucinations and delusions during the past couple of years, it took them a while to figure out it was a side effect and not the seizure.

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jordy1792 said on 18 May 2013

I personally had a psychotic episode when i was 18, a mere 6 weeks into university which had horrendous symptoms and i came close to being emitted into hospital as doctors were trying to use the mental health act to emit me against my will. I did however have home treatment and now 2 years on im still on anti-psychotic medication. Im a little worried i may suffer from schizophrenia but i have not been diagnosed yet as i don't want to get diagnosed out of fears of not getting work. what can i actually do ?

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Dark place said on 19 December 2012

Healthy early 50's Male.. Never had a days self doubt let alone depression before.... However, due to some financial and family health concerns.. I had not slept well for a while, and knew it was getting worse. After a period of flu, everything tasted awful, like Lemon and Onion or metallic, so ... I stopped eating and drinking! after a few days of not sleeping at all, I entered a horrible world in which all I could think of was dying to escape the failure, pain and hopelessness of it all..I had to end the pain. then. It went off the rails.. my conversations about this to my wife were not real and did not happen, I thought I was eating and drinking.. I was not. Crying uncontrollably, and the terrors... I have a multi-coloured whirl of recollections of which none make sense, anger, paranoia, death... failure.. skin crawling and shadows noises... and I now know.. most of, if indeed all of it did not even happen, apparently I was convinced I was an electrician capable of re wiring and then that I was under attack from hackers and viruses, it was only after I actually had a real conversation about my suicide that the GP was informed, Urgent Response Unit called... Some fluid, food and sleep made the pain go, after 1 nights sleep I could not believe I was even that person. My confidence has taken a bashing, I have never had thoughts or experienced anything like this before. The fear that it will return has made me return to the GP .. and through her reassurances I feel I have a handle on it now. I have decided to forget it.. put it down to delirium and delusion brought on by the flu and sleep and food deprivation, my memory seems to be unaffected apart from the episode, although it took a week or two to clear properly. It is so easy to look back and say "talk to someone!" but you must, and the early the better.....I know I could not have endured another day or two.... I have put this episode into a box marked Do Not Open! I can never return to that Hell.

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musician_hall said on 12 December 2012

@Juan I understand exactly what you are going through. I have a family member with a delusional disorder and he pretty much behaves similarly and gets violent as well. Your wife has to be evaluated by a psychiatrist so she can be given medication accordingly (anti-psychotics, mood stabilizers, anti depressants etc..). Im surprised when you took her to the ER the doctor didn’t notice this or have her evaluated by a psychiatrist. I live in the US and in my state by law, the cops can take the person to the hospital’s ER (against their will) for evaluation and temporary admission at the psychiatric ward if they are violent or pose a risk of harming themselves or others. The family members have to tell the cops when they come. There is even a mobile crisis team made up of medical professionals that come home and evaluate people or take them to the hospital if necessary. I suggest researching the mental health laws in your country of residence to see if this can be done, or speaking to a psychiatrist in the hospital. The choice is yours and every country, state or province has their own laws pertaining to involuntary admission, length of admission and specifics etc.. Unfortunately for my family calling the cops becomes our last and only resort when my brother stops taking his medication because he gets violent to the point where he has to be living on a different floor of the house separately for our safety. Just some advice…Feel free to ask more questions.

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cgarfield said on 11 December 2012

@juann, I would recommend seeking private psychotherapy. If she doesn't want to go on her own, you could seek therapy together, as a way of working through how this is effecting your relationship. I can also recommend any of the arts therapies (art, drama, dance, music), as this can seem less confrontational, and can be linked to something she perhaps already enjoys. You can search on the internet and arrange an assessment with a psychotherapist, or contact you doctor and see if there is anyone they recommend. This will mean a financial commitment, but could mean huge benefits.

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juann said on 09 November 2012

I am a robust man in my early 50's, but at the end of my tether with my wif'e's bizarre and irrational behaviour. I have studdied NLP and attended MHFA course to try to get help and answers. The bahaviour included incidents of spontaneous and irrational jealousy, belief in family members manipulating mind control, belief that I know everything and cannot make mistakes (if I do, its done deliberatly), conspiatorial paranoia, manic behaviour and, what we (me and the kids) coloured depressions. Our problem is (apart from living with it) getting treatment. You see, she does not accept responsability. She comes from an african carribean witchdoctor background and seems trapped in emotional childhood; culture is cuban spanish. Me and the kids (they don't like to talk about it) are at our wits end and desperately need help. What can we do? The doctor says he cannot refer anyone without there will. I have had to call the police out because of her dangerous behaviour, but nobody seems to pick up on how bizarre it is and do something to help. Don't get me wrong, I love my wife dearly and it pains me to see her in such a delusional state. It is ruining our life and marriage. I am accused of having affairs with any close friends, male or female, and she has decided to shadow me and is prone to outragous public outburst. I want to help her and seek cure, as she is the lovliest person on earth when not troubled. Does anyone out there have any experience and suggestions? I have been accused of causing marks and injury in bed during the night (for years, now) and am very conscious that I don't. Last Friday we had an episode of this and she wanted the doctor, so I took her as a presenting emergency. The doc couldn't see any marks or evidence of physical injury or pain and could not undertsand what the emergency was. My wife was very earnest and upset, and I explained that that was what the emergeny was; that she believed what she was saying, yet he could not see any physical evidenc

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Sean from Lancashire said on 15 April 2012

Is it me or the sound on the video not right ?

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Jorge46 said on 16 February 2012

For anyone who has come to this page for help and hope, please don't give up. Help is available from the NHS. My brother, a smart, 25 year old with a good family life and a fairly high profile city career, has just had his second psychotic episode, 2 years almost to the day from the first. This time round it seemed to happen very quickly and seemed much more violent than the first. We were all very scared and worried but with the help of the early intervention team, Dr's and the hospital we got him the help he needed and touch wood, fingers x'd he seems to be making a very good recovery. I was worried that leaving him in a strange place with strange people would make it worse but I think having some time alone, away from home and the stresses of life have helped. He's constantly being monitored and observed in the background. He's given the medication he needs, food and is generally well cared for. They tell me he will need to take medication now for the rest of his life but if that means I get my brother back then so be it. Two days ago he tried to explain to me how he felt, he said it was like being in a drunken state but 10,000x worse. He was hallucinating and voices in his head were telling him not to do certain things like drink water as it was alcohol and food as it was poison. After just one night of sleep, once the DR's and staff managed to calm him down, he was almost back to his normal self. As I said at the start, don't give up hope, help is at hand. And the more we can share the better we can understand.

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concerned carer said on 08 February 2012

To me, this page demonstrates the totally unscientific way that mental illness is considered in this country. If a person has cancer or a heart attack, then a highly trained person treats the problem with a highly refined set of procedures. The NHS infers from this video snippet that if someone has psychosis, then they are treated by well-meaning amateurs and go sailing. Which is why when someone I know had an acute psychotic episode, the local crisis doctor, after an hours interrogation, simply walked away and him to it. A week later my friend was in a mental hospital. It seems the only practical advice is to contact the DVLA. Oh well that's the health and safety box ticked. Thanks for absolutely nothing

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JuliesMum said on 16 August 2011

My daughter (now 15) is going through something rather similar to Sarah in the video, and I found her story fantastically helpful. It really helped me understand some of my daughter's experiences.

I have a blog about my daughter's illness and how we cope with it, which can be read at http://juliesmum.blogspot.com

I started this blog because I could find nothing that was written for families supporting a child with psychosis. It is a an extremely stressful situation! But at the same time, I wanted to show that you can survive it, and that life does go on.

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MissA said on 12 February 2011

I'm going through something similar, it is very perplexing.
I'm glad it worked out for Sarah. Hope she is still doing well.

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cvsouth said on 13 May 2009

To anyone who watched the video..

Take it from me, both those guys talked a LOT of sense there. Listen to what they are saying.

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