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Psychose

Psychose ist ein Symptom, aber keine eigenständige Diagnose. Psychosen können durch verschiedene psychische Erkrankungen wie Schizophrenie oder bipolare Störung, durch körperliche Krankheiten oder durch andere Ursachen wie Trauer oder Schlafmangel verursacht werden.

At a glance

  • Psychosis means interpreting reality abnormally, different from other people.

  • Common types of psychosis are hallucinations and delusions.

  • Hallucinations involve sensing things that are not real, like hearing voices.

  • Delusions are strong, false beliefs not shared by others.

  • Psychosis can be a symptom of mental health issues or other conditions.

  • See a doctor immediately if you have symptoms of psychosis.

  • Treatment involves talking therapies, medication, and self-help strategies.

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What is psychosis?

Psychosis means that you interpret reality abnormally and in a very different way from other people around you. This is like losing touch with reality.

Psychosis can feel positive. Seeing the faces of loved ones or hearing their voices may be very comforting. However, psychosis can also be very negative and distressing, affecting your behaviour and disrupting your life.

The most common types of psychosis are hallucinations and delusions. You might also experience problems with thinking and speech.

  • Hallucinations or delusions can make you feel very tired, overwhelmed, anxious, scared, threatened or confused. Delusions about certain people or organisations may make it hard for you to trust them.

  • People around you may be very dismissive of your experiences and this may make you feel very frustrated.

The main symptoms of psychosis are:

  • Halluzinationen. This means you hear, see, feel, smell or taste things that aren't really there. A common hallucination is hearing voices (auditory hallucinations).

  • Wahnvorstellungen. A delusion may occur when you have a strong belief that isn't real or shared by others. A common delusion is wrongly believing that there is a conspiracy to cause you or others harm.

  • Disorganised thinking and speech.

Halluzinationen

Hallucinations may include:

  • Seeing things that other people don't see.

  • Experiencing tastes, smells and sensations, such as feeling insects crawling on your skin when there are no insects there.

  • Hearing voices that other people don't hear (auditory hallucinations).

Wahnvorstellungen

Lots of people have beliefs that many other people don't share. But a delusion is a false belief that no one else shares. You still believe it even if it doesn't make any sense.

Some delusions are positive. You might believe you are very rich, powerful or important. This is sometimes called delusions of grandeur.

Delusions may also be very negative and frightening. You might feel that something or someone is trying to harm you. This is sometimes called having paranoid delusions.

Disorganised thinking and speech

Hallucinations and delusions can make your thoughts and emotions feel confused and disorganised. Disorganised thinking ('thought disorder') can also be a type of psychosis.

  • Racing thoughts: thoughts go through your head very fast.

  • Flight of ideas: your thoughts move very quickly from one idea to the next.

  • Speaking very quickly with other people finding it hard to understand you.

  • Your speech sounds jumbled and doesn't make sense to other people.

  • Finding it difficult to keep your attention on one thing.

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How often a psychotic episode occurs and how long it lasts are very variable and will depend on the underlying cause. You might experience psychosis once, have occasional short episodes, or have frequent and prolonged episodes of psychosis.

Psychosis can be a symptom of lots of different mental health problems, including:

Psychosis can also occur in the absence of any underlying mental health condition. Other causes of psychosis include:

  • Physical illness or injury - eg, with a high fever or following a head injury.

  • Erkrankungen, die das Gehirn betreffen - eg,:

    • Parkinson's disease or a brain tumour.

    • When taking street drugs like LSD, amphetamines, phencyclidine (PCP) and cannabis.

  • Alkoholkonsummissbrauch.

  • Nitrogen narcosis when diving at depth.

  • Side-effect of some prescribed Medikamenten (eg, Steroide) or when you stop taking a medicine for a mental health condition.

  • Lack of sleep.

  • Hunger.

  • Bereavement - if you have recently lost someone close to you, you may think you see them or hear them talking to you.

  • Abuse or trauma - you are more likely to experience psychosis if you have experienced abuse or a very traumatic event.

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Treatments for psychosis include:

Selbsthilfe

Support from others with psychosis. It often helps to share experiences with other people who experience psychosis. You may be able to find a local support group or a national support group, such as Mind in the UK .

Recognise your triggers. It might be helpful to keep a diary to help you understand what triggers your psychosis or makes it worse. Learn to recognise any warning signs.

Avoid triggers. Once you have identified any triggers, you can try to take steps to avoid them. If you learn to recognise warning signs, you can take action early to try to prevent the psychosis from becoming any worse. Family and friends may also be able to recognise any warning signs.

Learn to relax. Manage stress and try some relaxation techniques when you feel stressed, anxious or busy.

Look after yourself. Try to get enough sleep. Eating regularly and keeping to a healthy diet can improve your mood and energy levels.

Bewegung. Exercise can really help the way you feel.

Create a crisis plan. When you're feeling well you should talk to close friends and family about what would help you, including who should be contacted for professional help.

Andere Behandlungen

Treatment for psychosis involves using a combination of:

  • Gesprächstherapien such as kognitive Verhaltenstherapie (KVT) can help you understand your experiences and develop strategies to deal with them.

  • Medikation. Most people with psychosis will be offered an antipsychotic medicine. You may need other medicines for any mental health condition that is causing the psychosis.

  • Familientherapie. Family therapy may be very helpful if you are going through any difficulties as a family.

  • Arts therapies can help you express how you are feeling, especially if you find it difficult to talk about your experiences.

  • Soziale Unterstützung. This may include education, employment, or accommodation.

You should see your doctor immediately if you're experiencing symptoms of psychosis. You will usually be referred to a mental health specialist for further assessment and treatment. A very severe psychotic episode may mean you need to be admitted to hospital for treatment.

If you're concerned about someone who seems to be having a psychotic episode, you should contact their doctor or their mental health team or call an ambulance.

  • People with psychosis are more likely to have drug or alcohol problems. Some people use drugs, alcohol or both as a way of managing their psychotic symptoms. However, this can make the psychotic symptoms worse and cause other problems.

  • Selbstverletzung and suicide. People with psychosis have increased risk of self-harm and suicide.

The outcome (prognosis) is very variable and will depend on any underlying cause. If needed, medication is usually effective but may be needed long-term.

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Häufig gestellte Fragen

Can psychosis ever be a reassuring experience?

Yes, psychosis is not always negative. For some people, it can feel positive, such as seeing the faces of loved ones or hearing their voices, which can be very comforting.

What kind of false beliefs are considered delusions?

Delusions are strong beliefs that are not real or shared by others, and you continue to believe them even if they don't make sense. These can be positive, like believing you are very rich or powerful (delusions of grandeur), or very negative and frightening, such as feeling that someone is trying to harm you (paranoid delusions).

If my thoughts are racing or I'm speaking very quickly, could this be a sign of psychosis?

Yes, disorganised thinking and speech can be a type of psychosis, often referred to as 'thought disorder'. This can include thoughts racing very fast, quickly moving from one idea to the next (flight of ideas), speaking very quickly, or speech that sounds jumbled and doesn't make sense to others. It can also involve difficulty keeping attention on one thing.

Are there particular lifestyle factors or everyday situations that might trigger psychosis?

Yes, several factors outside of mental health conditions can contribute to psychosis. These include lack of sleep, hunger, and experiencing bereavement, where you might think you see or hear someone you've lost. Abuse or trauma also increases the likelihood of experiencing psychosis. Additionally, using street drugs, alcohol misuse, and a side-effect of some prescribed medicines can cause it.

How can I support myself if I'm experiencing psychosis?

Self-help strategies include seeking support from others who also experience psychosis, as sharing experiences can be helpful. Keeping a diary to recognise triggers and warning signs can help you avoid them or take early action. Learning relaxation techniques, prioritising good sleep, maintaining a healthy diet, and getting regular exercise can also improve your mood and energy. It's also important to create a crisis plan with friends and family when you are feeling well.

What should I do if I am worried about someone else who seems to be having a psychotic episode?

If you are concerned about someone who appears to be experiencing a psychotic episode, you should contact their doctor or their mental health team. In very severe cases, or if their safety is at risk, you should call an ambulance.

Can drugs or alcohol affect psychosis?

Yes, people with psychosis are more likely to have drug or alcohol problems. While some might use these substances to try and manage their psychotic symptoms, this can unfortunately make the symptoms worse and lead to other complications.

Weiterführende Literatur und Referenzen

About the authorView full bio

Author image

Dr Hayley Willacy, FRCGP

Allgemeinmediziner, Medizinischer Autor

MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)

Dr Hayley Willacy was an NHS GP working in northwest England, who retired from clinical practice in 2022 after 30 years. 

About the reviewerView full bio

Author image

Dr Colin Tidy, MRCGP

Allgemeinmediziner, Medizinischer Autor

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr. Colin Tidy ist ein NHS-Arzt mit Sitz in Oxfordshire.

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