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Psychosis

Psychosis occurs when an individual loses touch with reality—a break that can be terrifying to experience or to observe in a loved one. Psychosis can include hallucinations, delusions, disorganized speech, and abnormal movements. Hallucinations—perceiving something that doesn’t exist—and delusions or false beliefs are hallmarks of psychosis. Disorganized speech may manifest as incoherent babbling and abnormal movements can include motionlessness, a state called catatonia.

Psychosis is a symptom, not a classifiable disorder in and of itself. Persistent symptoms of psychosis may lead to a diagnosis of a schizophrenia spectrum disorder, such as schizophrenia, schizoaffective disorder, or schizophreniform disorder. Psychosis can also be a symptom of bipolar disorder. But psychosis can arise from other sources, such as sleep deprivation, alcohol, or drugs. It is important to seek professional help as soon as psychosis is experienced or suspected.

For signs, causes, and treatment of schizophrenia, see our Diagnosis Dictionary.

Understanding Psychosis

Before young adults experience their first psychotic episode, they often show signs that something is awry. Their behavior may seem unusual, confused, or withdrawn, and they may begin to struggle in school or at work. Seeking help during this phase or active psychosis is key. Treatment can allow individuals to manage the condition and continue along their life path during the years of early adulthood.

What are early warning signs and symptoms of psychosis?

Behavioral changes may be experienced and observed prior to a full psychotic episode. Those signs include:

• Withdrawal from friends and social activities

• A drop in grades or job performance

• Blunted emotion or inappropriate emotion

• An inability to think clearly and the sense that something is "off"

• Suspicions about the behavior of others

Aggression toward others

Memory problems and distractibility

• Sensitivity to stimuli such as bright lights, noise, colors, and textures

• Peculiar use of words and phrases, and mangled syntax

• Rapid speech and nonsensical statements.

What is first episode psychosis (FEP)?

Psychosis most often emerges in adolescence and young adulthood. In fact, around 100,000 individuals in the U.S. experience a first episode of psychosis, or FEP, each year. This may be preceded by a phase when their grasp on reality cracks and slips away. They may perceive things that aren't there, misinterpret social interactions, or struggle with abstract thought.

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Causes of Psychosis

Scientists still don’t have a clear understanding of what causes psychosis. Genetics plays a role, because the risk of developing schizophrenia is higher for twins and immediate relatives with the condition. But the development of psychosis encompasses much more than one’s genetic profile—it’s likely due to a combination of biological, psychological, and social factors. For those who are more vulnerable to it, psychosis can emerge due to stress, trauma, or other events.

What triggers a psychotic episode?

Psychotic episodes, in some cases, may be sparked by specific triggers. In addition to the underlying presence of conditions such as schizophrenia and bipolar disorder, symptoms may be provoked by anxiety and stress, alcohol or drug use, and lack of sleep.

Can cannabis cause psychosis?

The relationship between psychosis and cannabis is complicated, and it’s difficult to disentangle whether one causes the other. But some research suggests that using cannabis on a daily basis and using cannabis with high THC content are associated with increased odds of developing psychosis.

Treating Psychosis

A single episode of psychosis—especially the first (First Episode Psychosis) can be controlled with medication; and a recurrence can often be prevented once the underlying cause is identified. To prevent further episodes, it is critical to seek treatment immediately.

Symptoms of psychosis are treated with both antipsychotic medications and psychotherapy. Antipsychotics can take the form of pills, liquids, or monthly injections. Hallucinations tend to subside in a couple of days and delusions in a few weeks, but medications require around six weeks to be fully effective. When individuals adhere to a treatment plan, even those who have experienced multiple psychotic episodes can manage their symptoms effectively and lead fulfilling lives.

Can psychosis be cured?

While psychosis can be successfully managed over time, there is no medication or therapy that targets and cures the underlying disorder. Treatment instead focuses on curbing the symptoms of psychosis with therapy and medication so that the individual can live a functional, full life.

Why is it important to treat psychosis early?

Treatment is more successful when it begins right after symptoms emerge, research finds. One theory is that brain changes may spread during the delay. Perhaps more intuitively, early treatment prevents young adults from missing key developmental milestones, such as getting a job, going to college, or forging relationships.

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