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Psychose

La psychose est un symptôme mais ne constitue pas un diagnostic en soi. La psychose peut être causée par différentes affections mentales, telles que la schizophrénie ou le trouble bipolaire, par une maladie physique ou par d'autres causes, comme le deuil ou le manque de sommeil.

En un coup d'œil

  • Psychosis means you interpret reality differently from other people.

  • Common types of psychosis are hallucinations, delusions, and disorganised thinking.

  • Hallucinations involve sensing things that are not there, like hearing voices.

  • Delusions are strong, false beliefs not shared by others.

  • Psychosis can be caused by mental health conditions, illness, or other factors.

  • See your doctor immediately if you have symptoms of psychosis.

  • Treatments include talking therapies, medication, and self-help strategies.

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What is psychosis?

Psychosis means that you interpret reality abnormally and in a very different way from other people around you. This is like losing touch with reality.

Psychosis can feel positive. Seeing the faces of loved ones or hearing their voices may be very comforting. However, psychosis can also be very negative and distressing, affecting your behaviour and disrupting your life.

The most common types of psychosis are hallucinations and delusions. You might also experience problems with thinking and speech.

  • Hallucinations or delusions can make you feel very tired, overwhelmed, anxious, scared, threatened or confused. Delusions about certain people or organisations may make it hard for you to trust them.

  • People around you may be very dismissive of your experiences and this may make you feel very frustrated.

Psychosis symptoms

The main symptoms of psychosis are:

  • Hallucinations. This means you hear, see, feel, smell or taste things that aren't really there. A common hallucination is hearing voices (auditory hallucinations).

  • Delusions. A delusion may occur when you have a strong belief that isn't real or shared by others. A common delusion is wrongly believing that there is a conspiracy to cause you or others harm.

  • Disorganised thinking and speech.

Hallucinations

Hallucinations may include:

  • Seeing things that other people don't see.

  • Experiencing tastes, smells and sensations, such as feeling insects crawling on your skin when there are no insects there.

  • Hearing voices that other people don't hear (auditory hallucinations).

Delusions

Lots of people have beliefs that many other people don't share. But a delusion is a false belief that no one else shares. You still believe it even if it doesn't make any sense.

Some delusions are positive. You might believe you are very rich, powerful or important. This is sometimes called delusions of grandeur.

Delusions may also be very negative and frightening. You might feel that something or someone is trying to harm you. This is sometimes called having paranoid delusions.

Disorganised thinking and speech

Hallucinations and delusions can make your thoughts and emotions feel confused and disorganised. Disorganised thinking ('thought disorder') can also be a type of psychosis.

  • Racing thoughts: thoughts go through your head very fast.

  • Flight of ideas: your thoughts move very quickly from one idea to the next.

  • Speaking very quickly with other people finding it hard to understand you.

  • Your speech sounds jumbled and doesn't make sense to other people.

  • Finding it difficult to keep your attention on one thing.

How long does psychosis last?

How often a psychotic episode occurs and how long it lasts are very variable and will depend on the underlying cause. You might experience psychosis once, have occasional short episodes, or have frequent and prolonged episodes of psychosis.

Causes of psychosis

Psychosis can be a symptom of lots of different mental health problems, including:

Psychosis can also occur in the absence of any underlying mental health condition. Other causes of psychosis include:

  • Physical illness or injury - eg, with a high fever or following a head injury.

  • Conditions affectant le cerveau - eg,:

    • Parkinson's disease or a brain tumour.

    • When taking street drugs like LSD, amphetamines, phencyclidine (PCP) and cannabis.

  • Abus d'alcool.

  • Nitrogen narcosis when diving at depth.

  • Side-effect of some prescribed les médicaments (eg, stéroïdes) or when you stop taking a medicine for a mental health condition.

  • Manque de sommeil.

  • Hunger.

  • Bereavement - if you have recently lost someone close to you, you may think you see them or hear them talking to you.

  • Abuse or trauma - you are more likely to experience psychosis if you have experienced abuse or a very traumatic event.

Psychosis treatment

Treatments for psychosis include:

Auto-assistance

Support from others with psychosis. It often helps to share experiences with other people who experience psychosis. You may be able to find a local support group or a national support group, such as Mind in the UK .

Recognise your triggers. It might be helpful to keep a diary to help you understand what triggers your psychosis or makes it worse. Learn to recognise any warning signs.

Avoid triggers. Once you have identified any triggers, you can try to take steps to avoid them. If you learn to recognise warning signs, you can take action early to try to prevent the psychosis from becoming any worse. Family and friends may also be able to recognise any warning signs.

Learn to relax. Manage stress and try some relaxation techniques when you feel stressed, anxious or busy.

Look after yourself. Try to get enough sleep. Eating regularly and keeping to a healthy diet can improve your mood and energy levels.

Exercice. Exercise can really help the way you feel.

Create a crisis plan. When you're feeling well you should talk to close friends and family about what would help you, including who should be contacted for professional help.

Autres traitements

Treatment for psychosis involves using a combination of:

  • Talking therapies tel que thérapie cognitivo-comportementale (TCC) can help you understand your experiences and develop strategies to deal with them.

  • Médication. Most people with psychosis will be offered an antipsychotic medicine. You may need other medicines for any mental health condition that is causing the psychosis.

  • Family therapy. Family therapy may be very helpful if you are going through any difficulties as a family.

  • Arts therapies can help you express how you are feeling, especially if you find it difficult to talk about your experiences.

  • Social support. This may include education, employment, or accommodation.

You should see your doctor immediately if you're experiencing symptoms of psychosis. You will usually be referred to a mental health specialist for further assessment and treatment. A very severe psychotic episode may mean you need to be admitted to hospital for treatment.

If you're concerned about someone who seems to be having a psychotic episode, you should contact their doctor or their mental health team or call an ambulance.

Complications of psychosis

  • People with psychosis are more likely to have drug or alcohol problems. Some people use drugs, alcohol or both as a way of managing their psychotic symptoms. However, this can make the psychotic symptoms worse and cause other problems.

  • Auto-mutilation and suicide. People with psychosis have increased risk of self-harm and suicide.

Quel est le résultat ?

The outcome (prognosis) is very variable and will depend on any underlying cause. If needed, medication is usually effective but may be needed long-term.

Questions fréquemment posées

What is the difference between a strong belief and a delusion?

While many people hold strong beliefs that others don't share, a delusion is a false belief that no one else shares and which you continue to hold even if it doesn't make any sense. Delusions can be positive, such as believing you are very rich, or negative and frightening, like feeling someone is trying to harm you (paranoid delusions).

How can self-help strategies assist with managing psychosis?

Self-help involves several strategies. Sharing experiences with others who have psychosis can be beneficial. Keeping a diary to identify and avoid triggers can help prevent episodes from worsening. Learning relaxation techniques, prioritising sleep, maintaining a healthy diet, and exercising are also important. Additionally, creating a crisis plan with close friends and family while you are well can ensure you receive appropriate support if a severe episode occurs.

What kind of professional support is available for psychosis beyond medication?

Beyond medication, a combination of other treatments is available. Talking therapies like cognitive behavioural therapy (CBT) can help you understand and cope with your experiences. Family therapy can be useful if there are difficulties within the family. Arts therapies offer a way to express feelings, especially if talking is difficult. Social support, including help with education, employment, or accommodation, can also be provided.

Why might someone with psychosis turn to drugs or alcohol?

Some people with psychosis may use drugs or alcohol as a way to cope with their psychotic symptoms. However, this can actually worsen the symptoms and lead to additional problems.

When should someone seek immediate medical help for psychosis?

You should see your doctor immediately if you are experiencing symptoms of psychosis. If the psychotic episode is very severe, hospital admission may be necessary for treatment. If you are concerned about someone else who seems to be having a psychotic episode, you should contact their doctor, mental health team, or call an ambulance.

Lectures complémentaires et références

À propos de l'auteurVoir la biographie complète

Image de l'auteur

Dr Hayley Willacy, FRCGP

Médecin généraliste, Auteur médical

MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)

Le Dr Hayley Willacy était médecin généraliste au NHS travaillant dans le nord-ouest de l'Angleterre, qui a pris sa retraite de la pratique clinique en 2022 après 30 ans. 

À propos du critiqueVoir la biographie complète

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Dr Colin Tidy, MRCGP

Médecin généraliste, Auteur médical

MBBS, MRCGP, MRCP (Paediatrics), DCH

Le Dr Colin Tidy est un médecin du NHS, basé dans l'Oxfordshire.

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Les informations sur cette page sont rédigées et examinées par des cliniciens qualifiés.

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