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

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What is Psychosis?

Psychosis is a disruption to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t, including seeing, hearing and believing things that aren’t real or having strange, persistent thoughts, behaviors and emotions. Everyone’s experience is different, but most people say psychosis is frightening and confusing. Early or first-episode psychosis (FEP), refers to when a person first shows signs of beginning to lose contact with reality.

Psychosis includes a range of symptoms, but typically involves hallucinations or delusions or both.

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

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

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:

  • 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.

Causes of Psychosis

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

Several factors that can contribute to psychosis, including genetics or physical or mental trauma. In addition, the use of marijuana, LSD, amphetamines and other substances can increase the risk of psychosis in people who are already vulnerable.

Warning Signs BEFORE Psychosis

Early psychosis or First-Episode Psychosis (FEP) rarely comes suddenly. Usually, a person has gradual, non-specific changes in thoughts and perceptions. 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. Getting help early and beginning 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 and 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 identify the problem. A mental health professional can determine if a mental health condition is involved and discuss next steps.

Diagnosis and Treatment

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 receive treatment, the better their long-term quality of life.

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. There are many specialized centers that focus exclusively on psychosis and crisis treatment in youth.

Helping Someone Who has a Psychotic Episode

Going through a psychotic episode or watching a loved one experience one can be traumatic. If you or someone you know is in crisis, get help quickly. In East Texas, Burke has a 24-Hour Crisis Hotline: 1-800-392-8343. 

For non-crisis care, you can call Burke at 936-634-5010 for more information or to schedule an appointment.


This content was developed from information posted by the National Alliance on Mental Illness. Visit for more information.

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