Psychosis is when a person loses touch with reality, and the line between what is real and what is not becomes blurred. Psychosis often prevents a person from thinking clearly and inhibits their ability to define reality from their imagination.
If you experience psychosis, your perception and interpretation of what's happening may be very different to that of those around you. Your mind may play tricks on you, causing unusual thoughts, feelings and behaviours. You may experience hallucinations; seeing, hearing or believing things that other people do not.
For individuals with psychosis, the world can seem like a confusing jumble of feelings, images and sounds that are frustratingly outside of their immediate control.
This fact-sheet explores the symptoms and the possible causes of psychosis, the treatment options available as well as some practical suggestions on how you can help yourself when experiencing psychosis.
‘Psychosis’ is the term used to describe mental health problems that prevent an individual from thinking clearly and from being able to lucidly identify fact from fantasy. While psychosis is not diagnosed as a disorder itself, it is typically triggered by other conditions and so is usually identified by two symptoms; hallucinations and delusions.
Seeing, hearing or physically feeling something that isn’t there is known as a hallucination. Hallucinations may include:
A delusion is a belief that is unlikely to be true and which others don’t share. Delusions often fall into one of the following two categories:
In addition to hallucinations and delusions, psychosis can also include:
This combination of symptoms can severely disrupt and alter thoughts, emotions, behaviour and awareness. In addition, each individual’s experience of psychosis will be unique. Some may experience psychosis only once, others will go through a number of short bouts and some individuals will live with psychosis long-term.
The effects of psychosis differ for each person, and some may experience it once whereas others experience short episodes throughout their lives. It can be that psychosis is not always distressing, an example of this could be seeing the faces of loved ones who have died or hearing their voices, which could be comforting.
Psychosis can be a symptom of lots of different mental health problems, and so is not diagnosed as a standalone condition. If you have one or more of the following diagnoses, then you may experience psychosis - if you experience psychosis (and other symptoms) then you may be diagnosed with one of the following:
If you experience psychosis for less than a month and your symptoms aren't described by another diagnosis, you may be diagnosed with brief psychotic disorder.
Causes of psychosis are of course not limited to the above, and there are many varying explanations as to why people experience it. Below are some additional avenues of thought regarding possible causes:
The diagnosis you receive will take into account how severe your episodes are, how often they occur and whether you experience them alone or in conjunction with additional symptoms.
While there is no one-size-fits-all remedy, with the right support and treatment, it is possible to manage the symptoms and/or make a recovery. In many cases, the symptoms won’t vanish entirely and you may experience them from time to time - but with the right support and advice you can find ways of coping so that they are less distressing and disruptive.
As a precursor to the implementation of any psychosis treatment plan, your mental healthcare provider should inform you of all possible available options - taking into account your preferences, environment and possible physical causes before you make a decision together on which treatment would be most suitable.
Below are some of the treatment options available. Please know that what works for one person may not work for another, so it is important you speak to a medical professional and/or counsellor and ask as many questions as possible to get a thorough understanding of the treatment and whether it is right for you.
Talking therapies help you to understand and explore how you are feeling so that you can address negative thoughts and feelings and develop coping strategies to pave the way for positive change.
In the case of psychosis, a professional counsellor or psychotherapist may be able to help you challenge paranoid feelings while also helping you to address anxiety or depression that may have developed as a result of experiencing psychotic episodes.
Talking therapies that have been found particularly beneficial for psychosis treatment include:
Counselling for psychosis will provide you with an opportunity to explore your thoughts and feelings and the impact they may be having on your behaviour. As part of counselling you will also discuss any past experiences that may have influenced your present situation – and will find ways and methods of addressing them.
CBT for psychosis revolves around the way you think (cognitive) and the way you behave (behavioural). It is designed to help you recognise and foster the idea that it is possible to change, or recondition these thoughts and behaviours in order to overcome specific problems.
These therapies take a more in-depth look into unconscious thoughts and perceptions to identify issues from your past that may have acted as a trigger for your current experiences.
The National Institute for Health and Care Excellence (NICE) has recommended therapies such as music therapy and art therapy as treatment avenues for schizophrenia and other related conditions. These therapies harness your creative side and use it as a vehicle for communication and expression.
In most instances, individuals diagnosed with a psychotic illness will be offered antipsychotic drugs that may help to control symptoms and any associated anxiety and/or depression. In cases where antipsychotic drugs aren’t suitable or additional medication is needed to treat severe depression or mania, antidepressants or mood stabilisers may be prescribed.
If you have experienced a very severe episode of psychosis and are feeling distressed, you may require treatment as an inpatient. In hospital you can receive around the clock care and support to help you get back on your feet.
In some circumstances, it’s considered necessary for both your own health and safety, and for the health and safety of others that you be detained under the Mental Health Act. This can be an incredibly frustrating and upsetting experience but is not a decision that is taken lightly.
When someone has been under certain treatment sections of the Mental Health Act, it then becomes the duty of the healthcare provider to plan fully funded aftercare for after hospital discharge – with the aim of helping individuals to settle back into society and their lives.
Experiencing psychosis for any period of time is distressing, confusing and difficult. However, seeking support for yourself is the first step you can take to looking after yourself.
- Counsellor Joshua Miles writes in his article, Understanding psychosis and psychotic episodes.
While professional help will be needed to treat psychosis, there are of course some personal steps you can take to help you manage symptoms more effectively:
Support groups provide a place for you to meet other individuals with similar life experiences so that you can outlet your thoughts and feelings and share tips for coping. Individuals who attend support groups often report that this supportive and collaborative environment makes them feel more accepted, less isolated, more understanding of their own and other people’s experiences and more confident about making decisions.
It’s surprising what a simple change here and there can do in terms of helping to improve your physical and mental well-being. For example:
If you tend to experience repeated psychotic episodes then start a day-to-day diary in which you record daily activities and mood. It may be that after you have jotted down a few weeks worth, you are able to identify patterns or times at which you are vulnerable, and things which have been helpful so that you can then use this information to help you anticipate, prevent or manage an episode.
While are there no specific laws in position which stipulate the level of training and experience a counsellor or psychotherapist offering general talk therapy must have in order to treat psychosis, the National Institute for Health and Care Excellence (NICE) have issued guidelines which outline recommended psychological treatment.
It is also important to note that counsellors and psychotherapists offering arts therapies such as music therapy and art therapy, must be registered by law with the Health and Care Professions Council (HCPC) in order to deliver these therapies to clients.
Please find the NICE guidance below: