Psychotic disorders significantly affect how the brain functions by altering thoughts, beliefs and perceptions. A person suffering from a psychotic disorder can, for example, hear voices or have the impression that others are manipulating his or her thoughts. He or she has a difficult time differentiating between perception and reality. During episodes of crisis, a person suffering from a psychotic disorder is said to lose touch with reality.
Symptoms of a psychotic disorder can appear over time or suddenly. The period in which a person shows these symptoms is called a “psychotic episode”.
A person with a psychotic disorder has difficulty functioning day-to-day.
Psychotic disorders affect both children and adults regardless of ethnic origin, social and economic status and education. Psychotic disorders usually begin in adolescence or early adulthood.
Main types of psychotic disorders
The following are the main types of psychotic disorders:
- Schizophrenia: Schizophrenia causes a loss of contact with reality and affects thoughts, emotions, feelings and behaviour. A person suffering from it has difficulty functioning in his or her day-to-day activities.
- Schizoaffective disorder: A person with schizoaffective disorder has both symptoms of schizophrenia and symptoms associated with mood disorders (depression and bipolar disorder).
- Delusional disorder: Delusional disorder primarily affects thoughts and ideas. For example, a person may:
- Have difficulty concentrating or following a conversation
- Believe that a celebrity is in love with him or her
- Feel that he or she smells bad or have the impression that he or she is being followed or poisoned
- Brief psychotic disorder: Symptoms of brief psychotic disorder are the same as for schizophrenia. However, they appear suddenly and are often triggered by major stress, such as death, violence, illness or natural disaster. Brief psychotic disorder lasts no more than a month. Afterwards, the person returns to normal, often without relapsing.
- Substance-induced psychotic disorder: With this disorder, the loss of touch with reality is caused by the consumption of substances such as alcohol, drugs or medication. The person may show signs and symptoms, such as delusions and hallucinations.
Signs and symptoms
Friends and family of a person suffering from a psychotic disorder may notice certain signs:
- Disturbed sleep and loss of appetite
- Neglect of personal hygiene and appearance
- Lack of energy and motivation
- Mood swings (for example, may become abnormally excited and then depressed within minutes)
- Difficulty concentrating or paying attention for long periods
- Loss of interest in usual activities, work, studies or friends
- Altered feelings (for example, appears indifferent to loved ones, detached or disconnected from the world)
- Delusions, meaning strange or false ideas, bizarre preoccupations or beliefs (for example, has the impression that his or her thoughts are being controlled by an external force)
- Incoherent and confused thoughts (for example, has difficulty following a conversation and makes vague and illogical statements)
- Unusual behaviour (for example, laughs or gets angry for no reason, refuses to eat out of fear that the food is poisoned)
- Isolation behaviours (for example, stays in his or her room all day)
- Starts drinking or using drugs or consuming them more than usual
Symptoms may vary from person to person and change with time.
During psychotic episodes, the person may have:
- Hears one or more voices that nobody else hears
- Sees things that nobody else sees
- Smells odors that nobody else smells
- Feels unusual physical sensations (for example, has the impression that he or she is being touched by an invisible person)
- Delusional ideas, such as:
- Has the impression that he or she is able to control other people’s thoughts or that others are controlling his or hers
- Has the feeling that he or she is being watched, followed or persecuted
- Feels different from others or that he or she has changed
Delusional ideas can cause the person anguish and anxiety (for example, he or she can experience permanent insecurity).
At the onset of a psychotic disorder, many people suffering from it pay little attention to symptoms and think they’ll go away by themselves. In doing so, they delay getting help and benefiting from treatment.
When to consult
Do not wait until you are unable to perform your usual activities before getting help. A health-care professional can assess whether you have a psychotic disorder and, if so, what type of disorder it is. He or she can also assess if you have another health problem with similar symptoms. For a proper assessment, it could be necessary to conduct a physical exam or laboratory tests. You will be offered a treatment plan that is adapted to your needs.
Consult the Help and resources section to find out about the support available to you.
If you have suicidal thoughts and fear for your safety or that of people around you, read Preventing suicide. You will find further information on available help and resources.
Psychotic disorders are treatable. There are known treatments that allow people suffering from these illnesses to regain control of their lives and daily activities.
According to recent studies, the earlier a psychotic disorder is detected and treated, the greater the chances of recovering quickly. This way, a person can:
- Maintain a healthy and satisfying life
- Maintain and improve relationships with the people around him or her
- Experience less relapses of psychotic episodes
- Reduce the risks of aggressive or suicidal behaviour or behaviour that endangers his or her life or that of others
- Preserve his or her memory and concentration
In most cases, psychotic disorders are treated effectively with one or a combination of several treatments and rehabilitation activities:
- Group therapy
Experts generally recommend cognitive behavioural therapy to treat psychotic disorders. This form of psychotherapy aims to change the person’s thoughts and problematic behaviour and replace them with thoughts and responses that are appropriate to reality.
Medication for psychotic disorders
Different medications can be used to treat symptoms and prevent new psychotic episodes. These medications are called “antipsychotics” (also called “neuroleptics”).
Effects of antipsychotics
Antipsychotics, are designed to restore chemical balance in the brain. They rebalance:
These medications also lower anxiety and enable the person suffering to follow therapy and reduce the risk of experiencing a new psychotic episode.
Recommendations regarding medication
If your doctor prescribes you medication, it is important that you carefully follow the instructions for taking them.
Even if you feel better, continue the treatments as prescribed in order to avoid having the symptoms occurring again.
If you experience undesirable side effects due to medication, discuss the matter with your pharmacist or doctor as soon as possible. If necessary, your doctor may adjust your medication or recommend another medication.
Living with an untreated psychotic disorder can lead to many consequences for the person suffering from it as well as his or her family and friends. This could:
- Impact the person’s self-esteem negatively
- Hurt his or her relationships with others and lead to isolation
- Increase the distress of family and friends, who, for example, won’t always understand his or her behaviour, which may lead to conflicts
- Increase certain risks for the person, such as:
- Living in greater poverty
- Drinking or using drugs excessively. People suffering from a disorder often try to control their anxiety by drinking or doing drugs, which might lead to addiction
- Becoming homeless, suffering from depression and thinking about suicide
- Behaving in ways that could land him or her in trouble with the law or result in hospitalization
Protection and prevention
There are some simple methods that can help you feel better and reduce your risk of experiencing a new psychotic episode. To learn more, read Maintaining good mental health.
Psychotic disorders do not always have a single cause. It is often a combination of several factors that leads to signs and symptoms. Here are some factors:
- Heredity, meaning that other people in the family are suffering, or have suffered, from a psychotic disorder
- Alcohol abuse and the use of certain drugs
- Stress factors in the person’s life or environment
An increasing number of studies show that use of drugs such as cannabis, cocaine and amphetamines increase the risk of having a psychotic episode.
People at risk
Psychotic disorders affect slightly more men than women. They usually appear between the ages of 15 and 35.
Psychotic disorders most often appear in adolescence due to changes that occur during this period, which affect:
- Personal and sexual identity
- The ability to detach from family and seek independence
- Intellectual development
- The start of a career or post-secondary studies
- The search for personal and financial autonomy
Impact on family and friends
When a person experiences a psychotic episode, people around him or her can be severely affected. They may feel destabilized and powerless. They need help to understand the psychotic disorder the person is suffering from and to better communicate with him or her. They could, for example:
- Learn how to use effective communication techniques and adaptation strategies
- Participate in supportive interventions
Family and friends are in a good position to detect the signs of a psychotic episode in a person who has the disorder. Also, they are an important source of support for that person during his or her treatment.
Help and resources
Information and support resources
Resources are available for help and to obtain more information about psychotic disorders:
- Société québécoise de la schizophrénie (in French only)
- Info-Santé 811
- Suicide-prevention helpline: 1 866 APPELLE or 1 866 277‑3553
- Réseau d’entendeurs de voix du Québec – Pour les personnes qui entendent des voix et celles qui les appuient (in French only)
- Réseau avant de craquer – fédération d’organismes voués au mieux-être de l’entourage d’une personne atteinte de maladie mentale (in French only)
- Association québécoise des programmes pour premiers épisodes psychotiques (in French only)
- Association des médecins psychiatres du Québec (in French only)
You can also consult the Mental Illness page for more available resources.
If you would like to help a loved one suffering from a mental illness, read Living with a Person Suffering from Mental Illness to learn how to help within your limits.
Resources for care and services
To receive care or services, or to find a psychotherapist with whom you feel comfortable, contact one of the following resources:
Last update: October 25, 2018