Signs and symptoms of psychotic

Symptoms - Psychosis - NHS

Someone who develops psychosis will have their own unique set of symptoms and experiences, according to their particular circumstances.

But in general, 3 main symptoms are associated with a psychotic episode:

  • hallucinations
  • delusions
  • confused and disturbed thoughts


Hallucinations are where someone sees, hears, smells, tastes or feels things that do not exist outside their mind.

  • sight – seeing colours, shapes or people
  • sounds – hearing voices or other sounds
  • touch – feeling touched when there is nobody there
  • smell – an odour that other people cannot smell
  • taste – a taste when there is nothing in the mouth


A delusion is where a person has an unshakeable belief in something untrue.

A person with persecutory delusions may believe an individual or organisation is making plans to hurt or kill them.

A person with grandiose delusions may believe they have power or authority. For example, they may think they're the president of a country or they have the power to bring people back from the dead.

People who have psychotic episodes are often unaware that their delusions or hallucinations are not real, which may lead them to feel frightened or distressed.

Confused and disturbed thoughts

People with psychosis sometimes have disturbed, confused, and disrupted patterns of thought. Signs of this include:

  • rapid and constant speech
  • disturbed speech – for example, they may switch from one topic to another mid-sentence
  • a sudden loss in their train of thought, resulting in an abrupt pause in conversation or activity

Postnatal psychosis

Postnatal psychosis, also called puerperal psychosis, is a severe form of postnatal depression, a type of depression some women experience after having a baby.

It's estimated postnatal psychosis affects around 1 in every 1,000 women who give birth. It most commonly occurs during the first few weeks after having a baby.

Postnatal psychosis is more likely to affect women who already have a mental health condition, such as bipolar disorder or schizophrenia.

As well as the symptoms of psychosis, symptoms of postnatal psychosis can also include changes in mood:

  • a high mood (mania) – for example, feeling elated, talking and thinking too much or too quickly
  • a low mood – for example, feeling sad, a lack of energy, loss of appetite, and trouble sleeping

Contact a GP immediately if you think you or someone you know may have developed postnatal psychosis as it is a medical emergency. If this is not possible, call NHS 111 or your local out-of-hours service.

If you think there's an imminent danger of harm, call 999 and ask for an ambulance.

Psychosis is not the same as psychopath

The terms "psychosis" and "psychopath" should not be confused.

Someone with psychosis has a short-term (acute) condition that, if treated, can often lead to a full recovery.

A psychopath is someone with an antisocial personality disorder, which means they:

  • lack empathy – the capacity to understand how someone else feels
  • are manipulative
  • often have a total disregard for the consequences of their actions

People with an antisocial personality can sometimes pose a threat to others because they can be violent. Most people with psychosis are more likely to harm themselves than others.

Page last reviewed: 10 December 2019
Next review due: 10 December 2022

Early Psychosis and Psychosis | NAMI: National Alliance on Mental Illness

In this 2-part podcast series, NAMI Chief Medical Officer Dr. Ken Duckworth guides discussions on early psychosis that offer insights from individuals, family members and mental health professionals. Read the transcript.
Note: Content includes discussions on topics such as suicide attempts and may be triggering.


Most people think of psychosis as a break with reality. In a way it is. Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t. These disruptions are often experienced as seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. While everyone’s experience is different, most people say psychosis is frightening and confusing.

Psychosis is a symptom, not an illness, and it is more common than you may think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as 3 in 100 people will have an episode at some point in their lives.

Early or first-episode psychosis (FEP) refers to when a person first shows signs of beginning to lose contact with reality. Acting quickly to connect a person with the right treatment during early psychosis or FEP can be life-changing and radically alter that person’s future. Don’t wait to take the first step and prepare yourself with information by reviewing these tip sheets: 

What is Early and First-Episode Psychosis?
Early Psychosis: What's Going on and What Can You Do?
Encouraging People to Seek Help for Early Psychosis
Early Intervention: Tips for School Staff and Coaches


Early warning signs before psychosis

Early psychosis or FEP rarely comes suddenly. Usually, a person has gradual, non-specific changes in thoughts and perceptions, but doesn't understand what's going on. Early warning signs can be difficult to distinguish from typical teen or young adult behavior. While such signs should not be cause for alarm, they may indicate the need to get an assessment from a doctor.

Encouraging people to seek help for early psychosis is important. Families are often the first to see early signs of psychosis and the first to address the issue of seeking treatment. However, a person's willingness to accept help is often complicated by delusions, fears, stigma and feeling unsettled. In this case, families can find the situation extremely difficult, but there are engagement strategies to help encourage a person to seek help.

It's important to get help quickly since early treatment provides the best hope of recovery by slowing, stopping and possibly reversing the effects of psychosis. Early warning signs include the following:

  • A worrisome drop in grades or job performance
  • Trouble thinking clearly or concentrating
  • Suspiciousness or uneasiness with others
  • A decline in self-care or personal hygiene
  • Spending a lot more time alone than usual
  • Strong, inappropriate emotions or having no feelings at all

Signs of early or first-episode psychosis

Determining exactly when the first episode of psychosis begins can be hard, but these signs and symptoms strongly indicate an episode of psychosis:

  • Hearing, seeing, tasting or believing things that others don’t
  • Persistent, unusual thoughts or beliefs that can’t be set aside regardless of what others believe
  • Strong and inappropriate emotions or no emotions at all
  • Withdrawing from family or friends
  • A sudden decline in self-care
  • Trouble thinking clearly or concentrating

Such warning signs often point to a person’s deteriorating health, and a physical and neurological evaluation can help find the problem. A mental health professional performing a psychological evaluation can determine if a mental health condition is involved and discuss next steps. If the psychosis is a symptom of a mental health condition, early action helps to keep lives on track.


Psychosis includes a range of symptoms but typically involves one of these two major experiences:

Hallucinations are seeing, hearing or feeling things that aren’t there, such as the following:

  • Hearing voices (auditory hallucinations)
  • Strange sensations or unexplainable feelings
  • Seeing glimpses of objects or people that are not there or distortions

Delusions are strong beliefs that are not consistent with the person’s culture, are unlikely to be true and may seem irrational to others, such as the following:

  • Believing external forces are controlling thoughts, feelings and behaviors
  • Believing that trivial remarks, events or objects have personal meaning or significance
  • Thinking you have special powers, are on a special mission or even that you are God.


We are still learning about how and why psychosis develops, but several factors are likely involved. We do know that teenagers and young adults are at increased risk of experiencing an episode of psychosis because of hormonal changes in their brain during puberty.

Several factors that can contribute to psychosis:

  • Genetics. Many genes can contribute to the development of psychosis, but just because a person has a gene doesn’t mean they will experience psychosis. Ongoing studies will help us better understand which genes play a role in psychosis.
  • Trauma. A traumatic event such as a death, war or sexual assault can trigger a psychotic episode. The type of trauma—and a person’s age—affects whether a traumatic event will result in psychosis.
  • Substance use. The use of marijuana, LSD, amphetamines and other substances can increase the risk of psychosis in people who are already vulnerable.
  • Physical illness or injury. Traumatic brain injuries, brain tumors, strokes, HIV and some brain diseases such as Parkinson’s, Alzheimer’s and dementia can sometimes cause psychosis.
  • Mental health conditions. Sometimes psychosis is a symptom of a condition like schizophrenia, schizoaffective disorder, bipolar disorder or depression.


A diagnosis identifies an illness; symptoms are components of an illness. Health care providers draw on information from medical and family history and a physical examination to diagnose someone. If causes such as a brain tumor, infection or epilepsy are ruled out, a mental illness might be the reason.

If the cause is related to a mental health condition, early diagnosis and treatment provide the best hope of recovery. Research shows that the earlier people experiencing psychosis receive treatment, the better their long-term quality of life.


Early or first-episode psychosis

Early treatment of psychosis, especially during the first episode, leads to the best outcomes.

Research has shown significant success using a treatment approach called Coordinated Specialty Care (CSC). CSC uses a team of health professionals and specialists who work with a person to create a personal treatment plan based on life goals while involving family members as much as possible.

CSC has the following key components:

  • Case management
  • Family support and education
  • Psychotherapy
  • Medication management
  • Supported education and employment
  • Peer support

SAMHSA maintains an Early Serious Mental Illness (ESMI) Treatment Locator as a source of information for family members who are seeking CSC programs in the US. Portions of their website are available in Spanish.

Psychosis treatment

Traditional treatment for psychosis involves psychotherapy and medication. Several types of therapy have successfully helped individuals learn to manage their condition. In addition, medication targets symptoms and helps reduce their impact.

Related Conditions

Psychosis can be related to several mental health conditions:

  • Bipolar Disorder
  • Schizoaffective Disorder
  • Schizophrenia
  • Substance use disorders / Dual Diagnosis

Psychosis - American Medical Clinic

Psychosis - a pronounced violation of the mental state, when the perception of a person contradicts the real situation. In this regard, there is a disorder in the perception of the real world and disorganization of behavior.

People who suffer from psychosis often become isolated and do not make contact. However, it is early diagnosis that contributes to the return to a normal lifestyle. As psychosis develops, the patient's behavior becomes less and less adequate, and consequences that are irreversible for the psyche arise.

Many of the symptoms of psychosis appear in a mild form before the onset of an exacerbation. However, it is very difficult to recognize them. However, if you do this and seek help in a timely manner, you will avoid serious consequences.

Early symptoms of psychosis

Do you feel a sudden change in your mental state? You should be concerned if you experience the following symptoms:

  1. Character changes:

    • irritability, nervousness, anxiety;
    • hypersensitivity;
    • lack of energy, interest, lack of initiative.
  2. Changes in sensation:

    • fears;
    • depression.
  3. Decreased performance

  4. Changes in communication with people:

    • self-closure;
    • suspiciousness, incredulity;
    • rupture of contacts with friends and acquaintances.
  5. Change of interest:

    • lack of interest in the former increase;
    • unexpected interest in what was previously indifferent.
  6. Changes in perception:

    • feeling of extraneous influence, surveillance;
    • changes in the perception of noise, color and smells.

Often these signs are attributed to transitional age, hormonal disruptions, etc. Do not listen to anyone, trust your feelings! If you are experiencing these symptoms, see your doctor. This will prevent the further development of mental illness at an early stage.

However, if the moment is missed, then psychosis can have extremely negative manifestations.

Manic-depressive psychosis

Manic-depressive psychosis is one of the most common forms of the disease. It is characterized by the alternation of manic and depressive phases with healthy periods. The duration of one phase is from three months to two years, the healthy period is usually longer and takes an average of 3.5 years.

Symptoms of depressive psychosis:

  • sad mood;
  • stiffness of movements;
  • inhibition of thought processes.

With depressive psychosis, the patient is indifferent to everything and extremely depressed. He answers all questions in monosyllables, with a delay. Can spend a long time in one position, almost without movement - lying or sitting on the bed.

The depressive phase is characterized by a rapid increase in the disease to a certain peak. At this time, a feeling of worthlessness and meaninglessness of life can push the patient to suicide. After a short period, the disease gradually fades away.

Symptoms of manic psychosis:

  • elevated mood;
  • acceleration of thought processes;
  • psychomotor agitation.

With manic psychosis, a person has everything around him that pleases him. The patient laughs a lot, communicates with people, actively gesticulates during dialogues. He often overestimates his strength, nominates himself for candidates that he does not match. Sleeps little and eats a lot.

The manic phase is usually shorter than the depressive phase and lasts from several days to several months. A seasonal course of the disease is characteristic - more often patients fall into a depressive phase in the fall, and into a manic phase in the spring.

The “positive” side of manic-depressive psychosis is the absence of progressive personality changes, even with a long course of the disease. However, not all types of the disease are like this.

Alcoholic psychosis

Alcoholic psychosis is the general name for mental illness that occurs due to alcohol abuse. They are characterized by specific changes in the central nervous system and internal organs.

The most common type of alcoholic psychosis is delirium tremens. It occurs when there is a sharp reduction in alcohol consumption due to illness or injury.

She is characterized by the following symptoms:

  • sleep disorders;
  • causeless anxiety;
  • excessive sweating;
  • changeable mood;
  • depressed state;
  • trembling of hands and feet;
  • increased heart rate.

During the day, the patient's condition is satisfactory, and at night there is delirium, auditory, visual and tactile hallucinations. It seems to a person that insects are crawling on him, he sees dead relatives, he hears reproaches from various voices.

If left untreated, alcoholic psychosis causes serious complications - a person becomes stupid, dumb and forgets a lot of information known to him. In addition, irreparable damage to internal organs is caused. Perhaps the development of cirrhosis of the liver, coronary heart disease, stomach ulcers, etc.

Treatment of psychosis

Psychosis, as a rule, requires hospitalization so that the patient cannot harm himself or those around him.

The rehabilitation course includes drug therapy along with psychological help. In addition, physiotherapy is used, which relieves emotional stress and training programs that develop a positive outlook on the world in a person.

Remember that the timely start of treatment for psychosis of any kind is the key to a speedy return to your usual way of life and the prevention of irreversible mental abnormalities.

Psychosis - Hadassah Medical Moscow

Psychosis is a mental illness. Under it, a person cannot adequately behave, he does not perceive the world around him and does not react to it. At the initial stages, psychosis can be recognized by changes in behavior, atypical reactions appear in a person, and the emotional background is disturbed. He can't handle his

feelings, expresses emotions inappropriate to situations. If you or your loved ones experience these symptoms, you should immediately consult a doctor. The appearance of psychosis may indicate the development of schizophrenia, delirium tremens, senile dementia and other serious diseases.

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Symptoms of psychosis

Psychosis is a group of psychotic disorders. Their manifestations depend on the specific type of violation. However, all of them are characterized by a gradual increase in signs, a change in behavior. You can recognize the symptoms of psychosis by the following manifestations:

  • Hallucinations - can be auditory, visual, gustatory, tactile, olfactory;
  • Delusional ideas - there are obsessive thoughts and judgments that do not correspond to reality. A person may feel that he is being watched;
  • Movement disorders - periods of excitement are replaced by a sharp stupor;
  • Mood disorders - apathy, melancholy, indifference to everything;
  • Manic disorders - excessive aggressiveness, building unrealistic plans, a sharp addiction to alcohol, promiscuity;
  • Emotional disorders - a person cannot express his feelings, he does not correlate his feelings with what is happening.

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Causes of psychosis

Psychosis occurs due to problems in the work of neurons. Due to the violation of bonds in the molecules, they do not receive nutrition, they experience a lack of oxygen. This leads to the fact that neurons cannot transmit nerve impulses - multiple disorders occur in the central nervous system. The type of psychosis that occurs depends on which part of the brain suffered from a hunger strike. The causes of this disease are of 3 types:

  • Endogenous, associated with internal processes. These can be endocrine, neurological disorders, bronchial asthma, vitamin B deficiency, conditions accompanied by acute pain (ulcer, heart attack, sarcoidosis), electrolyte imbalance, systemic diseases, genetic predisposition, age;
  • Exogenous or external: stress, intoxication with alcohol, drugs, drugs, consequences of infectious processes, mental trauma;
  • Organic, when changes in the brain become the cause of psychosis: tumors, injuries, hemorrhages.

Methods for diagnosing psychosis

Psychosis is diagnosed by a psychologist. At the first appointment, he conducts a pathopsychological examination: he studies human behavior, asks questions to determine the process and course of thinking. It is necessary to understand how the patient reacts to the world around him. Relatives of a sick person are also involved in the diagnosis of psychosis - they will help to collect a complete clinical picture. Further diagnostics include

X-ray of the brain

MRI of the brain


Blood test for hormones

Urinalysis for drugs and alcohol

Treatments for psychosis

Psychosis is usually treated in a hospital setting. Such patients require hospitalization, as they cannot control their actions, they can harm themselves and others. The basis of therapy is taking medications, including:

  • Antipsychotics - stop psychosis, relieve delusions and hallucinations;
  • Atypical antipsychotics - restore neurochemical connections;
  • Nootropics - restore brain function, improve mental activity;
  • Normotimics - prevent the development of depressive and manic tendencies;
  • Antidepressants - relieve symptoms of depression.

Treatment of psychosis necessarily includes psychotherapy. The patient will have to work with a psychologist for a long time in order to successfully return to society. In some forms of the disease, an electroconstrictive effect is shown, in which the current restores the metabolic processes of the nervous system in the brain. A good effect in the treatment gives physiotherapy: acupuncture, exercise therapy, reflexology.

Prevention and treatment programs for psychosis at the Hadassah Clinic

Psychosis is a relapsing disease. With timely and comprehensive treatment, the prognosis will be favorable. However, the patient will have to undergo preventive examinations for several more years. If the patient follows all the recommendations of the doctor, the likelihood of exacerbations in the future will be minimal. To prevent the development of psychosis, you need to monitor your physical and mental health. For this:

  • Eat a healthy and balanced diet;
  • Give up bad habits, especially the use of alcohol and drugs;
  • Avoid stressful situations;
  • Avoid physical and psycho-emotional overload;
  • Seek medical attention for any head injury;
  • See a psychotherapist if necessary;
  • Observe the regime of the day;
  • Communicate more.

Psychosis is an insidious and dangerous problem. And it is very important to notice it in time and start treating it. If you see signs of approaching psychosis in yourself or loved ones, you should immediately consult a doctor. You can make an appointment at the Hadassah clinic in Moscow, where experienced specialists will determine the cause of psychosis and select an effective treatment regimen.


Olga Pavlovna

Endocrinologist, dietitian, Ph.D.

Work experience: 11 years

Published: 05/12/2020

Updated: 05/14/2021

Checked: 06/20/2022

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