Exis Recovery

The Early Signs of a Psychotic Disorder

Psychosis has been called a “trick of the mind” that causes a temporary “break from reality,” but the full nature of this serious mental health problem is a lot more nuanced. 

For starters, psychosis isn’t a mental illness, it’s a symptom. A psychotic episode is a disruption in thoughts and perceptions that make it hard to distinguish delusions and hallucinations from reality. A psychotic disorder is any mental health condition that can give rise to psychosis. 

As mental health experts who specialize in psychotic disorders, the team at EXIS Recovery knows that psychosis rarely appears out of nowhere. Most people demonstrate a range of early warning signs before a psychotic episode actually begins.

Psychosis makes it hard for people to separate what’s real from what’s not because it triggers a cascade of delusions (false beliefs) and hallucinations (false perceptions). 

Delusions may cause a person to believe that someone is out to get them, for example, or that cell phones transmit secret signals. Hallucinations cause people to see, hear, or feel something that’s not there.

Schizophrenia is a well-known psychotic disorder, while major depression and bipolar disorder can have psychotic features, too. Certain substance abuse disorders can also trigger psychosis, as can brain tumors, brain infections, and strokes.

There’s a widespread misconception that psychosis is relatively rare, when it’s actually fairly common. Some 3% of people in the United States have a psychotic episode at some point in life, and 100,000 American adolescents and young adults experience their first episode of psychosis each year.

Psychosis is usually an episodic symptom, which means it comes and goes over time. The atypical thoughts and perceptions that occur during a psychotic episode can cause the affected person to quickly lose touch with reality. 

But even though psychosis may seem to come on fast, that’s almost never the case. Usually, a person’s thoughts and perceptions change in gradual, nonspecific ways that can be difficult to register at first. 

Given that a person who’s on the path to psychosis can’t make sense of what’s happening, having family members and close friends who can take notice is especially important. 

Early, nonspecific changes before psychosis often include:

  • Difficulty staying focused or thinking clearly
  • Abnormal struggles with school or at work 
  • Feeling inexplicably “off,” sad, or worried
  • Decreased motivation and depressed mood
  • Unusual withdrawal from family and friends
  • Spending an increased amount of time alone
  • Disinterest in self-care or personal hygiene

It’s also common for people to have trouble sleeping, processing stress, and controlling or expressing their emotions leading up to a psychotic episode. Some people experience strong, inappropriate emotions, while others seem to have no feelings at all. 

Other early warning signs are more like the actual symptoms of a psychotic episode, but milder and more subtle. 

Also referred to as attenuated psychotic symptoms, these changes include:

  • Suspiciousness or uneasiness with others
  • Odd beliefs, associations, or “magical” thinking
  • Unusual or frightening perceptual experiences 
  • Hearing, seeing, or feeling things that don’t exist
  • Speaking in a tangential or hard-to-follow way

Whereas the nonspecific changes before psychosis may be a temporary reaction to stress or symptoms of a totally different mental health issue, attenuated psychotic symptoms indicate a high risk of impending psychosis. 

Research shows that many Americans who experience psychosis for the first time have clear and persistent symptoms for longer than a year before they receive a diagnosis. Yet it’s prompt diagnosis and care that typically leads to the best outcomes. 

Knowing how to spot the early signs of psychosis is the first critical step in reducing the average duration of untreated psychosis. This is especially important for those whose families have a history of schizophrenia, bipolar disorder, or any other psychotic disorder.

Our team at EXIS Recovery takes a multidisciplinary, evidence-based approach when caring for adults and adolescents with psychoses. Our coordinated care model includes everything from psychotherapy and medication management to family education and support. 

Call 424-832-0848 to reach our West Los Angeles office today, or use online booking to schedule a visit with one of our trusted mental health experts any time.