What is psychosis?
The word psychosis is used to describe conditions
that affect the mind, in which people have trouble distinguishing
between what is real and what is not. When this occurs, it is called a
psychotic episode. A first episode of psychosis is often very
frightening, confusing and distressing, particularly because it is an
About three out of every 100 people will experience
an episode of psychosis in their lifetime. Psychosis affects men and
women equally and occurs across all cultures and socioeconomic groups.
Psychosis usually first appears in a person's late
teens or early 20s. Psychotic illnesses seem to affect women at a later
age than men, when women may be farther along in their social and work
lives. On the whole, women respond better than men to most treatments.
However, there are times when the risk of relapse
for women is greater. These times are before their period is due, after
childbirth and around menopause. This suggests that women's hormones may
in some way affect psychosis.
A number of mental illnesses can include psychosis as a symptom, including:
Schizophrenia: A person has some psychotic symptoms for at least six months, with a significant decline in the ability to function.
Schizophreniform disorder: A person has some psychotic symptoms for less than six months.
Bipolar disorder: With this type of illness, the symptoms of psychosis relate more to mood disturbance than to thought disturbance.
Schizoaffective disorder: A person
will have symptoms of schizophrenia, and at some point in the course of
illness, concurrent symptoms of a mood disturbance.
Depression with psychotic features: A person has severe depression and symptoms of psychosis without the mania associated with bipolar disorder.
Drug-induced psychosis: The use of
drugs such as marijuana, cocaine, ecstasy, ketamine, LSD, amphetamines
and alcohol can sometimes cause psychotic symptoms.
Organic psychosis: Sometimes,
symptoms of psychosis come on suddenly and, in some cases, are triggered
by a major stress such as a death in the family.
Brief psychotic disorder: This
illness usually lasts less than a month. It is usually triggered by a
major stress in the person's life, such as a death in the family.
Delusional disorder: This type of psychosis consists of very strong, fixed beliefs in things that are not true.
What are the signs & symptoms of psychosis?
Psychosis affects the way a person thinks, feels and behaves.
The experience of psychosis varies greatly from person to person. Psychosis can
come on suddenly or can develop very gradually.
The symptoms of psychosis are often categorized as either
“positive” or “negative.”
Positive symptoms are those that add to or distort the
person’s normal functioning. They include:
- delusions (false beliefs that are firmly held
and are out of keeping with the person’s cultural environment)
- hallucinations (hearing,
seeing, tasting, smelling or feeling something that is not actually there)
- disorganized speech, thoughts or behaviour (e.g.,
switching rapidly between subjects in speaking; finding it hard to concentrate
or follow a conversation; being unable to complete everyday tasks).
Negative symptoms involve normal functioning becoming lost or
reduced. They may include:
- restricted emotional and facial expression
- restricted speech and verbal fluency
- difficulty with generating ideas or thoughts
- reduced ability to begin tasks
- reduced socialization and motivation.
- cognitive symptoms, such as difficulties with
attention, concentration and memory
- mood changes
- suicidal thoughts or behaviours
- substance abuse
- sleep disturbances.
What are the causes & risk factors of psychosis?
Psychosis occurs in a variety of mental and
physical disorders, so it is often difficult to know what has caused a
first episode. Research shows that a combination of biological factors,
including genetic factors, place a person at greater risk of developing
symptoms of psychosis. For such a person, a psychotic episode may be
triggered by many different environmental factors, such as stressful
events or substance use.
An imbalance in brain chemicals such as dopamine and serotonin can also be a factor.
A person who is having symptoms of psychosis should
have a thorough medical assessment to rule out any physical illness
that may be the cause.
What is the treatment for psychosis?
Psychosis can be treated, and many people make a
good recovery, especially if they get help early. Treatment may be
recommended either on an outpatient basis or in hospital. It usually
consists of medication and psychosocial interventions (e.g.,
Throughout treatment, families can receive support and education during sessions with the treatment team.
Medications called antipsychotics are usually
essential. They relieve symptoms of psychosis and may prevent further
episodes of illness.
A case manager or therapist can provide emotional
support, education about the illness and its management, and practical
assistance with day-to-day living. They may also recommend programs in
the community and provide supportive psychotherapy and vocational
Recovery from a first episode of psychosis varies
from person to person. Sometimes symptoms go away quickly and people are
able to resume their regular life right away. Other people may need
several weeks or months to recover. Some people will need medication and
support for the rest of their lives.
Where can I find help, treatment and support for psychosis?
Treatment at CAMH
Help for Families from CAMH
Ontario Mental Health Helpline (open 24/7 for treatment anywhere in Ontario)
Where can I find more information from CAMH related to psychosis?
Beyond Psychosis (video)
First Episode Psychosis: An Information Guide
Promoting Recovery from First Episode Psychosis (PDF)
Psychosis 101 (online tutorial) Please Note: Your pop-up blocker must be turned off to view this tutorial
Women and Psychosis
When a parent has experienced psychosis: what kids want to know
Schizophrenia: An Information Guide (PDF)