Severe mental illness: Can you spot psychosis?

brains! (Photo credit: cloois)

If I were to ask you to give me an example of someone experiencing a psychotic break would you know what to say? Would you know what symptoms to look for? Would you know the exact moment you should seek a psychiatric assessment? If you said no to any of these questions, you are not alone. It is very difficult for someone to identity symptoms of a psychiatric disorder without a professional’s point of view. For therapists such as myself, it takes multiple assessments, clinical visits, and discussions with the individual, family, friends, etc. to get a full picture of a potential psychiatric illness. But for a lot of individuals and their families, no one ever considers psychosis until something horrific occurs such as an extreme behavioral outburst or impulsive behavior, delusions, hallucinations, or disorganized speech. In some very rare cases, even these symptoms fail to grab proper attention.

According to,  there are multiple pre-warning signs of psychosis that we should all be aware of including behavioral, thought and speech, social, and emotional:


  • Strange posturing
  • Odd or bizarre behaviour
  • Feeling refreshed after much less sleep than normal
  • Excessive writing without meaning
  • Cutting oneself; threats of self-mutilation
  • Deterioration of personal hygiene
  • Hyperactivity or inactivity, or alternating between the two
  • Staring without blinking – or blinking incessantly
  • Agitation
  • Severe sleep disturbances
  • Drug or alcohol abuse (This may be a coping mechanism: self-medicating)

Thinking and Speech

  • Things around them seem changed in some way
  • Rapid speech that is difficult to interrupt
  • Irrational statements
  • Extreme preoccupation with religion or with the occult
  • Peculiar use of words or odd language structures
  • Unusual sensitivity to stimuli (noise, light, colours, textures)
  • Memory problems
  • Severe distractibility


  • Sensitivity and irritability when touched by others
  • Refusal to touch persons or objects; wearing gloves, etc.
  • Severe deterioration of social relationships
  • Dropping out of activities – or out of life in general
  • Social withdrawal, isolation, and reclusive
  • Unexpected aggression
  • Suspiciousness


  • Inappropriate laughter
  • Inability to cry, or excessive crying
  • Feelings of depression and anxiety
  • Inability to express joy
  • Euphoric mood Personality
  • Reckless behaviours that are out of character
  • Significantly prolonged drops in motivation or speech
  • Shift in basic personality


Conclusion: It is important for all of us to keep in mind that the above symptoms can occur without psychosis and can occur briefly. For example, someone who is grieving the loss of a loved one could become depressed for a few months and “recover.” An elderly woman who is caring for her husband with severe dementia may experience an inability to express joy, sleep disturbances, poor appetite, and shifts in personality. But this does not mean that she is nearing psychosis. The above symptoms are examples of the types of symptoms that might signal a deeper problem and need for psychiatric treatment. Symptoms are very complex and so it is important, if you see the above, to get a psychiatric assessment, professional recommendation, and proper treatment.

I wish you well