I’m hearing voices/seeing things/having strange thoughts. What can I do?

Note: NAMI volunteers are not medical or mental health professionals; we cannot offer medical or mental health advice. The material outlined below is informational, and we hope that it helps provide guidance toward getting support.

If you’re starting to have strange experiences like hearing voices, seeing things, feeling paranoid, or being unable to think straight, then you may be experiencing symptoms of psychosis. Experiencing psychosis might feel scary, but you are not alone. Help is available. With early support and treatment, you can manage your psychosis symptoms and live a safe, happy, and full life. This article will cover what it means to experience psychosis and how you can get help for early or first-episode psychosis.

What is psychosis?

Psychosis involves sensing, hearing, seeing, or believing information from your surroundings differently than someone without psychosis would. Pinpointing the exact moment you start experiencing psychosis is not easy, but you might notice becoming intensely focused on a thought or idea, feeling as if the world around you is suddenly unfamiliar, or thinking that your mind is playing tricks on you. This experience is called a psychotic episode when you start having symptoms of psychosis for the first time, after a period of stability, or in combination with another mental health or substance use condition.

Psychosis is more common than you might think. In the United States, about 100,000 young people experience psychosis each year. Psychosis is thought to be caused by family genetics, trauma, or a combination of both. Sometimes psychosis can mean the start of a more serious condition like schizophrenia, schizoaffective disorder, or bipolar disorder.

What are the signs?

Hearing, seeing, tasting, or believing things that others don’t
Persistent, unusual thoughts or beliefs
Suspiciousness or uneasiness with others
Strong and inappropriate emotions or no emotions at all
Withdrawing from family or friends
A sudden decline in self-care
Trouble thinking clearly or concentrating

Examples of psychosis symptoms:

Hearing a voice that other people don’t hear
Seeing a figure that other people don’t see
Thinking that someone is spying on you or controlling your mind
Believing that other people are plotting against you
Feeling all your emotions very strongly
Feeling no emotions at all
Being so focused on your beliefs and sensations that you don’t go to work or school
Feeling unable to think straight because there is too much going on in your head
Noticing that the world around you has started to feel strange and unfamiliar

Where should I start?

If you’re experiencing signs of early psychosis, ask for help from someone you trust right away. Psychosis can make you feel alone in your experience, but it’s important to be honest about what’s happening. Try talking to a parent, friend, or teacher who can connect you with help and support. You can check out these two articles to help you get the conversation started:

What kind of help should I ask for?

The most effective treatment for early psychosis is called Coordinated Specialty Care (CSC). CSC programs will work with you to help get your life back on track. These programs are for people between the ages of 16-30 years old who have been experiencing symptoms of psychosis for two years or less. CSC focuses on your unique needs using a team-based approach. This approach includes:

Case management—working with you to develop problem-solving skills, manageyourmedication,and coordinate services
Family support and education—giving families information and skills to support your treatment and recovery
Psychotherapy—promoting wellness and helping you developskills to help manage the impact of psychosis symptoms on your functioning and well-being
Medication management—finding the best medication for you at the lowest possible dose
Supported education and employment— providing support for you to be successful at school and/or work
Peer support—connecting you with others who have been through similar experiences

Where can I/my support system find a CSC program near me?

The Early Assessment and Support Alliance (EASA) Center for Excellence at Portland State University offers a database and directory of early intervention programs for psychosis within the U.S.
The Substance Abuse and Mental Health Services Administration (SAMHSA) Early Serious Mental Illness Treatment Locator is a source of information for family members who are seeking CSC programs across the United States.

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