Early signs of psychosis

Psychosis is not a diagnosis, but a term used to describe a group of symptoms. Psychosis is a break with reality where the thoughts and perceptions of a person become disrupted. These changes happen gradually, typically in three phases: early, acute, and recovery.

The onset of first episode psychosis typically presents when an individual is between the ages of 18-25, however, may present between the ages of 15-40. It is uncommon for first episode psychosis to present in childhood.

What should I know about psychosis?

  • Anyone can have a psychotic episode.

  • Psychosis does not discriminate across cultures, races, or social classes.

  • At this time it is still unknown exactly what causes psychosis, but it is known that psychosis is treatable and that the earlier it is identified and treated the more successful remission is.

Phases of psychosis

Psychosis occurs in three phases:

  1. Early
  2. Acute
  3. Recovery

Learn more about the phases of psychosis on the New Journeys website.

What should I look for?

The following are some of the more common signs of psychosis:

Changes in thinking
  • Everyday thoughts may be confused/jumbled or don't join up properly
  • Sentences may be unclear or don't make sense
  • Thoughts are sped up or come very slowly
  • Difficulties planning, reasoning, making decisions, completing tasks, following a conversation, remembering details
  • Having odd ideas
Changes in behavior
  • Shifts in basic personality
  • Mood changes (i.e., hyperactivity, inactivity, or alternating between the two)
  • Social withdrawal and isolation
  • Severe changes in sleep patterns
  • Deterioration in personal hygiene
  • Excessive writing without meaning
  • Unusual sensitivity to stimuli (such as noise, light, colors, textures)
  • Suicidal thoughts or behaviors
  • Use of alcohol and/or other drugs
Changes in feelings and perception
  • Feeling strange and cut off from the world
  • Feelings of distrust or suspicion about others and their actions
  • Things look or sound different from what others are experiencing
  • The tone in a person's speech may change
  • Facial expressions and physical movement may change
  • Hearing, seeing, tasting, smelling or feeling things that are not there, but seem very real to the person experiencing them
  • Hearing voices: the voices could be threatening to them or telling them to harm themselves
  • False beliefs such as being followed or monitored, or having special abilities or "powers"
  • Thinking they are being controlled by other people or forces, or that their thoughts are being broadcast so others can hear them
  • These beliefs are often held firmly, and attempts at reasoning or debating can lead to anger or mistrust

Want more information?

Watch ThriveNYC's video on psychosis.

Have others experienced this?

Yes. According to the National Alliance on Mental Illness (NAMI) approximately 100,000 young people will experience psychosis each year, and as many as 3 in 100 people will experience psychosis in their lifetime.

Watch recent New Journeys graduates share their recovery stories:



Is there help?

Yes. If someone you know is experiencing some of these symptoms, you can get help. Research shows that the longer psychosis goes untreated, the harder it is to control.

New Journeys statewide plan

  • Read the Washington Council for Behavioral Health and HCA's statewide plan.

Are you, or someone you know, in need of immediate help?

Tools for you, family, and friends

Video: "We can prevent major mental Illness"

Learn more about early psychosis in this 16-minute TEDxRosenburg talk by Dr. Ryan Melton, clinical director of the EASA Center for Excellence at Portland State University's Regional Research Institute and an Assistant Professor of Clinical Mental Health at Northwest Christian University.

New Journeys virtual gathering 2023

Thank you for attending the 2023 New Journeys virtual gathering. The event focused on early identification and intervention of psychosis and was held over two days.

Session recordings

To view all recordings from this event, please visit the New Journeys virtual gathering platform.

Additional resources