(Printable version of this fact sheet)

Imagine you wake up one day and find that you feel different.
It’s hard to say exactly what’s different but you find yourself thinking unusual thoughts.

Over the next while, you notice it’s also becoming harder and harder to talk to your family and friends. Although you used to do well at school, it is now very difficult even to follow what the teacher is saying in class.

You look around and your friends seem to be whispering and laughing at you. You hear voices telling you to do things or saying you’re worthless. You don’t even want to get out of the bed in the morning or bother putting on clean clothes. Your family is worried and wants you to see a doctor, but you don’t think there is anything wrong with you.

This may be the beginning of psychosis.

Psychosis is a word used to describe medical conditions that affect the brain, so that what a person thinks is real is different from what other people think is real. Although we don’t completely understand what causes psychosis, many medical researchers think that people are born with a vulnerability or tendency towards psychosis. This doesn’t mean they’ll automatically become ill, but that if the person is exposed to enough stress it can trigger psychosis. The more vulnerability to psychosis a person is born with, the less stress would be needed to make them ill. Vulnerabilities can be genetic (inherited through your genes from your parents) or caused by things that happen during pregnancy or while a person is being born. Stresses can include difficult life events or situations, injuries and illnesses or drug use.

Psychosis is a medical condition and it can be treated.

Many people recover fully after they are ill with psychosis for the first time and never have it again. Others may have more during the course of their life. Almost all people with psychosis improve with treatment.

Who gets psychosis?

About three out of every one hundred people will become ill with psychosis at some time in their life. Most people experiencing psychosis for the first time are between the ages of 16 and 30. Men and women are equally vulnerable to psychosis, although men tend to be slightly younger when it first appears. People are slightly more likely to become ill with psychosis if other close family members have been ill with it.

Early signs of Psychosis

Family or friends are likely to notice some changes in the person. Early on it’s hard to pin down what might be the cause. You may notice that the person has been moody or gets easily irritated. You may notice odd behaviours or see the person’s school or work performance go way down. The person becomes more withdrawn and less active, often spending long periods alone or shut away by themselves. Because these signs are not clear cut, family and friends may assume that the person is just going through a phase or suspect the person is using street drugs.
It is very important to seek medical help as soon as possible.

What are the signs of psychosis?

As the person becomes more ill, they will begin to have more of the symptoms described below.

False Beliefs - Strongly held false beliefs, such as the belief that a famous person is speaking directly to them through the television or radio, or that others are controlling their thoughts. “The radio had special messages meant only for me.”

Hallucinations -Seeing, hearing, feeling or smelling things that are not really there. These can seem so real that the person is not aware they are part of psychosis. The most common type of hallucination is hearing voices. “I’d hear someone telling me I was worthless and stupid.”

Changed Feelings - The person may show less emotion to others, or feel cut off from the world. They may also be unusually excited or depressed. “It was like a piece of me was gone; I tried to call up emotions that weren’t there”

Changed Behaviours - The person will behave differently than they used to. They may sit around all day, laugh or become angry and upset without a clear cause. The behaviours may be connected to the false beliefs or hallucinations. “He was covering his right eye so that the people trying to control his mind couldn’t get in.”

Confused thinking - Sentences are unclear or jumbled. The person appears to have difficulty concentrating, remembering or maintaining a train of thought. They may seem to be thinking faster or slower than usual. “It felt like too many thoughts going on at once, but all mixed up so I couldn’t get anything done.”

How can I help someone who might have psychosis?

• Encourage the person to go to their family doctor or a medical doctor for a check-up.
• Offer to make the appointment or go along as a support.
• You can contact a Mental Health Centre, or if your community has one, an Early Psychosis Intervention Program. The Blue Pages of your phone book will have the numbers of your local health authority.

If the person is acutely ill
If the person is acutely ill, you can take them to a hospital emergency ward, or call 911.
Calm and Quiet Helps

• Psychosis is very frightening to the person. It is important to create a calm quiet environment if you can.
• Sit beside instead of in front of them and speak simply and clearly.
• Do not argue with the person about their thoughts or experiences. Focus instead on how they are feeling and how frightening it must be for them.
• Be watchful, and if the person gets very agitated or aggressive, make sure you take steps to keep yourself and others safe. Leave or call 911 if you need to.

For information on helping a person in recovery, please see this fact sheet for family and friends

Why is it important to get help early?

Problems in thinking and perceiving the world can have a big effect on a person’s life, relationships, school and career. The longer problems go on, the more serious the effects will be and the more they will affect that person’s future. Whether problems are caused by psychosis or not, getting help is important.

Early, effective medical treatment can make a big difference in how quickly a person recovers and can reduce the chances of having more episodes. Each psychotic episode damages the brain, so that it takes longer to recover from a second or third episode and recovery is less complete.

Treatment almost always involves medication. Usually, the person must continue to take the medication as prescribed even when they feel well to avoid getting sick again. This is similar to other illnesses like diabetes.

It often takes a while for the doctor to work out what the right drug and dosage is for each person to keep them well with the fewest side effects. Letting the doctor know about any side effects will help. If they get proper treatment, many people recover fully from their first episode and never have another one.

Remember, psychosis is a medical condition, and early treatment is effective.
For More Information:
BC Schizophrenia Society www.bcss.org
Fraser South Early Psychosis Intervention Program www.psychosissucks.ca
Helping Overcome Psychosis Early www.hope.vancouver.bc.ca