What is psychosis?

The word "psychosis" describes conditions that affect the mind, where there has been some loss of contact with reality. The terms "early psychosis" or "first episode psychosis" mean that an individual is experiencing psychosis for the first time. Symptoms of psychosis include:

These symptoms can seem so real that often the person does not realize that they are experiencing psychosis. Psychosis also affects feelings and behaviour. Each person who experiences psychosis, experiences it differently.

"Psychotic episodes" are periods of time when symptoms of psychosis are strong and interfere with regular life. The duration of these kohls coupon code episodes vary from person to person and from episode to episode. The symptoms may only last a few hours or days. But psychosis may continue for weeks, months or even years unless the person gets proper treatment and support.

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Who gets psychosis?

Approximately 3% of people will experience a psychotic episode at some stage in their life. It is estimated that in the City of Toronto, there are approximately 875 new cases of first episode psychosis per year (based on an estimated incidence rate of 35 cases per 100,000 people). A first episode usually occurs in the teen years or early adult life. The overwhelming majority of first episodes of psychosis occur among young people between the ages of 15 and 34. Psychosis occurs in all cultures and levels of socioeconomic status. Men and women are affected equally.

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What are the signs and symptoms of psychosis?

There are three phases to psychosis. However, not all people having a psychotic episode will have clear symptoms of all three phases. Each person's experience will differ.

Prodromal phase

The first phase is called the prodromal phase. This is the period before the psychosis becomes more obvious. The person often experiences changes in feelings, thoughts, perceptions and behaviours. Prodromal symptoms vary from person to person and some people may not have a prodromal phase. How long this phase lasts is different for everyone but it usually spans several months. Some of the more common prodromal symptoms include:

These symptoms are very general. They could be signs of many different things, including normal teenage behaviour. Signs that this phase could be more than normal adolescent behaviour are steady declines in grades, social interactions and friendships, and/or the inability to continue part-time or full-time work.

It is important to be on the alert for changes in thoughts, feelings, perceptions and behaviour. It is also important to pay attention when these changes take place over a period of time. The earlier psychosis is identified and the earlier treatment starts, the greater the chance of a successful recovery.

Acute phase

The second stage is called the acute phase. This is the stage when the typical psychotic symptoms emerge. These are the symptoms that are hard to miss. They are intense, active and continuous. They interfere with normal life functioning. As a result, the acute phase is the easiest to recognize and diagnose. This is when most people begin receiving treatment.

Symptoms of acute psychosis are frequently separated into "positive" and "negative" categories.

"Positive" symptoms are referred to as "positive" because they are viewed as an excess or distortion of the person's normal functioning. Some of the positive symptoms include:

"Negative symptoms" reflect a decrease in, or loss of, normal functions. These symptoms are often less obvious than positive symptoms. People need to be carefully assessed for negative symptoms. Some examples of negative symptoms include:

It is also common for other symptoms or problems to occur along with the psychotic symptoms. Some examples of other problems include:


The third phase is recovery. With the right treatment and support, the great majority of people successfully recover from their first episode of psychosis. In the recovery stage, the acute symptoms will lessen. They will start to cause less distress to the person. However, some symptoms may linger.

The recovery process will vary from person to person. Some people will recover from the psychosis very quickly. They will soon be ready to return to their regular activities of life and their responsibilities. Other individuals will need time to respond to treatment. They may find it helpful to return to their responsibilities more gradually.

Recovery from the first episode usually does take a number of months. If symptoms remain or return, the recovery process may be prolonged. Once the psychosis has responded to treatment, problems such as depression, anxiety, decreased self-esteem and social impairment also may need to be addressed during the recovery phase.

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What causes psychosis?

Unfortunately, at this time there are many theories about what causes psychosis, but no definite answers. Psychosis occurs in a variety of mental and physical disorders. Because of this, it likely has multiple causes. The most common theories focus on the roles played by biology, stress and substance (i.e., drug or alcohol) use.



Some psychoses appear to occur primarily in response to stress. In most cases, it is believed that a biological vulnerability to psychosis combined with stress can lead to psychosis.

People may become more vulnerable to psychosis because of their genetic makeup. This might be shown by coming from a family where other members also had psychotic disorders. They may have had some damage to their brain. This can happen as a result of problems during their birth, such as being deprived of oxygen.

Stresses can include significant life events such as the death of a loved one. The experience of trauma - for example, as a result of living through war, being a refugee, experiencing domestic abuse, or having had a serious accident - has also been shown as a stressor related to psychosis. Stressful living conditions such as family conflict or problems with money can also trigger psychosis. Even stresses like moving to a new city can lead to psychosis if someone is vulnerable to it.

The degree of vulnerability varies from person to person. Likewise, the amount of stress that may trigger psychosis likely differs for each individual. For example, a person with a low vulnerability might withstand a large amount of stress without experiencing psychosis. In contrast, for a person with a high vulnerability, even a low amount of stress may lead to psychosis.

Substance use (i.e., drugs)

Psychosis can be caused or triggered by drugs. For example, it appears that amphetamines can cause a psychotic episode. Other drugs, including marijuana, can increase a person's natural vulnerability to psychosis resulting in a psychotic episode.

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Why is early intervention important?

It is important to intervene early in psychosis. Doing so has been shown to substantially reduce the duration of the illness, the need for medications and the need for stays in hospital. Specialized early intervention helps people to get better faster and return to their regular lives more quickly.

Intervening early is particularly important because psychosis can disrupt a very critical stage of a young person's life. Teenagers and young adults are just starting to develop their own identity, form lasting relationships, and make serious plans for their careers and future. A psychotic episode commonly isolates the person from others. This can impair family and social relationships. If left untreated, there is greater disruption to the person's family, friendships, study and work. Difficulties in school and work arise. Secondary problems can occur or intensify, such as unemployment, substance abuse, depression, self-harm or suicide, or illegal behaviour. Delays in treatment may lead to a slower and less complete recovery.

However, disruption to life functioning does not need to take place. If psychosis is detected early, many problems can be prevented. Current treatments are so effective that almost every individual can recover from a first episode of psychosis. Being able to treat psychosis early greatly increases the person's odds of being able to enjoy a healthy and productive future.

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What about stigma?

To many people, mental illness is frightening. Unfortunately, this fear can discourage people from seeking help early. Neither denial of the problem nor delay in seeking help will help a young person with psychosis.

Much of the fear surrounding mental illness is based on myths and misunderstandings. Mental illness need not be feared. Like other medical conditions, mental illness can be treated. People can and do recover.

Some common myths about psychosis are that people with psychosis have multiple personalities, are dangerous, and they never recover.

In fact, people who experience multiple personalities may be suffering from a psychiatric disorder called dissociative identity disorder. It is different from psychosis. Rather than being dangerous or violent toward others, people with psychosis often withdraw from people. They are more likely to hurt themselves or to attempt or commit suicide than to hurt others. Most importantly, with current treatments and support, most people make successful recoveries.

Education about psychosis is one of the ways to deal with stigma. Finding out what treatment is available and how recovery is possible can not only reduce some of the fear associated with psychosis, but can also promote recovery by helping people anticipate and prepare for what to expect from treatment and from themselves.

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