What is psychosis?
Psychosis is a medical term referring to the loss of contact with reality or difficulty telling what is real from what is not. It is not a diagnosis on its own, but rather references a set of symptoms that often combine to form the basis of a psychotic disorder. It’s like a person’s mind is “playing tricks” on them; the person experiencing psychosis may have difficulty telling the difference between their own thoughts and perceptions and those that come from the outside world. Although real to the person experiencing them, psychotic experiences are not experienced as real to others, even others from the person’s social groups.
Psychosis is more common than many people think. Symptoms may come and go, or be relatively constant. It is often associated with mental health disorders like depression, bipolar disorder, and schizophrenia. However, psychosis can also occur in the context of other conditions, including, but not limited to, substance use, brain injury, seizure disorders, or conditions of extreme sleep deprivation or isolation (see Medical Conditions on page 29).
Most importantly, psychosis is treatable, and in some cases, it may be preventable. It is one part of a person’s experience, and must be understood within the broader context of a person’s experiences and being.
Did you know?
of children and teenagers have psychotic-like experiences
Psychotic disorders are almost always preceded by early warning signs, often in adolescence.
Doesn't psychosis appear "out of the blue"?
For people developing a “primary” psychotic disorder such as schizophrenia, psychosis rarely comes on suddenly. Onset is typically in the late teens to early 20s, but most people experience gradual changes over a period of months to years before experiencing pronounced or diagnosable syndromes.
We now know that the earlier a person gets help when they are experiencing warning signs or initial psychotic symptoms, the better the person’s outcome is likely to be. In fact, early treatment may be able to delay or prevent the development of pronounced or disabling psychotic symptoms, thus helping the person stay in school or work, develop or maintain important social connections, and live meaningful and productive lives. Accurate recognition of these warning signs provides the best opportunity for early intervention and good outcomes.
average time between start of symptoms & first contact with treatment
of psychotic disorders are first diagnosed in crisis settings such as the ED or inpatient unit
What treatments are available?
The majority of individuals who experience psychosis respond to treatment. An important part of treatment is establishing a good relationship with a treatment provider or treatment team. Currently, there is strong research support for the following psychological treatments for treating psychosis in people with diagnosed illnesses such as schizophrenia or bipolar disorder:
- Assertive Community Treatment (ACT)
- Cognitive Behavioral Therapy (CBT)
- Cognitive Remediation
- Family Psychoeducation
- Social Skills Training
- Supported Employment
- Social Learning/ Token Economy Programs
- Perälä J, Suvisaari J, Saarni SI, et al. Lifetime Prevalence of Psychotic and Bipolar I Disorders in a General Population. Arch Gen Psychiatry. 2007;64(1):19–28. doi:10.1001/archpsyc.64.1.19
- Kelleher, I., Connor, D., Clarke, M., Devlin, N., Harley, M., & Cannon, M. (2012). Prevalence of psychotic symptoms in childhood and adolescence: A systematic review and meta-analysis of population-based studies. Psych Med, 42(9), 1857-1863. doi:10.1017/S003329171100296