What to do when psychosis first strikes

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Prompt action aids recovery – so here’s how to spot the early signs of this distressing condition, and where to go for help

Around 80% of people who experience psychosis for the first time are aged between 16 and 30 years old. These years are pivotal for a lot of us and, although psychotic symptoms don’t make you any less capable of success than others, for some it can make the journey a little more difficult. Psychosis, in a nutshell, is where someone’s reality is different from the rest of the population.

I know what you’re thinking, and sure, we all have different beliefs. But when these beliefs start to have a negative impact on our lives it can be distressing. Thankfully, lots of research over the years has proven that you can recover from psychosis and, just as with physical health conditions, the earlier we spot the signs, the faster we can recover. So, what are the first signs of psychosis?

The initial signs of a possible emerging psychosis are called ‘early warning signs’. By recognising these, we are able to seek support early in order to prevent an acute psychotic episode. The pattern of early warning signs is different for everyone, however there are some common themes.

A sense that something odd is happening, but finding it hard to explain

Some people describe feeling ‘different’ but not quite being able to put their finger on why. It could be that they think they’ve changed, people around them have changed, or there is something unusual about the whole world. This can range from a general feeling of unease to more specific thoughts; perhaps that you’re receiving personal subliminal messages from the TV or other media. You might not be convinced by these ideas initially, however the timeline of when they started could be a good indicator of when your mental health began to change.

Suspicion of others

Suspiciousness is often described as the distrust of others, which is a natural reaction we have when we are trying to protect ourselves from being hurt (physically or emotionally). We all slide up and down a trust continuum, depending on our life experiences and personality types. At one end of the scale is having absolutely no worries about someone’s intentions, and at the other end, feeling extremely uncomfortable and doubtful. We want to stay somewhere in the middle. If you notice you are becoming more suspicious of others, this could be an early warning sign.

Unusual sensory experiences

Our senses can play tricks on us and make us see, hear, taste, smell, or feel something that others cannot – sometimes known as hallucinations. It’s very likely that every one of us will experience a hallucination during our lifetime. Sometimes they are signs that we need to change-up our lifestyle, such as getting more sleep, reducing stress, or drinking more water. Hallucinations aren’t necessarily indicative of psychosis and, remember that even if they are, they won’t necessarily last forever.

If you are experiencing unusual sensory experiences that other people aren’t, and they are making everyday tasks difficult or causing you distress, you may want to speak to a professional about this. They will ask you specific details about these experiences, such as how long they last for and how often they’re present, and explore whether you have any other ideas as to why these experiences are happening. Usually, with psychosis, hallucinations become part of your reality. Some people live their entire lives with hallucinations, either becoming part of their norm, or providing comfort and reassurance throughout the day. When this is the case, some people may choose to decline interventions that are likely to reduce these experiences.

Finding it hard to do the things you used to

It’s important to remember that these symptoms affect people in different ways. For some, their life goes unchanged and they accept these experiences as part of them – and who are we to say that this is ‘unusual’? For others, these experiences can change their way of life. If they’re frightened, they may become socially isolated and find it hard to concentrate on anything else. If they’re preoccupied in this way, they may not value things that were previously important to them – such as their job, family, hobbies, or personal-care. It’s hard to know how much your mental health is impacting your life, but by asking yourself these three simple questions, it will help to identify any changes…

  • Is there anything I no longer do, but wish I could?
  • What would my perfect life look like?
  • What am I doing to work towards this?

If you aren’t yet achieving or working towards your goals, explore what the barriers to this are. If a barrier is mental health symptoms, it may be time to seek professional support.

Seeking support

One or more of these experiences could be an early warning sign or symptom of first-episode psychosis. Similarly, these experiences can also be otherwise explained. It’s important not to jump to conclusions, however getting a professional opinion could be useful. After all, if you choose to accept treatment, it is always more effective when you spot the signs quickly.

When we think ‘treatment’ we often jump to hospitals and medication, but this outdated assumption is no longer the go-to. Psychiatric hospitals do exist, but are only used to help people urgently when they are most in need. Similarly, medication isn’t always first-choice either (although they are available and can be effective). We now have lots of different evidence-based interventions to offer people experiencing psychosis for the first time, including different forms of therapy (such as cognitive behavioural therapy), and education about these symptoms to develop a plan.

Whether you’re worried or just curious, talking about these experiences is nothing to be ashamed of. Every single one of us will have experienced a symptom that can be associated with psychosis. Opening up the conversation about psychosis will allow everyone to notice that we’re not all that different. After all, we all have our own realities, so whose is the right one anyway?

If anything in this article has made you question whether you are experiencing early warning signs of psychosis and you want help with this, your GP will be able to discuss options with you. Now, in the UK, NHS England have implemented Early Intervention in Psychosis (EIP) teams to prevent and treat psychosis quickly and effectively. You can find self-referral details for your local EIP team online, or via your GP. If you’d prefer to have a confidential chat, you can also contact mental health support lines.


If you think you may currently experiencing psychosis, speak to your GP or call 111.

Need to talk? Connect with a professional using Counselling Directory.

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