Psychosis: Types, Causes, and Treatment Guide

Psychosis is a condition that affects how people think and experience the world. In simple terms, it can involve moments when someone loses touch with what is real, hearing or seeing things that others don’t, or holding beliefs that others find hard to believe. It can be scary, but with support and treatment, many people regain stability and a better sense of daily life.

What is psychosis?

Psychosis refers to a set of symptoms that disrupt reality perception. People may experience hallucinations, such as hearing voices, or delusions, which are strong, unshakable beliefs that aren’t based in reality. These experiences can occur on their own or as part of a larger mental health condition. Importantly, psychosis is not a single disease; it can arise from different conditions and situations, and it can be treated with appropriate care.

Main types of psychosis

Schizophrenia spectrum disorders

Schizophrenia and related disorders involve persistent psychotic symptoms—such as delusions, hallucinations, disorganized thinking, and impaired social functioning—for a significant period. People may also experience negative symptoms like reduced motivation or flat affect. Early diagnosis and ongoing treatment can help many people manage symptoms and maintain everyday activities.

Bipolar disorder with psychotic features

Some people with bipolar disorder experience psychotic symptoms during mood episodes. When a person is manic or depressed, thoughts and perceptions can become distorted. With mood stabilization and appropriate therapy, psychotic symptoms often improve as the mood episode resolves.

Major depressive disorder with psychotic features

In severe depression, psychotic symptoms can appear alongside low mood, feelings of worthlessness, or sleep disturbances. These psychotic features tend to align with the depressive state and typically improve with effective treatment for depression and the psychosis.

Schizoaffective disorder

Schizoaffective disorder blends symptoms of schizophrenia with mood disorder symptoms (such as depression or mania). The result is a combination of psychotic symptoms and mood changes that require coordinated treatment for both aspects.

Brief psychotic disorder

This type involves sudden, short-lived psychotic episodes—often triggered by extreme stress or trauma. Most people recover fully within days to weeks with supportive care and treatment as needed.

Substance-induced psychosis

Some substances, including certain drugs or alcohol withdrawal, can cause psychotic symptoms. If the substance is stopped or treated, psychosis may fade. In other cases, ongoing use or underlying mental health conditions require longer-term management.

Psychosis due to a medical condition

Medical illnesses affecting the brain or body—such as infections, metabolic problems, autoimmune diseases, or neurological conditions—can lead to psychotic symptoms. Addressing the underlying medical cause is a key part of treatment.

Common causes and contributing factors

• Genetics and brain development: A family history of psychosis or related conditions can increase risk.
• Brain chemistry and structure: Imbalances in neurotransmitters or changes in brain areas tied to perception and thinking can play a role.
• Substance use: Drugs like cannabis, stimulants, or certain medications can trigger psychotic symptoms in some people.
• Severe stress or trauma: Intense stress or traumatic experiences can precipitate psychosis in some individuals.
• Medical conditions: Infections, autoimmune disorders, thyroid problems, or sleep disorders can contribute to symptoms.
• Sleep deprivation and extreme fatigue: Lack of sleep can worsen perceptual distortions and thinking.
• Pregnancy and postpartum periods: Hormonal and lifestyle changes can, in rare cases, be linked to psychosis.

How psychosis affects daily life

Psychotic symptoms can disrupt many aspects of everyday life. People may struggle with focus, decision-making, and memory, which can affect work, school, or caregiving. Relationships can be strained as others misinterpret experiences, and safety concerns may arise if delusions or hallucinations lead to risky behavior. Mood changes, sleep problems, and social withdrawal are common, making routine activities and self-care more challenging. Receiving support and building understanding from family, friends, and professionals can help restore a sense of control and reconnect with daily routines.

When to seek professional help

If you notice persistent psychotic symptoms—such as hearing voices, believing things not shared by others, or having disorganized speech or behavior—seeking help is important. Early intervention can improve outcomes. Seek urgent care if there is any risk of harming yourself or others, or if you or someone you know is in immediate danger.

• Psychotic symptoms lasting more than a few days to two weeks, or worsening over time
• New or unusual changes in mood, appetite, sleep, or social withdrawal alongside perceptual changes
• Delusions or hallucinations accompanied by thoughts of self-harm or harming others
• Onset of symptoms after a head injury, serious illness, or substance use

If you’re unsure where to start, consider talking to a primary care clinician, a mental health professional, or a crisis line in your country. You can also contact emergency services in urgent situations.

Treatment and support options

Treatment for psychosis is tailored to the underlying cause and may include a combination of approaches:

• Medication: Antipsychotic medications are commonly used to reduce psychotic symptoms and help stabilize thinking and perception. Some people may need mood stabilizers or antidepressants as well, depending on accompanying conditions.
• Psychotherapy: Cognitive-behavioral therapy (CBT) for psychosis, family therapy, and psychoeducation can help people identify triggers, challenge unhelpful beliefs, and improve coping skills.
• Supportive services: Social work, vocational rehabilitation, and peer support can help with daily functioning and returning to work or school.
• Collaborative care: Regular follow-up with healthcare providers, monitoring for side effects, and coordinating care across specialists improves outcomes.
• Lifestyle and safety: Sleep hygiene, stress reduction techniques, avoiding substances, and safety planning contribute to overall well-being.

Early, compassionate care makes a real difference. If you or someone you know is experiencing psychotic symptoms, reaching out for professional evaluation is a proactive step toward stability and recovery.