Psychosis

Psychosis is a symptom of serious mental illness and if you are experiencing symptoms of psychosis it is a sign that you are not well and need support.

You might feel you are losing touch with ‘reality’, feel paranoid, see things that aren’t there, hear voices or have delusions, or confused thoughts.

Treating psychosis

The treatment of psychosis depends on the underlying cause. There are many different things that can cause psychosis, including:

• Mental health conditions such as schizophrenia, schizoaffective disorder, bipolar disorder, anxiety, OCD, dementia, or depression.
• Severe stress.
• Abuse of alcohol or drugs (e.g. cannabis, amphetamines, cocaine, LSD, magic mushrooms).
• Some prescribed medicines (e.g. high doses of steroids)
• Some physical health conditions (e.g. thyroid problems, vitamin deficiencies, brain infections or tumours, epilepsy)

If you think that you might have psychosis, then it is important to get help straight away. The earlier the psychosis is treated, the more chance you have of avoiding the symptoms coming back or getting worse.

You may feel scared of talking to someone about how you feel, but try to talk to your parents, a family member or a friend as they can support you, and make an appointment with your GP as soon as you can.

You will be referred on to a specialist and they will advise what treatment is right for you.

It is often necessary to use medicines to treat psychosis. Antipsychotic medicines are the main treatment for psychosis. Other types of medicine may also be used depending on the cause of the psychosis.

If you are prescribed an antipsychotic medicine, then it is very important that you do not miss doses or stop taking it without your doctor’s advice. This is because if you do miss doses or stop taking it too soon, then there is a bigger chance of the psychosis coming back or getting worse.

Sometimes psychological therapies (‘talking’ therapies) are used to help with the emotional effects of psychosis. This could be through counselling or cognitive behavioural therapy, which works by identifying unhelpful thinking patterns and emotions and learning to replace these with more balanced thoughts.

Symptoms of psychosis

Psychosis is the word used to refer to a group of symptoms related to the person losing contact with reality. These symptoms include:

• Hallucinations (seeing, hearing, smelling, tasting, or feeling things that aren’t really there).
• Delusions (believing something to be true even when there is evidence that proves that it isn’t true).
• Confused or odd thoughts (suddenly losing your train of thought, suddenly switching topics, feeling that your thoughts have been sped up or slowed down, or thinking and talking in a confused way).
• Lack of insight (not realising that things aren’t right and that you are unwell).

The delusions often involve believing that you are being watched, followed or persecuted by others, or that your life is in danger. Some people with psychosis believe that other people can influence their thoughts, or that they can influence the thoughts of others. Some have grandiose delusions, in which the person believes that they have powers, authority, or special status that they do not actually have.

There can be some other symptoms related to psychosis, such as:

• Withdrawal and loss of interest in usual activities.
• Loss of energy or motivation.
• Problems with memory, concentration, sleep or appetite.
• Lack of or inappropriate emotional response.

If you would like more information about psychosis and the way it affects young people, you can visit the YoungMinds website.

Related conditions

• Schizophrenia
• Bipolar
• Depression
• Mania

Medication

Your doctor may recommend you take antipsychotic medication, which works by blocking the effect of dopamine (a chemical that transmits messages in the brain).

If your doctor suggests that medication may help you, the HeadMeds website will provide you with more information about the medication they are recommending, how it works, how you should take it and how you might feel. It should also be able to answer any questions you might have about going on medication.

You may also be able to access more information about psychosis and medicines used to treat it on the Choice and Medications website (www.choiceandmedication.org), which is usually free to access via your mental health trust.

References

• NHS choices. Available online http://www.nhs.uk/pages/home.aspx
• Choice and Medications website (www.choiceandmedication.org – usually free to access via your mental health trust)
• NICE CG185 Bipolar disorder: assessment and management. Sep 2014. Available online www.nice.org.uk
• NICE CG155 Psychosis and schizophrenia in children and young people: recognition and management. Jan 2013. Available online www.nice.org.uk
• NICE CG178 Psychosis and schizophrenia in adults: prevention and management. Feb 2014. Available online www.nice.org.uk