Psychosis is a set of experiences in which a person perceives or interprets things differently from those around them: hallucinations, delusions, and confused or disorganised thinking. Psychosis is not a diagnosis in itself. It occurs in several mental health conditions, and also in physical illness, brain injury and drug use.
Key points
- Psychosis is a set of experiences, not a diagnosis in itself. It occurs in several mental health conditions, and in physical illness, brain injury and drug use.
- The main experiences are hallucinations, delusions and disorganised thinking.
- People experiencing psychosis are far more likely to be harmed than to harm anyone else.
- In England, Early Intervention in Psychosis treatment should start within two weeks of referral.
- NICE recommends antipsychotic medication and psychological therapy together, not medication alone.
Symptoms
- Hearing, seeing or feeling things other people do not (hallucinations).
- Strongly held beliefs others do not share, which do not shift with evidence against them (delusions).
- Speech that is fast, jumps between subjects or stops suddenly, and trouble concentrating.
Causes and risk factors
- Family history of psychosis or schizophrenia; raised dopamine activity in the brain.
- Cannabis: across Europe, daily use was associated with around three times the odds of a psychotic disorder, daily high-potency cannabis with around five times.
- Severe stress, anxiety, depression and prolonged sleep loss can all trigger episodes.
Treatment
- First episode: oral antipsychotic medication together with psychological therapy through an Early Intervention in Psychosis service.
- Cognitive behavioural therapy for psychosis (CBTp), at least 16 planned sessions.
- Family intervention, at least 10 planned sessions over three months to a year.
When to speak to a professional
- Hearing, seeing or feeling things other people do not; holding a belief others do not share that does not shift when questioned.
- Becoming hard to follow in conversation, or withdrawing sharply and no longer managing work, food or washing.
- Use the word psychosis and ask for an urgent referral to Early Intervention in Psychosis - getting in quickly matters.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.