Psychosis: Early Warning Signs and Treatment

In any 12 month period, one in every 200 adult Australians will experience a psychotic-related illness (Better Health Channel 2019).

In the case of psychosis, a person has lost the capacity to distinguish reality from their imagination.

Psychosis sometimes occurs alongside other mental illnesses such as schizophrenia, schizoaffective disorder or bipolar affective disorder. However, it is worth noting that up to three-quarters of psychotic experiences do not progress to a diagnosable illness (Headspace 2018).

Psychosis is a treatable condition.

What is a Psychotic Episode?

In the majority of cases, psychosis is experienced as an ‘episode’. In this period a person will experience acute symptoms such as delusions and hallucinations.

Often, psychosis begins with general and gradual changes in a person’s thinking and behaviour. These behaviours include, trouble with attention and concentration, irritability, depression, anxiety, suspiciousness, insomnia, social withdrawal and often cause trouble at work or school (Sane Australia 2017).

When Does Psychosis Typically Occur?

Psychosis typically manifests in teenage years or early adulthood (National Alliance on Mental Illness n.d.).

Psychosis and Stigma

There is a false public perception that people with psychosis are more likely to be violent than others. This idea permeates popular media such as television, and film, and has created a highly damaging and inaccurate idea of this condition (Sane Australia 2017).

The most effective way to reduce stigma is to educate yourself and others on this illness.

The Warning Signs of Psychosis

The following can be viewed as possible warning signs of psychosis. Keep in mind it can be difficult to distinguish this from typical teenage or early adult behaviour:

• A decrease in performance at work or at school.
• Trouble thinking clearly or concentrating.
• Suspiciousness or uneasiness with others.
• A decline in self-care or personal hygiene.
• Spending an excessive amount of time alone.
• Displaying strong, inappropriate emotions or having no feelings at all.

(National Alliance on Mental Illness n.d.)

It is crucial that someone experiencing these signs seeks prompt medical advice. It can be difficult to convince someone who is experiencing psychosis to seek help due to the nature of the condition and its association with feelings of fear, anxiety and unease (National Alliance on Mental Illness n.d.).

Common Symptoms of Psychosis

Psychosis can include a range of symptoms but often includes one of these two experiences:

Hallucinations

Hallucinations include seeing, hearing or feeling things that are not there), examples are:

• Hearing voices (auditory hallucinations);
• Experiencing strange sensations or unexplainable feelings;
• Seeing glimpses of objects or people that are not there or are distortions of reality.

(National Alliance on Mental Illness n.d.; Sane Australia 2017)

Delusions

Delusions are strong beliefs that are unlikely to be true and will seem irrational to others, examples are:

• Believing external forces are controlling or manipulating thoughts, feelings or behaviours.
• Believing that trivial remarks, events or objects have personal meaning or significance.
• Thinking that they have special powers, are on a special mission or that they are God.

(National Alliance on Mental Illness n.d.; Sane Australia 2017)

Psychosis can also include symptoms such as:

Confused thinking

Everyday thoughts can become difficult to comprehend and both thoughts and speech may seem slowed or mixed-up. A person may find it difficult to concentrate, follow a conversation or remember things (Sane Australia 2017; Headspace 2018).

Changed emotions

A person may feel confused and alienated from their environment. They may appear to feel less emotion or show less feeling to those around them (Headspace 2018).

Changed behaviour

A person may have bursts of energy or find it difficult to get things done. They may laugh at inappropriate times, or become angry or upset without obvious reason. They might stop doing things that once brought them joy such as spending time with friends and family. They may seem excited, depressed or irritable without reason (Sane Australia 2017; Headspace 2018).

What Causes Psychosis?

Several factors are thought to contribute to psychosis, though the exact causes are still unclear:

• Genetic vulnerability: A family history of psychosis can contribute to the development of psychosis.
• Trauma, loss and grief: Witnessing a traumatic event such as death, war or sexual assault can trigger a psychotic episode.
• Substance use: The use of marijuana, LSD, amphetamines and other substances can increase the risk of developing psychosis.
• Physical illness or injury: Traumatic brain injuries, brain tumours, strokes, HIV and some brain injuries such as Parkinson’s, Alzheimer’s and dementia can sometimes cause psychosis.
• Mental health conditions: Sometimes psychosis is a symptom of a condition such as schizophrenia, schizoaffective disorder, bipolar or depression.

(National Alliance on Mental Illness n.d.; Better Health Channel 2019; Headspace 2018)

Diagnosing Psychosis

A general practitioner (GP) will assess the person’s symptoms to confirm psychosis. They may also refer a person to a psychiatrist for full diagnosis and treatment.

Psychosis is sometimes diagnosed as part of another illness such as schizophrenia, schizoaffective disorder or bipolar affective disorder. This diagnosis can change over time (Sane Australia 2017). The presence of psychotic symptoms does not automatically mean that someone has a psychotic illness (Better Health Channel 2019).

Treatment for Psychosis

Psychosis is a treatable condition. Several types of therapy have successfully helped people living with psychosis to manage their condition.

Treatment for psychosis typically involves:

• Specialist psychotherapy;
• Antipsychotic medication;
• Counselling or community support groups;
• Practical support, such as getting help getting back to work or school.

(Headspace 2018; Better Health Channel 2019; Reachout n.d.)

Often treatment can last from two to five years or longer. In that time, treatment can change according to the needs of the person and reduce the specific side-effects they have been experiencing (Sane Australia 2017).

If you’re in crisis and need support, call Lifeline on 13 11 14. Lifeline is open 24 hours a day, 7 days a week.

Additional Resources

• Sane Australia, https://www.sane.org/information-stories/facts-and-guides/psychosis

References

• Better Health Channel 2019, Psychosis and Mental Illness, Better Health Channel, viewed 24 February 2020, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/psychosis
• Sane Australia 2017, Psychosis, Sane Australia, viewed 24 February 2020, https://www.sane.org/information-stories/facts-and-guides/psychosis
• National Alliance on Mental Illness n.d., Early Psychosis And Psychosis, National Alliance on Mental Illness, viewed 24 February 2020, https://www.nami.org/earlypsychosis
• Headspace 2018, What is Psychosis and the Effects on Mental Health, Headspace, viewed 24 February 2020, https://headspace.org.au/young-people/understanding-psychosis-for-young-people/
• Reachout n.d., What is Psychosis?, Reachout, viewed 24 February 2020, https://au.reachout.com/articles/what-is-psychosis