Psychosis - Symptoms 

Symptoms of psychosis  

There are four main symptoms associated with a psychotic episode:

  • hallucinations
  • delusions
  • confused and disturbed thoughts
  • a lack of insight and self-awareness

These are outlined in more detail below.

Hallucinations

hallucination is when you perceive something that does not exist in reality. Hallucinations can occur in all five of your senses:  

  • sight – someone with psychosis may see colours and shapes, or imaginary people or animals
  • sounds – someone with psychosis may hear voices that are angry, unpleasant or sarcastic
  • touch – a common psychotic hallucination is that insects are crawling on the skin
  • smell – usually a strange or unpleasant smell
  • taste – some people with psychosis have complained of having a constant unpleasant taste in their mouth

Delusion

A delusion is where you have an unshakeable belief in something implausible, bizarre or obviously untrue. Two examples of psychotic delusions are:

  • paranoid delusion
  • delusions of grandeur

These are described below.

Paranoid delusion

A person with psychosis will often believe an individual or organisation is making plans to hurt or kill them. This can lead to unusual behaviour. For example, a person with psychosis may refuse to be in the same room as a mobile phone because they believe they are mind-control devices.

Delusions of grandeur

A person with psychosis may have delusions of grandeur where they believe they have some imaginary power or authority. For example, they may think they are president of a country, or have the power to bring people back from the dead.

Confusion of thought

People with psychosis often have disturbed, confused and disrupted patterns of thought. Signs of this include that:

  • their speech may be rapid and constant
  • the content of their speech may appear random; for example, they may switch from one topic to another mid-sentence
  • their train of thought may suddenly stop, resulting in an abrupt pause in conversation or activity

Lack of insight

People experiencing a psychotic episode are often totally unaware their behaviour is in any way strange, or their delusions or hallucinations could be imaginary.

They may be capable of recognising delusional or bizarre behaviour in others, but lack the self-awareness to recognise it in themselves. For example, a person with psychosis who is being treated in a psychiatric ward may complain that all of their fellow patients are mentally unwell while they are perfectly normal.

Postnatal psychosis

Postnatal psychosis, also called puerperal psychosis, is a severe form of postnatal depression (a type of depression some women experience after they have had a baby).

It is estimated that postnatal psychosis affects one or two women in every 1,000 who give birth, and most commonly occurs during the first few weeks after having a baby. Postnatal psychosis is more likely in women who already have a mental health condition, such as bipolar disorder or schizophrenia. 

As well as symptoms of psychosis (see above), symptoms of postnatal psychosis can include:

  • a high mood (mania)  for example, talking and thinking too much or too quickly
  • a low mood  for example, depression, lack of energy, loss of appetite and trouble sleeping

Postnatal psychosis is regarded as an emergency. If you are concerned someone you know may have developed postnatal psychosis contact your GP immediately. If this is not possible call NHS Direct on 0845 46 47 or your local out-of-hours service.

If you think there is a danger of imminent harm you can call:

  • your local A&E services
  • NHS Direct on 0845 46 47
  • 999 and ask for an ambulance

Page last reviewed: 28/05/2012

Next review due: 28/05/2014

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