Psychosis can surface when someone is in their late teens or twenties, often catching them and their families off guard.
They might hear voices that no one else hears, see shadows or people only they can see, and feel suspicious that someone is watching them, scheming.
What’s real and what’s not can be hard to figure out during an episode of psychosis, which can last a few days or years.
Causes of psychosis
Many different factors can raise the risk of psychosis, including:
- Using drugs
- Extreme sleep deprivation
- Intense stress
- Non-psychiatric illnesses, such as encephalitis or thyroid disease
- A problem affecting the brain, such as a brain tumor or stroke
- A mental illness that includes psychosis
Some causes of psychosis can be resolved, bringing an end to what can be a scary experience for the person going through it as well as their family members and friends witnessing it.
Risk factors for psychosis
Genetics, brain chemistry and stress all can affect whether a person develops a mental illness with psychosis.
I treat adolescents and young adults who had or have psychosis, some just once or twice, others many times. Psychosis affects people in different ways, but there are some common aspects.
Symptoms of psychosis
Hallucinations – You hear something that others don’t, which is the most common hallucination. You could also see or smell something that’s not actually there.
Delusions – You believe strongly in something that’s not true, such as that you’re being followed or being controlled by an outside force.
Confused thinking – You have tangled thoughts and might speak in a way that’s hard for others to understand.
Psychosis develops slowly
For many people, psychosis doesn’t happen overnight. More often, it comes on gradually over the course of months or years.
At first, someone might think they hear whispers rather than distinct voices, as if a radio were on with the volume low. Someone might say: “I was home alone, and it sounded like there was someone in the other room talking or walking around.”
Early warning signs of psychosis
Someone showing signs of being at risk for psychosis might:
- withdraw from socializing from others
- have a sudden decline in their grades or work performance
- experience changes in mood
- have trouble concentrating
- have difficulty sleeping
- begin to worry people may be watching them or that they may be unsafe in their environment
Treatment for psychosis
If someone has one or more episodes of psychosis, that may lead them to drop out of school, abuse drugs or alcohol, get in trouble with the law and, sometimes, attempt suicide.
However, the good news is there’s a specific type of treatment for early psychosis, founded on evidence from years of research. It’s been proven to work.
The Substance Abuse and Mental Health Services Administration considers this approach, called coordinated specialty care, to be the gold standard.
It includes:
- Therapy including cognitive behavioral therapy
- Medication management
- Support with succeeding in work and school
- Education and support for family members
- Case management to help with day-to-day activities
This treatment has been shown to help with symptoms and make everyday life, including work or school, more manageable.
Recovery from psychosis is possible
Early treatment is important in helping people with psychosis work toward recovery. If someone receives treatment as soon as possible after first experiencing psychosis, they typically fare better than people who experience long delays before receiving care.
That’s true of physical illnesses as well. If you break your leg and wait for several weeks or months to be treated, recovering takes more time and is more difficult.
People used to think if you had psychosis, you could never live independently, hold a job or have meaningful relationships. That’s not true. Many people with psychosis return to school, to jobs and to the life they had before they ever experienced psychosis. Recovery is possible.
When psychosis starts, help starts here.
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