Column: Psychosis, Early Detection Is Critical

Psychosis describes a condition that affects the mind, where there has been some loss of contact with reality. During a period of psychosis, a person’s thoughts and perceptions are disordered and the individual may have difficulty distinguishing what is real from what is not.

Psychosis can happen to anyone, though symptoms most often begin between ages 16 and 30. According to the National Institute of Mental Health (NIMH), there are about 100,000 new cases of psychosis each year in the U.S.

There is no one specific cause of psychosis. Psychosis may be a symptom of a mental illness, such as schizophrenia or bipolar disorder; however, a person may experience psychosis without a diagnosed mental illness. Other causes may include sleep deprivation, acute severe stress, general medical conditions, certain prescription medications, and the misuse of alcohol or drugs.

Psychosis can be frustrating for the individual and alarming to families, siblings, and peers. Without help, the condition can worsen and cause severe disruptions in school and life. Early signs of psychosis can be difficult to interpret, but learning how to identify the signs may help your family avoid painful developments.

Typically, a person will show changes in his or her behaviors before psychosis develops. Warning signs of psychosis include:

- Worrisome decline in school/ job performance
- New trouble thinking clearly or concentrating
- Suspiciousness, paranoid ideas, or uneasiness with others
- Withdrawing socially or spending a lot more time alone than usual
- Unusual, overly intense new ideas, strange feelings or having no feelings at all
- Decline in self-care or personal hygiene
- Difficulty telling reality from fantasy
- Confused speech or trouble communicating

Any one of these changes by itself may not be significant, but someone ticking several boxes on the list could be in danger. It is crucial for young adults to have an established primary care provider prior to an issue so they can get care quickly.

Left untreated, the condition could result in a psychotic episode. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions), which can result in erratic or aggressive behavior.

Take action now. Establish a primary care provider for young adults to ensure the quickest pathway to care if needed. Once established, a primary care provider can provide a referral to a specialist.

In a crisis. Try to remain calm and use the following resources for help: In an emergency, dial 911 or visit the nearest emergency department; for the El Dorado County 24-Hour Crisis Phone Line, call 530.544.2219; for the National Suicide Prevention Hotline, call 800.273.8255.


Dr. Tracy Protell is a board-certified psychiatrist at Barton Health in South Lake Tahoe, CA, and Stateline, NV. May is Mental Health Awareness Month. Dr. Protell will host a free Wellness Webinar: “Anxiety Disorders in Kids & Teens” on Thursday, May 12 at 5:30 p.m. Register in advance or view previously recorded webinars at BartonHealth.org/Lecture. For a list of area mental health resources and crisis lines, visit BartonHealth.org/MentalHealth.