Symptoms of psychosis can include alterations of thinking, beliefs, feelings and emotions, motivation and perception. Major categories are described below.
Confused thinking
Everyday thoughts and language may seem confused or jumbled. Or someone’s thinking might seem to jump from topic to topic for no clear reason. Sometimes it may be difficult to follow what they’re saying, or feel like they’re not able to hear or process what someone else is saying. Clinicians generally refer to this as “disorganized thinking.”
Changed Beliefs
People may become strongly focused on beliefs or themes that are extreme, out of character, or contradict beliefs widely held by their family, peers and cultural group. For example, a young person might believe that they’re being followed (when there is no evidence that they are), that they have been selected to advise high ranked government officials, or unexpectedly become intensely preoccupied with religious or spiritual beliefs they never previously held. In the context of clinical care, these beliefs may be referred to as “delusions” or “paranoia.”
Changed perceptions
Alterations of perception including hearing, seeing or sensing things other’s don’t. These may include hearing voices, seeing things or seeing distortions of shape, color or form, and tactile sensations, such as the feeling of bugs crawling up a leg that are actually there. Clinicians generally refer to these as “hallucinations.”
Changed feelings
Psychosis can be associated with a variety of changes in mood or emotion. For many people, the onset of psychosis and consequences of onset—including social rejection, the belief that one will no longer be able to pursue long-held dreams and goals—can trigger feelings of hopeless, demoralization, and depression. Young people with onset of psychosis within the past five years are considered one of the groups at the very highest risk of suicide.
Psychosis is also associated with what clinicians refer to as “negative” symptoms, however: the absence or dampening of emotion, motivation and interest in doing things that a young person may previously have greatly enjoyed. In some cases, an individual may appear emotionally “flat” rather than expressive, or no longer response to displays of affection the way that they used to.
Changed behaviors
Finally, people with psychosis may behave in ways that, to an observer, appear to be strange, inappropriate or out of character: for instance laughing at odd times, making repetitive movements or gestures, pacing.