Psychosis or schizophrenia

Overview

During psychosis, a person may see or hear things that aren't there (hallucinations) or believe things that aren't true (delusions), like being followed or watched. Thinking and speech can become jumbled.

Schizophrenia also causes negative symptoms, like low motivation and pulling away from others, and trouble with focus and memory. Psychosis can also come from drugs, other illnesses, or severe depression or bipolar disorder.

Symptoms

Early changes in thinking, mood, and social life often come before the first episode.

• Beliefs others say aren't real, or feeling watched or followed
• Hearing voices or seeing things
• Confused or jumbled thinking and speech

Less common

• Pulling away from friends and family
• Low motivation or flat emotions
• Trouble focusing
• Neglecting hygiene
• Sleep changes

When to get medical care

Causes

Many genes, brain development before birth, and life experiences play a part. Heavy cannabis use, especially in teens, raises the risk. It is not split personality.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.
• It can run in families. Tell your doctor if a parent, brother, or sister has it.

Who is more likely to get it

• Family history
• Heavy cannabis or stimulant use
• Stress and trauma
• Problems before or at birth

Possible complications

• Depression
• Substance use problems

Diagnosis

A healthcare professional asks about symptoms and rules out other causes.

Questions you may be asked

• What the person sees, hears, or believes
• Drug and alcohol use
• Family history of mental illness

The exam

A physical exam and mental health evaluation.

Tests

Tests to rule out other causes:

• Blood and drug tests: Look for medical causes and substances.
• Brain scan: Sometimes, to rule out other problems.

Treatment

Starting treatment soon after the first episode gives the best chance of recovery.

Self-care

• Take medicine as prescribed and report side effects
• Avoid alcohol and drugs, including cannabis
• Keep a regular sleep schedule
• Stay connected with family, friends, and your care team

Medicines

Antipsychotic medicines reduce hallucinations and delusions.

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Coordinated specialty care combines medicine, therapy, family education, and help with school or work. It's now the standard of care for early psychosis.

Prevention

Psychosis can't always be prevented, but you can lower risk:

• Avoid cannabis and drugs in teen years
• Get help early for unusual thoughts or withdrawal

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a psychiatrist (for medicine) and a psychologist or licensed therapist (for talk therapy).

Living with it

• Keep a regular sleep, meal, and activity routine.
• Tell one trusted person how you're doing, and plan who to call on hard days.
• Limit alcohol and drugs. They often make symptoms worse.
• In a crisis, call or text 988 any time.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• NAMI (National Alliance on Mental Illness): Free support groups and a helpline (1-800-950-6264) for people and families.
• 988 Suicide & Crisis Lifeline: Call or text 988 any time for free, private support in a crisis.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.
• The Family and Medical Leave Act (FMLA) may let you take unpaid time off for treatment without losing your job.

Children, pregnancy, and older adults

• Teens and young adults: This is when symptoms most often start. Early care matters.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Many mental health medicines are used safely in pregnancy. Stopping suddenly can cause a relapse.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Mood problems can start during or after pregnancy. Postpartum Support International: 1-800-944-4773.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Listen without judging, and let them know you care.
• Encourage treatment, but don't force it unless they're in danger.
• If they talk about suicide, call or text 988 with them.
• Take breaks and ask for help. Caregivers need care too.

Outlook

With early, ongoing treatment and support, many people recover, work, study, and have strong relationships. Some never have another episode.

Getting ready for your visit

A family member can help describe changes.

What to bring

• A list of changes and when they began

Questions to ask

• Is there a coordinated specialty care program near us?
• What side effects should we watch for?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Psychosis or schizophrenia