{"id":608816,"date":"2026-05-28T17:08:13","date_gmt":"2026-05-28T17:08:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/608816\/"},"modified":"2026-05-28T17:08:13","modified_gmt":"2026-05-28T17:08:13","slug":"could-you-recognize-the-first-signs-of-psychosis","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/608816\/","title":{"rendered":"Could You Recognize the First Signs of Psychosis?"},"content":{"rendered":"

Psychosis<\/a> and schizophrenia are among the most common mental health concerns. Yet, these terms remain draped in misunderstanding, even among clinicians.<\/p>\n

As a therapist who has experienced psychosis herself, I often find myself seeking to correct misunderstandings. No, not all (or even most) extreme or difficult-to-understand behavior is considered “psychosis.” Yes, people can have a first episode of psychosis after their 20s, especially women (D\u00edaz-Pons et al., 2022). In psychosis care, multiple diagnoses are often the norm, not the exception, with many individuals’ experiences falling outside the straightforward confines of DSM<\/a> criteria. Watchful waiting is not always a good idea, even when we want to protect someone from the stigma<\/a> of particular diagnostic labels.<\/p>\n

And yes, often, people do get better.<\/p>\n

Why All Therapists Need a Working Knowledge of Psychosis<\/p>\n

I recognize the lack of knowledge. Psychosis is one of thousands of difficulties that lead people to see mental health practitioners, and aspects of psychosis remain mysterious even to psychosis experts and researchers.<\/p>\n

Still, with early detection and intervention being documented as one of the best predictors of quality of life and recovery (Salazar de Pablo et al., 2024), being able to identify the signs of psychosis and route to appropriate care when necessary is essential for mental health clinicians.<\/p>\n

Within the United States, more than 400 early psychosis specialty clinics exist. Mostly funded through a large block grant through the Substance Abuse<\/a> and Mental Health Services Administration (SAMHSA), these programs offer wraparound assessment and support to individuals in the earliest stages of psychosis. Called coordinated specialty care (CSC) programs, the philosophy<\/a> of these centers is that through specialized psychotherapy<\/a>, family interventions, psychiatric<\/a> care, peer support, and assistance with work or school, individuals experiencing psychosis can live well with their conditions.<\/p>\n

And the evidence has been outstandingly positive, with many such programs showing results of 80 percent of participants re-engaging with work or school after 6 months, and just 10 percent needing hospitalization after 3 months (Nossel et al., 2018).<\/p>\n

Lauri Stephens is a psychologist and senior director of Autism Services at the Help Group, which offers such an early psychosis program. I spoke with her about what clinicians and others can look out for in terms of the early signs of psychosis.<\/p>\n

Together, we identified four key signs.<\/p>\n

Early Warning Signs<\/p>\n

Social withdrawal: When someone is experiencing psychosis, and before it, it is common for people to isolate. Symptoms like hearing voices and paranoia<\/a> can make it harder to be around others. In addition, loss of interest in social interactions and trouble connecting with others are common in a first episode of psychosis. According to Stephens, it can look like this: “All of a sudden, they used to be social, but now they are no longer wanting to text people back, go to family events, or do things that they used to want to do.” Still, she clarifies that while this can indicate psychosis, it doesn’t always, sharing, “Someone who is experiencing extreme depression<\/a> or anxiety<\/a> might be showing the same social withdrawal\u2014becoming flatter in their affect too.”
\nOdd beliefs or paranoia: Unusual beliefs about others being out to get you or reading your mind are a hallmark of psychosis. In the earliest phases, people are sometimes aware that their perceptions have been altered. This very beginning stage, sometimes called a “clinically high risk” or prodromal phase, marks what could but doesn’t always become psychosis. Stephens illuminates, “The things we tend to look for are in the prodromal phase, there’s a lot of uncertainty, when it moves into clear psychosis, it is real to them. The person can’t usually say, ‘It could be in my mind.'”
\nChanges in day-to-day behaviors: When someone is experiencing psychosis, keeping up with day-to-day tasks like cleaning, completing homework, going to school, or even showering can be very difficult. Stephens shares that others might notice “Grades dropping, changes in ability to attend and ability to deal with daily hygiene.” Such changes are not caused by laziness, but rather by loss of motivation<\/a>, and cognitive changes common to psychosis can make these activities feel impossible.
\nBeginning of visions and voices: Hallucinations are common in psychosis. At the start, this might look like a rustling sound in one’s ear, hearing chimes when none are there, illusions, or more developed voices and visions. In Stephens’ words, “The potential hearing of things that aren’t there\u2014seeing things that aren’t there\u2014the paranoia\u2014that’s where you start to think that there is some sort of different processing going on with that particular client.”<\/p>\n

A Complex Phenomenon<\/p>\n

While schizophrenia is one cause of psychotic symptoms, several origins exist. The most prevailing theory of what causes psychosis involves a mix of genetic vulnerability to stress<\/a> and stress\/trauma<\/a>, with sufficient stress being believed to ignite a cascade of biological events culminating in psychosis (Gr\u0105\u017alewski et al., 2023). The stress hormone<\/a> cortisol appears to be a key player, with individuals at high risk of psychosis having alterations in the cortisol awakening response. <\/p>\n

Stephens shares, “Trauma exposure has a high correlation with psychosis, and there is a genetic component. When you put the genetic component in with these extremely high stressors, it becomes very difficult to cope.” She expands, “PTSD<\/a> and trauma have a high comorbidity<\/a> with psychosis.”<\/p>\n

Stephens emphasizes that it is important to ask, “Could this be because of extreme and new kinds of stress? In those cases, we might deal with that instead of moving straight into medication<\/a> management<\/a> for psychosis…It is a dual-modality treatment of trauma-informed care and treatment for psychosis.”<\/p>\n

Autistic<\/a> individuals are also at a heightened risk of psychosis. Stephens reflects, “Out of our population, about 35 percent either carry an autism spectrum diagnosis or are suspected of having an autism spectrum diagnosis.”<\/p>\n

Closing<\/p>\n

What is most important to know is that the outlook for people experiencing psychosis is bright. People living with these conditions can have meaningful relationships and chase their dreams<\/a> just like everyone else. A study that followed people who received treatment for a first episode of psychosis over 10 years found that 60 percent reported satisfaction with their lives, a number likely comparable to the general population (Simonsen et al., 2024).<\/p>\n

For those in need, SAMHSA offers a treatment locator<\/a> for early psychosis care. To find a therapist near you, visit the Psychology Today Therapy Directory.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Psychosis and schizophrenia are among the most common mental health concerns. Yet, these terms remain draped in misunderstanding,…\n","protected":false},"author":2,"featured_media":608817,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[59,57,58,50,56,54,55],"class_list":["post-608816","post","type-post","status-publish","format-standard","has-post-thumbnail","category-united-kingdom","tag-gb","tag-great-britain","tag-greatbritain","tag-news","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/608816","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=608816"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/608816\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/608817"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=608816"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=608816"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=608816"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}