While the exact cause of psychosis is unknown, research suggests it results from a combination of genetic, biological, environmental, and psychological factors:

Biological factors:

• Genetic traits inherited or chemical imbalances in the brain can increase vulnerability to psychosis.
• Some may be prone to psychosis, and life stresses can trigger a psychotic episode. Stresses include short-term stress such as managing work stresses, dealing with family issues, financial concerns, and ongoing relationship challenges with loved ones.
• Psychosis can sometimes arise from other medical conditions such as HIV, Alzheimer’s disease, Parkinson's disease, or brain tumours.

Substance abuse:

• Misuse of alcohol or drug can cause psychotic episodes.
• Withdrawal from long-term alcohol or drug use may also trigger psychosis. Withdrawal symptoms can include headaches, fatigue, difficulty sleeping, and irritability, which may further complicate the recovery process.

Proper medical supervision and support, such as services offered by the National Addictions Management Service (NAMS) are crucial for individuals undergoing treatment for substance use disorders to minimise the risk of psychosis and other severe withdrawal symptoms.

Psychological factors:

• Mental conditions such as schizophrenia, depression and bipolar disorder.
• Sleep deprivation.
• Severe prolonged stress or trauma.

Social factors:

• Traumatic events, such as childhood abuse, and an individual’s upbringing and surroundings.

Early signs of psychosis:

The early signs of psychosis vary from person to person. But if they begin feeling suspicious or paranoid, hearing voices that aren’t there, being unable to concentrate like before, or have difficulty thinking logically — these could be a sign for you to step in.

Abnormal experiences or behaviours:

• Hallucinations – Hallucinations occur when individuals hear, see, feel, smell, or taste things that aren't there. For example, they might hear voices telling them what to do, even though no one is actually speaking.
• Delusions – Delusions are strong beliefs that don’t match reality and don’t change, even when there’s evidence that they aren’t true. For example, individuals with psychosis may believe others are plotting against them or trying to harm them.
• Disorganised thinking or speech – Individuals with psychosis have trouble thinking in an organised way. They may have difficulty getting to the main point of a conversation and may talk about various topics before reaching the intended topic. Sometimes, they make up words or say things that do not make sense.

Behaviours that are reduced or stopped because of psychosis. Examples include:

• Showing little to no emotion or not changing their facial expression.
  • Not moving or talking much.
  • Neglecting personal hygiene like not taking showers or keeping clean.
  • Losing interest in spending time with others or having fun.

Cognitive symptoms: These symptoms affect thinking and memory.

Individuals with psychosis have difficulty:

• Learning and remembering.
• Understanding speech or other forms of communication.
• Making sense of new information.
• Solving problems.
• Starting or maintaining goal-directed tasks.

Emotional symptoms:

• Individuals with psychosis often experience anxiety or depression.

If your loved ones have been diagnosed with psychosis, here are some ways you can help them to better manage their condition.

Learn about psychosis and their treatment:

• Discuss their condition with a mental health professional to gain better understanding.
• Request written information about their diagnosis and treatment to help them stay informed and take active steps toward improvement.
• If their medication is not working effectively, ask their doctor about alternative options.
• Attend workshops and seminars designed for caregivers of family members with mental health issues.

Educating ourselves with information related to the condition, can reduce anxiety and help us feel more in control.

While there are many resources available for those suffering from psychosis, the most important part of recovery is still having support from the people around them.

Supporting your family members involves being there for them emotionally and practically. Here are some ways you can help:

• Be there for your loved one — listen and show understanding.
• Help with daily tasks like going for appointments, managing expenses, or providing housing support.
• If possible, participate in their therapy sessions or engage with healthcare providers to better understand their needs.

While it’s natural to want to support and protect our loved ones, it is also important to remember that learning to take care of themselves is a key part of recovery.