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Understanding Psychosis and Psychotic Episodes

Updated on June 8, 2019
Carola Finch profile image

Carola is a mental health advocate and a freelance writer who focuses on mental illness and cognitive conditions..


The term “psychotic” is often used by the public to describe someone they consider to be “crazy” or mentally ill, but what does the word "psychotic" really mean? What does a "psychotic episode" really look like?

Definition of Psychosis

The National Institute of Mental Health defines psychosis as a state in which a person loses touch with reality. During a psychotic episode, an individual has difficulty distinguishing between reality and fantasy. They may have delusions (false beliefs), or auditory or visual hallucinations.

Psychosis can be caused by a complex combination of biological, environmental, and social factors. Illness and drugs or alcohol may also play a role in triggering the onset of psychotic episodes.

Characteristics of People in a Psychotic State

  • Difficulty thinking and concentrating
  • Trouble following conversations
  • Jumbled and incomprehensible speech
  • Confused thinking
  • Thoughts seem to speed up or slow down
  • Unable to express everyday thoughts in a clear way

Psychosis hits 3 out of 100 people and mostly in youth. Approximately 80 percent of psychotic people experience their first psychotic episode between the ages of 15 to 30.

The causes of psychosis are not fully understood, but scientists do know that young people with a family history of mental illness are at a higher risk of developing mental health disorders. Psychosis may also triggered by stress, social changes, or drug abuse.

Psychosis-Related Diagnoses

  • Schizophrenia - the most common
  • Bipolar disorder
  • Schizoaffective disorder
  • Delusional disorder
  • Schizoehrenaform disorder
  • Drug intoxication
  • Major depression with psychosis
  • short term reactive psychosis
  • people with medical conditions such as Parkinson's disease may develop symptoms of psychosis, usually several years after they are first diagnosed

Types of Psychotic Episodes

Each person experiences psychosis differently, but their experiences share certain characteristics. Here are some examples of how some people experience delusions:

  • Complaining that there are some intimidating men dressed in black sitting on the garage roof when there is no one there
  • Telling a detailed story with great conviction about being in an accident which never happened
  • Worrying that dear old dad is building a bomb in the basement to destroy the family and the house
  • Being afraid that the man in the blue sedan driving down the street is a stalker
  • Hearing voices that say, “you are worthless (or stupid, a waste of space)” or “they know about you”
  • Fear that someone is trying to poison or kill them
  • A conviction that co-workers are conspiring to get them fired
  • Constantly accusing their spouse of infidelity without cause

John Nash, a Nobel Laureate in Economics and professor, demonstrated various signs of psychosis in the highly acclaimed movie A Beautiful Mind. Nash had schizophrenia. The movie is highly recommended for those who want to learn more about this condition.

Signs of Psychosis


Seeing, hearing, tasting, smelling or feeling experiences that aren’t really occurring, heightened awareness of their surroundings, and feeling overwhelmed by these sensations

Poor memory

Seeing significance, connections, and conspiracies in unimportant things that are not actually connected


Thinking that people are watching and following them

Grandiose thinking

Thinking that they are someone prominent they are not, like the Dalai Lama, someone with superpowers, or someone who could read other people’s minds

False beliefs/delusions

  • A conviction that loved ones or others are their enemies.
  • Believing things are true that are not and in some cases, stubbornly holding on to them even when others try to contradict their delusion or present a logical argument against the false. beliefs
  • Considering a psychotic episode as a religious or spiritual experience,


Inappropriate or extreme emotional states

Severe mood swings May feel extremely excited, depressed, or less emotional

  • Inappropriate emotional responses such as laughing at something sad or becoming enraged without cause.
  • Showing a lack of emotion.
  • Changes in behavior as a result such as being either lethargic or extremely active.

Other signs

  • Lost interest in things they used to enjoy doing
  • Difficulty coping with school or work
  • Strained family and personal relationships

Physical signs:

  • sleep disturbances
  • Loss of appetite
  • Lack of motivation to do everyday tasks
  • Decline in personal hygiene


Barriers to dealing with psychosis


It is very difficult for people experiencing psychotic disorders to admit that they have a problem. Some young people do not understand what happened to them. They may be unwilling to talk about their psychosis.

Fear of stigma

People sometimes do not seek help because of their fear of being stigmatized and g labeled as mentally ill. Sometimes young people end up being hospitalized because they exhibited signs of psychosis to others.

Not taking medication

Another problem is that when young people on medication start to feel better, they stop taking their pills. They feel they are "cured." Anti-psychotic drugs are very powerful and a sudden withdrawal could cause severe symptoms of psychosis and physical weakness. Young people should not change their medication intake unless advised to do so by a medical professional.

Anti-Psychotic Treatment

Treatment is most successful when the mental health disorder is caught in the early stages when young people often have more insight into their illness. Family and friends may be the first to point out the possibility of a psychotic disorder. Psychotic episodes can be successfully treated with a combination of medication and therapy. Some young people may continue to experience psychotic episodes from time to time in their lives.

Individual counseling, recovering programs, family involvement, and practical support along with medication will help patients to recover from mental illness. Individualized programs can help young people to understand and overcome associated trauma, prevent relapse, and assist in practical areas such as finding housing or gaining employment.

Other activities such as art, music, hobbies, exercise and physical activities can also help the person heal. Patients also benefit from support from family, loved ones, friends, and contact with people who have the same mental health challenges.

Concluding Thoughts

Finding the right treatments of psychosis takes time and patience that requires the skills of a specialist in mental health disorders. Psychiatrists may need to change or adjust medications during the course of the illness. In the end, many young people can hope for recovery from the psychosis,

The Substance Abuse & Mental Health offers a behavioral health treatment services locator from the U.S.

Psychotic Disorders, Centers for Disease Control and Prevention

What is Psychosis? National Insitute of Mental Health
Introduction To Psychosis, PsychCentral, Lauren Walters
Causes of Psychosis, PsychCentral


Submit a Comment
  • Carola Finch profile imageAUTHOR

    Carola Finch 

    6 years ago from Ontario, Canada

    Thanks for your comments.

  • MsDora profile image

    Dora Weithers 

    6 years ago from The Caribbean

    Good job! Thanks for listing the signs and the types of episodes. That helps. Voted Up and Useful.


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