Key Takeaways
Psychotic disorders, like schizophrenia and schizoaffective disorder, influence the way people think, feel, and perceive the world around them.
Symptoms of psychotic disorders include hallucinations, delusions, and disorganized thoughts and behaviors.
If you’re experiencing psychosis, it’s best to seek professional support right away. Recovery and symptom management can include talk therapy, medication, and community support.
Psychotic disorders are severe mental health conditions that affect the way people think, feel, and behave. Research suggests that as many as 3.5% of people will meet the diagnostic criteria for a psychotic disorder, like schizophrenia and schizoaffective disorder, at some point during their lives.
A leading characteristic of psychotic disorders is psychosis — a collection of symptoms that cause a disconnect from reality. Unmanaged psychosis can be extremely distressing and impact everything from completing basic tasks to maintaining relationships.
Early intervention can help people understand their diagnoses, manage symptoms, and improve daily functioning.
What is a psychotic disorder?
A psychotic disorder is a mental health condition in which psychosis is a core feature. Psychosis refers to symptoms that cause a break from reality, like hallucinations or delusions.
Psychosis itself is not a diagnosis. It can happen for many reasons — including mood disorders, substance use, medical conditions, or severe stress. In psychotic disorders like schizophrenia or schizoaffective disorder, psychosis is ongoing or recurring and shapes how a person experiences daily life.
Understanding this difference matters. It helps explain why some people may experience psychosis briefly, while others need longer-term care and support for a psychotic disorder.
Symptoms of psychotic disorders
Primary psychotic disorders include schizophrenia, delusional disorder, schizoaffective disorder, schizophreniform disorder, and brief psychotic disorder. These conditions are characterized by periods called psychotic episodes in which symptoms like hallucinations, delusions, or disorganized thinking are present. Symptoms vary by condition and may change over time, which is why some people experience episodes that come and go while others have more ongoing symptoms.
However, they typically include some combination of the following:
1. Hallucinations
A hallucination is a sensory experience that seems real but doesn’t exist outside of your mind. A common hallucination is hearing things that aren’t really there. For example, you may hear voices talking to you or telling you what to do. Hallucinations can also involve sight, smell, taste, or touch.
2. Delusions
A delusion is a strong belief in something that’s not true. Delusions can be bizarre, meaning they’re clearly impossible, or non-bizarre, meaning they’re possible but not probable. Psychotic disorders are associated with several types of delusions, including persecutory delusions — false beliefs that someone is trying to harm you.
3. Disorganized thoughts and speech
People with psychotic disorders may have trouble expressing their thoughts in a clear and logical way. This might include repeating specific words or statements or answering questions with excessive and unnecessary details.
4. Disorganized behavior
Psychotic disorders can cause odd and unpredictable behaviors. For example, you may have trouble managing your emotional responses, controlling impulses, or following directions. Some people may even exhibit catatonic behaviors, such as unresponsiveness or being “frozen” in place.
5. Negative symptoms
Psychotic disorders can also cause symptoms that impact normal functioning. One example is a lack of motivation, making it difficult to get out of bed, shower, and go to work or school. You may also have trouble concentrating or finding pleasure in activities you usually enjoy.
Potential causes of psychotic disorders
Research has linked psychotic disorders to several possible risk factors, including genetics, brain chemistry, and exposure to trauma. Some people may have a genetic predisposition to psychotic disorders. For example, you’re six times more likely to develop schizophrenia if you have a close relative with the condition.
Other research suggests that psychotic disorders are associated with brain abnormalities, such as an imbalance of chemical messengers called neurotransmitters. Environmental stressors — including trauma, substance use, and prenatal exposure to certain viruses — may also play a role.
For some people, certain factors can trigger a psychotic episode. A trigger doesn’t cause a psychotic disorder, but it can bring symptoms on or make them worse.
Common triggers include severe stress, lack of sleep, substance use, major life changes, and stopping psychiatric medication suddenly. Illness or hormonal changes can also increase risk for some people.
Knowing these triggers can help people notice early warning signs and get support sooner.
Getting diagnosed with a psychotic disorder
Most psychotic disorders develop between late adolescence and early 30s, though many people experience symptoms sooner. Research shows that psychotic-like experiences, such as unusual thoughts and beliefs, may be an indicator of developing a psychotic disorder or other mental health concerns later in life. Regardless of when your symptoms start, it’s best to seek professional support right away.
Before making a diagnosis, your provider will likely conduct a thorough evaluation to learn more about your symptoms, health history, and current medications. Psychotic disorders often share overlapping symptoms, so this can help distinguish short-term conditions (like schizophreniform disorder) from lifelong conditions (like schizophrenia and schizoaffective disorder).
Your provider may also order brain imaging tests and lab work to rule out any underlying causes. For example, some psychotic episodes are triggered by drugs, alcohol, and prescription medication.
Recovery is possible for people with psychotic disorders. Medication, therapy, and community support can help people effectively manage their symptoms.
Medication: Antipsychotic medications are considered a first-choice treatment for psychotic disorders, but the exact medication and dosage will depend on each person.
Talk therapy: Therapeutic techniques like cognitive behavioral therapy (CBT) help you understand the connection between your thoughts, feelings, and behaviors. You’ll also develop the skills to increase resilience and cope in healthier ways.
Community support: Many people benefit from working with a case manager and other wraparound services that address issues related to work, school, transportation, and housing.
Clinician's take
A therapist can help you manage challenging psychotic symptoms by teaching you grounding techniques, reality-testing strategies, and coping skills to reduce your distress and improve your daily functioning.
Find care with Rula
Hallucinations, delusions, and other psychotic symptoms can be scary, but they don’t have to define you. Getting a psychotic disorder diagnosis is the first step in learning how to manage your symptoms and improve your daily functioning.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.
