What is psychosis?

What is psychosis?

What is psychosis?

What is psychosis?

  • Psychosis happens when people experience a loss of contact with reality. It can come on from a variety of psychiatric, neurologic, and other medical conditions.
  • People experiencing psychosis describe disruptions or bizarre changes in their perceptions that are often not readily observable by others.
  • Core examples of symptoms in psychosis include hearing, seeing, or feeling things that are not objectively real or may not be experienced by others.
  • People sometimes describe having strange or unusual thoughts, behaviors, or emotions that won’t go away. They might feel like they are being watched or that people are placing messages for them to see. Understanding what circumstances occur with these symptoms can aid diagnosis.
  • When a person first shows signs of psychosis, this is called first episode psychosis or early psychosis. The sooner someone is treated for psychosis, the better the long term outcome.
  • For some people early psychosis may indicate the early stages of a mental illness such as schizophrenia or bipolar disorder, which seem to come on around the teenage years to young adulthood.

What is Psychosis?

  • Psychosis happens when people experience a loss of contact with reality.
  • People describe disruptions in their thoughts and perceptions.
  • Examples of psychosis include hearing, seeing, or believing in things that are not real.
  • People also describe having strange or unusual thoughts, behaviors, or emotions that won’t go away.
  • Psychosis is not an illness but is a symptom. 
  • Sometimes the symptoms of psychosis are the sign of a mental illness such as schizophrenia or bipolar disorder.

What is Psychosis?

  • Feeling like the world is unreal in a way that is hard to describe to others.
  • Thoughts might change--they may speed up or slow down a lot.
  • Hearing or seeing things that may be unusual or not shared by others.
  • Experiencing an upsetting, but very convincing belief that something is true.
  • Symptoms of psychosis require thorough evaluation by a professional.
  • When a person first shows signs of psychosis, this is called first episode psychosis or early psychosis.

Signs I might be experiencing psychosis:

  • Performance in school, work, or family life is rapidly dropping
  • Spending a lot of time alone in my room
  • Doing or saying things that seem strange, even bizarre
  • Experiencing feelings of sadness or depression
  • Feeling irritable
  • Having problems sleeping

How do I know if my loved one is experiencing psychosis?

  • Your loved one experiences a loss of contact with reality or may question what is real or not.
  • You notice that your loved one has thoughts and perceptions that may seem strange or unusual.
  • Your loved one might describe hearing, seeing, or feeling things that cannot be easily explained and may not be observable to others.
  • You notice that your loved one has strange or unusual thoughts, beliefs, behaviors, or emotions that won’t go away or may come and go.

It is important to remember that:

  • Psychosis is not an illness but is a syndrome, meaning a bunch of symptoms that happen at the same time in a number of diseases.
  • The symptoms of psychosis may be an indicator of a mental illness, such as schizophrenia or bipolar disorder; however, diagnosis of a mental illness requires careful evaluation over long periods of time from a trained professional.
  • For some people early psychosis may be the start of a mental illness such as schizophrenia or bipolar disorder, but these diagnoses are made over months to years.

Signs of psychosis I might notice:

  • A quick decline in your loved one’s performance in school, work, or family life. This might look like going from A’s to B’s or C’s.
  • Your loved one is spending a lot of time alone, and it may difficult to get them to leave their room.
  • Your loved one is doing or saying things that seem strange or bizarre.
  • Your loved one has lost interest in activities they used to like or expresses feelings of sadness, worthlessness, or a loss of hope.
  • Your loved one is more irritable, regardless of their current mood.

What are some signs that a person might be experiencing early psychosis?

  • A person’s performance in school, work, or family life is rapidly dropping (A’s to B’s or C’s, warnings at work)
  • A person is spending a lot of time alone, in their room, away from others in seclusion
  • A person may be doing or saying things that seem strange, even bizarre
  • A person expresses feelings of sadness or depression, or they may seem not overly concerned with their wellbeing or their health.
  • A person feels irritable or on edge, even if they are feeling sad at the same time.
  • A person describes having problems sleeping, which might be falling asleep, staying asleep, or waking up too early.

Why do people start experiencing psychosis?

There are many different things that can bring on psychosis or some of the symptoms of psychosis including:

  • Recreational drugs and alcohol
  • Stress
  • Environmental deprivation
  • Sleep deprivation
  • Experiences of trauma
  • Damage to the brain
  • Mental illness

What treatment is helpful for psychosis?

What are some signs that I (my loved one or my client) might be experiencing early psychosis?

  • My performance in school, work, or family life is rapidly dropping
  • Spending a lot of time alone in my room
  • Doing or saying things that seem strange, even bizarre
  • Experiencing feelings of sadness or depression
  • Feeling irritable
  • Having problems sleeping


What treatments are helpful for person experiencing the symptoms of psychosis?
There are many helpful strategies and interventions for people experiencing the symptoms of psychosis. Some treatments for psychosis are aimed at treating the start of schizophrenia. Typically treatment for psychosis or early schizophrenia can include:

  • Medication
  • Psychotherapy
  • Case management such as referrals for income support, health insurance, housing, or Supplemental Nutrition Assistance Program
  • Vocational counseling
  • Family counseling
  • Hospitalization or crisis stabilization

What can help me if I am experiencing psychosis?

  • Medications that provide some relief for most people
  • Working with a therapist you can build coping skills and strategies
  • Real world case management to help with daily life challenges related to housing, insurance, income, and meeting basic needs
  • Job or educational support through skill building and coaching
  • Working with your loved ones to help communicate needs to each other and make sure everyone feels heard
  • Hospitalization or crisis stabilization in the event of emergencies

NAVIGATE is a treatment program for people with first episode psychosis. NAVIGATE treatment includes:

  • Medication Management to help you find the right medication to get your life back on track.
  • A Family Education Program to help your loved ones learn more about the signs and symptoms of psychosis and strategies to increase your support at home.
  • Individual Resiliency Training to help you develop a plan to stay well and work towards your goals.
  • Supported Employment and Education that provides support for you to reach your goals for work or school.

Who can enroll in the NAVIGATE program?

  • People between the age of 15 to 40
  • People who have a diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder
  • People who have had less than one year of treatment on an antipsychotic medication

What can help a person experiencing psychosis?

You can help your loved one who is experiencing psychosis. Typically treatment should include:

  • Medication to help decrease the experiences of psychosis.
  • Meeting with a therapist to learn skills and strategies to manage the symptoms of psychosis and work towards meaningful goals.
  • Support from a case manager to connect to resources for help with insurance, income support, housing, or daily living needs
  • Working on goals to return to work or school through skill building and coaching
  • Meeting with your loved one to learn about psychosis, improve problem-solving, and build strong, effective communication in the family
  • Hospitalization or crisis stabilization in the case of an emergency

NAVIGATE is one of the most effective treatment programs for people with first episode psychosis. Treatment on the NAVIGATE team includes:

  • Medication Management to identify medication for people experiencing early psychosis and closely monitor any side effects
  • Family Education Program where you can learn more about the experiences of psychosis and skills to improve effective communication and problem-solving at home
  • Individual Resiliency Training to help your loved one work towards a meaningful goal and practice skills and strategies to manage the symptoms of psychosis
  • Supported Employment and Education meets with your loved one in the community to practice skills and take steps towards work and school goals

How can I figure out if my loved could be enrolled in a NAVIGATE program?:
The NAVIGATE programs works with people who are:

  • Ages 15 to 40
  • A diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder
  • Less than 1 year of treatment on an antipsychotic medication

What treatment is helpful for psychosis?

There are many helpful strategies and interventions for people experiencing the symptoms of psychosis. Treatment for psychosis that is aimed at treating the start of schizophrenia should include:

  • Medication
  • Psychotherapy
  • Case management such as referrals for income support, health insurance, housing, or daily living supports
  • Vocational counseling
  • Family Education
  • Hospitalization or crisis stabilization

What is NAVIGATE?

NAVIGATE is an evidence-based treatment program for people with first episode psychosis related to schizophrenia.
NAVIGATE includes:

  • Medication Management to work together with a prescriber to find the right medication that is specifically designed to help people in early psychosis and to closely monitor the medication response and any side effects.
  • The Family Education Program includes any supportive people that a person wants to include in treatment to help them learn about psychosis and increase support and communication at home.
  • The Individual Resiliency Training Program works with a therapist to make a plan towards meaningful goals, practice coping strategies for symptoms, learn strategies to improve health and wellness, and learn strategies to make a change in alcohol or drug use.
  • The Supported Employment and Education Program meets with a specialist in the community to help a person find a job or school program that meets their needs and practice skills to take steps towards their goal of work or school.

The enrollment criteria for a NAVIGATE treatment team includes:

  • Ages 15 to 40
  • A diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder
  • Less than 1 year of treatment on an antipsychotic medication

“Committed to recovery.”

Following a two week hospitalization this past spring, Peter entered the NAVIGATE program having recently lost his job, was living with parents, and was using substances daily. Like many individuals following an episode of psychosis, Peter wasn't sure what direction to take in his life, or how he could reach his goals. After his hospitalization, Peter resided in supportive housing for several months and began taking medication. He started attending weekly individual resiliency training sessions, and began regular check-ins with his psychiatrist and supported employment & education specialist. His parents attended family support & education sessions and were determined to learn as much as they could about his illness and support needs. They took notes, read articles, completed homework practice options, and at the end of their first three months of the program, their confidence in themselves and Peter had grown by leaps and bounds. They learned how to work together as a family under these new circumstances, and learned a lot about themselves. Peter, never having been one for talking or dealing with feelings, flourished in individual resiliency training sessions, and demonstrated an unwavering commitment to taking charge of his recovery over those months.

In the last few months, Peter's commitment to his recovery has steadily led to him to meet many of his goals. He recently got a new job, moved into his own apartment, and is learning how to create and maintain a budget. In the next few weeks, Peter will be starting college!! We are thrilled to see their successes and are humbled by their strength, fortitude, and resilience. With over eight months in the program, Peter and his family continue to be engaged with all aspects of the program, and plan to continue over the next few years.

~Peter

“I’m doing better.”

The word “recovery” in my life means that I’m doing better. I don’t think about my symptoms anymore, and feel like my life is better. I’ve made more friends. The HOPE program at HCMC has helped me get a job and transportation set up to appointments. My favorite part about working with the HOPE Program staff is that I like them. They are funny but we get our stuff done. They are nice people. I met some pretty cool people at HOPE.

~Jacob

“We Can NAVIGATE”

Gregory is a 20 yo male diagnosed with schizophrenia. His first episode of psychosis was one year ago. His story highlights the unique benefits of coordinated specialty care. Gregory has never been hospitalized. He visited the emergency room after experiencing psychotic symptoms for a couple months. He was discharged home from the emergency room with instruction to establish care with a psychiatrist. His psychosis proceeded to worsen to the point of suicidal and homicidal thoughts. At the recommendation of a family friend, Gregory's family reached out to the M Health Psychiatry Clinic. He ended up establishing care with the NAVIGATE team in a matter of days. He and his family participated in all elements of the program. He was prescribed medications, met with the IRT clinician weekly, and with the SEE weekly while his family met with the family clinician weekly. It was through a strengths-based, client-centered, shared decision making model that Gregory was able to cope with his symptoms and work toward personal goals of finding employment. He completed a training program for a professional career in auto mechanics. He started working and was on his path to recovery. As Gregory felt better he chose to stop medications. Unfortunately, symptoms returned in the presence of job loss and financial stress. He reached out to the Navigate team, who banned together to worked with him and his family to manage crises, restarted medications and schedule clinic appointments. In hindsight, Gregory was able to establish a trusting relationship with his providers that allowed him to avoid another potential hospitalization. Additionally, he and his family were able to gain the necessary knowledge and skills to intervene before a full relapse occurred.

~Gregory

“My reflections.”

At one point in my life, I figured that working three jobs would not be so stressful and that I could very much endure the hardship of work in a more casual way, as if I was Superman or something of the sort. Apparently, the work took its toll, and my well-being was superseded by stress levels in such a way that it triggered my condition of schizophrenia. Not only was my body in a state of fatigue, but my mental framework went into disarray after I began to hear hallucinations with voices. The struggle with my condition brought much hardship and I struggled to concentrate at work and on normal day tasks.

I got connected to the HOPE program, which uses the NAVIGATE model. I received help in ways that I could not have imagined. A case manager from the HOPE program helped to set me up with doctor appointments and handling much of the paperwork processes. After I was prescribed the correct medication by my doctor, my symptoms gradually diminished after a few months. Extensively through weekly therapy, I was more and more able to feel like my old self again. I felt more educated about my condition and the therapy helped to understand my delusional state with hearing voices. I learned some coping skills that would help with the symptoms and strategies to build resilience. Essentially, I learned more about myself and steps that I could take to maintain a healthy lifestyle. After meeting with a nutritionist, it became more evident that eating correct food would help me to have less symptoms. I also learned a couple of my strengths, which included, spirituality and kindness. The practice of prayer also played a major role in helping me cope through the symptoms, and my spirituality became more important to me. By keeping a positive attitude though the symptoms of schizophrenia, my experience was not as harsh, so I was able to persevere through the mental instructions more steadily without having any negative feelings.

I believe that some of the stressors of my life were partly caused by not obtaining the career that I would enjoy. I also felt that I procrastinated more of my life goals in such a way that I had not accomplished any of the contrivances that I had hoped for after graduating with a degree in film. Before I knew it, time flew by and I spent my life counterintuitively in jobs that were not in accordance with what I had in mind. I felt trapped, hopeless, and unworthy at some points, especially having acute episodes of schizophrenia.

Accordingly, the career counselor with the HOPE program brought more hope to my future. I am even more confident now about landing a better job, especially since the counselor was very helpful and shed light on the greater possibilities around me in terms of focusing my efforts with a career in film. Now that I have not had any symptoms in a few months, I am closer to a brighter future. I have full assurance that I will accomplish my goals and have a better career in the near future, especially if I keep on track with preserving a healthy lifestyle.

~Maria

What is the Minnesota Center for Chemical and Mental Health?

The Minnesota Center for Chemical and Mental Health is driven to discover and disseminate innovative, evidence-informed tools and resources to enhance wellness and recovery in the lives of individuals affected by mental illness, substance use disorders, or co-occurring disorders.

What is the Minnesota Center for Chemical and Mental Health?

The Minnesota Center for Chemical and Mental Health is driven to discover and disseminate innovative, evidence-informed tools and resources to enhance wellness and recovery in the lives of individuals affected by mental illness, substance use disorders, or co-occurring disorders.

What is the Minnesota Center for Chemical and Mental Health?

The Minnesota Center for Chemical and Mental Health is driven to discover and disseminate innovative, evidence-informed tools and resources to enhance wellness and recovery in the lives of individuals affected by mental illness, substance use disorders, or co-occurring disorders.

What is the NAVIGATE program?

NAVIGATE is an evidence-based treatment program for people with first episode psychosis related to schizophrenia.
NAVIGATE includes:

  • Medication Management to work together with a prescriber to find the right medication that is specifically designed to help people in early psychosis and to closely monitor the medication response and any side effects.
  • The Family Education Program includes any supportive people that a person wants to include in treatment to help them learn about psychosis and increase support and communication at home.
  • The Individual Resiliency Training Program works with a therapist to make a plan towards meaningful goals, practice coping strategies for symptoms, learn strategies to improve health and wellness, and learn strategies to make a change in alcohol or drug use.
  • The Supported Employment and Education Program meets with a specialist in the community to help a person find a job or school program that meets their needs and practice skills to take steps towards their goal of work or school.

The enrollment criteria for a NAVIGATE treatment team includes:

  • Ages 15 to 40
  • A diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder
  • Less than 6 months of treatment on an antipsychotic medication

Location of content: similar to the other 2 groups-this could come after the description of NAVIGATE. I would like to highlight this because these are helpful treatment strategies for working with people with first episode psychosis
Content to be added: Title: What can I do to help someone experiencing first episode psychosis?

  • Begin by asking information about a person’s experience of psychosis and why the person has had these experiences.
  • It is important to recognize the language a person uses to describe their experience of psychosis and what has happened to them.
  • Try to understand how the person makes sense of what happened
  • When working together, think about what it would be like to get treatment for the first time
  • Meet with people in the community
  • Engage family members and supporters in treatment as much and as soon as possible

What can I do to support my loved one experiencing psychosis?

Helpful things you can do:

  • Setting a goal that is meaningful for you to work towards such as making a friend, getting a job or going back to school, or starting a new hobby
  • Talking to someone about your experiences and sharing your feelings
  • Finding ways to live a healthy lifestyle like getting good sleep, getting more physical activity, and eating healthy foods
  • Learning more about your experiences of psychosis

What can I do about psychosis?

Helpful things you can do include:

  • Setting a goal that is meaningful for you to work towards such as making a friend, getting a job or going back to school, or starting a new hobby
  • Talking to someone about your experiences and sharing your feelings
  • Finding ways to live a healthy lifestyle like getting good sleep, getting more physical activity, and eating healthy foods
  • Learning more about your experiences of psychosis

What can I do about psychosis?

Helpful things you can do include:

  • Keep expectations for recovery low, but don’t let them go. This is a often a long term process with stops and starts.

  • Encourage, but do not prod. Choose your battles; remember that a symptom of psychosis can be difficulty starting things. Small, readily achievable goals can help.

  • Help your loved one keep as close to a normal routine as possible, particularly when it comes to getting healthy sleep.

  • Don’t argue with a loved one over worrisome thoughts, rather try to listen and show that you understand their feelings using Active Listening.

  • Continue to do any enjoyable activities together and help encourage new ones where possible. This might be playing a card game together, going for a walk, or watching a movie. Don’t assume that something small won’t have a big impact.

What can I do to help someone experiencing first episode psychosis?

Helpful things you can do include:

  •   Begin by asking information about a person’s experience of psychosis and why the person has had these experiences.

  • Pay attention to the language a person uses to describe their experience of psychosis and what has happened to them.

  • Try to understand how the person makes sense of what happened.

  • When working together, think about what it would be like to get treatment for the first time.

  • Meet with people in the community.

  • Engage family members and supporters in treatment as much and as soon as possible

Prescription Practices in the Treatment of First-Episode Schizophrenia Spectrum Disorders: Data From the National RAISE-ETP Study - Robinson, et al.

This article explains why patients with first episode psychosis need to be distributed medication separate from those with multi-episodic forms, and how common practice is to overmedicate patients in their first episode.

The RAISE Early Treatment Program for First-Episode Psychosis: Background, Rationale, and Study Design - Kane, et al.

This article illustrates the setup of NIMH’s pilot study for the RAISE project, comparing the experimental intervention to “usual care” on quality of life measurements.

Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program - Kane, et al.

This article explains the results of NIMH’s pilot study for the RAISE project, using data from a diverse range of settings to illustrate how NAVIGATE increases adherence to treatment and quality of life.

The NAVIGATE Program for First-Episode Psychosis: Rationale, Overview, and Description of Psychosocial Components - Mueser, et al.

This article provides a description of the background, rationale, and nature of the intervention known as NAVIGATE, focusing on its psychosocial components.

Duration of Untreated Psychosis in Community Treatment Settings in the United States - Addington, et al.

This article examines the amount of time that people endure psychosis while in the care of community mental health organizations, and the effects of that duration of untreated psychosis.

Understanding a First Episode of Psychosis - SAMHSA

A fact sheet for young adults experiencing their first episode of psychosis.

Early Psychosis And Psychosis - NAMI

NAMI’s information on Early Psychosis and Psychosis, specifically focused on informing families and friends.

Early Intervention Treatments for Psychosis - National Council

A detailed guide of the specific treatments effective for treating psychosis in its earliest stages.

NAMI Minnesota

National Alliance on Mental Illness provides support, advocacy, and resources to improve the lives of persons with mental illness. NAMI Minnesota offers an online booklet with more information about first episode psychosis, classes, and peer support groups.