Psychosis is often misunderstood, yet it is more common than many people realise. At MQ Mental Health Research, we are committed to improving understanding of mental health conditions through research and evidence. By breaking down what psychosis is, how it can present, and what support is available, we can help reduce stigma and support earlier access to care.
What is psychosis?
Psychosis is not a diagnosis in itself. It is a term used to describe a group of symptoms that affect how a person experiences reality. When someone is experiencing psychosis, their thoughts, perceptions and beliefs can change in ways that make it difficult to distinguish what is real from what is not.
For the person going through it, these experiences can feel completely real and can often be frightening or confusing. Psychosis can also be distressing for friends, family and carers who may not understand what is happening.
Although it can feel overwhelming, it is important to recognise that help and support are available, and many people recover or learn to manage their symptoms over time.
What are the symptoms of psychosis?
Psychosis can look different from person to person. Symptoms may come and go, and their intensity can vary. Some people experience only one type of symptom, while others experience several at different times.
Delusions
Delusions are strong beliefs that feel completely real to the person experiencing them, even if they are unlikely or not shared by others.
These beliefs can take different forms. Someone might believe they are especially powerful, important or well known. Others may feel that everyday events are directly connected to them, such as thinking that messages on television or radio are meant specifically for them. Some people may believe they are being watched, followed or harmed.
These beliefs can influence behaviour. A person might avoid certain places, withdraw from others, or act in ways that reflect their fears or interpretations of what is happening.
Hallucinations
Hallucinations involve sensing things that are not present. This can include seeing, hearing, feeling, smelling or tasting things that others do not experience.
The most common type is hearing voices. These voices may seem to come from outside the person, such as from behind them or across the room. They might speak directly to the person, talk about them, or do both.
People’s experiences of voices can vary widely. Some may find them frightening or critical, while others may experience them as neutral or even comforting. Over time, these experiences can change.
Hallucinations and delusions can sometimes become linked. For example, hearing voices might lead someone to believe that others are watching or targeting them.
Disorganised thinking
Psychosis can affect how a person thinks and communicates. Thoughts may feel jumbled or disconnected, making it difficult to concentrate or express ideas clearly.
Speech can become hard to follow, and in some cases it may become so disorganised that it is difficult for others to understand.
Feeling controlled or influenced
Some people experience a strong sense that their thoughts, feelings or actions are being controlled by an outside force. This might include believing that thoughts are being placed into their mind, removed from it, or shared with others.
These experiences can lead to feelings of suspicion or mistrust, and may make it harder to feel safe around others.
It is important to note that people do not usually experience all of these symptoms at once. Symptoms can develop gradually and change over time, which can make it harder to recognise that something is wrong.
What does psychosis feel like?
Psychosis can be difficult to describe, especially for those who have not experienced it. Many people describe a sense that the world has changed or become unfamiliar. Everyday surroundings can feel distorted or unreal.
Experiences can be intense and emotional. Some people feel frightened or overwhelmed, while others may feel confused or disconnected. Physical sensations can also play a role, such as feeling pain or discomfort that has no clear medical cause.
Because these experiences feel real, it can be difficult for someone to recognise that they need help. This is one of the reasons why understanding and awareness are so important.
How is psychosis related to other mental health conditions?
Psychosis can occur as part of a range of mental health conditions. These include conditions such as schizophrenia, schizoaffective disorder, bipolar disorder and severe depression.
It can also occur alongside other conditions, particularly during periods of intense stress. In some cases, psychosis may be linked to physical health issues, substance use, sleep deprivation or certain medications.
For some people, it is not possible to identify a clear cause.
Psychosis does not follow a single pattern. Some people may experience one episode and recover fully, while others may have recurring episodes over time. A diagnosis, if given, is based on a combination of symptoms, their duration and their impact.
Why does psychosis happen?
There is no single cause of psychosis. Research suggests that it develops through a combination of biological, psychological and social factors.
Stressful or traumatic life events can increase vulnerability. This might include bereavement, abuse or significant life changes. Psychosis can also occur after childbirth, known as postpartum psychosis.
Substance use can play a role in some cases, particularly with drugs such as cannabis, cocaine or hallucinogens. However, the relationship between substance use and psychosis is complex and varies between individuals.
Severe mood episodes, such as depression or mania, can also trigger psychotic symptoms. In addition, extreme sleep deprivation has been linked to the onset of psychosis.
It is important to emphasise that many people experience these risk factors and never develop psychosis. In some cases, psychosis can occur without any clear trigger.
How Childhood Trauma Shapes the Risk of Psychosis
Around one in ten children will experience psychotic symptoms, such as hearing voices or seeing things others don’t. Research has long suggested a link between early adversity, such as bullying or abuse, and the later development of conditions like schizophrenia, but the mechanisms behind this connection have remained poorly understood.
MQ Fellow Dr Helen Fisher and her team at King’s College London analysed data from three large longitudinal studies to identify the biological, psychological, and social pathways through which childhood trauma can lead to psychosis in young people.
Key findings included that children who developed post-traumatic stress symptoms following adversity were at heightened risk of psychosis, and that differences in gene regulation were observed between children with and without psychotic experiences. The study has since informed early intervention strategies, contributed to public resources including ChildLine, and is feeding into the MQ-funded IDEA consortium, which aims to improve early identification of adolescent depression internationally.
What should you do if you think you are experiencing psychosis?
If you or someone you know is experiencing symptoms of psychosis, it is important to seek help as soon as possible. Speaking to a GP is often the first step. They can arrange a referral to specialist mental health services.
In the UK, Early Intervention in Psychosis services are designed to provide timely support for people experiencing psychosis for the first time. Evidence shows that early support can improve outcomes and support recovery.
An assessment will usually involve discussing mental health, physical health, lifestyle factors and personal circumstances. This helps professionals build a full picture and offer the most appropriate support.
How is psychosis treated?
Treatment for psychosis often involves a combination of approaches. What works best can vary from person to person.
Medication
Antipsychotic medications are commonly offered, particularly during a first episode. These medications work by affecting brain chemicals such as dopamine, which are thought to play a role in psychotic symptoms.
Different medications can have different side effects, and finding the right one can take time. Ongoing physical health monitoring is an important part of treatment.
Psychological therapies
Talking therapies are an important part of treatment and are often offered alongside medication.
One commonly used approach is cognitive behavioural therapy, which helps people understand the relationship between their thoughts, feelings and behaviours. It can also support people in developing coping strategies and reducing distress linked to their symptoms.
Other approaches, such as family interventions and creative therapies, can also play a valuable role in recovery.
Can Folic Acid Help Prevent Schizophrenia?
Folic acid is already known to reduce the risk of serious conditions affecting the nervous system, such as spina bifida. There is also growing evidence that it may offer protective benefits for mental health, but until now, no research has established a clear biological link between prenatal folic acid exposure and reduced risk of psychosis.
MQ-funded researcher and MQ Fellow Dr Joshua Roffman and his team at Massachusetts General Hospital set out to find that evidence. Studying MRI scans from over 1,300 children born before, during, and after the US introduction of mandatory folic acid fortification in 1998, they found that children born after fortification showed delayed cortical thinning in the brain — a marker associated with reduced psychosis risk.
The findings provided the first biological evidence that prenatal folic acid exposure can alter brain development in ways that appear to protect against psychosis. The research has since contributed to a policy change in the UK, supporting the introduction of folic acid fortification of bread and wheat products.
Support in the community
Many people receive care from community mental health teams, which include a range of professionals such as psychiatrists, psychologists and support workers.
Support may also include help with housing, employment and daily living. In some cases, a short stay in the hospital may be needed if someone is very unwell.
Recovery and living with psychosis
Recovery from psychosis looks different for everyone. For some, it may mean no longer experiencing symptoms. For others, it may involve learning how to manage symptoms and live a meaningful life.
Recovery is often a gradual process. It can include understanding your experiences, recognising early warning signs, and building strategies to stay well.
Support from friends, family and professionals can make a significant difference.
Supporting yourself and others
There are practical steps that can support wellbeing and recovery. These include maintaining a regular routine, eating well, staying active and managing stress.
Avoiding drugs and alcohol can also be important, as these can worsen symptoms or interfere with treatment.
Understanding personal warning signs, sometimes called a relapse signature, can help people recognise when they may need additional support.
For friends and family, learning about psychosis can make it easier to provide meaningful support. It can be helpful to focus on how the person is feeling, rather than challenging their beliefs directly.
The role of research
At MQ Mental Health Research, research is central to improving outcomes for people affected by psychosis. From understanding causes to developing more effective treatments, research helps shape better care and support.
What Happens in the Brain When Schizophrenia Begins?
Schizophrenia affects 1% of the population and often first arises during the teenage years — a period of significant brain reorganisation. Yet the specific biological mechanisms involved, and the genes responsible for them, have remained poorly understood.
MQ Fellow Dr Petra Vértes and her team at the University of Cambridge analysed brain scans from hundreds of healthy volunteers, people who had experienced psychosis, and those identified as being at risk. By cross-referencing these with the Allen Brain Atlas, a comprehensive map of gene activity across the entire brain, the team developed a novel method of linking brain imaging with gene expression data.
Key findings included that male and female brains develop differently during adolescence, with certain regions showing more pronounced changes in women that overlap with areas linked to depression. The study also identified a cluster of genes highly expressed in brain regions vulnerable to schizophrenia, including potential new drug targets. The methodological tools developed are now being applied to a range of other conditions, including autism, depression, and epilepsy.
Psychosis can be a challenging and distressing experience, but it is not something anyone has to face alone. With the right support, treatment and understanding, recovery is possible.
By increasing awareness and investing in research, we can continue to improve the lives of people affected by psychosis and move closer to a future where mental health conditions are better understood and more effectively treated.
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The post Understanding Psychosis: Symptoms, Causes, Treatment and Support first appeared on MQ Mental Health Research.
