Psychotic Behavior: Signs And Symptoms Of Psychosis

Medically reviewed by Julie Dodson, MA
Updated July 24, 2023by BetterHelp Editorial Team

Psychotic behavior is often categorized by its way of causing the person affected to have a skewed idea of reality. It can cause a person to experience hallucinations or delusions, which are sensory experiences in which someone sees or hears something that isn’t there, or believes something that isn’t true, respectively. The signs and symptoms of psychosis can be terrifying and life-altering for those who experience them. Psychosis often appears alongside a mental illness, such as schizophrenia, but it can also be present in individuals with other health conditions or those who use drugs or other medications that are associated with such side effects. Understanding how psychosis can present itself may help you identify it in yourself or a loved one.

Are You Or A Loved One Displaying Signs Of Psychosis?

Psychotic Behavior: Losing Touch With Reality

One of the hallmark symptoms of psychosis is thought to be a loss of touch with reality. Those who are experiencing psychosis can have difficulty differentiating between what is happening and what they see. When this shift in perception occurs, it can leave a person disoriented and confused. They may hallucinate about things or people who are not there. These hallucinations can be euphoric or terrifying. Depending on the experience the person is having at the time, they can be considered dangerous to themselves or others.

Someone who is experiencing a negative hallucination may resist help or lash out at others. Their frustration may be furthered by the people in their life who insist that what they are seeing or feeling isn't real. However, these moments are their reality. Whether these events are grounded in the real world or not, they can seem very real to a person experiencing psychosis.

Unclear And Disorganized Speech

When experiencing a psychotic episode, a person may slur their words or emit some other unclear speech. Some researchers believe our words form from pre-existing thoughts and emotions. When these thoughts and emotions are disturbed by psychosis, it can have a significant impact on our linguistics. When a person's brain is not grounded in reality, the words that come out when they’re having a conversation can seem nonsensical.

In addition to slurring words, a person with psychotic or schizophrenic behavior may switch their sentences mid-thought. They might string several ideas together into one thought, which often does not make sense. They may also pay little attention to grammar, which can prove to be confusing in conversation.

Disorganized Behavior

Disorganized behavior may accompany the other symptoms that individuals with psychotic or schizophrenic behaviors experience. Some examples of disorganized behaviors could include dressing for the wrong season or disregarding the environment around them. They might also inappropriately respond to news given to them or have difficulty managing their emotions or responses.

These behaviors can be perceived as confusing to outsiders who don't understand their condition. Interfering with individuals experiencing these types of behaviors can sometimes cause further confusion and disorientation. Therefore, although someone may not fully understand psychosis, it can be important to recognize how real these symptoms often feel to a person experiencing them.

Problems Sleeping

The frequency of a person’s delusions or hallucinations can make restful sleep difficult to achieve. Someone with psychosis may experience severe anxiety, which can cause their thoughts to race and keep them tossing and turning throughout the night. Additionally, it can be almost impossible to "shut off" one's mind to relax and get some sleep. Delusions can also affect this aspect of life as a result of fear of going to sleep.

No matter how unbelievable a belief might seem, as with hallucinations, delusions can seem very real to a person experiencing psychosis. Further, lack of sleep has also been known to trigger hallucinations and delusions in individuals with this condition. In many cases, doctors prescribe medications to help them sleep.


Lack Of Motivation

For a person who is not in touch with reality, staying motivated to carry out everyday tasks and responsibilities can be strenuous. On the other hand, a person with schizophrenic tendencies may have trouble prioritizing and understanding what they should be motivated to do in the first place. It is a common occurrence for a person with psychosis to focus all their energy on their hallucinations and delusions. This may leave little room for much else.

Difficulty Functioning

Depending on the severity of a person's psychotic behavior, it can be challenging to take on normal daily tasks. The individual may have a belief that someone is watching them or is out to get them, which may cause them to remain housebound. Additionally, they may experience frequent hallucinations, which can make it hard to carry out any task that would take more than a few seconds.

For this reason, many people who experience psychosis are looked after by a caretaker. Additionally, a therapist may see them regularly to assist with the negative effects of their condition.

Withdrawal From Social Situations

Another common symptom of psychosis can be withdrawal from social situations. This could also be a sign that someone may be going into a psychotic state. People who were once social may shrink into the background or stop coming to social events altogether. Similarly, if you are at an event with someone with psychosis, you may notice them withdrawn or distressed.

Overstimulation can be a common cause of delusions and hallucinations. When many people are speaking at once, or when a person with psychosis is in a strange environment, the lack of stability and familiarity can cause anxiety. Heightened anxiety can cause receptors in the brain to fire and could bring on a hallucination.

Additionally, an individual’s realization that they are misunderstood or are scaring other people can cause them to want to withdraw as well. Even though psychotic behaviors are widely misunderstood, people with psychosis are often friendly and harmless. It can be important for a person with psychosis to receive friendliness and acceptance, just as any other person would.

Preoccupation With Strange Fears

A preoccupation with strange fears can go hand in hand with delusions. An individual may believe someone is watching them or is out to get them, but these fears can also go much deeper.

A common complaint of those with psychosis is the idea that their thoughts are being broadcast for all to hear. They may not understand that the voices in their head aren't something that others can hear. They might also believe that they have a microphone to their head and think that people can hear everything they are thinking.

Lavish conspiracy theories can also be formed in the brain of someone with psychosis. They may believe that the government is an evil entity or that larger powers are at work to demolish them or others. Additionally, they may have a strange fear of a deity or other religious figures.

Increase Or Decrease In Appetite

With all of the activity in the mind of a person with psychosis, a change in appetite can be common. When they experience an episode, an increase or decrease in appetite may occur. This can also be the result of a hallucination or delusion that is particularly disturbing. A person might forget to eat because of a preoccupation with all the thoughts in their head. Following an episode, the person’s anxiety can be so severe that it makes it difficult to eat, or a person can be so relieved that the episode is over that they are ready to regain their energy and eat a hearty meal.

Changes In Personality

Someone experiencing a psychotic episode may appear to be a completely different person. The loss of touch with reality could have something to do with this. In addition, many irrational thoughts and actions can result from the distressing things that may happen during an episode. When the episode passes, the person’s usual personality often returns. It’s hard to tell how long a personality shift will last, but it often dissipates with time until the next episode occurs.

Beliefs Of Grandiosity

A sense of grandiosity is the belief that one is extremely superior to other people. A person may think they are the king of the world in a sense and that no one (or only a very small group of people) understands them or is equal to them. This can cause an inflated sense of self-esteem and go hand in hand with narcissism as well.

Another aspect of grandiosity may be the belief that a person has a special relationship with world leaders or religious figures. They may have a deep belief that they were chosen to save the world or all of humanity. Similarly, they could believe that they have superpowers, like being able to fly.

These behaviors are classified under the umbrella of delusions but may warrant a section of their own. Grandiosity can take many shapes and forms depending on the person and the severity of their illness.

Are You Or A Loved One Displaying Signs Of Psychosis?

Online Counseling With BetterHelp

If you’re experiencing mental health concerns, such as symptoms of psychosis, it may be useful to reach out to a mental health professional. BetterHelp is an online counseling platform that can connect you with a licensed therapist who has experience with psychosis or any other specific areas of concern you’re facing. Whether it’s psychosis, anxiety, depression, or something else, you can find a counselor who has successfully guided others through difficult times in their life. With online therapy, you can choose how you want to communicate with your therapist, whether you use video chats, phone calls, or live chat. Also, you can contact your therapist at any time through in-app messaging, and they’ll respond as soon as they can. This may prove especially helpful if you experience symptoms in between sessions.

The Efficacy Of Online Counseling

Research shows that individuals experiencing psychosis may benefit from online CBT-based treatment. One study published in the Journal of Consulting and Clinical Psychology concluded that online CBT-oriented interventions can “provide an add-on effect to care as usual and have the potential to narrow the psychological treatment gap in psychosis.”


Experiencing symptoms of psychosis can be frightening and confusing, whether you’re going through it yourself or watching a loved one experience it. Rather than self-diagnosing, it may help to discuss your symptoms with a licensed mental health professional. Talking about these concerns can be challenging, but online therapy may provide you with a safe space in which you can speak openly without fear of judgment. Take the first step toward getting help with your symptoms and reach out to BetterHelp today.

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