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What are the symptoms of psychosis?

Psychosis is a ‘loss of contact with reality’. It typically refers to:

Hallucinations: Hearing seeing, tasting or smelling things that other people cannot. For example, hearing your name being called when there is no one there.

Unusual beliefs: You might strongly believe something that others don’t. For example, you may think that the government is spying on you, that people want to harm you, or that you have special powers.

Changes in thinking: Everyday thoughts can become confused, making sentences unclear or hard to understand. For example, you might have difficulty concentrating, following a conversation or remembering things. Thoughts can seem to speed up or slow down.

Changed feelings & behaviours: How you feel can change for no obvious reason. For example, you might feel strange or cut off from the world, you might experience mood swings or feel unusually excited or depressed. This may lead to you experiencing difficulties in everyday living. You may seem to feel less emotion or show less emotion to those around you and you may lose interest in things that you previously valued and enjoyed.

How common is psychosis?

Around 3% of people will experience a psychotic experience, of some kind, during their lifetime. Although an individual can experience a first episode of psychosis at any age, this typically occurs between the ages of 14 and 35.

What causes psychosis?

There is no single known cause of psychosis. It is probable that genetic, biological and environmental (social and psychological) factors all play a part. Each individual will likely have a different combination of these factors.

Psychosis can often be a response to things that happen in our lives, particularly traumatic or stressful events. These could include relationships, family difficulties, abuse or loss.

Substance Misuse:
Using drugs such as Cannabis, Amphetamine, or other new psychoactive substances such as ‘Spice’ can increase your risk of developing psychosis.

If you have a family member with psychosis, you are more likely to experience the condition. However, the majority of people with a close relative with psychosis, won’t experience psychosis themselves. Various brain chemicals may play a part in psychosis including Dopamine and Glutamate, and some of the causes and treatments of psychosis can influence these brain chemicals.

Life experiences are linked to how we experience and interpret the here and now (beliefs about self, world, and others), negative emotional stages, coping skills.
Increasingly we see the link between life events and psychosis, with our past experiences, affecting how we experience and interpret things that happen to us now. Psychosis can sometimes have an origin, past events can impact how you experience things that can happen in the here and now. For example, someone who is bullied as a child could develop beliefs that other people may be untrustworthy or likely to cause them harm. The way that you make sense of things and reach conclusions can also be affected by how you feel. For example, if you are feeling stressed or anxious the way that you view others or the world may be different in comparison to when you are feeling happy and relaxed.


The Stress Vulnerability Bucket

This bucket represents your ability to cope with stress. People who have a large capacity to cope with stress and are very resilient have a ‘large bucket’. the size of your bucket is down to a lot of things from your background, like being bullied or being abused as a child. the more of these issues from your background that you have, the smaller the bucket.

When you have to worry or something stressful happens, it fills up the bucket, one by one. Perhaps you’re having a tough time at college or work, then you get an unexpected bill to pay, and then you find out someone close to you is unwell. If your bucket gets too full then it overflows and this is when unusual experiences can occur. For example, hearing voices or becoming extremely worried about other people wanting to hurt you.

It’s possible to reduce the stress in your bucket by employing helpful ways of coping. This is like punching holes in the bottom of the bucket. Different coping strategies work for different people but good examples are talking about your problems through with others or getting a good night’s sleep.

If you cope by doing unhelpful things, then that could make the stress worse. This is like blocking the holes in your bucket. Unhelpful ways of coping are things like taking drugs, drinking too much alcohol, or keeping your problems to yourself.
Have a look at the picture above and think about which things fill up your bucket and which things you could do to cope and make a few holes in the bucket.

The phases of psychosis

In a typical case of psychosis, it can be thought of as having three stages; the prodromal phase, the acute phase and the recovery phase.

Prodromal phase:
You may notice that you have difficulty following your normal routines, such as washing, dressing, or going to school or work. You may withdraw from family and friends and lose interest in your hobbies. During this period some people also develop a feeling that “things do not seem right” or that something strange is beginning to happen. People can also begin to feel anxious or depressed. This is also described as the ‘at risk’ phase. Whilst most people with these experiences don’t go on to develop psychosis, if they are distressing you or impacting your life, then you should consider approaching your GP or someone who you trust such a parent or tutor.

Acute phase:
During this phase, you would experience the symptoms of psychosis, such as hallucinations, unusual beliefs and changes in thinking. This is the stage where you would most commonly be referred to mental health services or to an Early Intervention Service, who will discuss treatment options with you. It may also be possible for you to refer yourself, or for your family to refer you, directly to an Early Intervention Service.

Recovery phase:
At this stage, people start to recover, experience less of the distressing symptoms and begin to re-establish relationships with friends and family. This is also the time that people consider their plans for the future such as work, education and training. The Early Intervention Service will provide ongoing support throughout this period.

It is important to know that most people make a good recovery from psychosis

When should I seek help?

You should seek help from your GP immediately if you have concerns about your mental health. The earlier you seek help the better. Your GP may ask you some questions to help determine what’s causing your psychosis. They may refer you to a mental health specialist for further assessment and treatment.

What help is available?

Most people will find that they require help from a professional, to deal with psychosis.

Following an initial assessment, the teams provide support for up to three years for individuals experiencing psychosis symptoms and their families. In some areas, the teams work alongside Child and Adolescent Mental Health Services (CAMHS) with 14-16-year-olds.
The assessment and support you will receive will depend on the service provided in your area – click here to find your nearest service.

In general, this may include:

  • Help individuals and families to increase their understanding of what is happening
  • Reduce the level of distress caused by unusual experiences
  • Provide proven treatments and therapies such as Physical Health Monitoring, Behavioural Family Therapy (BFT), Medication and
    Cognitive Behavioural Therapy for Psychosis (CBTp).
  • Prioritise personal recovery and a quick return to valued roles and social relationships.