Types of psychosis
The experience of psychosis is different for everyone, and you may find it varies for you at different times. Types of psychosis include hallucinations, delusions and disorganised thinking and speech.
- Hallucinations – this is when you hear, see, feel, taste or smell something that is not there. Hearing voices is the most common hallucination. These voices might talk about or to you and might command you to do things.
- Delusions – unusual beliefs that are real to you but not to those around you. You may experience ‘paranoid delusions’, believing that other people want to harm you (e.g. that the government is trying to hunt you down). Or you may believe you have extraordinary abilities (e.g. being able to read people’s minds).
- Disorganised thinking and speech – you may feel your thoughts are racing, and friends may notice that you constantly change the topic of conversation, are easily distracted, or laugh at irrational times. You may speak in an unusual way, perhaps using words that only you understand.
It’s important to note that these experiences are relatively common: research suggests that about 1 in 10 of us has heard voices before, and many people have beliefs that others may describe as false or delusional. In most cases, you will only be treated for psychosis if it is causing you distress and preventing you from living well.
Being with a group of people who understood what it was like to hear voices and to know I wasn’t alone in my experience was so incredibly valuable. To be able to talk about the voices, what they were saying, how they were distressing me, helped me so much. I felt heard and validated and this supported me on my recovery journey
If you are experiencing psychosis and it is causing you distress, the first step is to talk to your GP. You may approach them yourself, or your whānau or friends may reach out for help for you. The GP will want to rule out any physical illnesses that could be causing the psychosis. They can also refer you to a specialist (a psychiatrist).
Psychosis is not a condition or diagnosis in itself. After being assessed by the psychiatrist, you may be diagnosed with a mental health condition. However, many people experience psychosis but are not given any specific mental health diagnosis.
Either way, there are effective treatments that can help you manage psychosis and live a fulfilling life. The main components are talking therapies and medication.
Talking therapies are effective in the treatment of psychosis. Sessions may be held on a one-to-one basis or include partners or family/whānau.
Cognitive behavioural therapy (CBT) is the main type of therapy used to treat psychosis. During CBT, your therapist will help you identify patterns of thought and behaviour that are unhelpful to you. They will work with you to change these patterns and learn new ways of coping with psychosis, as well as any other challenges you are experiencing.
All types of therapy/counselling should be provided in a manner which is respectful to you and which validates your experiences. You should feel comfortable, listened to, and free to ask questions.
The therapy should be consistent with and incorporate your cultural beliefs and practices.
If you are prescribed medication, it will likely be an ‘atypical antipsychotic’ (e.g. olanzapine, quetiapine, risperidone or aripiprazole) to treat psychotic symptoms, such as hallucinations. You may also be prescribed other medications alongside these, to manage things like anxiety or poor sleep.
You are entitled to know:
- the names of the medicines
- what symptoms they are supposed to treat
- how long it will be before they take effect
- how long you will have to take them for
- whether your current dose could change over time
- possible side effects (both short and long term)
- possible interactions with other medications, drugs or alcohol
- what the process of stopping them could look like.
The side effects of antipsychotic medication can be uncomfortable, and some people will want to stop taking them as a result. If this is how you feel, it’s important that you talk to your doctor before you make changes to your medication yourself. They can help you come up with a plan, which might involve finding a way to better manage side effects, safely changing how much medication you take, changing to a new medication, or stopping altogether.
If you are pregnant or breastfeeding, medication may still be an option. Talk to your doctor about what is right for your situation.
Thanks to Dr Paul Skirrow, on behalf of the NZ College of Clinical Psychologists, and Chloe Shaw of the Mental Health Foundation's lived experience group for reviewing this content. Date last reviewed: September, 2022.
Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.