Psychosis: Symptoms, risk factors, and treatment

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therapist.com team

Last updated: 02/13/2024

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What is psychosis?

Psychosis is a condition that affects how we process and experience reality. It can make us feel disconnected and believe we see, hear, or feel things that aren’t there. A period in which someone experiences psychosis is sometimes called a “psychotic episode” or “psychotic break.”

Psychosis is more common than some may think: Between 1.5% and 3.5% of people will meet the criteria for a psychotic disorder in their lifetime, with many more people experiencing psychotic symptoms at some point in their lives.¹

What causes psychosis?

A psychotic episode can be a sign of an ongoing mental health condition, or it can be a one-time event triggered by:

• Substance abuse
• Depression
• Anxiety
• Insomnia
• Grief
• Injury or illness
• Stress
• Trauma

Psychosis vs. schizophrenia

Schizophrenia is a mental health disorder that causes people to misinterpret reality and seriously affects their daily lives. It’s rarer than other mental illnesses, but the condition still affects around 24 million people worldwide.² Along with delusions, hallucinations, and disorganized speech or thought, symptoms of schizophrenia can include lack of eye contact, reduced range of emotions, poor hygiene, and lack of motivation. 

While people with schizophrenia often have psychosis as a symptom, a person experiencing psychosis doesn’t necessarily have schizophrenia.

Related mental health disorders

In addition to schizophrenia, other mental health disorders that can involve psychosis include:

• Bipolar disorder: This disorder can result in episodes of extreme highs (mania) and extreme lows (depression). During an episode of mania, someone with bipolar disorder may experience psychosis.
• Psychotic depression: This severe form of depression includes psychosis as a symptom. Other common symptoms include fatigue, sleep problems, and not eating enough.
• Posttraumatic stress disorder (PTSD): PTSD is caused by trauma. It can make a person feel constantly on guard. They may have upsetting memories or flashbacks of the traumatic event, experience changes in their thinking and mood, and avoid things they associate with the trauma. Psychosis can occasionally be a symptom of PTSD because some people with PTSD experience hallucinations and delusions.
• Postpartum psychosis: This rare condition can develop shortly after someone gives birth. Along with psychosis, its symptoms include confusion, anxiety, and depression.

Early warning signs

Psychosis rarely comes out of nowhere. It can have many different early warning signs. These commonly include:

• Disorganized thoughts
• Withdrawal from school or work
• Extreme emotions or lack of emotions
• Sudden decline in self-care
• Suspicion or paranoia
• Uneasiness around others
• Isolation

These early symptoms don’t always point to psychosis—they may be symptoms of other mental health conditions or normal reactions to stressful life events. But if you or a loved one are experiencing any of these warning signs, it’s a good idea to talk to a mental health professional or your primary care doctor.

If you’re currently in crisis, help is available right away. Call or text the 988 Lifeline at 988 for free, confidential support anytime, 24/7.

Common symptoms

Psychosis can have a range of symptoms, but the most common are hallucinations and delusions.

In a hallucination, you perceive something that isn’t there. Hallucinations can be felt with any of the five senses. For example, you may see a person who isn’t really there, or smell smoke when there isn’t any.

Delusions are strong beliefs that don’t match reality. For example, you may believe that you’re being followed or that you’re communicating with powerful forces, such as aliens or deities.

Potential complications

Psychosis is a serious condition that affects the way people understand and interact with the world. As a result, it can deeply impact relationships, employment, school performance, and quality of life. This condition can also lead to serious complications such as a higher risk for substance use disorders, self-harm, and suicide.

Risk factors

Researchers are still studying how psychosis develops. Factors that may make you more likely to experience psychosis include:

• Genetics: If you have a family history of psychotic disorders, it may increase your likelihood of developing one yourself. However, genes alone don’t guarantee you’ll develop psychosis.
• Brain chemistry: Chemical imbalances in the brain may increase risk.
• Trauma: Traumatic events may trigger psychotic breaks.³
• Drug or alcohol use: Substances that alter your experience of reality can cause or worsen psychotic symptoms.
• Brain injury: Suffering from a traumatic brain injury can increase your likelihood of experiencing psychosis.⁴
• Mental illness: If you have certain mental health disorders, such as schizophrenia or bipolar disorder, you may experience psychosis.

Treatment options

Treatment for psychosis varies depending on how severe a person’s symptoms are and whether they have any other mental health concerns. Antipsychotic medications are generally recommended as the first step to treat psychosis, often in combination with psychotherapy.⁵ Depending on the underlying causes of the condition, therapy may also be helpful on its own.

• Medications: Antipsychotic medications can help regulate moods, emotions, and thought patterns, which can reduce the severity of psychotic symptoms.
• Cognitive behavioral therapy (CBT): CBT offers tools and techniques to identify and change unhelpful thinking and behavior patterns.
• Internal Family Systems (IFS) therapy: IFS therapy involves looking at the parts that make up your inner self and understanding each part’s role, intentions, and positive attributes.
• Eye movement desensitization and reprocessing (EMDR): EMDR helps you reprocess traumatic memories and reduce the distress associated with them.

With the right approach, psychosis is treatable. If you believe you may be experiencing psychosis, talk to a therapist or your doctor right away.

Get help now

If you’re in crisis, help is available now. For free, confidential 24/7 support, call or text the 988 Lifeline at 988 or text HOME to 741741 to chat with a crisis counselor.