Psychosis

Psychosis is when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions).

The 2 main symptoms of psychosis are:

hallucinations – where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices
delusions – where a person has strong beliefs that are not shared by others; a common delusion is someone believing there's a conspiracy to harm them

The combination of hallucinations and delusional thinking can cause severe distress and a change in behaviour.

Experiencing the symptoms of psychosis is often referred to as having a psychotic episode.

When to seek medical advice

You should see a GP immediately if you're experiencing symptoms of psychosis.

It's important psychosis is treated as soon as possible, as early treatment can be more effective.

The GP may ask you some questions to help determine what's causing your psychosis.

They should also refer you to a mental health specialist for further assessment and treatment.

Find out more about diagnosing psychosis

Getting help for others

If you're concerned about someone you know, you could contact a GP for them.

If they're receiving support from a mental health service, you could contact their mental health worker.

If you think the person's symptoms are severe enough to require urgent treatment and could be placing them at possible risk, you can:

take them to the nearest A&E, if they agree
call their GP or local out-of-hours GP
call 999 and ask for an ambulance

A number of mental health helplines are also available that can offer expert advice.

Find out more about how to get help for others

It's sometimes possible to identify the cause of psychosis as a specific mental health condition, such as:

schizophrenia – a condition that causes a range of psychological symptoms, including hallucinations and delusions
bipolar disorder – a mental health condition that affects mood; a person with bipolar disorder can have episodes of low mood (depression) and highs or elated mood (mania)
severe depression – some people with depression also have symptoms of psychosis when they're very depressed

Psychosis can also be triggered by:

a traumatic experience
stress
drug misuse
alcohol misuse
side effects of prescribed medicine
a physical condition, such as a brain tumour

How often a psychotic episode occurs and how long it lasts can depend on the underlying cause.

Treatment for psychosis involves using a combination of:

antipsychotic medicine – which can help relieve the symptoms of psychosis
psychological therapies – the 1-to-1 talking therapy cognitive behavioural therapy (CBT) has proved successful in helping people with psychosis, and family interventions (a form of therapy that may involve partners, family members and close friends) have been shown to reduce the need for hospital treatment in people with psychosis
social support – support with social needs, such as education, employment or accommodation

Some people are recommended to take antipsychotics on a long-term basis (and possibly for the rest of their lives). Other people may be able to gradually reduce their dosage and then stop taking them altogether if there is a marked improvement in symptoms.

Do not stop suddenly taking any prescribed medicines as this could trigger a relapse of your symptoms.

If a person's psychotic episodes are severe, they may need to be admitted to a psychiatric hospital for treatment.

Complications of psychosis

People with a history of psychosis are more likely than others to have drug or alcohol misuse problems, or both.

Some people use these substances as a way of managing psychotic symptoms.

But substance abuse can make psychotic symptoms worse or cause other problems.

Self-harm and suicide

People with psychosis have a higher than average risk of self-harm and suicide.

See a GP if you're self-harming.

You can also call the Samaritans, free of charge, on 116 123 for support.

The mental health charity Mind also has some useful information and advice.

If you think a friend or relative is self-harming, look out for signs of unexplained cuts, bruises or cigarette burns, usually on the wrists, arms, thighs and chest.

People who self-harm may keep themselves covered up at all times, even in hot weather.