Psychosis is a medical word used to describe mental health problems that stop the person from thinking clearly, telling the difference between reality and their imagination, and acting in a normal way.
The two main symptoms of psychosis are:
- hallucinations – where a person hears, sees (and in some cases smells) things that are not really there; a common hallucination is when people hear voices in their head
- delusions – where a person believes things that, when examined rationally, are obviously untrue; such as believing that your next door neighbour is secretly planning to kill you
The combination of hallucinations and delusional thinking can cause an often severe disruption to perception, thinking, emotion and behaviour.
Experiencing symptoms of psychosis is often referred to as having a psychotic episode.
Read more about the symptoms of psychosis.
Causes
Psychosis is not a condition in itself – it is triggered by other conditions.
Sometimes it is possible to identify the cause of psychosis as a specific mental health condition such as:
- schizophrenia – a condition where people may have repeated episodes of psychosis
- bipolar disorder – a condition where people have periods of depression at times and at other times have periods of feeling energetic, impulsive and happy (manic)
Psychosis can also be triggered by physical conditions, such as Parkinson’s disease, a brain tumour, or a result of drug or alcohol misuse.
The length of time that someone will experience a psychotic episode, will depend on underlying causes. Drug- or alcohol-induced psychosis may only last a few days.
However, psychosis that results from schizophrenia or bipolar disorder may last indefinitely unless treated.
Read more about the causes of psychosis.
Treatment
Treatment for psychosis involves using a combination of:
- antipsychotic medicines, which can help relieve symptoms of psychosis
- psychological therapies, which can help address the underlying cause of the psychosis – for example the talking therapy cognitive behavioural therapy has proved successful in helping people with schizophrenia
- social support – help to support the person with psychosis with social needs, such as education, employment or accommodation
Some people may only need to take antipsychotic medicines on a short-term basis. Other people may need them for months or, in some cases, years to prevent symptoms reoccurring.
In severe cases a person may need to be admitted to hospital or a secure psychiatric unit.
Read more about the treatment of psychosis.
Getting help for others
People with psychosis often have what is known as a lack of insight, meaning they are unaware they are thinking and acting strangely.
Due to their lack of insight, it is often down to friends, relatives or carers of people affected by psychosis to seek help for them.
If you are concerned that someone you know may be affected by psychosis you could contact their social worker or community mental health nurse if they have previously been diagnosed with a mental health condition.
If you think the person’s symptoms are placing them at possible risk of harm then you can:
- take the person to the nearest accident and emergency department, if they agree
- call their GP or local out of hours GP
- call NHS Direct on 0845 4647
- call 999 and ask for an ambulance
See diagnosing psychosis for more information on how 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 the use of these substances can provide short-term relief from symptoms (though they usually make symptoms worse in the long-term).
People with psychosis also have a higher risk of suicide than the population at large. It is estimated that one in five people with psychosis will attempt suicide at some point in their life and one in 25 people with psychosis will kill themselves.
Also, side effects can occur if taking antipsychotics on a long-term basis. A common side effect is weight gain, and in rare cases, type 2 diabetes.
Read more about the complications of psychosis.
Who is affected
Psychosis is more common than most people realise. Research carried out in 2010 found that in England in any given year, there would be one new diagnosed case of psychosis for every 2,000 people.
Another study estimated that around one in 100 people have at least one episode of psychosis at some point during their life.
Most cases of psychosis first develop during the older teenage years (15 or above) or during adulthood. Cases affecting children under the age of 15 are rare, accounting for only one in every 500 cases.
