Early Symptoms of Psychosis You Should Know About

Psychoeducation is essential to detect certain early signs of psychosis. We'll tell you everything you need to know about it here.

Reviewed and approved by the psychologist Maria Fatima Seppi Vinuales.

Written by Maria Fatima Seppi Vinuales

Last update: 06 December, 2022

Knowing the early symptoms of psychosis is the first step in understanding how this mental disorder occurs. A psychotic break tends to have a profound impact on both the experiencer and the bystander.

Often, it’s difficult to understand what is happening; it’s as if “something has clicked out of place,” as some say. In any case, psychosis is a disease that affects the brain and its functioning. Hence, it leads to situations in which behavior is incomprehensible. It is therefore essential to raise awareness in order to prevent stigmatization.

What is psychosis?

To speak of psychosis is to refer to a mental illness that tends to present itself in a variety of ways. However, its common denominator is the loss of a sense of reality. It’s estimated that the first symptoms usually occur between the ages of 20 and 30.

However, between 20 and 40% of patients have initial clinical manifestations before the age of 20. In terms of etiology, psychosis is multifactorial. Therefore, there are multiple causes (genetic, biological, vulnerability to stress, environmental, etc.).

The genetic component plays an important role, although it’s not sufficient by itself. It’s the combination of all factors that predispose to a greater or lesser extent to experiencing a psychotic episode.

In general terms, a psychotic episode presents itself as follows:

• An episode with prodromal symptoms. These are often ambiguous or vague. For this reason, it’s often difficult to detect them if one is not informed about the subject. In any case, they function as an early warning.
• The acute phase. Symptoms are clear; hallucinations, delusions, and disorganized thinking are likely present.
• The remission phase. This refers to the gradual disappearance of symptoms and recovery.

Early symptoms of psychosis

Knowing the early symptoms of psychosis is decisive for patients and the people around them. These manifestations often evolve over time, although many can be addressed with treatment.

To be more precise, the signs of the disease include the following:

• Changes in mood that are prolonged over time (this is not just “having had a bad day”)
• Nervousness and anxiety
• Difficulties concentrating
• Neglecting personal hygiene
• Sleep problems
• Incoherent speech
• Difficulties when starting or continuing a task and a lack of motivation
• Alterations in the course of thought (typical expressions are disorientation, difficulty in understanding what is happening, and inability to distinguish between reality and fantasy)
• Hallucinations (this refers to having the perception that something exists, although it does not. For example, sometimes, the person may refer to hearing voices)
• Delusions (this refers to the belief that something is happening and is real. For example, the person may believe that he/she is being persecuted or stared at)

The treatment approach to psychosis

For the approach to psychosis, it’s important to keep a few basic things in mind. Among them, the following recommendations stand out:

• It should be approached in an interdisciplinary manner. That is to say, the follow-up should be carried out by different health professionals; from psychiatrists and psychologists to nursing staff, therapeutic companions, and all those who are necessary.
• It’s important to enhance the context and the relational circle of the patient with symptoms of psychosis.
• Maintain continuity with their pharmacological treatment. It’s important they strictly adhere to taking their prescribed medication since it favors both improvement and prevents relapses. Along the same lines, the consumption of stimulants, drugs, and alcohol is highly discouraged.
• Work on social and emotional skills. In this way, the person will be able to develop resources to express emotions and face conflicts.
• Encourage social support and integration. It’s necessary that the person can be part of a community, that he/she can continue his/her studies or carry out some activity on a continuous basis. Routines that bring a certain degree of predictability to their daily lives work very well for these diagnoses.

Work on psychoeducation

This point should be emphasized, as it involves not only the patient, but also his or her family. In the case of most relapses, situations linked to stress and emotional and affective dysregulation were identified.
In this sense, the feeling of being collapsed and overwhelmed appeared, which then derived or was “chained” with a reduction of consciousness and behavioral and affective disinhibition.

If we teach people how to detect such signs, early intervention can be achieved. In addition, while relapses are to be expected, they also affect the confidence of the person and their families regarding improvement or recovery.

Educating about the early symptoms of psychosis is key

In the first instance, psychoeducation about the early symptoms of psychosis allows both those who have these conditions and their families and loved ones to acquire adequate resources to cope with this mental disorder. Likewise, this plays a relevant role in treatment adherence and relapse prevention.

Many times, it happens that these diseases are seen as a catalog of symptoms. However, as the saying goes,“there’s no such thing as an illness; only people who are ill.” This means that each illness has different forms of expression depending on the patient, apart from the “universal” signs.

Being able to educate ourselves about early warning signs and provide concrete guidelines is essential to enhance protective factors and reduce those that are at risk. In this sense, it’s also paramount to understand the disease’s own timings in order to encourage the person and not put pressure on them.

Ultimately, psychoeducational should focus on the care of the caregivers. That is, it’s about informing them of the possibility of asking for help, sharing tasks, and providing resources to learn how to handle difficult situations. This is very necessary since – as is the case with any type of illness – there’s a high risk of caretaking experiencing exhaustion or burnout.