An experience of psychosis impacts a person's sense of what is real and what isn't. This could be because of hallucinations (seeing, hearing, or sensing something that doesn’t exist) or delusions (false beliefs that the person is convinced are true or real).
A person can have a single episode of psychosis or more over a lifetime. Psychosis can occur as a symptom of mental health issues like schizophrenia, neurocognitive conditions like dementia, as a result of substance intoxication, and can occur in many other conditions that affect the brain (e.g., Parkinson’s disease, epilepsy, migraine). Effective medical, community, and psychological treatment is available and a person who has experienced psychosis can live a fulfilling life.
- The causes are complex: genetics, early childhood development, adverse life experiences, physical illness or injury, drug use and other factors increase your chances of experiencing psychosis.
- According to the 2010 National Psychosis Survey 64,000 Australians aged 18-64 experienced a psychotic illness. This comes to roughly 0.5% of the population.
Psychotic symptoms vary from person to person and even between one episode and another. If you are concerned that you may be experiencing or have experienced psychosis, talk to your doctor. Symptoms include:
False ideas or beliefs that can’t be changed by evidence and aren’t shared by other people from the same cultural background.
Seeing, hearing, feeling, tasting or smelling something that isn’t there.
I thought I was under constant surveillance and everyone was out to harm me.Television, radio and newspapers were talking directly to me
A person with psychosis might make up words or use them in strange ways, use mixed-up sentences or change topic frequently. It can sometimes be hard for someone else to understand what the person with psychosis is trying to say.
A person with psychosis may become agitated, act in a child-like way, mutter, swear or otherwise act inappropriately given the situation they’re in. They may find it challenging to keep up their personal hygiene and housework. In severe cases, they may become unresponsive to the world around them – this is sometimes referred to as ‘catatonia’.
These symptoms include reduced emotional expression (perhaps in eye contact, speech, or facial expression), motivation, talking, or experience of enjoyment and pleasure.
In most cases, psychosis is experienced as an ‘episode’: a period of acute symptoms of delusions or hallucinations The length of an episode varies from person to person and depends factors such as the type and cause of the episode. Episodes can be as brief as a few hours (in the case of some drug-induced episodes), while for a diagnosis of schizophrenia someone needs to experience these symptoms for a period of six months.
Psychosis can also develop gradually over time, beginning in ways that are subtle or hard to pin-point. Some common signs to look out for are:
- Changes in emotion: depression, anxiety, irritability, suspiciousness, and flattened or reduced emotional responses.
- Changes in thinking: trouble with concentration or attention, changed sense of self or the world, and odd ideas or perceptual experiences.
- Changes in behaviour: changes in sleep or appetite, withdrawing socially, or having troubles at work, school, or socially.
If untreated, these symptoms can develop into a full psychotic episode. If you think you or someone you know might be experiencing these changes in their thinking or behaviour now, see a doctor immediately.
Diagnosis & treatment
The best place to start in getting a diagnosis is your GP. They can make an assessment and refer you to a psychiatrist for full diagnosis & treatment if appropriate.
Psychosis may be part of a diagnosed mental health issue, like schizophrenia, schizoaffective disorder, bipolar affective disorder or major depressive disorder. Over time, your diagnosis might change or stay the same.
Treatments for psychosis include antipsychotic medication, specialist psychological therapies and community support programs to help with social connection, physical health, accommodation and work or school.
Treatment for mental health issues characterised by psychosis can last 2–5 years, or even longer. During that time, your treatments may change to improve the results and reduce side-effects.
It became a journey of rediscovering myself and developing techniques to help me get well and stay well
There’s a strong public perception that people experiencing psychosis are likely to be violent, even though this isn’t true. Film & TV depictions of violent killers are often labelled with a false, highly damaging idea of psychosis. Some people react fearfully or judgmentally when they learn a person has experienced psychosis.
Stigma hurts, but you can protect yourself against false perceptions of psychosis by learning as much as you can about it from reputable sources, and by talking with other people who have experienced psychosis, for example on the SANE Forums.
Help for family & friends
Caring for someone experiencing psychosis can be stressful. Carers need care too — it’s okay to set boundaries for the care you can give, and to prioritise your own physical and mental health.
There are many other people out there who share your experience, and many services designed to help carers of people with mental health issues. Here are a few places to find support:
- SANE Friends, Family & Carers Forum
- SANE counselling support - 1800 18 72 63
- Mental Health Carers Australia (formerly ARAFEMI) - 1300 554 660
- Carer Gateway - 1800 422 737
- NDIS families & carers page - 1800 800 110
- Young Carers Network
If you’re caring for someone and feeling isolated, you’ve got to reach out. You are honestly not alone, there are so many of us out there
SANE factsheets provide brief, introductory information about mental health. For more in-depth information, read SANE’s Psychosis Guide.
This SANE factsheet is currently being reviewed by industry professionals and people with lived experience.