Approximately three in 100 people will experience a psychotic episode at some point in their life. Some people only experience a few episodes of psychosis or a brief episode that lasts for a few days or weeks. Others will experience symptoms more frequently, in association with a longer-term illness such as schizophrenia. The first episode of psychosis usually occurs in a person's late teens or early 20s.
Confused thinking and psychosis
In psychosis, the everyday thoughts that enable us to lead our daily lives become confused. Words and ideas lose their meanings or take on meanings that make no sense. This is usually recognisable to others through changes in speech, which can include:
- speaking very quickly or slowly
- changing topics frequently
- speaking in muddled-up sentences
- using the wrong words to describe things
- making up words.
These disturbances in thinking can affect a person's ability to concentrate, remember things and to make plans. These effects can persist, even after the psychotic episode has subsided.
Delusions and psychosis
Delusions are false beliefs that are not shared by others. Delusions can take various forms, including:
- paranoid delusion – for example, the person believes they are being watched and singled out for some harmful purpose
- grandiose delusion – for example, the person believes they have special powers or that they are an important religious or political figure
- reference delusion – the person believes they are receiving special messages or codes – for example in TV shows, songs or advertising
- control delusion – the person believes their thoughts are being controlled or influenced by outside forces – aliens, some real or invented group, an individual or something more vague
- somatic delusion – the person believes something has happened to their body: something is wrong with it, some part of it is missing or dead, or that they are infested with disease or parasites
- depressive delusion – for example, the person believes they are guilty of some terrible crime.
Hallucinations and psychosis
A hallucination is when someone hears, sees, smells or tastes something that isn't there. A common form of hallucination is to hear voices that aren't there. Hallucinations can lead to agitation, distress and even hostility.
Low motivation and psychosis
The effect of psychotic symptoms on the brain can make it difficult for a person to translate thought into action. They may become very lethargic (sluggish). Even getting up in the morning or doing the dishes may feel like impossible hurdles.
Changed feelings and psychosis
Psychosis can lead to changes in emotions. It may become difficult for the person to:
- communicate their feelings
- distinguish what their emotions are
- know how to react to things.
Types of psychotic illness
There are many factors that can produce psychotic symptoms. Some examples are:
- brief reactive psychosis – psychotic symptoms lasting less than a month and due to a very stressful event
- drug induced psychosis – caused by drugs such as alcohol, speed, LSD, marijuana, ecstasy or magic mushrooms. The symptoms last until the effects of the drugs wear off (hours or days)
- schizophrenia – most people affected by schizophrenia experience a range of psychotic symptoms and commonly have difficulty organising their thoughts
- bipolar disorder – involves very extreme moods (either very high or very low) that can lead to psychotic symptoms
- severe depression – depression can be so intense that it causes psychotic symptoms.
Causes of psychosis
The causes of psychosis are not fully understood. It is likely that psychosis is caused by a combination of hereditary and other factors. Psychosis may be associated with a chemical imbalance in the brain. Stress and certain drugs (for example, marijuana, speed or LSD) can trigger the first episode of psychosis.
Diagnosis of psychosis
When someone experiences an episode of psychosis, a full medical examination is required. A period of observation by a team of mental health professionals will be necessary (either in the home or in hospital). Psychosis caused by drugs or other diseases will be checked for first.
Treatment for psychosis
Treatment can do much to relieve, or even eliminate, the symptoms of psychosis. Treatments include:
- medication – certain medications help the brain to restore its normal chemical balance
- community support programs – ongoing support is needed to help a person with psychosis to keep living independently in the community. Support may include help with accommodation, finding suitable work, and assistance with the development of social and personal skills
- psychological therapy such as psychotherapy, cognitive-behaviour therapy and family therapy
- family support
- self-help groups
- avoiding alcohol or other drugs
- reducing and learning how to manage stress
A long period of convalescence from an episode (weeks, months or even longer) may be needed.
Where to get help
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