Psychosis (also called a ‘psychotic experience’ or ‘psychotic episode’) is when you perceive or interpret reality in a very different way from people around you. You might be said to ‘lose touch’ with reality.
The most common types of psychotic experiences are hallucinations, delusions and disorganised thinking and speech. For more information on these see our page on types of psychosis.
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. It might help to share our section for friends and family with them.
Is psychosis a diagnosis or a symptom?
The word psychosis is usually used to refer to an experience. It is a symptom of certain mental health problems rather than a diagnosis itself.
Doctors and psychiatrists may describe someone as experiencing psychosis rather than giving them a specific diagnosis. Some people prefer this.
If you are diagnosed with one or more of these conditions then you may experience psychosis. Alternatively, if you experience psychosis (and you have other symptoms too), then you may be given one of these diagnoses:
Some people experience psychosis on its own. If you experience psychosis for less than a month and your doctor doesn’t think that another diagnosis describes your symptoms better, you may receive the diagnosis of ‘brief psychotic disorder’.
See our types of psychosis and causes of psychosis pages for more information.
Psychosis and stigma
There are a lot of misunderstandings about what it means to experience psychosis. Lots of people wrongly think that the word ‘psychotic’ means ‘dangerous’. The media often shows people with psychosis behaving like this even though very few people who experience psychosis ever hurt anyone else.
It’s important to remember that you aren’t alone and you don’t have to put up with people treating you badly. For some suggestions on things you can do to tackle stigma have a look at this information page on stigma and misconceptions.
More information about psychosis
What types of psychosis are there?
This page covers:
hallucinations
delusions
disorganised thinking and speech
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. See Mind’s pages on money and mental health for more information and support.
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.
Hearing voices, paranoia and schizophrenia
Watch Miles talk about his experiences of paranoia and hearing voices. Our thanks to Mind for allowing us to share this film.
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 – 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 – 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.
Watch Alice, Brian, Jamie, Martin and Louise talk about their experiences of psychosis as part of being diagnosed with schizophrenia. Our thanks to Mind for allowing us to share this film.
What causes psychosis?
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
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
How can I help myself?
These suggestions could help you cope with psychosis. You may choose to try them on their own or alongside treatment. Here are some ideas:
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 find peer support groups for psychosis through:
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 – our pages on managing stress can help you manage pressure and build up your coping skills
Try some relaxation techniques – these pages on relaxation have lots of suggestions for looking after your wellbeing when you are feeling stressed, anxious or busy
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. See our pages on coping with sleep problems
Think about your diet – eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. See Mind’s pages on food and mood
Try to do some physical activity – exercise can be really helpful for your mental wellbeing. See Mind’s pages on physical activity
Spend time outside – spending time in green space can boost your wellbeing. See Mind’s pages on nature and mental health
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. See our pages on recreational drugs and alcohol
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. See Mind’s page on crisis plans for more information.
What treatments are there for psychosis?
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.
How do doctors decide my treatment?
Before you start any treatment, your mental health professionals should discuss all your options with you and listen to what you want. They should look at all aspects of your life including your environment, culture and ethnicity, and any possible physical causes of your psychosis.
Your treatment may depend on whether you are diagnosed with a specific mental health problem. It may be that psychosis is one of several symptoms you’re experiencing, which will influence what treatment you are offered.
An advocate can help you get the treatment you need. See our pages on advocacy for more information.
What treatment is available?
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 CBTp). 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. Your GP will be able to find out if this is available in your area
What other support can I get?
Early intervention (EI) teams
Early intervention (EI) teams work with you during your first experience of psychosis. They usually include people who can help you in different ways. For example:
If you experience psychosis a lot or it lasts a long time, you may be referred to community care services to help you cope. The phrase ‘community care’ is used to describe the various services available to help you manage your physical and mental health problems in the community. This might include:
your community mental health team (CMHT)
nursing or social work support
home help
day centres
supported accommodation
Community care can also include crisis services and early intervention teams.
If you become very distressed during an episode of psychosis you may need to be cared for in hospital. See Mind’s pages on hospital admission for more information on this.
How can friends and family help?
It can be really hard to see someone you care about experiencing psychosis. But there are some things you can do to try and help. This page has some suggestions for ways you can support them while also looking after your own wellbeing.
Listen and try to understand – it can help if your loved one feels able to discuss their feelings and options with someone supportive and calm. Listen to their experiences and ask them what would help. Our information can help you understand more about psychosis
Focus on feelings rather than experiences – it’s hard to know how to respond when someone sees, hears or believes something that you don’t. Instead of confirming or denying their experience it can help to say something like “I understand that you see things that way, but it’s not like that for me”. It’s usually more helpful to focus on how the person is feeling about what they are experiencing
Offer practical help – ask them if they would like any practical help. For example they may like your help to access a particular service or ask you to act as an advocate for them
Respect their wishes – even if you feel that you know what’s best, it’s important to respect their wishes and don’t try and take over or make decisions without them. People tend to do less well if family and friends are very critical or over-protective
Family intervention – family intervention can help the whole family understand what the person with psychosis is going through and identify what is helpful and unhelpful for them and for you. You might want to ask your GP if this is available in your area
Plan for a crisis – when your loved one is feeling well you may want to discuss and plan how you can help them in a crisis. This could include planning practical things like treatment and hospital visits. You might also find it helpful to state clearly what you feel you can and can’t support them with during a crisis
If you are worried that your family member or friend is becoming very unwell or experiencing a mental health crisis you could suggest that they use their crisis plan (if they have one). Our information on crisis services explains more about the help available to support someone in crisis.
Useful contacts
Bipolar UK
bipolaruk.org
Information and support for people affected by bipolar disorder, hypomania and mania. Offers a telephone peer support line, an online peer support community, and local support groups across the country.
Hearing Voices Network
hearing-voices.org
Information and support for people who hear voices or have other unshared perceptions, including local support groups.
Hub of Hope
hubofhope.co.uk
UK-wide mental health service database. Lets you search for local, national, peer, community, charity, private and NHS mental health support. You can filter results to find specific kinds of support.
Mind
Mind’s helplines provide information and support by phone and email.
Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.
If you or someone you know needs urgent mental health help, please call 111 – the NHS
non-emergency
number. It’s available 24 hours a day, 7 days a week and is free from any phone. They have
specialist
mental health nurses who can support adults and young people.
