What is psychosis?
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Psychosis affects people in different ways. You might experience it once, have short episodes throughout your life, or live with it most of the time.
Some people have positive experiences of psychosis. For example, if you see the faces of loved ones or hear their voices you may find this comforting. Some people say it helps them understand the world or makes them more creative.
However, for other people psychosis can be a very difficult or frightening experience. You may find that it:
affects your behaviour or disrupts your life
makes you feel very tired or overwhelmed
makes you feel anxious, scared, threatened or confused
leaves you finding it very difficult to trust some organisations or people.
It can also be upsetting if people around you dismiss your experiences as untrue when they seem very real to you. You may feel misunderstood and frustrated if other people don't understand.
Symptoms
Hallucinations
Hallucinations could include:
seeing things that other people don't (for example people's faces, animals or religious figures)
seeing objects that seem to be distorted or move in ways that they usually wouldn't
experiencing tastes, smells and sensations that have no apparent cause (for example feeling insects crawling on your skin)
Hearing voices that other people don't (these could be positive and helpful or hostile and nasty).
Delusions
Lots of people have beliefs that many other people don't share. But a delusion is usually a belief that nobody else shares and which other experiences or perceptions show cannot be true. It is natural for delusions to feel completely real to you when you are experiencing them.
You might think that you are a very important person. For example, you may believe that you are rich and powerful or that you can control the stock markets or the weather. These kinds of beliefs are sometimes called 'delusions of grandeur'.
Some people find that they can spend a lot of money or take on a lot of debt while they are experiencing psychosis, because their sense of reality has been affected.
Some delusions can be very frightening and can make you feel threatened or unsafe. For example, you might feel that something or someone is trying to control, harm or kill you (even when you have no reason to believe this). These ideas are sometimes called paranoid delusions.
Disorganised thinking and speech
Hallucinations and delusions can make your thoughts and emotions feel confused and disorganised, but disorganised thinking (sometimes called 'formal thought disorder') can also be a specific type of psychosis.
Mental health professionals may use the following terms to describe what you are experiencing:
Racing thoughts is when your thoughts go through your head very fast. It can involve them racing so fast that they feel out of control.
Flight of ideas is where your thoughts move very quickly from idea to idea, making links and seeing meaning between things that other people don't.
Many people find that they experience racing thoughts and flight of ideas at the same time. If you have disorganised thinking you might:
speak very quickly and stumble over your words so that other people may find it difficult to understand what you're saying
link words together because of the way they sound rather than what they mean, which can make your speech sound jumbled to other people (this is sometimes called word salad)
change the topic of conversation very quickly as your thoughts move from one thing to another
find it difficult to keep your attention on one thing.
You may also have racing thoughts and flight of ideas if you experience mania or hypomania. If you only experience them during a depressive, manic or mixed episode then you may be given a diagnosis of bipolar disorder.
Causes
The cause of psychosis can be different for everyone, and research into it is happening all the time. Psychosis could be triggered by a number of things, such as:
Physical illness or injury. You may see or hear things if you have a high fever, head injury, or lead or mercury poisoning. If you have Alzheimer's disease or Parkinson's disease you may also experience hallucinations or delusions.
Abuse or trauma. If you have experienced abuse or a traumatic event, you are more likely to experience psychosis. This includes experiences of racism.
Recreational drugs. Researchers still aren't sure whether using recreational drugs directly causes psychosis but you may be more likely to hear or see things as a result of taking certain recreational drugs, like cannabis and LSD. If you have already experienced psychosis, using recreational drugs can make the symptoms worse, in particular if you take high-potency cannabis ('skunk').
Alcohol and smoking. Drinking alcohol and smoking may also stop medication from effectively treating your symptoms, making relapse more likely.
Prescribed medication. You might also experience psychosis as a side effect of some prescribed drugs or while you are coming off psychiatric drugs.
Hunger. You may experience hallucinations if you are very hungry, have low blood sugar or if you are not getting enough food.
Lack of sleep. You may experience hallucinations if you have a severe lack of sleep.
Bereavement. If you have recently been bereaved, you may hear them talking to you. You may also feel that they are with you even though you can't see them.
Spiritual experiences. Some people experience voices or visions as part of a spiritual experience. This may be a positive experience for you. It may make you feel special or important and help you make sense of your life. It could, however, also be a negative experience – for example, you may feel that you're possessed by an evil spirit.
Genetic inheritance. You are more likely to develop psychosis if you have a parent or sibling who has experienced psychosis, but researchers aren't sure why this happens.
Treatment
For many people, there is no quick and simple treatment for psychosis, but with the right support it is possible to manage the symptoms of psychosis and recover.
This does not mean that the experience of psychosis will go away entirely. You may find that you still experience symptoms during and after treatment. What treatment can do though is help you learn ways of coping so that your experiences are less distressing and don't interfere with your life as much.
Talking therapies can help you understand your experiences and develop coping strategies to deal with them. You may be offered 'cognitive behavioural therapy for psychosis' (sometimes called CBT). This is a type of cognitive behavioural therapy (CBT) specifically for people experiencing psychosis.
Antipsychotic medication is offered to most people with psychosis, as a way of managing symptoms. You may also be offered other drugs (for example antidepressants or mood stabilisers) if you experience mood-based symptoms, as well as additional medication to help reduce the side effects caused by the antipsychotics.
Arts therapies can help you express how you are feeling in different ways. They can be helpful if you are having difficulty talking about your experience.
Family intervention focuses on helping family members talk to each other about what helps, solve problems and plan for a crisis.
Tips
Try peer support
Peer support brings together people who've had similar experiences to support each other. You could access peer support online or try a support group in your local area. You can search our directory for group support.
Recognise your triggers
It might be helpful to keep a diary of things that might have triggered a psychotic experience, such as:
life events
your mood
your diet
lack of sleep.
You could do this in a notebook, or use an app or online tool.
Keeping a diary can help you:
understand what triggers your psychosis or makes it worse
think about what has been helpful in the past
recognise warning signs that tell you when you are becoming unwell.
Once you have a better understanding of your triggers, you can try to take steps to avoid or manage them. If you learn to recognise your warning signs, you can take action early to try and prevent your psychosis getting worse.
Family and friends may also be able to help you spot when you are becoming unwell, including noticing early symptoms before your experience psychosis.
Learn to relax
Manage your stress.
Try some relaxation techniques.
Look after your physical health
Looking after your physical health can make a difference to how you feel emotionally. For example, it can help to:
Try to get enough sleep. Sleep can help give you the energy to cope with difficult feelings and experiences.
Think about your diet. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels.
Try to do some physical activity. Exercise can be really helpful for your mental wellbeing.
Spend time outside. Spending time in green space can boost your wellbeing.
Avoid drugs and alcohol. While you might want to use drugs or alcohol to cope with difficult feelings, in the long run they can make you feel a lot worse and can prevent you from dealing with any underlying problems that the drug or alcohol use may have been masking.
Create a crisis plan
During a crisis you may not be able to tell people what helps you. When you are feeling well it can be a good idea to talk to someone you trust about what you would like to happen (or not to happen) when you are in crisis. It might help to create a crisis plan.