Psychosis is when your perception of reality is changed and you find it hard to know what is real. This means that psychosis may cause you to misinterpret or confuse what is going on around you.
- Psychosis is quite common (3 in 100 people will experience psychosis at some stage in their life). It can be treated and most people make a full recovery.
- There are several types of psychosis; it may be part of a mental illness, a response to major stress or triggered by drug use.
- Psychosis alters your reality and changes the way you behave, think, feel and see the world.
- Symptoms vary from person to person and may interfere with day-to-day life. Signs of psychosis may be mild at first and become more serious over time.
- Getting treatment and support early makes a good recovery more likely.
- Research shows that cannabis use increases the risk of developing a psychotic illness.
What is psychosis?
Psychosis is when the way you perceive reality changes and you find it hard to know what is real. Experiencing the symptoms of psychosis is often referred to as having a psychotic episode.
During a psychotic episode, you may have trouble thinking straight, experience delusions (false beliefs or ideas) and/or hallucinations (seeing, hearing, smelling, sensing things that others can’t). You may feel disconnected from who you normally are, and from others around you. Your behaviour and mood can change. You might feel very sad or very happy.
A psychotic episode is most likely to first happen in your teenage years or early twenties. Because psychosis can be distressing and can distort your reality, it’s important to get help early. There is a range of treatments available, including medication, psychological therapies and social support. After recovering from the first episode many people never have an episode again, but others may experience a number of relapses. See also our page on psychosis in adults.
If you are worried that you or someone else is at immediate risk of self-harm, call 111. If there is no immediate risk, contact your family doctor.
What causes psychosis?
There is no one cause of psychosis. But there are certain risk factors that can make you more vulnerable to psychosis. These include genes (inherited factors) and the environment you are exposed to in life, such as:
- a family history of mental illness
- a head injury
- alcohol and drug use (especially cannabis and amphetamines)
- trauma history
- stressful life events such as abuse, being bullied or a big life change.
What are the symptoms of psychosis?
Symptoms of psychosis vary from person to person and may interfere with day-to-day life. Signs of psychosis may be mild at first and become more serious over time. Symptoms include:
- delusions and confused thinking – beliefs that people from your background don’t usually believe.
- hallucinations – hearing, seeing, smelling, tasting or touching something that isn’t actually there.
- suspicion or paranoia.
- lack of initiative and interests.
- preoccupation with unusual ideas or beliefs.
- change in function at school, work or home.
- change in relationships.
- changes in mood, irritability or anger.
- avoidance of normal activities and social contact, isolation.
- changes in self-care (ie, personal hygiene).
People who experience psychosis are rarely violent. They are more often frightened, confused and despondent (low, down on themselves).
How is psychosis diagnosed?
If you are concerned about yourself or someone else talk to your family doctor (GP). They are used to talking about unusual experiences people may have and will know how to help.
Your doctor will ask about:
- any recent major or stressful events
- physical and mental health history
- drug and alcohol use
- any family history of mental illness.
They may also ask for blood and urine tests, an X-ray and for you to see a mental health specialist.
What are the different types of psychosis?
There are several types of psychosis, depending on what has caused it.
Drug-induced psychosis – using or withdrawing from drugs, especially cannabis and amphetamines, can cause psychotic symptoms that last for short or long periods.
Brief reactive psychosis –psychotic symptoms that appear suddenly after a major stress in your life. Recovery is often quick.
Schizophrenia – an illness in which the symptoms of psychosis have continued for at least six months. Many people with schizophrenia lead happy and fulfilling lives, and many make a full recovery. Read more about schizophrenia.
Bipolar disorder – this condition involves major changes including extreme highs and lows. You can experience psychotic symptoms as part of this disorder. Read more about bipolar disorder.
Depression – psychotic symptoms can occur in people with very severe depression. Read more about severe depression.
What is the treatment for psychosis?
Your doctor may recommend:
- medication, such as an antipsychotic or drugs to reduce depression, anxiety or insomnia (difficulty sleeping)
- counselling or psychological therapy on your own or in a group with other young people
- social support for any other problems you might be experiencing
- referral to a service which specialises in psychosis.
Māori models of care
For Māori, Western models of mental health and mental healthcare will not always be appropriate. An approach based on a Māori model of health has a more holistic understanding of wellbeing. For example, the four cornerstones (or sides) of Māori health in the Te Whare Tapa Whā model of health are:
- whānau (family health)
- tinana (physical health)
- hinengaro (mental health)
- wairua (spiritual health).
You can find a health practitioner who has a kaupapa Māori approach to wellbeing in this directory.
What can I do to help myself?
It’s important that you don’t try and get through this on your own. You can help yourself by:
- having a plan for who to contact if you start to feel unwell and so others know what you need from them
- asking your friends and family to support you
- checking out the links on this page
- taking medication as agreed with your doctor
- avoiding illegal drugs or alcohol
- avoiding stressful events and situations and learning how to cope with stress
- getting plenty of sleep and eating well
- keeping up with your normal activities as much as you are able to.
Where can I find support?
For ongoing support, see your family doctor, your school guidance counsellor or trusted teacher, your contact person at community mental health services or your psychiatrist or psychotherapist. Learn more about mental health services for youth. See also Supporting Families, who provide support for families and whānau to provide the best possible quality of life and recovery to their loved one who has a mental illness and to their own self-care.
If you need urgent help, phone:
- Lifeline 0800 543 354 (available 24/7), or
- Youthline 0800 376 633, 234 free text or email firstname.lastname@example.org
- Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.
- McGorry PD, Goldstone S. Is this normal? Assessing mental health in young people Aust Fam Physician. 2011 Mar;40(3):94-7.
- Lee HE, Jureidini J. Emerging psychosis in adolescents Aust FamPhysician. 2013; 42(8):624-627.
- What is psychosis and the effects on mental health headspace, Australia