You may be experiencing psychosis if you are having trouble distinguishing what’s real and what’s not. This may include seeing things and hearing voices that aren’t there, being unable to let go of unusual thoughts or beliefs that seem irrational to others, and experiencing unexplainable bodily sensations. However, these symptoms don’t necessarily appear all at once, out of the blue. Often, there’s a period of time when you start to notice some gradual changes to your mental health that indicate you’re heading towards psychosis.
Psychosis itself is not an illness but a symptom, typically of other mental health conditions like schizophrenia, bipolar disorder or depression. If you haven’t experienced psychosis before, it can be tough to identify the early “red flags” that a psychotic episode is on its way, especially because the symptoms can overlap with other conditions and a common characteristic of psychosis is having a lack of awareness of your own mental state.
To shed light on what those early signs can look like, we asked our Mighty community to share “red flags” they experience that let them know they are slipping into psychosis. By identifying your own warning signs, you may find it easier to understand how you’re feeling and get help the next time you experience psychosis. If you can relate to these red flags, let this serve as a reminder that there are others out there who know exactly what you’re going through, and that it’s OK to reach out and ask for help.
Here’s what our Mighty community told us:
1. Sleeping Less
“I sleep little amounts or not at all for days on end. While neglecting my self-care and being preoccupied with thoughts inside my head.” — Amanda G.
“Lack of sleep. Whether it’s lack of sleep just because I can’t sleep or lack of sleep linked to the psychotic episode. Whenever I don’t get enough sleep, it will trigger psychosis at some point.” — Amy L.
“Suddenly being able to function off of four hours of sleep. Previously needing 15 hours to function.” — Ashley M.
2. Not Wanting to Do Anything
“I don’t want to do anything. Doesn’t matter what it is — cook dinner (whether my child is home or not), feed the pets, go to work, etc. When I don’t want to do anything, I know it’s going to be bad. Cleaning takes longer, cooking takes longer, everything takes a longer time for me to do because I’m forcing myself to do it and there’s nothing that will bring me joy. Not until the mood passes.” — Jackie D.
3. Brain Fog
“Brain fog and constantly forgetting the simplest of things.” — Joanna L.
4. Short Temper
“Little things annoy me so much more than normal. When I notice my husband or one of the kids didn’t put something up ‘the right way’ and I feel so much rage that I feel my blood pressure rise, I know that I need to seek treatment and remove myself from the current situation.” — Emily H.
“Irritability. I have to watch very closely, as it happens like the flip of a switch.” – Jess C.
5. Believing Your Loved Ones Are Angry With You
“I start to believe that my friends hate me and are out to get me. It’s actually happened in the past so it becomes a regular delusion of mine, and unless I get reassurance, it gets worse until I have a full psychotic episode.” — Isaac C.
“I am in overdrive with non-stop thinking and feeling everyone hates me or thinks I’m a stupid pain in the ass and they are tired of me and my depression.” — Cathy P.
6. Racing Thoughts
“When I can’t settle to read a book, watch telly, or even sleep but my mind feels like a washing machine beginning its spin. This can last for a day to months and then one day something clicks and I settle again and am able to enjoy life again.” — Rachael M.
“My paranoia goes through the roof where I’m even too paranoid to look at my phone in fear that someone is watching me through the camera.” — Caitie W.
“Paranoia, being unable to sleep because of racing thoughts, and elevated heart rate. Generally feeling afraid but unsure why.” — Lauren H.
8. Reliving Traumatic Memories
“Spacing out (dissociating) and reliving memories that lead up to traumatic events… it’s the equivalent of the dozer tracks on the road meant to wake you up before you run off the road…” — Keli J.
9. Not Taking Care of Responsibilities
“I’m an aquarist and reptile enthusiast, I have five tanks to keep up and keep clean for the inhabitants. I’m usually super particular about keeping them spotless… whenever they start to slide, I know that I’m heading to ‘the dark place’ and I need to get myself some help. My animals are always my number one priority and it’s pretty amazing that they seem to know when I’m not OK. It’s really no wonder that I can monitor myself by watching them.” — Ginny D.
10. Difficulty Maintaining Hygiene and Cleanliness
“The state of order/cleanliness of my house (when I’m in a good place, there’s some clutter here and there, but the house is clean; when I’m manic, the house is spotless; when I’m depressed, it’s a biohazard every couple of days). My hygiene habits (depressed: shower once-twice a week; manic/good place: daily shower).” — Autumn R.
“When I keep on putting aside cleaning. It gets to the point that cleaning causes me anxiety attacks.” — Rebecca T.
“I just feel different. Usually starts with feeling more anxious. My bipolar makes me anxious when I’m depressed which leads to psychotic symptoms.” — Carrie G.
“My anxiety kicks into overdrive. My thoughts become more and more intrusive and I become super sensitive.” — Michelle S.
12. Mood Swings
“I will feel extremely elevated. Like I could take on the world and I feel like I have a sense of clarity of myself and the world and life in general. Then some while later I plummet low and hard and then I’m stuck in a black hole for a few days. It happens this way every. Time.” — Gen L.
“Thoughts racing from one thing to another. Anger with people that have hurt me over my life. Not wanting to speak to anybody. Annoyance that people want to speak to me. Longing to stay in bed all day. Sensitively. Irritability. Anger. Complete lack of concentration. No motivation. Disassociation. Lack of emotion. Paranoid. Dreams and thoughts that I believe are going to become real. Feeling like if I think it, it must be a sign that it’s going to happen. This can last for a few weeks and then it goes as suddenly as it came on. Then I feel full on energy total grandiose behavior, extreme positivity and total love for the world.” — Laura L.
13. Feelings of Worthlessness
“Deep, unfounded feelings of worthlessness, that I’m not good enough, that I’m not worth loving, and that life isn’t worth living. Hopelessness drowns me. I let laundry and dishes pile up. Why bother? The thought then of tackling it overwhelms and depresses me even more.” — Rachel L.
14. Sense of Dread
“Waking up feeling ‘heavy.’ When things start to feel muted and weighty I know I’m in for a rough time.” — Alex O.
“I start to feel a creeping dread for no reason. Then I want to cry a lot, but the meds won’t let me so I just feel like I’m going to burst.” — Cheryl M.
15. Breathing Too Fast
“I have trouble breathing. It’s like I’ve run a marathon, just breathing fast, almost panting.” — Belynda K.
16. Isolating Yourself
“Dissociating with everyone and spending way too much time on my phone.” — Erin R.
“Getting snappy with my partner, dropping off from friends, ignoring conversations, etc. Staying in bed as long as possible.” — Jenny B.
“Just staying in my room all day. Drowning myself to music of whatever, not being able to bathe, withdrawn to everyone.” — Dominique G.
17. Negative Intrusive Thoughts
“Conversations with myself become more erratic. I can feel them going from those normal internal monologues about not forgetting to get milk to slightly more negative and intrusive thoughts. I also become very quiet and withdrawn.” — Eve C.
18. Starting to Hear Voices and See Things
“Starting to hear whispers is a big sign to me that I’m headed that way, also feeling very disconnected from my surroundings.” — Helen J.
“I don’t sleep as much, my thoughts become more scattered, and the faces you see in things (the normal thing that even non-psychotic folk see) turn into demons rather than neutral faces and I become more paranoid.” — Michaela R.
19. Eating Less
“Just snacking instead of eating proper meals.” — Ashlin M.
“Not eating and getting out of the bed for more than two days in a row.” — Maria M.
For more insight into psychosis, check out these stories by our Mighty community:
- Psychosis Isn’t a Bad Word
- I Was a Person With Psychosis Who Was Considered ‘Too Far Gone’
- The Divisive Issue of Medicating Psychosis Among Those With Lived Experience