Signs, Symptoms, and Causes of Psychotic Disorders

Psychosis is a group of symptoms that affect the mind and cause some loss of contact with reality. Psychotic disorders, such as schizophrenia, are conditions in which these symptoms happen or come back over time.

The National Institute of Mental Health (NIMH) estimates that 15 to 100 out of every 100,000 people develop psychosis each year. It often starts between the late teens and the mid-20s.

Symptoms of schizophrenia and other psychotic disorders often fit these groups:

• Hallucinations: Seeing or hearing things that other people don't, such as voices.
• Delusions: Strong beliefs that aren't true, such as feeling sure that others are trying to cause harm.
• Disorganized thinking: Speech or thoughts that are hard to follow.
• Changes in daily life: Pulling away from people, feeling little motivation, or having trouble focusing and remembering.

There's no single cause, and genes, differences in how the brain develops, and stress or trauma can all play a part. Sleep loss, certain medicines, and alcohol or drug use can also bring on psychotic symptoms. Psychosis can be part of a mood disorder such as bipolar disorder, or of severe depression.

When to See a Provider About Psychosis

It's time to see a provider when changes in thinking, mood, or behavior linger or get in the way of daily life. You don't need a diagnosis first, and you don't need to be sure about what's happening.

Early warning signs can include:

• Suspiciousness or worry that people mean you harm
• Trouble thinking clearly or following what people say
• Pulling away from friends and family
• Changes in sleep, or less attention to self-care
• Trouble telling what's real
• A sudden drop in how you're doing at work or school

Family and friends often notice these changes first. If you're worried about someone, you can encourage them to talk with a provider. You're welcome to call our office with questions. You can also read about the other mental health conditions we treat.

How Our Team Treats Psychotic Disorders

Treatment for psychotic disorders usually combines medicine with ongoing support, and our team builds a plan around you. That plan can include:

• Evaluation: A psychiatric evaluation helps us learn about your symptoms, history, and goals.
• Medication management: Antipsychotic medicine is the most common treatment for psychotic symptoms. Through medication management, Dr. De Lay prescribes medicine and adjusts it over time. We work together to find the option that helps most with the fewest side effects. If you ever want to change or stop a medicine, talk with your provider first so the plan can be adjusted safely.
• Brief psychotherapy: This is short-term talk therapy that's available on request with medication management. Supportive therapy and cognitive behavioral therapy (CBT) are both options, and CBT helps people notice and change unhelpful thoughts.
• Related concerns: If alcohol or drug use is part of the picture, we can help with that too through our addiction treatment.
• Visit options: You can see us in person at our Miramar Beach office or, if you live in Florida, by telehealth.

Warning Signs and Risks of Untreated Psychosis

Psychotic symptoms that go untreated can grow stronger and harder to manage, and they can affect safety, relationships, school, and work. Treatment lowers these risks, so getting care early matters.

Get help right away if a person:

• Talks about harming themselves or someone else
• Hears voices that tell them to do something dangerous
• Can't take care of basic needs, such as eating, sleeping, or staying safe
• Seems unable to tell what's real and feels frightened or in danger

If you or someone you know is in crisis, call or text 988 (the Suicide and Crisis Lifeline), or call 911 for an emergency.

Long-Term Outlook and Ongoing Care

Many people with psychotic disorders build steady, meaningful lives with ongoing care. NIMH explains that for some people, psychotic symptoms come and go, and for others they become stable over time.

NIMH says people who regularly take part in therapy and skills training are less likely to have symptoms return or be hospitalized. Medication management visits are a time to review how a medicine is working. We can adjust the plan as your needs change.

Meet Dr. Larry De Lay

Dr. De Lay has practiced psychiatry since 2008 and spent almost five years at the U.S. Department of Veterans Affairs (VA). He's a veteran himself, and he sees adults in person at our Miramar Beach office and by telehealth across Florida. At Sea Breeze Psychiatry, the patient comes first, and care stays personal and compassionate.