Psychosis Contributed by: Dr Zoe Davidson. Speciality Registrar Child and Adolescent Psychiatrist.

What is Psychosis?

Psychosis is an umbrella term for a group of symptoms or experiences. It can affect someone’s ability to work out what is real and what is not real. People can experience a change in their thinking pattern, change in their mood and emotions and they can experience delusions and hallucinations.

Some people also find it hard to concentrate on things and they don’t sleep well. Psychosis can be distressing and seem a bit scary, but there is a lot that can help

Fast Facts!

Up to 1 in 10 people will hear voices at some point.

Studies have estimated it being as many as 3 in every 100 people who will have a psychotic episode in their lifetime.

What causes it?

We don’t know exactly what causes psychosis. But we know that some people are more vulnerable to psychosis because of their genetic makeup and life experience.

We know that people who use alcohol and drugs excessively can be at a higher risk of experiencing psychosis.

When a person is physically unwell, they can experience psychotic symptoms.

We also know that that in those who have a vulnerable brain, stress, drugs (including legal highs) and alcohol can make things worse.

Psychosis can be associated with other illnesses  including- Schizophrenia, Depression, Bipolar disorder, Severe anxiety, Brain injuries and other medical conditions

What are the symptoms?

People with psychosis can find that their thoughts move quickly and sometimes don’t seem linked. They can find that they speak quickly and others might find them hard to follow. Others find that their mind goes blank and they don’t know what to say.

Some people with psychosis have strange or unusual thoughts, often known as delusional beliefs. Examples might be that they think they have special powers, are being targeted or followed or are being monitored by others. This can make it feel hard to trust other people.

Some young people can experience thoughts of self harm or suicide due to their psychotic illness.

Hallucinations happen when you experience something as real when it is not real or not actually happening. Examples of this might be hearing voices when no one is there, or seeing something that no one else can see.

Some people experience voices talking about them with each other, and some people describe the voices talking directly to them. Hallucinations can also happen in your sense of touch, smell and taste. Hallucinations are actually quite common, especially if you are falling off to sleep or waking up. They become more of a problem however, when they happen frequently and interfere with your life, your ability to function and your relationships with other people

How is it diagnosed?

There is not a medical test for psychosis. The diagnosis is made by a psychiatrist, who will spent time assessing the patient and will often also talk to those who know them well, such as their school, family or carer and friends. They may arrange for some physical tests such as bloods and in some cases this might include a scan of the persons brain. They may also ask for drug and alcohol tests to ensure that this is a not a cause of the illness.

Sometimes it is very difficult to diagnose psychosis immediately, and the psychiatrist can see a person several times to rule out that there is not another cause for their presentation first.

How is it treated?

It’s best to get help as soon as possible. Depending on your age and where you live there will be specialist services available to help you, and your GP will be able to refer you to them. In some areas this will be Child and Adolescent Mental Health Services (CAMHS) and in other areas this will be Early Intervention services. They will then spend some time getting to know you and your family better.

Treatment for psychosis will always be delivered at home when possible. If however a person is unwell they may need to come into hospital for a period of time.

Treatment may include making sure that the person is physically well – this might include tests like a physical examination and blood tests. Medication is often used to treat psychosis, and you can find out more from our handy Medication PDF.

It is really important in treating psychosis that a person and their family or carer is given lots of information about the illness, and some psychoeducation around their triggers and symptoms to allow them to recognise if they are becoming unwell again in the future. This helps young people to access help when needed. Its important to keep a good sleep pattern and appetite as well as we know these can also be triggers for psychosis.

Case Study

I first noticed something wasn’t right when I was 15. It was the run up to pretty important exams and I was feeling a lot of pressure. I wasn’t sleeping well and kept waking up through the night. I then started to hear voices . They tended to say things to each other about me. I was finding it hard to concentrate and stopped going out with my friends. I started to think that things on TV were about me and I was paranoid I was being watched. It was really scary, but I got help. I’ve had good support from my key worker, psychiatrist, psychologist and GP. They’ve also helped my family and the school to understand what I was experiencing so that they could support me better. I’m now back at school and have learned new ways to cope with stress as well as recognising my warning signs for becoming unwell, so that I can stay well.

Want to know more?

The Royal College of Psychiatrists  have excellent resources on their website, including handy information leaflets about the medications used in psychosis.

Young Minds have good case study examples of psychosis.

If you are worried about yourself or a friend/family member, then you should encourage them to go and see their GP.