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Frequently Asked Questions - Early Psychosis and Young People

What is Psychosis?

The word "psychosis" is used to describe conditions that affect the mind, in which 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. Hallucinations, delusions (false beliefs), paranoia and disorganized thoughts and speech are symptoms of psychosis.  Psychotic episodes are periods of time when symptoms of psychosis are strong and interfere with regular life. Although the lengths of these episodes vary from person to person and may only last a few days, psychosis is most likely to continue for weeks, months or even years unless the person is given proper treatment.


What are the symptoms of psychosis?

Early Signs

Early warning signs of psychosis include:
Social withdrawal
Reduced concentration, attention
Sleep disturbance
Skipping school or work

These symptoms could be signs of many things, including adolescent behaviour. Early intervention increases the chance of a successful recovery and so it is important to address changes in one’s thoughts, behaviours, moods and perceptions.

Symptoms During a Psychotic Episode

Symptoms are frequently separated into "positive" and "negative" categories. It is important to realize that this does not mean that the symptoms are either “good” or “bad”. Positive refers to symptoms that someone would not typically experience and therefore they are something that has been added to the person’s experience. Negative symptoms are things that are typical of human functioning but that are absent.

Some of the positive symptoms include:

Delusions (Fixed false beliefs) Such as the belief that one is:

Being followed or monitored
Being plotted against
Having special abilities or "powers"


Hallucinations involve seeing, hearing, feeling, smelling or tasting something that is not actually there. The most common type of hallucination involves hearing things - such as voices or particular sounds. These hallucinations can seem very real to the person experiencing them.

Disorganized Speech or Behaviour

People with psychosis often have difficulty organizing their thoughts, actions and speech. One may move quickly from one topic to the next, or be difficult to understand. The person may have difficulty performing activities of daily living (e.g., cooking, self-care) or display inappropriate behaviours or responses (e.g., laughing while describing a personal tragedy).

 Some examples of negative symptoms include:

Little display of emotions
Not speaking very much
Difficulties in thinking or coming up with ideas
Lowered levels of motivation or drive


What are the risk factors/triggers?

Approximately 3% of people will experience a psychotic episode at some stage in their life, although a first episode usually occurs in adolescence or early adult life. Psychosis occurs across all cultures and levels of socioeconomic status and affects males and females equally.

Psychosis can occur as a result of an illness, medical condition, drug use and stress. Some conditions in which psychosis may be present include:

Bipolar Disorder
Brain Injury/ Brain Tumor
A Thyroid disorder

Unfortunately, at this time there are many theories about what causes psychosis, but no definite answers. Because psychosis occurs in a variety of mental and physical disorders it likely has multiple causes. Biology, stress and drug use are widely supported as being contributors to the development of psychosis.


Neurotransmitters. There is strong evidence that psychosis involves a dysfunction in neurotransmitters, the “chemical messengers” in the brain, particularly dopamine.
Genetics. Those with a family history of psychosis seem to be at an increased risk of developing it themselves. For example, the risk of developing à psychosis associated with schizophrenia is approximately 1%. This risk increases to 13% if you have a parent with schizophrenia and 9% if you have a sibling.
Brain Changes. There is some evidence that those who have experienced some types of psychosis have had changes in the brain. Possible causes of the changes include: genetics, abnormal neurodevelopment due to pregnancy or birth complications.


Stress or stressful events, such as divorce, loss of a loved one, giving birth, or a traumatic event, can contribute to the development  of psychosis. The amount of stress that may trigger psychosis differs for each person and likely contributes greater to those that are already vulnerable to developing psychosis.


Psychosis can be induced by drugs or can be drug assisted. For example, it appears that amphetamines can cause a psychotic episode, while other drugs, including marijuana, can increase a person's natural vulnerability to psychosis resulting in a psychotic episode.


What do I need to tell my doctor?
Write down any symptoms you’ve had
Write down key personal information
Make a list of all medications and drugs you are taking 
Write down questions to ask your doctor
Take a family member or friend along

Discuss all of your symptoms with your doctor and describe how they are affecting your life (e.g. racing thoughts that cause you to lose focus and not get things done). Make sure to discuss all of the available treatments and their benefits and side effects before making any decisions.


What are the treatment options?

Treating psychosis involves education, medication, close monitoring of symptoms, stress management and creating a strong, supportive environment.

Education - Becoming educated about psychosis is important for the person and the family to help understand  psychosis and how to recover.

Medication - Medication can relieve symptoms of psychosis and is critical in preventing relapse. There are many different medications available to treat psychosis. These medications are called antipsychotics (or sometimes neuroleptics).

Stress management and coping skills - Stress can worsen a person's symptoms and ability to function. It is important to learn your warning signs and triggers of stress and find ways to manage it, such as exercise, relaxation techniques and finding artistic hobbies.

Support groups - Groups provide a safe environment to meet with others who have been through similar experiences and can offer education and support about psychosis and the recovery process.

Counselling/Psychotherapy– There are many types of “talk therapy” and it is important to find a counsellor with whom you feel comfortable to speak openly. Cognitive Behavioural Therapy is one type of therapy that  has been found to help people understand and manage their thoughts, feelings and behaviours. Be sure to ask your potential counsellor what their focus and style of counselling is to determine if it will suit your goals.



What are the things I need to do to get well?

The recovery process will vary from person to person in terms of duration and degree of functional improvement. Some people will recover from the psychosis very quickly and be ready to return to their life and responsibilities soon after. Other individuals will need time to respond to treatment and may need to return to their responsibilities more gradually. Recovery from a first episode may take months or last several years.

All of the treatments listed above are important in helping a person recover. Some more strategies for staying well include:

Setting achievable goals, including specific strategies for coping with change, staying social and having a trusted support network
Maintaining regular medical check-ups
Participating in positive social, recreational and work activities
Maintaining a healthy lifestyle – diet, exercise, sleep


Where else can I go to learn more?