What is Psychosis?

Mental health care

Psychosis – a definition

Psychosis is when an individual interprets or perceives reality in a different way to those around them. It could be said that they lose sense of what is real. Psychosis can also be described with the terms ‘psychotic episode’ and ‘psychotic experience.’

Most commonly, psychosis is presented with delusions and hallucinations but individuals may also experience paranoia, confused and disturbed thoughts and changes in their behaviour.

Psychosis is different for each individual. Some people might only have it once, for example after having a baby (postpartum psychosis) whereas others might have episodes throughout their life or experience psychosis most of the time.

Delusions and paranoia

Oftentimes people have beliefs that others don’t share. However, when talking about delusions, we are talking about an individual having a belief that is false and that nobody else shares. Even with all logic or experiences that demonstrate its falsehood, the individual will still believe the delusion. To take an example, an individual might believe that he or she is somebody that they are not. They might believe themselves to be rich or powerful or famous. Delusions like this are given the name ‘delusions of grandeur’.

It can be extremely frightening to have a delusion as they can feel very threatening. For example, an individual could feel that someone is trying to harm, kill or control them with no evidence or reason. Delusions like this are called ‘paranoid delusions’.

When an individual experiences paranoia, they think and feel threatened despite there being no reason and no evidence that they are under threat. Paranoid thoughts might also be referred to as delusions. There are many different types of threat that an individual could be worried about or frightened of.

Thoughts that are paranoid might also be suspicions that are exaggerated. For example, if a person once made an unkind remark about an individual, that individual might have a paranoid thought that they are the victim of a hate campaign.

With paranoia, fears are intensified and all other people become part of it. A paranoid individual is the centre of a very threatening and frightening world.

What types of things do people have paranoid thoughts about?

Each individual with paranoid thoughts will have a completely different experience. Here are some common paranoid thoughts.

An individual might feel that:

  • They are being talked about behind their back or they are being watched by organisations or people (this could be online or offline)
  • Others are out to exclude them or make them look bad
  • They are at risk of being killed or physically harmed
  • Others use double meanings or hints that are secret threats
  • Others deliberately try to irritate them or upset them
  • Others are trying to take their possessions or money
  • Their thoughts or actions are being intercepted or interfered with by other people
  • They are under the control of someone else or that they are being targeted by the government

Someone with paranoia might have very strong thoughts like these all of the time or they might just have thoughts like this when they are under pressure. Paranoid thoughts can cause people to be really distressed but some people don’t mind them as much.

Confused and disturbed thoughts

Those who are suffering from psychosis will sometimes have confused and disturbed thoughts or disrupted thought patterns.

Signs of confused and disturbed thoughts include:

  • Speech that is constant and rapid
  • Speech that is disturbed. This means that the individual switches from one conversation topic to another in the middle of a sentence
  • An individual losing their train of thought, which results in a sudden pause in an activity or conversation

Disordered thinking alone isn’t always psychosis, though it often is. You might hear this being referred to as ‘formal thought disorder’.

Other types of thoughts:

  • Racing thoughts – this is where people have thoughts that go through their heads very quickly.
  • Flight of ideas – this is where people move really quickly between ideas, often making links that others don’t

If a person has disordered thinking, they might:

  • Stumble over words and speak fast. Others won’t find it easy to understand you.
  • Experience ‘word salad’. Their speech will seem jumbled and won’t make sense to others because words are linked together because of how they sound.
  • Change the subject rapidly as their thoughts are moving and changing quickly.
  • Find it hard to maintain attention and focus


Hallucinations can be extremely frightening. They can include:

  • Seeing things that others don’t. This could be animals, religious figures or people’s faces
  • Seeing things that move unusually or that are distorted
  • Tasting, smelling or feeling things that aren’t there. For example, having a feeling that there are insects crawling on your arms.
  • Hearing things that aren’t there, like voices. Voices aren’t always nasty or hostile as many people believe. It is just as likely that an individual will hear positive or helpful voices in their hallucinations.

Change of behaviour

Since delusional thinking and hallucinations often cause individuals to be severely distressed, others will probably see a change in their behaviour. Behaviour, here, is used as an umbrella term to talk about a person’s body language, gestures, movements, the things they say and the places they go, for example.

Behaviour can be described as ‘disorganised’ or ‘disordered’. This might mean than an individual does things that aren’t acceptable or usual in public, for example undressing, swearing, shouting, or even masturbating. Disorganised behaviour might also mean that someone is simply not able to behave ‘normally’. They may find it difficult to do everyday activities like getting food or keeping clean.

A person who has psychosis might act inappropriately, act like a child, become agitated easily or mutter and swear. It is common for individuals with psychosis to neglect housework and person hygiene.

It is worth mention that not all changes in behaviour are due to psychosis or a mental disorder.