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What is psychosis?
When someone is experiencing psychosis, they experience the world differently to everyone else around them. This can be because they have sensory experiences (like hearing voices or seeing things) that don’t make sense to other people or because they believe things that don’t make sense to other people.
Psychosis is not a mental health condition, it’s an experience, but it can be a symptom of mental health conditions including schizophrenia and bipolar disorder. If you get help for psychosis, you might not be diagnosed with a mental health condition straight away, especially if you haven’t experienced psychosis before.
A period of time where someone is experiencing psychosis is often called an ‘episode’. Some people only ever experience one or two short episodes of psychosis, some people experience short episodes throughout their lives, and some people experience ongoing psychosis and live with it a lot of the time.
But there are reasons that people might experience symptoms of psychosis, like hearing voices, without having a mental health condition at all.
Why might people have symptoms of psychosis if they don’t have a mental health condition?
People might have an experience often associated with psychosis for a lot of different reasons, including because:
- Someone close to them has died. It’s common for people experiencing grief to hear the voice of the person who’s died, or to feel that the person who’s died is with them.
- They’re falling asleep or waking up. You might hear voices or see things while you’re half-asleep and still kind of dreaming.
- They have a high temperature. You might hear things or see things if you have a fever.
- They’ve taken drugs. Some drugs might cause you to hear or see things.
- They’ve experienced something traumatic. This can be associated with PTSD but doesn’t necessarily mean you have the condition.
- Hearing voices is part of a spiritual experience. This might be a positive, special experience or a distressing one.
It’s always important to speak to a trusted adult if you have any symptoms of psychosis, even if you think you might know the cause.
Symptoms and signs of psychosis
Psychosis usually means you experience:
- hallucinations, when you have sensory experiences that are in your mind, rather than based on the reality of the world around you
- delusions – beliefs that feel real to you but that don’t make sense (or are obviously not true) to other people
- disorganised thinking and speech, which might mean your thoughts race or jump from one idea to another. This can be reflected in how you talk if you speak quickly or link words together because of how they sound (rather than what they mean)
You might experience one or more of these things. It’s important to remember that these experiences feel very real to the person experiencing psychosis, even if it seems obvious to everyone around them that they’re experiencing hallucinations or delusions.
What are some examples of hallucinations and delusions?
It would be impossible to list all of the possible hallucinations and delusions because they’re often very personal to people.
Hallucinations can affect any of your senses. Someone experiencing psychosis might:
- hear voices that other people can’t hear. The voices might be helpful and kind, but they can also be frightening
- see things that other people can’t see, like people or animals, or things acting strangely, like a piece of furniture moving on its own
- feel insects crawling all over them when there aren’t any insects there
- taste unusual things like metal, without having anything in their mouths
People also experience different delusions. For example, someone experiencing psychosis might believe that:
- their thoughts are being controlled by someone else
- they can control nature
- they’re a member of the royal family or an important celebrity
- someone from the government is following them and will try to harm them
How does psychosis affect someone’s life
Lots of people find experiencing psychosis really distressing. They might feel unsafe or scared, and they might find it difficult to trust people or organisations, even if they know them and have trusted them in the past when they’re well. This can affect their relationships with friends and family, especially if they disagree about whether the person is unwell.
But some people have positive experiences of psychosis too. They might find it comforting to hear the voice of someone they love or find that psychosis is linked to their creativity, for example. This can make it feel more complicated to get treatment and support.
Experiencing psychosis can affect your decision-making too. People might spend money they can’t afford or take risks they wouldn’t take when they’re well (for example, having unsafe sex or using drugs).
And psychosis can affect day-to-day things like whether people are allowed to drive, as well as making it more difficult (but not impossible) to work or access education.
Lots of people who experience psychosis are affected by the attitudes and responses of the people around them. There’s a lot of stigma around psychosis, which can be difficult to live with.
Sometimes people might apply their own meanings to your experiences of psychosis – they might think your experiences mean that you’re very unwell or even dangerous, when that isn’t true.
People might also presume that there’s no way to recover from psychosis, or that experiencing psychosis means you won’t be able to live on your own, go to university, or have a job. Again, this isn’t true for everyone – lots of people who have experienced psychosis go on to live independently and achieve their goals in education and work.
What causes psychosis?
There are different causes for psychosis. Sometimes it can be linked back to a specific experience or reason, but it can also be caused by a complex mix of things that all play a part in someone’s experience.
Physical health conditions
People can experience psychosis (especially hallucinations) if they have a stroke or epilepsy. People with certain conditions (like Parkinson’s disease or a brain tumour) can also experience hallucinations or delusions.
Head injuries
Some types of severe head injury can cause psychosis, though this is rare.
Childhood experiences
Going through difficult experiences when you’re a child or young person, and the distress that they cause, might be part of the reason someone experiences psychosis. People often think of ‘difficult experiences’ as a big, traumatic event. But going through multiple smaller difficult experiences can also have a big impact.
Life events
Almost everyone will experience some things that are stressful or upsetting (like a relationship ending, work stress, or someone they love dying) at some point. For some people, these stressful situations may trigger an episode of psychosis, especially if they’re already vulnerable to developing the condition.
Drugs and alcohol
Evidence suggests that alcohol misuse and drug misuse can trigger episodes of psychosis, as can consuming large amounts in one go. Some people also experience psychosis if they suddenly stop using alcohol and drugs after using them for a long time.
Medication
Some prescribed medications can also cause psychosis as a side effect, including when you stop taking the medication. Doctors can often help people find alternative medications that don’t affect their mood.
Family history
Research suggests that people with a close family member who’s experienced psychosis are more likely (but not certain) to experience it too. We don’t know how much of this is due to biology (like genes inherited from your parents) and how much is due to your family being around you as you grow up and learn how to cope with the world. If genes are involved, it’s likely that it’s much more complex than one gene causing psychosis.
Severe stress, lack of sleep, or food
If you’re under a lot of stress, have really significant sleep problems, or have really low blood sugar, you might experience psychosis (especially hallucinations).
Treatment and looking after yourself if you experience psychosis
Treatment for psychosis can include medication and talking therapies such as cognitive behavioural therapy (CBT).
You may be referred to an early intervention team, who work specifically with people who have experienced their first episode of psychosis.
Things you can do while you’re experiencing psychosis
There are lots of things you can try to do to help you stay well if you experience psychosis:
Ground yourself in the moment
Focusing on your senses or using grounding exercises you’ve practised when you feel well can help you feel safer if you’re experiencing psychosis. Find out more about ways to ground yourself, including breathing exercises.
Respond to hallucinations
Especially if you hear voices, you can try different ways of responding. Some people try to stand up to voices and tell them they’re not going to listen, for example, while others find it more helpful to try to figure out what the voices need.
Find more ideas for coping with hearing voices on the charity Mind’s website.
Distract yourself with something else
The idea of ‘distracting’ yourself from psychosis is not meant to invalidate how distressing it can be, or to suggest it’s easy to ‘just’ do something else. The idea is that engaging your brain in something else can help stop thoughts spiralling and getting worse.
Ask for help
If you can, try to tell a trusted adult what’s happening so they can help you stay safe and access the support you need and deserve.
Things you can do when you’re feeling more well
There are also things you can do while you’re well that can help you manage psychosis if it happens again:
Make a plan
It’s a good idea to make a plan with the people who support you, including things that help your symptoms, things can help stop you getting unwell, early warning signs that you might be getting unwell, and things you (and the people around you) can do in response to those early warning signs.
Get enough sleep
It’s common for people who experience psychosis to struggle with getting enough sleep, but we also know that being sleep-deprived can be a trigger for psychosis (and can make symptoms worse). Read our tips for getting enough sleep.
Eat regularly
Eating a balanced diet with regular meals and snacks can help keep your blood sugar level, which is important if you find that changes to your blood sugar can trigger psychosis.
Take care of yourself and your body
Psychosis can make it challenging to take care of yourself, but trying to make time for movement and personal hygiene can make a positive difference. If you’re finding it difficult, check out our tips for when you’re struggling with self-care.
Avoid drugs, alcohol, and smoking
Drugs, alcohol, and smoking can affect how medication for psychosis works and make it less effective. Drugs and alcohol can also play a part in causing some people to experience psychosis.
How to get more help if you experience psychosis
Emergency?
If anyone is in immediate danger, call 999 now.
If you need urgent help for mental or physical health, call NHS 111 or get help from NHS 111 online.
If you think you may be experiencing psychosis (or are accessing support for psychosis but are struggling to manage), you should make an appointment with your GP (or the mental health service supporting you, if you’re already accessing mental health care). Find out more about getting help from an NHS GP in England.
You could ask an adult you trust to help you make the appointment or to go with you, if you would find that helpful.
Text NATTER for help
Anyone can text ‘NATTER’ to 85258 to seek
help, wherever they are in the UK. It’s a free, anonymous service and available 24/7.
More about NATTER
How to help someone else who experiences psychosis
If someone you care about experiences psychosis, it can be difficult to know how to support them. You might be able to offer support in different ways, depending on your own life and your relationship with the person.
Learn about psychosis
If you learn more about psychosis, people with psychosis don’t have to spend as much time raising awareness. It also means you can better understand what’s going on for them, which can be really helpful if they do something you find difficult, like treating you differently due to a delusion.
Know how to respond to psychosis
If someone’s experiencing a hallucination or delusion, it’s often best to focus on how they’re feeling, rather than the truth or reality surrounding what they’re experiencing. Instead of trying to ‘challenge’ their psychosis, you could offer support to help them cope with how they’re feeling.
Ask how you can help
Psychosis is complex and affects people in different ways. Depending on your relationship with someone, you could offer practical support like going with them to appointments or food shopping, or spending time socialising when they feel up to it.
Celebrate the little wins
People who experience psychosis spend a lot of time being reminded of the difficulties they have in navigating the world, so help your friends remember what they’re great at and why you love spending time with them. Celebrate their success (no matter how small) with them too.
Do normal ‘friend stuff’
When someone’s struggling with their mental health, spending time together talking about shared interests (or doing a hobby you both enjoy) can help them feel more like themselves again. This might mean continuing to invite someone to do stuff, even if they’re not always able to say yes.
Stay calm
It’s really helpful if you can stay calm and predictable when someone is experiencing psychosis. This might mean you need to take a break (like going for a walk) if you start to feel overwhelmed, and that’s OK.
Help them make a plan
When someone who experiences psychosis is doing well, it’s important for them to think about a plan for spotting any signs they’re becoming unwell – and what to do to get support as soon as possible. You could help someone make a plan, or remind them about what’s on their plan when needed.
Find more information
You can find more information on how to talk to someone who’s struggling, how to listen, and understanding boundaries and responsibility in the ‘Supporting others’ section of the website.
There’s also support if you’re a young carer, and tips for looking after yourself while supporting someone else.
