Psychosis can be a terrifying illness. The loss of certainty about what is real and what is not is debilitating. Those experiencing psychosis may or may not be aware of their sickness. When psychosis is present, those who are struggling with any other psychiatric disorder are likelier to die by suicide. For these reasons, it is especially important that we are all informed and ready to respond when we see signs of psychosis.


  • It is extremely important to take even subtle signs of psychosis seriously as it is one of the top three causes of suicide.
  • First episodes of psychosis peak between ages 15-25. It often coincides with starting college – possibly triggered by the stress of this transition.
  • Untreated psychosis becomes increasingly difficult to treat so recognizing it early is critical.
  • Signs of psychosis can be subtle and a person suffering mild or even moderate psychosis can often control their behavior in public in order to mask their suffering.
  • Many mental health and physical disorders can cause psychosis including schizophrenia, bipolar disorder, depression, postpartum depression, severe stress or anxiety, sleep deprivation, Alzheimer’s disease, Parkinson’s disease, lupus, multiple sclerosis, HIV/AIDS, malaria, strokes, dementia, and brain tumors.
  • Both prescription and illicit drugs can cause psychosis.


Psychosis is characterized by an impaired relationship with reality. People who are experiencing psychosis have hallucinations and/or delusions.

  • Hallucinations are defined as the “perception of a nonexistent object or event” and “sensory experiences that are not caused by stimulation of the relevant sensory organs.” (from VeryWellMind)
    • Auditory: Hearing voices or sounds that no one else can – the most common type of hallucination
    • Visual: Seeing people, colors, shapes, or items that aren’t real – the second most common type of hallucination
    • Tactile: Feeling sensations within (eg., bugs crawling under your skin) or outside your body (eg,. being touched when you’re not)
    • Olfactory: Smelling something that has no physical source
    • Gustatory: Tasting something that has no source (often metallic) – the rarest type of hallucination
  • Delusions are defined as fixed, false beliefs that conflict with reality. Despite contrary evidence, a person in a delusional state can’t let go of their convictions. Delusions are often reinforced by the misinterpretation of events. Many delusions also involve some level of paranoia. (from VeryWellMind)
    • Erotomanic: In this type of delusion, individuals believe that a person—usually with a higher social standing—is in love with them. An example of this type of delusion would be a man who believes an actress loves him and that she’s communicating with him via secret hand gestures during her TV show.
    • Grandiose: In grandiose delusions, individuals believe they have extraordinary talent, fame, wealth, or power despite the lack of evidence. An instance of this type of delusion would be a woman who believes God gave her the power to save the universe and every day she completes certain tasks that will help the planet continue on.
    • Persecutory: Individuals with persecutory delusions believe they are being spied on, drugged, followed, slandered, cheated on, or somehow mistreated. An example might include a woman who believes the flowers she received at home have been bugged so her boss can spy on her.
    • Jealous: With this type of delusion, individuals might believe their partners are unfaithful. For instance, a man with this type of delusion might believe his partner is meeting her lover every time she uses the restroom in public settings—he also thinks she’s sending her lover secret messages through other people (like the cashier in a grocery store).
    • Somatic: Individuals with somatic delusions believe that they are experiencing physical sensations or bodily dysfunctions under the skin, or that they’re suffering from a general medical condition or defect. For instance, a man who believes there are parasites living inside his body may be suffering from somatic delusions.
    • Mixed or Unspecified: When delusions don’t fall into a single category and no single theme dominates, the delusions are considered “mixed.” Mental health professionals may refer to the disorder as “unspecified” when delusions don’t fall into a specific category or the delusion type can’t be clearly determined.

People experiencing psychosis may also show the following signs (from North South Wales Government Health)

  • being distracted by things they hear, see, or perceive that you do not sense
  • seeming to have conversations with those you cannot see
  • being difficult to understand or follow
  • speaking very quickly or very slowly
  • changing topics very quickly
  • having difficulty with concentration and remembering things
  • having strange beliefs that do not seem rooted in reality
  • being lethargic or sluggish
  • using words or phrases that you might not understand

IF YOU OR SOMEONE YOU KNOW FEEL(S) SUICIDAL, go to the emergency room, call a mental health professional who can talk to you NOW, or call the police and say you have a mental health crisis, not a criminal situation!

In the US, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)


Text HOME to The Crisis Textline at 741741. They are available 24/7 in the U.S., Canada, United Kingdom, and Ireland.