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Psychosis information

Psychosis is the term used to describe a condition which makes people see, hear or believe things that other people don't experience or share. A person suffering from a psychotic illness becomes out of touch with everyday reality.

About three out of every 100 people will experience a psychotic episode in their lives. Most people make a full recovery from the experience. Psychosis is most likely to occur in young adults.

Sometimes names like 'psycho' or 'split personality' are used to describe a person with psychosis. It's important to know that these terms are not accurate. They are also very unhelpful for someone who is already having a difficult time.

What causes psychosis?

A lot of people have heard voices during their lives – often during or after a stressful or traumatic event such as the loss of a loved one or a difficult family situation.

If the voices are not unpleasant or don't come back then many people do not see this as an issue.

However, psychosis can be very unpleasant and extremely frightening and distressing for the person and those around them.

Anyone can experience a psychotic episode. A short episode can be caused by not having enough sleep, having a fever, or use of alcohol and street drugs. Cannabis can trigger psychotic experiences in some people.

Most experts, however, generally agree that stress and trauma can contribute to an individual developing psychosis.

There is also evidence to suggest that psychosis has a genetic basis (i.e. it's something that's passed down in your genes by your family). A difficult family situation might also contribute.

Many people who experience psychosis have been physically, emotionally or sexually abused. These traumas can make people very anxious and suspicious in life and cause problems with self-esteem.

Who is more likely to experience psychosis?

A first episode of psychotic illness will often occur when someone is in their late teens and early twenties.

Psychosis affects males and females equally, but men usually develop it at an earlier age.

What are the signs and symptoms of psychosis?

If you experience psychosis, you will find your thoughts are very muddled and you may find it hard to communicate.

The psychosis distorts your senses, making it very difficult for you to tell what is real from what's not real. It can be extremely upsetting and disrupt your life, as it makes relationships and everyday situations difficult.

One of the key signs of a serious psychotic illness is that the person affected doesn't realise there's a problem. They cannot understand (at the time) that other people don't share what they're experiencing and that their behaviour is different to normal.

Psychotic symptoms include hearing, smelling, tasting and seeing things which don't seem to be caused by anything. Other people cannot see (or hear) what you are experiencing.

Hearing voices is the most common symptom of psychosis and is actually a very common experience. The voices may be the voices of people you know or you might not recognise them.

Other psychotic symptoms can include delusions and feelings of paranoia.

How is psychosis normally diagnosed?

Mental health professionals will look at your problems as a whole and make a diagnosis on the basis of your symptoms. They will also probably use information from your GP and your family, as well as your past medical history.

Depending on your symptoms you may be given a diagnosis of severe depression, schizophrenia, bipolar disorder (manic depression), paranoia, or psychotic illness.

A psychiatrist will give you information about your condition and discuss options for treatment with you.

How is a psychotic illness normally treated?

Most people diagnosed with psychosis will be offered antipsychotic medication (major tranquillisers or neuroleptics which are often effective in alleviating the symptoms). Some can have unpleasant side effects (extreme tiredness and movement problems for example) although the newer types ('atypicals') have fewer side-effects.

There is some good evidence that treatments such as counselling, psychotherapy and cognitive behavioural therapy (CBT) in particular, can help to relieve some of the symptoms of psychosis. These 'talking therapies' can also help to reduce the frequency of the episodes.

Talking about the problem can help you to develop coping strategies and to understand about psychosis. They can also help to tackle some of the underlying anxiety or issues that may trigger the episodes.

If you have an episode that is particularly severe, you may need to go into hospital or an adolescent unit.

If the psychosis is very serious or your behaviour means you are a danger to yourself and possibly to others, then you may be sectioned.

Your psychiatrist will see if medication is going to be helpful for you and if so, which drug at what dosage will work best. You may need to take the drug every day, or just when you are experiencing an episode.

Group therapy as well as learning relaxation techniques can be of real benefit to people who have psychotic episodes. Meditation can also be very beneficial, but is recommended only when you are feeling well and not during an episode.

Family therapy can also be a very useful treatment. This involves talking with your parents and any brother and sisters as a group. This can make the family a stronger and more supportive unit, which can help you when you have an episode. It can also help to resolve any difficult issues or tensions within the family.

What's going to help?

Getting help as early as possible for this condition is really important. Treating it quickly, learning about the condition can really improve your chances and prevent regular relapses.

If medication is required it is important to take it regularly as prescribed.

Looking forward

Psychosis is treatable and most people recover.

The pattern of recovery is not the same for everyone but most people get better after the first episode. A lot of these people never have another psychotic episode.

However, some people may be affected by repeated but short episodes throughout their lives. For a minority of people, they have psychosis as a long-term ongoing problem, which can be much harder to manage.

However serious the difficulties, there are always treatments and ways of coping that can relieve your symptoms. Many people are still able to lead rewarding lives and achieve the things they set out to do.

More information

Last reviewed by Great Ormond Street Hospital: 18 June 2008