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refers to loss of contact with reality, such as seeing or believing things that aren't real

Psychosis is a state in which people perceive, hear, or hold beliefs that aren’t real. Often, those experiencing psychosis are unaware that their experiences are not real and remain convinced of their authenticity. About 1,600 new cases of psychosis are reported in Scotland each year. 

Contrary to common beliefs, psychosis is not a separate mental disorder. It’s a symptom that can be related to different mental health conditions like schizophrenia or bipolar disorder. The experience of psychosis varies in how long it lasts and how often it happens, from brief episodes to daily occurrences. 

Psychosis has two main symptoms: hallucinations and delusions. Hallucinations make individuals see things that aren’t there, while delusions make them believe false things. However, it affects people differently. Some may feel tired or anxious and have trouble with their daily routine. Others may experience positive internal feelings and even come up with creative ideas.

Myths about psychosis

People with psychosis
are ‘psychopaths’

Psychosis and psychopathy are not the same. Psychosis is about losing touch with reality, while psychopathy involves a lack of empathy, emotional problems, and impulsive behaviour, often leading to antisocial behaviour. 

People with psychosis
cannot recover

Although it varies for each person, there are treatments that can help people with psychosis.

People with psychosis cannot lead fulfilling lives

With the right help and support, people with psychosis can have fulfilling lives, managing their symptoms, working, having relationships, and enjoying life.

Psychosis makes
people violent

The vast majority of people with psychosis are not violent. Psychosis can make a person feel scared or confused, but it doesn’t necessarily lead to harmful behaviour.

People with psychosis have multiple personalities or a “split personality”

Psychosis doesn’t change a person’s personality. People with psychosis usually act in line with their usual personality.


There are three main symptoms associated with psychosis: hallucinations, delusions, and disturbed patterns of thought. 


Hallucinations involve one’s senses (sound, sight, touch, smell, and taste), particularly when someone perceives things that aren’t real. This could include:  

  • Hearing voices in your head  
  • Seeing people that aren’t there  
  • Feeling someone touching you who is not there  
  • Smelling something that others don’t  
  • Tasting something despite not having food in the mouth  


Delusions involve one’s beliefs, particularly when one’s beliefs are untrue. Some examples include:  

  • Feeling like you are being constantly followed or monitored by someone  
  • Thinking that you have supernatural powers or are a supernatural being  
  • Believing in conspiracies 

Disturbed Thoughts

People with psychosis may have confusing and disturbing patterns of thought. This could include:  

  • Jumbled or incoherent speech  
  • Sudden thought interruptions  
  • Memory problems  
  • Difficulty taking in new information  


Psychosis can be linked to depression, anxiety, schizophrenia, and bipolar disorder. This also extends to physical conditions such as syphilis, Parkinson’s disease, and hypoglycaemia. Studies have also shown that increased stress could lead to the triggering of psychosis. Even having a family member or relative with psychosis makes one more likely to develop psychosis.

A psychotic episode may be triggered by drug and alcohol abuse. Stopping drug or alcohol use suddenly after a long consumption period can also lead to psychosis. The drugs that could lead to psychotic episodes include, but are not limited to:

  • Cocaine
  • LSD
  • Crystal meth
  • MDMA

In rare cases, psychosis may develop as a side effect of a particular prescribed medication or as the result of a medication overdose.


Treatment of psychosis typically includes antipsychotic medications, psychotherapeutic interventions, and assistance from social support networks.

Antipsychotic Medication

For individuals experiencing psychosis, the primary approach often involves prescribing antipsychotic medications. Additionally, your healthcare provider may consider offering antidepressants or medications designed to soothe the potential side effects of antipsychotic drugs.

When starting antipsychotic medication, your doctor will check your overall health, including your weight, blood pressure, and blood tests, to decide on the right medication and dosage.

It’s crucial to discuss medication choices with your doctor.


Along with medication, people with psychosis often have therapy to help them understand their condition better.

One popular form of therapy is Cognitive Behavioural Therapy (CBT), which is a form of psychotherapy aimed at enhancing your understanding of your experiences and addressing any distressing or troubling thoughts and beliefs you may have. It focuses on connecting thoughts, beliefs, feelings, and behaviours. CBT provides tools to manage and reduce distress linked to the condition.

It’s OK if you’ve been recommended other types of therapy besides CBT, such as Acceptance and Commitment Therapy (ACT), Peer Support, or Compassion Focused Therapy (CFT). The decision on which treatment to pursue typically depends on your particular requirements, preferences, and the severity of your symptoms. In some cases, a combination of therapies and treatments may be suggested to ensure comprehensive care and support for those experiencing psychosis.


Change Mental Health runs the Hearing Voices service in Tayside and Fife, to support people to live around their voices and other symptoms of psychosis. Our support pages share lived experience from our staff and people supported within the service and how we support people to develop strategies when coping with psychosis. Getting support or medical advice from your GP will make treatment more effective.

We have more information on hearing voices through our ‘A Guide to Voices and Sensory Disturbances’ resource. 


Our Advice and Support Service is open Monday to Friday, 10 am to 4 pm, where advisers can signpost you to local support that most fits your needs, including our Change Mental Health services. We offer initial advice on money worries and help to deal with emergencies.

Contact 0808 8010 515, email us at or fill out the enquiry form on the Advice and Support Service page.

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