What is psychosis? Signs, causes, and how to get help

Mental Health

Sep 26

Written By Calm Editorial Team

Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA

Learn the signs of psychosis, what might cause it, and 10 tips help a loved one through this journey with care and compassion.

Psychosis is often deeply misunderstood, both within and outside the mental health community. Frequently depicted in media as a condition marked by dangerous or unpredictable behavior, it is, at its core, a temporary disruption in how a person interprets reality. This can involve hallucinations, delusions, disorganized thinking, or profound confusion — and it may come on gradually or suddenly, with symptoms that vary widely from one person to the next.

These experiences are not always immediately recognizable. In fact, early signs can be subtle: a shift in behavior, a growing sense of disconnection, or changes in speech or thought patterns. Many times, only those closest to the individual recognize that something might be wrong.

That's why understanding what psychosis is and how it manifests is so important. Whether you’re experiencing it yourself or supporting someone who is, knowing the signs, causes, and treatment options can help reduce fear, encourage earlier intervention, and support long-term recovery.

What is psychosis?

Psychosis is a mental state where someone temporarily loses touch with reality. This could mean hearing voices that others don’t hear, seeing things that aren’t there, or believing something that doesn’t align with reality. These experiences are typically vivid, highly realistic, and often deeply distressing.

Many people experience psychosis once or twice and recover fully, while others live with longer-term conditions where psychosis is one piece of a much bigger picture.

It’s important to note that psychosis is a symptom, not a condition. Yes, it can be scary, but it’s treatable, and recovery is possible.

6 types of psychosis

People experience psychosis in different ways and for different reasons. Here are six of the most common types:

Brief reactive psychosis: This can be triggered by extreme stress or trauma and usually resolves within a few days or weeks with the right care.
Substance-induced psychosis: Certain drugs can trigger it, especially in high doses or during withdrawal. Common culprits are stimulants, hallucinogens, steroids, and antidepressants.
Psychotic depression: This is a severe form of depression where someone can experience delusions or hallucinations alongside deep feelings of hopelessness.
Bipolar disorder with psychotic features: In some manic or depressive episodes, a person can experience psychosis tied to the intensity of their mood.
Schizophrenia and related disorders: Some longer-term conditions, like Schizophrenia, have psychosis as a core symptom. Those with these types of disorders can experience persistent or recurring hallucinations, delusions, and disorganized thinking.
Medical or neurological causes: Illnesses like epilepsy, brain injuries, dementia, and infections can also trigger psychosis.

What are the symptoms of psychosis?

Psychosis isn’t something that comes out of nowhere. This mental state usually builds gradually. It may start with small changes, like trouble focusing or pulling away from others. Then, over time, these small changes lead to more noticeable, overwhelming symptoms.

Here are five classic symptoms of psychosis:

Hallucinations: Hearing, seeing, or sensing things that others don’t, like voices, shadows, or physical sensations that feel very real.
Delusions: Strong beliefs that don’t reflect reality, like thinking you’re being followed or that you have special powers.
Disorganized thinking and speech: Your thoughts start to become jumbled or hard to express. This can lead to speech that’s scattered or confusing.
Disrupted emotions or behaviors: Mood swings, slowed movements, agitation, and withdrawing from daily life are all signs you could be experiencing psychosis.
Loss of insight: Many people don’t realize they’re experiencing psychosis in the moment. This is one of the most common ways it can impact your self-awareness.

Why does psychosis happen?

Most often, psychosis is triggered by a mix of biological, psychological, and environmental factors that build up or collide all at once. Sometimes, it’s a one-time experience. Other times, it’s part of a longer-term condition. But typically, the biggest contributors are:

Stress or trauma, especially early in life
Genetics and brain chemistry, including dopamine imbalances
Sleep deprivation, which can distort thinking and perception
Substance use or withdrawal, particularly from stimulants, cannabis, or hallucinogens
Medical conditions, like brain injuries, infections, epilepsy, or hormonal shifts
Mental health conditions, like schizophrenia, bipolar disorder, depression, and PTSD

Is recovery from psychosis possible?

Recovery from psychosis is definitely possible. Many people go on to live full, meaningful lives after experiencing psychosis. They work, build relationships, raise families, create art, and find stability. But recovery isn’t always linear. Symptoms can still come and go, especially during stressful times.

Early intervention, through programs like Coordinated Specialty Care (CSC), can make a big difference by providing therapy, case management, medication support, and family education all in one place.

Other treatments that can help include medication, peer groups, community support, and structure, such as consistent sleep, gentle routines, and rest.

How to take care of yourself if you’re recovering from psychosis

Psychosis can shake your sense of self and safety. It can leave you feeling exhausted, fearful, and overwhelmed. If you’re currently recovering from this state, here are some ways to be kind to yourself as you navigate this process:

Start small: Keep your routines simple. Focus on just getting dressed, drinking water, and eating something nourishing. Then have one other steady part of your day, like taking a walk in the morning or napping at a specific time.
Say yes to support: Therapy, peer support, case workers, and a trusted friend can all help you feel less alone. They can also make sense of things and hold the pieces when it feels like it’s too much.
Let your brain rest: Give yourself permission to take breaks, cancel plans, and say no to pressure, especially internal pressure.
Notice what helps: Over time, figure out what grounds you. This could be music, drawing, meditation, quiet routines, or time outside. Then write them down and come back to them.
Don’t rush insight: It’s okay if you don’t understand everything that happened. Reflection takes time. So, trust that clarity will come, little by little.

How to help a loved one in psychosis: 10 tips to support

Watching someone you love go through psychosis can feel scary and confusing. In moments like this, remind yourself that there’s no perfect way to support someone experiencing these symptoms. What matters most is showing up in ways that are steady, kind, and safe for both of you.

Here are 10 mindful tips to help your loved one (and you) move through this journey.

1. Gently encourage professional support

Psychosis is treatable, and early care, especially after a first episode, can make a big difference in long-term recovery.

Local therapists, psychiatrists, or early intervention programs like Coordinated Specialty Care can offer wraparound services like therapy and medication support. But not everyone will be ready to accept help right away, so meet them with patience.

You could bring the topic up by saying, “I’m worried about you, and I think it might help to talk to someone. I can help you find the right person.” You could also offer to make the call or sit with them during the appointment.

2. Respond with calm and respect

When someone is in psychosis, they may say or believe things that seem confusing or alarming. But try not to argue or correct them. Instead, focus on how they’re feeling. Stay calm, use a soft voice, and keep your body language relaxed.

You can acknowledge the emotion without reinforcing the belief by saying something like, “That sounds really overwhelming. I’m here with you.”

Another good rule of thumb is to avoid dismissive responses like, “That’s not real.” What they’re experiencing feels real to them, and respect goes a long way toward building trust.

3. Focus on safety

If your loved one appears confused, frightened, or unpredictable, consider how to minimize stimulation and maintain a calm environment. This could mean turning off the TV, removing unnecessary people from the room, or giving them space while keeping an eye on their wellbeing.

If you believe someone is at risk of harming themselves or others, reach out to emergency services. However, use this option carefully, with as much consent and transparency as possible. In some places, you can even request a mental health crisis team rather than the police.

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4. Learn about psychosis

The more you learn, the more prepared you’ll be to respond with clarity instead of panic. So, explore reliable sources, like NAMI, Hearing Voices Network, or Early Psychosis Intervention programs.

Knowing the signs of early psychosis, like changes in sleep, mood, hygiene, or speech, can also help you spot subtle shifts in the future.

5. Don’t take it personally

During episodes, your loved one might seem distant, mistrustful, or upset. They might even say things that are hurtful or paranoid. Try not to take this as a reflection of how they actually feel about you. Remember, it’s a symptom, and not the truth.

At the same time, this is a lot to take on, so also give yourself permission to feel whatever you feel as you go through the process.

6. Support practical needs

To make it easier for your loved one, offer help by preparing meals, reminding them to take their medication, or transporting them to appointments. You could also coordinate care and help them keep track of paperwork.

Be specific in the way you offer help. You might say something like, “Would you like me to bring you groceries this week?” instead of, “Let me know if you need anything.”

7. Know what to do in a crisis

If your loved one is having a psychotic episode and appears disoriented, paranoid, or at risk of harm, try to speak clearly and slowly to them. Use short, simple sentences, avoid sudden movements, and keep your voice steady.

If immediate help is needed, look up your local mental health crisis line or mobile response team. These places are often better equipped than standard emergency services.

8. Support their recovery

Once a crisis has passed, continue to show up. Psychosis recovery can be lonely, especially if friends or family drift away out of fear.

To help them feel less alone, invite them to low-pressure activities like short walks or quiet meals. You could also celebrate their small wins, like taking their meds consistently or cooking a meal.

9. Care for yourself, too

Supporting someone through psychosis is typically emotionally and physically draining. And while you may want to give them all they care they need, remember that you deserve support, too.

Make an effort to talk to a therapist if you’re feeling overwhelmed, and consider connecting with peer groups for families, like NAMI Family Support Group.

💙 Fill your cup up during this tough time with help from Lama Rod Owens' series on Radical Self-Care.

10. Be patient with the process

Healing from psychosis usually requires redefining what stability looks like, and some days will be harder than others. But what matters most is consistency, care, and showing up.

Remind yourself that recovery takes time, so celebrate the small steps like making it to an appointment and getting dressed. These moments may seem minor, but they’re signs of resilience. Your patience and quiet encouragement can help create the conditions for long-term healing.

What is psychosis FAQs

What are the early signs of psychosis?

The early signs of psychosis, often called “prodromal symptoms,” typically manifest as trouble concentrating, withdrawing from friends and family, disrupted sleep, reduced motivation, and a growing sense of suspicion or unease.

It’s also common for thoughts to feel jumbled or not like your own, and for emotions to feel flat or unpredictable.

What are the reasons for psychosis?

Psychosis usually arises from a combination of factors. But two common reasons are genetics and brain chemistry. This can be especially true if someone has a family history of mental illness or imbalances in dopamine.

External stressors like trauma, lack of sleep, substance use, or major life disruptions can also trigger psychosis. Additionally, some medical conditions, like epilepsy, infections, and hormonal shifts, can cause psychotic symptoms.

What does a psychotic episode feel like?

A psychotic episode can be intense and isolating for both the person experiencing it and their loved ones.

For the person experiencing it, it can feel like waking up in an alternate reality. If someone experiences hallucinations, it can feel confusing or frightening. And if they experience delusions, it can feel urgent and deeply convincing. Thought patterns may become scattered, making it difficult to follow conversations or express oneself.

Can someone have psychosis from stress or lack of sleep?

Both intense stress and severe sleep deprivation can trigger psychosis, especially in someone who already has underlying vulnerabilities. This can look like paranoid thoughts, hallucinations, or a sense of detachment from reality.

In some cases, symptoms resolve quickly with rest and support. But if stress-induced psychosis becomes recurring or doesn’t fade after sleep is restored, it can be a sign that deeper care is needed.

Is it possible to recover from psychosis?

It’s possible to recover from psychosis. In fact, many people make a full recovery after a single episode, especially with early treatment and a strong support system.

There are also others who live with ongoing vulnerability but manage it successfully with therapy, medication, and structure.

How do I talk to someone who I think is experiencing psychosis?

Start by slowing down, lowering your voice, and approaching the person with gentleness. Then use short and calm sentences.

Instead of challenging what they’re experiencing, try to reflect the emotion underneath. You might say something like, “It seems like you’re scared. I’m here with you,” rather than, “That’s not real.”

Additionally, ask what they need in the moment, like water or someone to sit with them. But most of all, listen more than you speak, and know that your presence, even in silence, can be grounding.

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mental health

Calm Editorial Team