Psychosis

Psychosis is a mental-health condition in which a person experiences reality in a different way from those around them. They may see or hear things that others cannot (hallucinations), believe things that aren't true (delusions), or have disordered thinking and speech. Psychosis is a symptom, not a diagnosis on its own — it can happen in several conditions.

Symptoms

Psychosis can include:

• Hallucinations — most commonly hearing voices; also seeing, smelling, or feeling things that aren't there
• Delusions — firmly held beliefs not shared by others and not supported by reality. May include feeling followed, special or chosen, or that others are plotting against them
• Disorganised thinking and speech — hard to follow, jumping between topics
• Unusual movements or loss of motivation
• Confusion about time, place, or identity
• Difficulty distinguishing thoughts from reality

Causes

Psychosis can occur in:

• Schizophrenia — psychosis is a core feature
• Bipolar disorder — during severe manic or depressive episodes
• Severe depression (psychotic depression)
• Postpartum psychosis — rare, occurs after childbirth
• Substance use — cannabis, amphetamines, cocaine, alcohol withdrawal, some prescription medicines
• Medical conditions — infections, brain tumours, head injury, thyroid problems, dementia
• Trauma or extreme stress

Diagnosis

A doctor or psychiatrist assesses the person through conversation, medical history, and examination. Investigations often include blood tests (to rule out infections, thyroid issues, vitamin deficiencies), sometimes brain imaging, and a urine drug screen to check for substance-induced psychosis. A detailed psychiatric assessment determines the underlying cause and guides treatment.

Treatment

Most psychosis responds well to treatment, especially when started early:

• Antipsychotic medicines — reduce hallucinations and delusions, calm agitation, and over time help thinking become clearer. Work best taken consistently under medical supervision — don't stop abruptly.
• Psychological therapy — cognitive behavioural therapy for psychosis (CBTp), family therapy, and other approaches
• Treating the underlying cause — substance use support, treatment of medical conditions, therapy for trauma
• Hospital admission — for severe episodes where safety is a concern
• Rehabilitation and social support — supported employment, skills training, housing help, and peer support all make a real difference for recovery

Early treatment leads to better outcomes. Family members play a crucial role — learning to recognise warning signs (sleep changes, withdrawal, unusual beliefs), supporting treatment adherence, and reducing high-stress environments all help.

If you or someone you know is experiencing psychosis

Seek help from a doctor or psychiatrist. In India, the District Mental Health Programme (DMHP) provides services in most districts, and private psychiatrists are available in all cities. Free confidential mental-health helplines:

• KIRAN (Government of India): 1800-599-0019 — 24h, 13 languages
• Vandrevala Foundation: +91 9999 666 555 — WhatsApp, 24h
• In an emergency, dial 112