Have you been feeling a little off lately? Hearing or seeing things that aren’t really there? Having trouble distinguishing fantasy from reality? You’re not alone. Many people experience brief psychotic episodes at some point, often due to severe stress, trauma, or mental health conditions like schizophrenia or bipolar disorder.
“The psychotic drowns in the same waters in which the mystic swims with delight.”
― Joseph Campbell, Psychology of the Future: Lessons from Modern Consciousness Research
As someone who has lived with psychosis for years, I know how frightening it can be. The good news is, the earlier you recognize the symptoms, the sooner you can get the treatment and support you need.
That’s why I put together this list of 18 warning signs that you may be experiencing psychosis. If a few of these sound familiar, don’t panic — but do talk to your doctor right away. The sooner we catch it, the easier it is to get back to feeling like yourself again.
1. Hearing Voices Or Sounds That Aren’t Real
When I started hearing voices and sounds that weren’t really there, I knew something wasn’t right. At first, I thought I was just imagining things, but the auditory hallucinations persisted and even got worse.
- I would hear distant conversations that sounded so real but were actually in my head.
- Ordinary background noises like the hum of the AC or fridge seemed amplified and distorted.
- Random sounds like knocking, scratching, or music would seem to come out of nowhere when there was really no source.
These false perceptions of sound can be a sign of psychosis, a mental health condition where you lose touch with reality. The voices and noises seemed utterly real to me even though I knew deep down they were just figments of my imagination.
“Schizophrenia cannot be understood without understanding despair.”
― R.D. Laing
If you’re experiencing similar auditory hallucinations, please talk to your doctor right away. Early diagnosis and treatment of psychotic disorders are critical to managing symptoms and improving quality of life.
You don’t have to deal with this alone. Help is out there, so don’t delay in seeking professional support. Your mental health and safety should be a top priority right now. There are people who want to help you, so please don’t lose hope!
2. Seeing Things That Others Can’t See
The first time I saw something that wasn’t really there, I brushed it off as just being overly tired. But then it happened again, and again. At first, the hallucinations were subtle, like seeing a flash of light or shadow in my peripheral vision. But over time, they became more frequent and vivid.
- I’d see animals or people that would disappear when I looked directly at them.
- Hear voices talking or whispering when no one is around.
- Smell strange odors like smoke when there were no flames.
If you’re experiencing psychosis, the line between what’s real and what’s not can become blurry. The hallucinations seem completely authentic to you, even though others can’t perceive them. Psychosis can be frightening, but the good news is there are effective treatments.
The best way to start getting help is by talking to someone you trust about what you’re experiencing, like close friends or a medical professional. A psychiatrist or therapist can properly assess what’s going on and determine the appropriate next steps, such as:
- Antipsychotic medications to help reduce symptoms like hallucinations and delusions.
- Psychotherapy or counseling to learn coping strategies.
- Hospitalization in severe cases to stabilize your condition.
The path to recovery can take time, but with proper treatment and support, psychosis can be managed. The key is not ignoring the signs and getting help right away. Your mental health is too important to delay.
3. False Beliefs Or Paranoid Delusions
One of the most alarming signs of psychosis is developing false beliefs that feel very real to you. These paranoid delusions can convince you that people or events that seem harmless to others are actually threatening or persecutory.
For me, the delusions began as a nagging feeling that coworkers were gossiping about me behind my back. Then I became convinced my boss was plotting to fire me, despite no evidence this was true. These beliefs grew increasingly bizarre and elaborate over time.
I was sure strangers on the street were following or spying on me. My home felt bugged, and I believed a secret organization was monitoring my every move.
“A transference neurosis corresponds to a conflict between ego and id, a narcissistic neurosis corresponds to that between ego and super-ego, and a psychosis to that between ego and outer world.”
― Sigmund Freud, General Psychological Theory: Papers on Metapsychology
Looking back, these delusions should have been a glaring red flag that I was losing touch with reality. But when you’re experiencing psychosis, false beliefs can feel utterly believable.
The lines between fantasy and reality become irrevocably blurred. It’s often not until the psychotic episode has passed and clarity returns that you realize how implausible your delusions really were.
4. Inability To Cry Or Express Emotion
One of the most alarming warning signs for me was losing the ability to cry or express emotions. I had always been an emotional person, quick to tear up during sad movies or when hearing about something tragic happening to someone else. But during my episode of psychosis, it’s like that part of me shut down. I felt detached from my emotions and unable to access them.
Nothing seemed to move me or stir me in an emotional sense. I knew logically that certain events were sad or upsetting, but I couldn’t feel it. My emotional range felt completely blunted. I seemed to lose all capacity for empathy or compassion. The world felt like a cold, harsh place and I felt utterly alone and isolated in my inability to feel.
Looking back, this emotional numbness and flat affect was one of the most frightening symptoms I experienced. Our emotions connect us to humanity and to each other. Losing access to such a vital part of the human experience made me feel less than human. I knew this loss of emotion was a sign that something was very wrong, even if I couldn’t put a name to it at the time.
6. Disorganized Behavior Or Catatonia
One of the signs I experienced was disorganized behavior and strange actions that weren’t like my usual self. For me, this manifested as:
- Wandering around aimlessly or pacing for no reason. I would find myself walking in circles around the house or yard, unable to stop moving.
- Difficulty completing routine tasks. Simple things like getting dressed, making food, or brushing my teeth seemed complicated and overwhelming.
- Poor hygiene. I stopped bathing regularly or changing my clothes as frequently. My appearance became disheveled since self-care seemed unimportant.
- Strange sleeping or eating patterns. I would stay up for days at a time with boundless energy then crash and sleep for 18–20 hours. My appetite was erratic, ranging from ravenous to nonexistent.
- Peculiar gestures or postures. At times, I would make odd facial expressions, twist my body into strange positions, or walk in an unusual manner. These mannerisms were outside my normal behavior and I couldn’t explain why I was doing them.
If you or someone you know is exhibiting these types of behaviors, it could indicate the onset or worsening of psychosis. The earlier treatment is sought through psychiatric intervention, the better the prognosis and outcome. No one deserves to suffer from psychosis alone, so please get help right away.
7. Suspiciousness Or Feelings Of Being Stocked
Psychosis can manifest as extreme suspiciousness and paranoia. You may start to feel like people are watching or following you, even close friends and family.
I recall becoming convinced that my neighbors were monitoring me through hidden cameras in my home. These unwarranted fears felt completely real to me at the time.
“Am I racially kin to this man? Baynes wondered. So closely so that for all intents and purposes it is the same? Then it is in me, too, the psychotic streak. A psychotic world we live in. The madmen are in power. How long have we known this? Faced this? And — how many of us do know it?”
― Philip K. Dick, The Man in the High Castle
Paranoia and a sense of being threatened are common signs of psychosis. You might believe that strangers intend to cause you harm or that acquaintances are deliberately trying to upset you.
Regular interactions with others may fuel irrational fears and distrust in your mind. The smallest actions of people around you seem like veiled threats or personal attacks.
Mistrust and hypervigilance transform the world into a frightening place. Familiar surroundings become filled with unseen dangers. Your home no longer feels like a safe haven, and you believe sinister forces are conspiring against you. These troubling perceptions steadily intensify, further isolating you from external reality.
Loved ones attempting to reassure you are unable to penetrate the haze of suspicion. Their caring words and acts of kindness are misinterpreted, only reinforcing false beliefs.
Professional intervention through medication and therapy is typically required to alleviate severe paranoia and restore clarity of thought. With proper treatment, many of these troubling symptoms will significantly improve or resolve completely.
8. Withdrawing Socially From Others
When I started withdrawing from friends and family, that was one of the first signs something wasn’t right. I just didn’t feel up to socializing like I used to. Making plans seemed like too much effort, and when I did go out, I couldn’t wait to get home.
My usual interests and hobbies didn’t appeal to me anymore either. I chalked it up to stress or exhaustion at first but looking back, it was really one of the earliest symptoms of psychosis to emerge.
Social withdrawal and lack of motivation are common warning signs that you may be experiencing psychosis. This can show up as:
- Not calling or texting friends and family as often
- Canceling plans or avoiding new social opportunities
- Not engaging in activities or interests you used to enjoy
- Feelings of being overwhelmed, irritated, or unable to cope with the demands of social interactions
For me, social withdrawal progressed to spending most of my time alone in my room. I felt like I didn’t have the mental or emotional energy for relationships. If this sounds familiar, don’t ignore it. Reach out to people you trust about what you’re experiencing, whether it’s a medical professional, close friend, or family member.
9. Decline In Self-care And Hygiene
One of the warning signs of psychosis I experienced was a decline in my self-care and hygiene. I just didn’t have the motivation or energy to shower regularly or brush my teeth. Basic grooming seemed trivial and unimportant. Looking back, this was really out of character for me and a sign that something wasn’t right.
Performing self-care tasks requires mental effort and focus, even for small things like taking a shower or doing laundry. When psychosis starts to set in, your mind can become disorganized and scattered, making these routine chores feel overwhelming or pointless.
You may stop caring about how you look or if you’ve bathed. Your home may become messier and dirtier as keeping up with household chores slips by the wayside.
If people close to you start commenting on your hygiene or the state of your living space, don’t ignore it. Take it as a warning that your mental health may be suffering and it’s time to seek professional help.
Speaking to a doctor or therapist can help determine if psychosis or another mental health condition is emerging, and get treatment started right away. The earlier intervention begins, the better the chances of managing symptoms and avoiding a full psychotic break.
“…I have sometimes imagined my own sanity as resting on the surface of a membrane, a thin and fragile membrane that can easily be ripped open, plunging me into the abyss of madness, where I join the tumbling souls whose membranes have likewise been pieced over the ages. Sometimes, when my thoughts are especially fevered, I can visualize the agent of this piercing. It is a watchful presence at the edge of things, silent and dripping, a stranger in a raincoat… When we fall into such psychosis, there are no other membranes below to catch and protect us. And the horror and helplessness of the fall are intensified by an uncaring world.”
― Ron Powers, No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America
It’s not easy to recognize declining self-care and hygiene in yourself. But if basic life tasks start to feel pointless or slip out of your normal routine, pay attention. Your mental health and well-being could depend on it.
10. Irrational, Dangerous Behaviors
One of the warning signs that really scared me was when I started behaving in dangerous and irrational ways. I began making poor decisions that put myself and others at risk, and I didn’t even realize it at the time.
For example, I decided to stop taking my medications without consulting my doctor. I convinced myself that the side effects were worse than the benefits and that I didn’t really need them anyway. Turns out quitting those medications cold turkey was a really bad idea and caused my symptoms to worsen quickly.
Another time, I became paranoid that my neighbor was spying on me, so I started filming them whenever they were outside. I would stay up late at night monitoring the footage, trying to catch them in the act. My irrational suspicion and compulsive behavior kept escalating until my family intervened and made me see my doctor.
Looking back, it’s frightening to see how much control psychosis had taken over my thoughts and actions. I put myself and others in unsafe situations, behaved erratically, and made poor life decisions during that time, all due to delusional beliefs and a lack of insight into my own condition.
If you or someone you know starts exhibiting dangerous or irrational behaviors, especially if it’s a change from their normal personality, it could indicate the onset or worsening of psychosis. Speaking to a medical professional as soon as possible for an accurate diagnosis and treatment plan is critical. The sooner psychosis is properly managed, the better the outcome can be.
11. Change In Sleep Patterns
My sleep schedule has always been a bit erratic, but lately, I’ve noticed some significant changes that worry me. I used to be able to fall asleep around 11 p.m. and wake up at 7 a.m. for work with no issues. Now, I find myself tossing and turning for hours before finally drifting off, only to wake up repeatedly during the night. When morning comes, I struggle to get out of bed and often feel extremely drowsy throughout the day.
These disruptions to my circadian rhythm could be a warning sign of psychosis. Changes in sleep patterns are common symptoms, and trouble falling or staying asleep are frequent complaints. The body’s internal clock gets thrown off, making it hard to maintain a normal sleep-wake cycle. Some nights I’m wired and can’t sleep at all, while other days I can barely keep my eyes open. The fluctuations in my energy levels concern me, as psychosis can sap your vigor and vitality.
Lack of sleep exacerbates my symptoms of psychosis like delusional thoughts or hallucinations. In the wee hours when I’m struggling to rest, my mind races and I become paranoid or suspicious. Shadows seem to move and shift, and nonexistent noises startle me. Once I finally pass out from sheer exhaustion, my dreams are intensely bizarre and frightening. Upon waking, it’s hard to shake the lingering effects.
Overall, the changes in my sleep point to a disruption in my mental state that requires evaluation. Speaking to a doctor about treatment options, whether therapy, medication, or both, could help stabilize my circadian rhythm and mood. Getting the rest I need is essential for my health, productivity, and quality of life.
12. Rapidly Shifting Emotions
I’ve experienced rapid shifts in my emotions before, and it can be really disconcerting. One minute I’m feeling upbeat and optimistic, the next I’m irritable or tearful for no reason. These abrupt changes in mood and affect can be an indicator that I’m dealing with psychosis or another mental health condition.
When my emotions start changing quickly, seemingly out of the blue, it’s usually a sign that something’s off. I may feel intense sadness, euphoria, anger, or anxiety that builds up rapidly and feels impossible to control.
My mood can flip from positive to negative and back again over the course of a day, or even within a few hours. These rapid transitions often don’t correspond with events going on in my life or environment.
Sudden shifts in emotions and mood can significantly impact my thoughts, behavior, and overall well-being. When I experience them, it becomes difficult to concentrate and function normally. I may behave in ways that are out of character or that I later regret. My self-esteem and confidence tend to decrease, and feelings of fear or hopelessness tend to increase.
If I start noticing my emotions changing abruptly for no reason, it’s a good idea for me to speak to a doctor or mental health professional. They can help determine if rapid mood changes are a symptom of an underlying condition, and recommend an appropriate treatment plan. The earlier I get help, the sooner I can gain awareness and control over my emotions again.
13. Extreme Reaction To Criticism
I tend to be very sensitive to criticism, whether constructive or not. Even the slightest bit of feedback can send me into a tailspin, causing an extreme reaction that’s hard to recover from.
When someone offers me criticism at work or in my personal life, my first instinct is to get defensive. I instantly feel like the other person is attacking or judging me, even if their intent is actually helpful. My thoughts race as I try to come up with explanations and excuses. I have trouble accepting that I may have made a mistake or could improve in some way.
This extreme sensitivity and defensiveness in the face of criticism often do more harm than good. It damages my relationships and prevents me from growing and improving. The truth is, no one is perfect. We all have room for improvement, and we should welcome feedback from those who care about us and want to see us succeed.
Learning to better accept criticism without overreacting is an important life skill I’m still working to develop. When someone offers me feedback now, I try to stay calm and open-minded. I listen for the grain of truth in what they’re saying instead of instantly denying it. I ask follow-up questions to make sure I understand their perspective fully. And I try to say “thank you” — because even criticism, when delivered constructively, is meant to help.
Over time, developing this ability to better accept feedback and see it as an opportunity for growth has helped reduce my extreme reactions. I still have a way to go, but staying aware of this tendency in myself and making an effort to shift my mindset has made a big difference. The ability to accept criticism with grace is a hallmark of emotional maturity — and one I strive for.
14. Confused Thought Process And Rambling
One of the signs that worried me the most was noticing my thought process becoming increasingly confused and rambling. I found myself frequently getting lost in the middle of conversations, struggling to maintain a logical flow of thoughts. My mind often felt like a tangled ball of yarn, ideas twisting and knotting together in a nonsensical jumble.
Trying to articulate my disordered thinking to others was nearly impossible. When I spoke, the words would tumble out in a messy, haphazard way. I’d start a sentence with one idea in mind but end up in a completely different place by the time I finished talking. My speech lacked coherence and cohesion. Looking back, I’m sure I sounded utterly incomprehensible to the people listening to my rambling, tangled discourses.
The internal experience of my confused thought process felt chaotic and uncontrollable. One fleeting thought triggered another and another in rapid succession, weaving an intricate web of loosely associated ideas and impressions. I struggled in vain to grab hold of a clear or rational line of thinking, but my mind refused to oblige. At times, this mental disarray left me feeling distressed and powerless over my own cognition.
In retrospect, my rambling, tangled thinking, and difficulty articulating coherent thoughts were warning signs I couldn’t ignore. The problems with my mind and thought process signaled that something was amiss and help was needed. If only I had recognized these red flags earlier, I may have sought treatment sooner and avoided some of the chaos that ensued. But hindsight is 20/20, and at the time I lacked insight into my own condition.
The lesson here is not to dismiss or minimize any signs of confused or irrational thinking. Take them seriously and consider consulting a mental health professional. Early intervention and treatment can help prevent symptoms from worsening or becoming unmanageable. Your mental health is nothing to gamble with.
15. Giving Away Possessions For No Reason
One of the signs I started to realize something was really wrong was when I began giving away my most prized possessions for no apparent reason. I had collected vintage vinyl records for years and considered them some of my most cherished belongings. One day, I just started giving them away to random acquaintances and people I barely knew.
At the time, it seemed like a great idea and I felt totally unattached to things I had previously valued highly. I just wanted to spread the joy of music with everyone around me. Looking back now, it was completely out of character and a warning sign I was losing touch with reality. Giving away meaningful possessions impulsively or for no logical reason could indicate psychosis or mania.
Our belongings often represent parts of our identity, memories, and connections to meaningful times or people in our lives. If you suddenly feel detached from prized possessions and have an urge to give them away frivolously, pay attention. It may be a symptom of an underlying mental health condition that requires evaluation and treatment.
16. Difficulty Handling Stress And Depression
Difficulty handling stress and depression were major warning signs for me that I was experiencing psychosis. When life threw me more curveballs than usual, I struggled to cope in a healthy way.
Small inconveniences felt like the end of the world. I had trouble brushing off little annoyances and setbacks that I normally would take in stride. My anxiety and worry seemed out of proportion to the situation. I felt overwhelmed by responsibilities that never used to faze me.
Negative emotions consumed me, and I had trouble lifting my mood. I felt sad, hopeless, or irritable for long periods. Activities I used to enjoy brought me little pleasure or happiness. I isolated myself from others and lost interest in socializing or hobbies.
My sleep and appetite were also affected. I had trouble falling or staying asleep, and I either had no appetite or craved junk food for comfort. These changes in my daily functioning made it difficult to handle what life threw at me and maintain a stable mood and routine.
In hindsight, these symptoms showed that my usual coping strategies weren’t working and my mental health was suffering. If you recognize similar signs in yourself or a loved one, don’t ignore them. Speaking to a doctor about treatment options such as therapy or medication can help prevent the symptoms from progressing into a full-blown psychotic episode. Getting the right support and resources in place is key to managing stress and depression in a healthy way.
17. Obsession With Religious Or Supernatural Topics
My obsession with religion and the supernatural started gradually but grew more intense over time. At first, I was just really interested in learning about different faiths and beliefs. I read books on Buddhism, Hinduism, paganism, and more.
Then I started becoming fixated on certain ideas.
For a while, I was convinced that if I didn’t follow a strict routine of prayer and meditation every day, something terrible would happen. I felt like supernatural forces were guiding my every move.
I also began interpreting random events or coincidences as having some greater cosmic meaning or message for me. Like seeing a bird fly by or the way leaves fell from a tree — I thought these were secret signs from the universe telling me what to do.
Looking back, these were telltale signs I was losing touch with reality. My interests had morphed into irrational beliefs and obsessive behaviors I felt compelled to act on. I was experiencing a form of psychosis where my mind was playing tricks on me. If any of this sounds familiar, please talk to someone you trust. Get help from a doctor or mental health professional right away.
Don’t wait until your life starts unraveling and you can no longer distinguish what’s real from fantasy. The sooner you recognize the symptoms and get treatment, the better your chances of recovery and avoiding a serious psychotic episode.
My journey back to mental stability and wellness was difficult, but with professional support and medication, I was able to overcome psychosis and live a fulfilling life grounded in reality. You can too.
18. Agitation And Restlessness
My anxiety and restlessness were through the roof. I couldn’t sit still and felt compelled to constantly move around or pace. It was as if I had consumed 10 cups of coffee and a few energy drinks. My mind was racing with intrusive thoughts I couldn’t turn off.
At night, I tossed and turned for hours, struggling to fall asleep while my mind spun in circles. I’d wake up exhausted but then feel wide awake and on high alert shortly after. My agitation made it nearly impossible to concentrate or focus. I couldn’t read a book or follow a TV show. Menial tasks felt insurmountable.
Looking back, this was one of the first major signs that I was experiencing psychosis. My agitation and restlessness were far beyond normal levels of anxiety or stress. I felt out of control and at the mercy of my racing thoughts and excess energy.
If you find yourself feeling unusually restless, agitated, wired, or on edge for extended periods of time, especially if it’s interfering with your life and daily activities, it could be a warning sign of impending psychosis. Don’t ignore these signals. Reach out to a doctor or mental health professional right away.
Early treatment and intervention are key to managing psychotic symptoms and avoiding a full-blown psychotic episode.
The sooner you get help, the better. There are many effective treatments available, but the progression of untreated psychosis can be devastating. You don’t have to go through this alone. Help and support are out there.
That wraps up the major warning signs I wanted to share about psychosis. As with any medical condition, the earlier psychosis is detected and properly diagnosed, the better the prognosis.
If you or someone you know is exhibiting these symptoms, especially a combination of them that seems to be worsening or causing problems in day-to-day life, please seek professional evaluation right away.
Mental health is just as important as physical health, so don’t hesitate to speak up and get the help you need. I hope this information has been helpful in identifying psychosis, reducing the stigma around mental illness, and empowering people to take action for themselves or others. Our mental health is worth fighting for.