Psychosis is a mental disorder where a person loses the capacity to tell what’s real from what isn’t. They may believe or sense things that aren’t real, and become confused or slow in their thinking.
Psychosis often occurs as a part of other mental illnesses. It is treatable.
The facts
- The causes are complex: genetics, early childhood development, adverse life experiences, drug use and other factors increase your chances of experiencing psychosis.
- In any given 12-month period, just under one in every 200 adult Australians will experience a psychotic illness.
The myths
- Myth: ‘Psychotic means violent’
- Reality: People being treated for psychosis are no more likely to be violent than anyone else, but they are more likely to be the victims of violence.
- Myth: ‘You can “catch” it’
- Reality: Psychosis is not contagious.
- Myth: ‘You can just will it away’
- Reality: Psychosis can’t be treated by diet, exercise, prayer or willpower alone. It requires evidence-based treatment by qualified mental health professionals.
Symptoms
Psychotic symptoms vary from person to person and even between one episode and another, so for the best diagnosis, talk to your doctor. Symptoms include:
Delusions
False, irrational beliefs that can’t be changed by evidence and aren’t shared by other people from the same cultural background.
Hallucinations
Seeing, hearing, feeling, tasting or smelling something that isn’t there. The most common hallucinations in psychosis are voices that are often very negative.
Disordered thinking
Thoughts and speech that become jumbled or slowed. A person with psychosis might make up words or use them in strange ways, use mixed-up sentences or change topic frequently. They may also have memory problems.
Disordered behaviour
A person with psychosis may become agitated, act in a child-like way, mutter or swear or otherwise act inappropriately. They may neglect their personal hygiene and housework. In severe cases, they may become unresponsive to the world around them.
I thought I was under constant surveillance and everyone was out to harm me. Television, radio and newspapers were talking directly to me
— Carlo
Psychotic episodes
In most cases, psychosis is experienced as an ‘episode’: a period of acute symptoms like delusions and hallucinations.
But psychosis frequently begins with general, hard-to-pin-down changes in a person’s thinking and behaviour, like trouble with attention and concentration, irritability, depression, anxiety, suspiciousness, insomnia, social withdrawal and trouble at work or school.
They don’t necessarily mean someone is developing psychosis, just that something might not be right. The following changes are much stronger indicators of psychosis:
- preoccupation with a subject
- speech or writing that is very fast, muddled, irrational or hard to understand
- talking much less
- loss of concentration, memory and/or attention
- increased sensitivity to light, noise and/or other sensory inputs
- withdrawing from relationships or hobbies
- increased anger, aggression or suspiciousness
- decreased or disturbed sleep
- inactivity and/or hyperactivity
- behaving in a way that’s reckless, strange or out of character
- laughing or crying inappropriately, or being unable to laugh or cry
- inattention to personal hygiene
- depression and anxiety
- being unable to feel or express happiness.
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.
Psychosis is usually diagnosed as part of another mental illness, like schizophrenia, schizoaffective disorder or bipolar affective 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 psychotic illness can last 2–5 years, or even longer. During that time, your treatments may change to improve the results and reduce side-effects.
Related: Getting better • Antipsychotic medication • Involuntary treatment • What use is a diagnosis?
It became a journey of rediscovering myself and developing techniques to help me get well and stay well
— Cameron
Stigma
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 a psychotic illness.
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.
Related: Guide to reducing stigma • Fact vs myth: mental illness & violence • Who should I trust to tell about my mental illness?
Help for family & friends
Caring for someone experiencing psychosis can be frightening, frustrating and exhausting. 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 illness. Here are a few places to find support:
- SANE’s carers’ forum, Help Centre 1800 18 72 63
- Mental Health Carers Australia (formerly ARAFMI) 1300 554 660
- Carers Australia 1800 242 636
- Carer Gateway (Commonwealth government)
- NDIS families & carers page 1800 800 110
- Young Carers
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
— Penelope
Related: Guide for families, friends & carers • Boundary-setting and mental illness • CBT & mindfulness for carers • Avoiding carer burnout • What I wish I knew when I became a carer
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.