Psychosis is a state in which a person loses some contact with reality. Its main features are hallucinations, perceiving things that are not there, most often hearing voices; delusions, fixed false beliefs that do not change with evidence, such as being watched or having special powers; and disorganized thinking or speech. Psychosis is a symptom, not a diagnosis in itself. It occurs in schizophrenia and schizoaffective disorder, in severe episodes of bipolar disorder and major depression, in the postpartum period, after substance use including cannabis and stimulants, in delirium, and in dementia and other medical conditions.
About three in 100 people experience an episode of psychosis in their lifetime, with first episodes most often appearing between the late teens and early thirties. Early treatment matters: research on coordinated specialty care shows that the shorter the time between onset and treatment, the better the long-term outcome. Evaluation includes a careful history, a check for substances and medical causes, and sometimes laboratory tests or brain imaging. Treatment usually combines an antipsychotic medication, most often an atypical antipsychotic, with psychotherapy, family education and support for work or school. Many people recover fully from a first episode, and most achieve meaningful stability with ongoing care. If someone is in danger or unable to care for themselves, emergency evaluation is appropriate, and the 988 Suicide and Crisis Lifeline can help in a crisis. Stedfast Psychiatry treats psychotic disorders at all offices and through telehealth for stable follow-up care.