What is psychosis?

Psychosis is a medical condition. It can be serious, but it is treatable.

Experiencing psychosis is often called having a psychotic episode. When this happens, you have difficulty telling what is real from what is not real. The way you think, act and experience the world can change. This can be scary and confusing.

Who gets psychosis?

About 3 in 100 people experience psychosis sometime in their life. It usually happens for the first time in adolescence (teenage years) or early adulthood. Psychoses affects an equal number of men and women.

What causes psychosis?

There are many reasons why you could experience psychosis or a psychotic episode. Some of these reasons include:

Mental illness: Psychosis can be a symptom of mental illness such as schizophrenia, bipolar disorder, major depression.

Physical illness: Some medical conditions and prescription medicines can cause psychosis.

Drug and alcohol use: Some drugs, for example, amphetamines, can cause psychosis. Others (for example, marijuana) can increase your chance of having a psychotic episode if you are already at risk.

Stress: Sometimes stressful life events can cause psychosis. Stress can increase your chance of having a psychotic episode if you are already at risk.

Remember: Psychosis is a medical condition, it can be treated, is should be treated as early as possible.

What are the phases of a psychotic episode?

A psychotic episode usually happens in three phases. Phases are steps or stages of the psychotic episode.

How long each phase lasts is different for everyone.

Phase 1: The prodromal phase

This phase happens before more obvious symptoms of psychosis appear. You or those around you may feel that “something is not quite right”. Not everyone experiences a prodromal phase.

Signs of the prodromal phase may include:

  • Difficulty concentrating, thinking, or understanding;
  • Sleeping too little or sleeping too much;
  • Eating more or less than usual;
  • Unusual ideas or behaviors;
  • Changes in mood;
  • Changes in energy level;
  • Loss of interest in activities you used to enjoy;
  • Wanting to be alone;
  • Difficulties with work or school.

Phase 2: The active phase

The symptoms in this phase are the most noticeable. These symbols can affect your day to day life. Most people seek treatment during this phase.

Signs of the active phase may include:

Delusions: strong thoughts or beliefs that are not true.

Examples of delusions are beliefs that: 

  • Other people can read your thoughts
  • You have special powers or great talents
  • You are being watched or followed
  • Someone is trying to harm you.

Hallucinations: Hallucinations are experiences that seem very real but are not. You may hear, see, taste, smell, feel something that is not there. The most common type of hallucination is hearing voices that no one else hears.

Strange speech or behaviour:

This phase can cause changes in your speech like:

  • Changing from one topic to the next very quickly
  • Having difficulty finding words
  • Speaking in a way that is hard for others to understand.

This phase can also cause changes in your behaviour like:

  • Acting in a way that doesn’t match what is happening. For example: laughing when someone is talking about something sad or tragic
  • Difficulty with daily tasks. Examples: bathing, shopping, cooking.

Negative symptoms: Negative symptoms are losses in a person’s normal functioning. These symptoms are less noticeable than the other symptoms of psychosis.

Examples of negative symptoms are:

  • Difficulty thinking or understanding
  • Not feeling any emotions, either happy or sad
  • Having no interest to do anything
  • Being unusually quiet.

Phase 3: The recovery phase

Recovery from psychosis takes time. Everyone’s recovery will be different. With treatment, the symptoms you experienced in the active phase will lessen but may not go away completely.

What treatments will help?

Psychosis is treatable. Some people experience psychosis once and never experience it again. Others need outgoing treatment to keep symptoms from coming back.

Two types of treatment are used to help psychosis:

1. Medicine: Medicine is important part of treatment for psychosis. Medicine is used to decrease symptoms and to keep them from coming back.

Medicines used to treat psychosis are called antipsychotics. Your doctor will work with you to decide which antipsychotic medicine works best for you.

2. Psychosocial treatments: Psychological treatments don`t use medicine. Different kinds of health professionals teach you how to manage your psychosis. For example, they can help you:

  • Learn about your illness
  • Learn skills to deal with your illness and prevent symptoms from coming back
  • Learn how to manage your stress
  • Stop using drugs or alcohol.

Most times, both types of treatment are used together. Medicines are usually started first to get your symptoms under control.


Hallucinations are experiences that seem very real but are not. Illustration: © Megan Jorgensen