Early signs of psychosis

Psychosis refers to a collection of symptoms that affect the mind, where there has been some loss of contact with reality. During an episode of psychosis, a person’s thoughts and perceptions are disrupted, and they may have difficulty recognizing what is real and what is not. Learn more about what to look for and where to go to get help.

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What is psychosis?

Psychosis often begins in young adulthood when a person is in their late teens to mid-20s. However, people can experience a psychotic episode at younger and older ages and as a part of many disorders and illnesses.

Sometimes, and depending on the cultural context, psychosis may not be a cause for concern. In other instances, these experiences may be disruptive to a person’s life and wellbeing, causing significant distress and decline in functioning.

According to the National Alliance on Mental Illness (NAMI) approximately 100,000 young people will experience psychosis each year, and as many as 3 in 100 people will experience psychosis in their lifetime.

Despite common myths that promote the belief that a diagnosis of a psychotic disorder is akin to a life-sentence of accumulating disability and social marginalization, the truth is that recovery from psychosis is not only possible, but common. Individuals that experience a first episode of psychosis can access person-centered treatment and, with the support of their loved ones and communities, go on to define their own meaning of recovery and lead fulfilling lives.

National Institute of Mental Health, “Understanding Psychosis”; Pat Deegan, “Putting the Human Back in Human Services”

New Journeys: Coordinated Specialty Care in Washington locations

If someone you know is experiencing symptoms, you can talk to your doctor, or request a referral for New Journeys, which is Washington State’s Coordinated Specialty Care for First Episode Psychosis. Anyone can make a referral by visiting the website and filling out the referral form.

Find a New Journeys team

New Journeys teams are trained to provide outreach, screening, assessment, specialized treatment, and referrals to other community-based supports for individuals experiencing symptoms and their families. New Journeys services are currently available in the following areas:

Early signs and symptoms

The early signs of psychosis may be subtle, and each person’s experience will be unique. Here are some common signs and symptoms.

Unusual thoughts, feelings, or beliefs
  • Believing that things in their environment hold special meaning or refer to them
  • Believing that others can read their mind or know what they’re thinking
  • Feeling suspicious or worried that others are trying to harm them
Sensory or perceptual changes
  • Hearing, seeing, feeling, or tasting things that others cannot
  • Feeling confused about whether something is real or not
  • Feeling their thoughts are so loud others can hear them
Changes in social activity, speech, concentration, and work
  • Losing interest in participating in social activities and hobbies
  • Spending more time alone
  • Difficulties at school or work
  • New trouble with concentration or memory
  • Trouble organizing thoughts or changes in speech
  • Decline in personal hygiene
Mood
  • Anxiety Depression Irritability Extreme changes in mood or emotions, energy level, or activity level

Psychosis symptoms

During an episode of psychosis, a person experiences symptoms that cause disruption to their personal well-being and functioning. During an episode, symptoms are frequent and persistent.

Hallucinations
  • Perceiving things that others do not but seem very real to the person experiencing them, such as:
    • Hearing voices
    • Seeing things
    • Feeling sensations that are not present
  • Oftentimes, the person may report that the sensory experience (e.g., hearing voices) is coming from outside of them.
Delusions
  • Strongly held beliefs that are resistant to reason or contradictory to reality, are not shared by others in their culture, or may lead to unusual or distressing behaviors.
Disorganized thinking
  • Difficulty organizing thoughts
  • Trouble expressing oneself clearly
  • Struggling to follow a logical sequence of ideas
Loss of typical drives
  • Loss of interest, motivation, or energy
  • Loss of emotional expression
  • Loss of social connection
  • Loss of clear speech

Causes of psychosis

There is no one cause of psychosis. Psychosis may have a variety of underlying causes, including:

Psychiatric causes
  • Schizophrenia Spectrum Disorder
  • Bipolar Disorder with psychotic features
  • Major Depression with psychotic features
Medical causes
  • Pharmacological
  • Substance intoxication or withdrawal
  • Sleep deprivation
  • Endocrine disorders
  • Neurological conditions
  • Infections
Psychotic-Like Experiences (PLEs)

Psychotic-Like Experiences, or PLEs, are defined as psychotic symptoms in absence of an underlying psychiatric or medical cause.

Examples include:

  • Vivid images or noises associated with trauma
  • Magical thinking associated with Autism
  • Strongly held beliefs related to Obsessive Compulsive Disorder

PLEs typically are;

  • Infrequent and episodic in nature
  • Culturally normative
  • Developmentally normative
  • Cause little to no impairment to daily living/minimal distress
  • Insight to experiences is maintained

Additionally, some research indicates that PLEs may be considered a psychosis risk state, and that individuals that experience PLEs may be more vulnerable to developing a mental health disorder in their lifetime.

Resources and stories from New Journeys

Recovery stories: New Journeys participants
Resources

Find publications, resources, and information about psychosis, New Journeys, and the First Episode Psychosis Initiative in Washington State.

This list of recent articles and videos highlights first episode initiatives across the United States.

Are you, or someone you know, in need of immediate help?

  • For life-threatening emergencies, Call 911.
  • For 24-hour suicide prevention or a mental health crisis support, Call or text 988.
  • You can also contact your local mobile crisis team for on-the-ground assistance.

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