What Psychosis Is 

Psychosis is not a disorder on its own… it is a symptom. It describes a break or disruption in how a person interprets reality. Psychosis can include hallucinations (seeing, hearing, or feeling things that others don’t), delusions (false but firmly held beliefs), and disorganized thoughts or speech. 

These symptoms can appear in several mental health disorders, medical conditions, or after substance use.

Misconceptions About Psychosis 

Psychosis is often misunderstood. Many people believe it always means someone is violent or “out of control.” In reality, most people experiencing psychosis are not dangerous, but they may be scared or confused. 

Another misconception is that psychosis is the same as paranoia. While paranoia (an intense fear that others are watching, judging, or harming you) can be a part of psychosis, it can also appear separately in anxiety disorders or trauma. Psychosis involves a larger disruption in perceiving reality itself, not just mistrust or fear of others.

Types of Psychotic Disorders 

Schizophrenia

Schizophrenia involves ongoing psychotic symptoms such as hallucinations, delusions, disorganized thoughts, and changes in behavior. It can affect motivation, memory, and the ability to function in daily life. 

Day in the life: someone may struggle to follow conversations at work, feel suspicious of coworkers, and hear voices criticizing them when no one is speaking.

Schizoaffective Disorder

This disorder combines symptoms of schizophrenia with mood disorder symptoms such as depression or mania. 

Day in the life: someone may experience delusions while also going through a severe depressive episode, or hear voices while feeling euphoric and restless during mania. The mix of mood and psychotic symptoms often makes this condition difficult to recognize without proper evaluation.

Brief Psychotic Disorder

Brief psychotic disorder involves sudden, short-term episodes of psychosis, usually in response to stress or trauma. These episodes may last days or weeks and then resolve. 

Day in the life: after a major stressor, someone may suddenly begin believing that neighbors are spying on them or hear voices for the first time, then return to normal functioning after the episode passes.

Delusional Disorder

This disorder is marked by strong but false beliefs that persist for at least a month. These beliefs often focus on specific themes, such as being followed, poisoned, or deceived by a partner. Unlike schizophrenia, other areas of life may appear relatively unaffected. 

Day in the life: someone may work and socialize normally but live with the firm belief that government agencies are tracking their movements.

Substance-Induced Psychosis

Drugs and alcohol can trigger psychosis, either during use or withdrawal. Substances such as stimulants, hallucinogens, cannabis, or alcohol withdrawal can all produce hallucinations and delusions. 

Day in the life: after heavy stimulant use, someone may stay awake for days, convinced that people are following them or that bugs are crawling on their skin. Substance-induced psychosis may resolve with abstinence, but in some cases it can trigger ongoing psychotic symptoms.

Society’s Perspective on Psychosis 

Society often views psychosis through a lens of fear and stigma. Media portrayals focus on violence or unpredictability, reinforcing the belief that psychosis means someone is dangerous. This stigma can prevent people from seeking help and can leave families feeling isolated. In reality, psychosis is a symptom of illness, not a reflection of character. People experiencing psychosis deserve understanding, treatment, and support.

Why Psychosis Happens 

There is no single cause of psychosis. Genetics play a role: having a family history of psychotic disorders increases risk. Environmental factors matter as well, including trauma, stress, or medical illness. Brain chemistry, especially dopamine imbalances, is strongly linked to psychosis. Substance use can trigger or worsen symptoms. In some cases, psychosis appears after a major life event or as part of another mental health disorder.

Treatment Approaches For Psychosis 

Treatment for psychosis usually includes a combination of medication, therapy, and support systems.

1. Medication: Antipsychotic medications help regulate brain chemistry and reduce hallucinations and delusions.
2. Therapy: Approaches like CBT for psychosis help people challenge distorted thoughts, cope with hallucinations, and build confidence. Supportive psychotherapy focuses on stability and stress management. Family therapy can improve communication and reduce relapse risk.
3. Skills Training and Groups: Social skills training, psychoeducation, and peer support groups can help rebuild confidence and connection.

Reality Testing 

Reality testing is an important part of therapy for psychosis. It involves practicing ways to check whether a thought or perception matches reality. For example, if someone hears a voice, they might write it down, ask others if they hear it, or compare the experience against past patterns. Reality testing does not dismiss the person’s experience—it creates tools for deciding what is real and what may be a symptom.

Levels of Care for Psychosis 

At HighTide, we provide highly-skilled care for people experiencing psychotic symptoms.

Partial Hospitalization Program (PHP): Clients attend daily from 9:00am to 4:00pm. The program includes therapy, psychiatry, skills groups, and a safe environment for stabilization. PHP offers close monitoring for symptoms and medication adjustments while providing education and coping tools.

Intensive Outpatient Program (IOP): Clients attend several days a week while living at home. IOP focuses on continuing therapy, practicing reality testing, learning grounding skills, and maintaining medication routines. This level helps clients return to work, school, or relationships with continued support.