What are Psychosis and Early Psychosis?
Psychosis is characterized by the temporary inability to distinguish what is real from what isn’t real. Losing touch with reality in this way is called a psychotic episode. During a psychotic episode, a person may see or hear things that don’t exist. They may believe things that aren’t true. Early psychosis, also referred to as first-episode psychosis (FEP), is when an individual first begins to experience a break with reality. Seeking help for psychosis, especially for early psychosis, is critical because the earlier treatment begins, the better the outcome.
It is important to understand that psychosis is not a psychiatric condition, rather it is a symptom of serious mental illness or it can be related to another condition. (See below for more information on Types of Psychotic Disorders and Psychosis in Related Conditions.)
Who Experiences Psychosis or Early Psychosis?
There are several myths surrounding psychosis. Many assume it’s rare, but studies show that about 3 in every 100 people will experience at least one psychotic episode in their lifetime. Each year, an estimated 100,000 adolescents and young adults in the U.S. experience their first episode.
Another misconception is that individuals with psychosis are violent. In truth, people experiencing psychosis are no more likely to be violent than anyone else. However, they may be at increased risk of self-harm.
Common Symptoms of Psychosis
During a psychotic episode, a person may find it hard to carry out daily tasks. Symptoms may include:
- Feelings of anxiety or depression
- Lack of motivation
- Sleep disturbances
- Social withdrawal
What Causes Psychosis?
During a psychotic episode, a person may find it hard to carry out daily tasks. Symptoms may include:
Genetics: A family history of psychosis increases risk
Trauma: Experiencing trauma can trigger psychotic symptoms
Substance use: Drugs such as cannabis, LSD, amphetamines, and alcohol are strongly linked to psychosis, particularly in individuals with a genetic predisposition. Studies show that 74% of people with early psychosis have had a substance use disorder at some point
Head trauma: Brain injuries can raise the risk of developing psychotic symptoms later
Neurological conditions: Disorders like Alzheimer’s, Parkinson’s, strokes, and brain tumors may lead to psychosis
Mental health disorders: Psychosis often occurs in conditions like schizophrenia, bipolar disorder, and severe depression
Infections: Ongoing infections (e.g., Lyme disease) have been linked to psychotic episodes
Hormonal changes: Puberty-related hormone fluctuations increase vulnerability in teens and young adults
Sleep deprivation: Chronic lack of sleep can result in psychotic-like symptoms
Medication reactions: Certain antibiotics, painkillers, and muscle relaxants have been known to induce psychosis in some individuals
Warning Signs of Psychosis and Early Psychosis
Key Features of Psychosis:
- Hallucinations: Hearing voices or seeing things that aren’t present
- Delusions: Strong false beliefs (e.g., believing one has special powers or is being controlled by outside forces)
- Disorganized thinking: Illogical speech, disconnected thoughts, or incoherence
- Erratic behavior: Agitation, confusion, or unpredictable actions
- Difficulty focusing: Trouble with attention or memory
- Catatonia: Little to no responsiveness or movement
Early Warning Signs of Psychosis:
- Declining ability to concentrate
- Increased suspicion or paranoia
- Isolating from friends or family
- Decline in academic or job performance
- Neglecting personal hygiene or self-care
- Changes in emotional expression
- Difficulty sleeping
Types of Psychotic Disorders
Psychotic disorders are mental health conditions where psychosis is a central or defining symptom. These disorders can significantly impair an individual’s perception of reality. Below are some of the most recognized types of psychotic disorders:
A chronic mental illness that disrupts a person’s perception of reality, leading to hallucinations, delusions, and disorganized thinking.
This condition presents a combination of schizophrenic symptoms (such as hallucinations or delusions) along with features of a mood disorder, such as depression or bipolar disorder.
Individuals with this disorder often display odd beliefs, eccentric behavior, and social difficulties, along with paranoia or magical thinking.
The main feature is persistent false beliefs (delusions) that are not influenced by logic or contradictory evidence, even when other aspects of life remain relatively normal.
A short-term psychotic episode that typically occurs suddenly and may be linked to acute stress or trauma. Symptoms usually resolve within a month.
Psychosis in Related Mental Health Conditions
Psychosis can also occur as a secondary symptom in several other psychiatric conditions:
- Bipolar Disorder: Individuals may experience hallucinations or delusions during manic or depressive episodes.
- Psychotic Depression: A form of major depressive disorder where psychotic features, such as delusions or hallucinations, are present.
- Postpartum Psychosis: A rare but severe perinatal mental health condition that typically emerges shortly after childbirth.
- Substance-Induced Psychosis / Dual Diagnosis: Drug or alcohol use can trigger psychotic symptoms, particularly in individuals with an underlying mental health disorder.