Psychosis is a word most of us are familiar with: it that describes symptoms related to several serious mental health disorders, which means early signs of psychosis are things a person does or says that indicate they’re experiencing symptoms that may lead to or precede a mental health disorder. In most cases, the disorders associated with psychosis appear in adults, but early signs of psychosis can appear throughout life, including during childhood or adolescence.
The National Alliance on Mental Illness (NAMI) defines psychosis as:
“…a disruption or impairment in an individual’s ability to differentiate between their perceptions and reality. This may include an inability to identify boundaries between real and unreal experiences and disruption to cognitive processing, as evidenced by delusions, hallucinations, and significantly disorganized speech.”
Although the disorders associated with psychosis are complex, a simple way to think of psychosis is that it’s an indication of “a break with reality.” When we read the definition above closely, we see that psychosis disrupts our ability to discern what’s real and what’s not.
A person with psychosis may see or hear things that aren’t there, and believe they’re real – because they look and sound real to them.
That’s why the symptoms of psychosis can be scary for the person experiencing them and for their friends, loved ones, and family. Friends and family are often the first people that notice a change in a person experiencing psychosis, which makes it important to know and recognize the early signs of psychosis: the earlier a person developing a mental health disorder gets appropriate, evidence-based treatment, the better the outcome.
Symptoms of Psychosis/Mental Health Disorders Related to Psychosis
The symptoms of psychosis appear in two main types: hallucinations and delusions. Hallucinations are things a person sees, hears, or feels that aren’t really there, and delusions are ideas, thoughts, or beliefs that are objectively false.
The mental health disorders associated with psychosis include:
- Schizophrenia
- Schizoaffective disorder
- Schizophreniform disorder
- Brief psychotic disorder
- Mood disorders
- Substance Use
- Severe illness or injury
While some mental health disorders appear rapidly, most develop over time. Before a person develops one of the mental health disorders on the bullet list above, for instance, there are small changes that may only be recognizable to the people close to them. These may include:
- Isolating/spending more time alone than usual
- Decline in academic performance
- Decline in job performance
- Problems thinking/concentrating
- Inattention to personal hygiene/self-care
- Powerful emotions/mood swings that seem inappropriate
- Total absence of/lack of emotion
Taken individually, the things on that list are not uncommon. Most of us want to be alone sometimes, and most of us also have bad days at school or work. However, if those bad days pile up, and the signs in the first three bullets appear alongside the signs in the last four, it’s important to realize there may be something serious going on.
When these warning signs are followed by symptoms such as hallucinations and delusions, then the warning signs and the symptoms may be considered the early signs of psychosis.
Early Signs of Psychosis: What to Watch For
Hallucinations show up in three distinct types:
Visual:
Seeing things that aren’t really there. People may see other people who don’t exist, see a chair that’s not there, or watch a plain white wall change color. In some cases these hallucinations are benign, but at other times they can be very frightening.
1. Auditory: Hearing things that aren’t really there.
People may hear voices coming from inside their own head, or from an external source. Like visual hallucinations, auditory hallucinations can be benign or very frightening.
2. Tactile: Feeling things that aren’t really there.
People may feel like bugs are crawling on their skin, or have the disturbing sensation something is moving under their skin. In some cases, people feel a tap or touch on the arm or shoulder when no one has tapped or touched them.
3. Olfactory: Smelling things that aren’t really there.
People may smell pleasant odors, like flowers, or things most of us would agree are gross, like garbage or rotting eggs. Olfactory hallucinations may come and go, or they may be constant.
Delusions appear in four primary types:
1. Delusions of grandeur.
People may think they have special powers, secret knowledge, possess secret skills. In some cases, people believe they have a direct connection to religious figures or special access to spiritual knowledge.
2. Delusions of persecution.
People may believe – without evidence – that external forces control them, monitor them, seek to cause them harm, or cause them to behave in specific ways.
3. Delusions of thought.
People may believe – without evidence – that external forces control their thoughts, plant thoughts in their heads, steal thoughts form their heads, or have the ability to read or hear their thoughts.
4. Delusions of relationship.
People may believe their partner is cheating on them, or believe they’re in a relationship with a celebrity they’ve never met.
It’s easy to see why psychosis can frighten the person who experiences the symptoms, as well as their friends and loved ones. However, what everyone should understand is this: it’s possible to treat psychosis, and early treatment leads to the most successful outcomes.
Treatment for Psychosis
The treatment experts at the National Alliance on Mental Illness (NAMI) indicate the most effective treatment for psychosis is an approach called Coordinated Specialty Care (CSC). CSC is a team-based, patient-centered, family-focused approach to treatment that includes six components:
1. Psychotherapy/Counseling
2. Medication
3. Peer support
4. Case Management
5. Family Involvement/Education
6. Patient Education/Employment
This template for treatment is based on the idea that the patient and family are key elements in successful treatment, and focuses on a positive, trusting treatment alliance between treatment providers and the family.
Evidence indicates this team-based approach is effective. When the patient, family, and mental health providers cooperate, outcomes are positive. When a team collaborates, communicates, and agrees to commit to treatment and work toward mutually agreed upon recovery goals, it’s possible to address early signs of psychosis, and reduce or prevent long-term negative consequences.
Gianna Melendez
Jodie Dahl, CpHT