When you are experiencing psychosis, you might think and act in unusual ways, believe in things or have experiences that others find odd or alarming, or become socially withdrawn and neglect yourself or your responsibilities.

Causes of psychosis

If someone has psychosis, it often starts when they are between the ages of 15 and 25. It usually happens as part of a serious mental illness but there are some other causes. 

Serious mental illnesses such as schizophrenia, severe depression or bipolar disorder can lead to psychosis.

Very rarely, a woman can develop psychosis after giving birth – this is called postnatal psychosis.

Psychosis can also happen due to severe stress or drug or alcohol use.

Sometimes a medical condition such as a reaction to a medicine, high fever, a brain condition or dementia can cause psychosis.

One in 5 people who have psychosis for the first time get better and never have it again.

Symptoms of psychosis

Psychosis can show in a variety of ways and can range from mild symptoms to severe ones that interfere with daily activities.

People who are developing psychosis may not understand that what they think and believe is not real. They may tell others about their ideas, thoughts and unusual experiences, or they might keep them to themselves. The change may happen gradually, or it may suddenly show in bizarre ways. Each person's experience is different.

It is very rare for a person with psychosis to be violent towards other people. They are more often frightened, confused or feeling low.

These are the main symptoms of psychosis.


Hallucinations are when you hear, see, smell, taste or touch something that is not really there. Hearing voices is a common hallucination, but hearing voices alone does not mean psychosis. There are many other reasons why it might happen.


Delusions are when you have a strong belief that is not real or shared by others. A common delusion is wrongly believing there is a plan to cause you or others harm.

Disorganised thinking and speech

Disorganised thinking and speech is when you have racing or jumbled thoughts and trouble keeping your attention on one thing.

In a crisis

Diagnosing psychosis

When someone first shows signs of psychosis, it can be hard to tell what is going on. They may simply start to withdraw, care less about the people in their lives, and struggle to do their job as well as before, or start to take less care with their appearance. If this happens in teenagers, it can be very hard to tell if they're developing a psychotic disorder or just struggling with being a teenager.

When healthcare providers try to find out what is happening to someone with psychosis, they will consider whether there is an underlying temporary cause such as an acute physical illness or reaction. They may need to do tests to check for this.

In rangatahi (young people), it may take a long time of watching to work out the most likely cause of the psychosis.

If there is concern that you have a psychotic mental illness, your healthcare provider is likely to send you to see a psychiatrist.

If you are very unwell you may need to be admitted into hospital. Many people will agree that this is the best way to get care and will go to hospital willingly. But some people will need to be admitted to hospital against their will, using the Mental Health Act.

Self care with psychosis

Having psychosis can seem like a big challenge, but there are ways you can reduce its impact on your life, including:

  • looking after you physical health
  • having a wellbeing plan
  • avoiding things that set off your symptoms
  • avoiding drugs and alcohol.

The Mental Health Foundation has more information on treatment options. 

Treatment options for psychosis — Mental Health Foundation (external link)

Getting help with psychosis

The treatment for a psychotic disorder aims to bring back your normal feeling of reality so you can manage your daily life again. It is usually started by a specialist mental health service, though you may get ongoing care from your healthcare provider.


Many people with psychosis need to take antipsychotic medication to feel better.

Some people will need to keep taking it after they have improved to stay well.

The type of medication and how long you need to take it varies with each individual and their particular type of psychosis.

Antipsychotics — HealthInfo (external link)

Talking therapies

Talking therapies help you cope with your condition and manage symptoms of psychosis.

Treatment options — Mental Health Foundation (external link)

Supporting someone with psychosis

If you are close to someone who has a psychotic disorder, the way you support them will be very important to their recovery. They may not realise that they are unwell, or that what they think and believe is not real. This can leave them (and anyone who depends on them) at risk.

Caring for a loved one who is unwell but does not want to accept your help can be a challenge. It is normal to feel guilty or disloyal in this situation. But remember that your loved one is not thinking properly. Right now, they are vulnerable to harm. 

It can be hard to know how to react and how to help your loved one. You can get more information and advice from Talking Minds.

Talking Minds

It is also important to look after yourself and seek help if needed.

Getting help

Call or make an appointment with the person's healthcare provider to talk about your concerns. If your friend or family member has become unwell, their healthcare provider can get them assessed by a mental health team.

Mental Health Foundation

Information about psychosis, symptoms, signs, and treatment options.

Talking Minds

Information about psychosis and ways to treat it, and stories from people who have psychosis, and their whānau.

Clinical review

This content was written by HealthInfo clinical advisers. It has been adapted for Health Information and Services.

Clinical advisers — HealthInfo (external link)

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