🕷️ Crawler Inspector

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Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 98 (from laksa170)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa098.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.michiganmedicine.org/health-lab/when-reality-fails-what-know-about-psychosis\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.michiganmedicine.org/health-lab/when-reality-fails-what-know-about-psychosis\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.michiganmedicine.org\/health-lab\/when-reality-fails-what-know-about-psychosis","crawl_time":1776061099,"first_indexed_time":1675337899,"http_code":200,"src_unparsed":"org,michiganmedicine!www,\/health-lab\/when-reality-fails-what-know-about-psychosis s443","src_root_hash":"10189133355254079098","history_drop_reason":null,"meta_title":"When reality fails: What to know about psychosis","meta_descriptions":["Delusions, hearing voices, hallucinations, and other symptoms of psychosis can be treated and the earlier treatment begins, the better"],"attrs_boilerpipe_text":"What to know about psychosis\n1. It takes many forms – and starts in teen\/young adult years\nA voice occasionally whispering in someone's head. \nA faint fleeting shadow glimpsed out of the corner of an eye. A nagging, unshakeable feeling that others are out to get you or want to harm you.\nBeing convinced that someone is monitoring what you're thinking or is even controlling you.\nSymptoms of psychosis like these most often start in people between the ages of 14 and 30.\nThe hallucinations and delusions may be subtle at first but can worsen over time.\nAt first, a person may be able to tell that the distorted perceptions aren't real.\nBut this ability can fade as they start to lose the power to make an accurate mental model of their reality.\n\"They may believe things that are out of sync with other peoples' beliefs or have disorganization of their thoughts that lead them to say things that don't make sense or have confusion about things that should not be confusing,\" said Taylor.\n2. Psychosis is like a fever: it can happen with many conditions\nPeople can develop fevers as part of infections caused by many kinds of bacteria or viruses. \nAnd psychosis symptoms can happen as part of many mental health conditions.\nHaving psychosis symptoms could mean someone has schizophrenia – which is the condition that many people think of first with such symptoms.\nBut hallucinations, delusions and other psychosis signs could also happen as part of depression, bipolar disorder, post-traumatic stress disorder, autism spectrum disorder or borderline personality disorder. \nIn older adults, they can be part of dementia, Alzheimer's disease and Parkinson's disease, among others.\nAnd sometimes, people can have mild psychosis symptoms without having a diagnosable mental health condition at all.\n\"We didn't previously accept that people could experience voices or delusions and be perfectly functioning members of society without any distress,\" said Taylor. \n\"Now we see that in some people, it can be just another dimension of human experience.\nBut for people seen in the PREP clinic, symptoms usually interfere with someone's life, education, relationships or ability to work. \nThey can cause someone to withdraw from others, to stop eating or even to refuse to see a mental health professional if voices in their head tell them not to. \nThey can even cause a person to think about harming themselves or others.\nThat's why, said Tso, \"Psychosis can indicate more severe mental illness, so we need to take it seriously,\" by doing a complete evaluation that considers the psychosis symptoms in conjunction with other symptoms.\n3. There's no one cause for psychosis – but many risk factors\nThe Michigan Medicine PREP team does research to explore the roots of psychosis, as part of a worldwide effort to learn more and develop targeted treatments.\nSo far, research at U-M and other research centers has shown that:\nRisk of psychosis is higher in people who have family members who have it, such as parents. But even in identical twins, one can have psychosis and the other – whose DNA is a near-perfect copy – does not. And in general, there is no one gene variation, or collection of genetic factors, that 'cause' mild or severe psychosis. \"Hundreds or thousands of genes can set up vulnerability to schizophrenia,\" said Taylor.\nThe age of onset of psychosis coincides with the ages when the brain is undergoing many changes on its way to maturity.\nBrain changes can happen in people whose psychosis goes untreated. \"The more relapses and episodes a person has, the more we see that it can permanently change their brain function and structure,\" said Tso. \"And that is something we might not be able to reverse later on even with medication.\" Unfortunately, these changes are very subtle, and there's no specific change in the brain that can be seen on a scan and diagnose schizophrenia or other conditions in a single individual.\nIntense stress, whether from an early-life trauma, pregnancy or birth complications, intense loneliness, or the onset of adult responsibilities and pressures, have been linked to the risk of psychosis as a trigger for underlying vulnerability. \nInflammation, post-infection or autoimmune reactions, where the body's defense systems attack brain tissue, have also been implicated in some, less common forms of psychosis.\nThe U-M team is\nalways looking for people with the condition to volunteer for their studies\n– as well as people who don't have psychosis but want to help with the search for answers by acting as comparisons.\nThe U-M team and their counterparts at the\nacademic network called EPINET\nare pursuing many more research questions about psychosis.\n4. The earlier someone gets treatment, the better\nExperts worldwide recommend that no more than three to six months go by between the first signs of psychosis, and the start of treatment.\nBut in the United States, that gap averages three years.\nGetting more people in to see a specialist who can evaluate them, and recommend next steps, is an urgent need nationwide, says Taylor.\nNearly as important as getting started is sticking with the effort to find what will work for the individual. \nThat's true within many mental health conditions.\nIn order to get someone started on the path to care, Tso says, more people need to know what to look for and what to do.\n\"Often the signs are noticed by the people closest to the young person experiencing symptoms,\" she said. \n\"If we want to detect it early, then we need to make sure the community is aware of symptoms,\" and the importance of connecting with a school counselor or medical provider who can reach out to specialists.\nHowever, while almost all counselors and medical professionals will work with people with psychosis over the course of their careers, many could improve their knowledge and skills related to this population. \nLapidos says a better understanding of the psychosis spectrum by health care professionals can lead to early detection and appropriate referrals to specialty care. \n“During a first episode of psychosis, the person affected and their family often feel hopeless and afraid. But there is always hope. Recovery is real and it happens all the time,” she said. \n“If medical professionals can convey that sense of hope, and place appropriate and timely referrals to specialty care when needed, they can make a huge difference in the trajectory of someone’s life.”\n\"There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes,\" Taylor said. \n\"When intervention happens early, people get better – though not right away all the time.\"\n5. Medications work for most; adding talk therapy helps more\nThe group of medications called antipsychotics can quell the psychosis symptoms of about two-thirds of people who take one of them. \nThe medications start to have an effect within a week after they start, says Taylor.\nThose who don't get help from just one drug can often have success when another is added by an experienced prescriber.\nBut getting the dose right, and finding a medication whose side effects are acceptable, can take time and patience. \nWeight gain, diabetes and movement-related side effects can result from many of the medications, so the minimum dose that quiets a person's symptoms is best.\nResearch is under way to find better medications, and ways to tailor the choice of medication to a person's unique brain mechanisms – but will take time.\nIn the meantime, it's important for people taking these medications to take them consistently as directed and to communicate with their provider about side effects. \nAnd that can be hard for a young person who may resist being diagnosed with a serious mental illness.\nForms of talk therapy such as cognitive behavioral therapy have also proven very effective – both when done one-on-one with a trained therapist, and in group settings, says Tso. \nThese can help patients come to terms with having an illness and assist with the kinds of issues that medications often cannot, including social engagement, and skills to improve focus and other cognitive functions.\nAdding other supports to help people with psychosis navigate school, work, relationships and life skills has also been proven to improve long-term outcomes, the U-M experts say. \nThe PREP Clinic, and others like it nationally, seek to offer this kind of wraparound support. \nBut it's not always paid for by insurance companies.\n6. Violent acts by people experiencing psychosis are rare and mostly impulsive\nThe U-M experts are concerned about the popular perception and media depictions of people with serious mental illness as far more prone to violence than other people. \nThis is inaccurate, they say.\nIn fact, someone with psychosis is more likely to be a victim of a violent act than to commit one.\nBut when someone with uncontrolled psychosis does act in a violent way, it's often a spontaneous, impulsive outburst or physical struggle, not a premeditated act or planned attack, says Taylor.\nScapegoating people with any sort of mental illness after violent tragedies such as mass shootings is dangerous, he says, and can increase the already damaging stigma around seeking help.\n7. Beware the risk of suicide and self-harm\nHaving psychosis does increase the risk that someone might attempt suicide or put themselves in potentially dangerous situations. \nSo, it's critical for patients, and those around them, to understand this risk and take steps to reduce it.\n\"We know that there are very high rates of suicide in people with psychosis, compared with the general population,\" says Tso. \"Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time.\"\nTaylor notes that sometimes, people with psychosis do things that put them in danger, such as going out in extremely cold weather without a coat or even a shirt. \nTheir illness keeps them from having insight into the potential harm, and they may even need help from family, friends, health professionals or police to get to safety.\nHaving a safety plan ahead of time, which patients and their loved ones can create with their treatment providers, can make a big difference when someone has suicidal thoughts or makes an attempt to end their life.  \nThis can include having the national\nSuicide & Crisis Lifeline\nnumber, 988, memorized or saved on their phone and written down in prominent places. \nAnyone can call or text 988 from a mobile phone, or use webchat on the lifeline's website, to receive help 24 hours a day, seven days a week with any kind of mental health or substance use crisis. \nOther crisis plans can include setting up a list of people who the person can confide in when they're having suicidal thoughts or impulses, and who know what to do or can check on them regularly. \nPeople at higher risk of suicide and their trusted contacts should also know how to reach their therapist's office or other treatment provider at all hours and know where the nearest psychiatric emergency treatment center is located or how to contact it for advice.\nRemoving firearms and other potentially lethal means from the home or locking them away out of sight (with ammunition stored separately in the case of firearms) is also important. \nThe impulsive nature of many suicides, especially among young people, makes this important for families of young people with many forms of mental illness.  ","attrs_markdown":"Consent for Cookie Use\n\nWe use cookies to improve your experience on our websites. You can learn more about what information we collect and how we use it on our [Internet Privacy Statement](https:\/\/www.michiganmedicine.org\/internet-privacy-statement \"Privacy & Cookies Policy\").\n\n[Skip to main content](https:\/\/www.michiganmedicine.org\/health-lab\/when-reality-fails-what-know-about-psychosis#main-content)\n\n[About Michigan Medicine](https:\/\/www.michiganmedicine.org\/) [Patient Care](https:\/\/www.uofmhealth.org\/) [Research](https:\/\/medresearch.umich.edu\/) [Education](https:\/\/medschool.umich.edu\/) [Departments](https:\/\/medschool.umich.edu\/departments)\n\nEvents\n\nCareers\n\nContact\n\n[![logo](https:\/\/www.michiganmedicine.org\/themes\/custom\/outline_frontend\/logo-enterprise.svg)](https:\/\/www.michiganmedicine.org\/)\n\nAbout Us\n\n[About Us](https:\/\/www.michiganmedicine.org\/about-us)\n\n[History](https:\/\/www.michiganmedicine.org\/about-us\/michigan-medicine-history)\n\n[Honors & Awards](https:\/\/www.michiganmedicine.org\/about-us\/michigan-medicine-honors-awards)\n\n[Leadership](https:\/\/www.michiganmedicine.org\/about-us\/michigan-medicine-leadership)\n\n[Health Advancement](https:\/\/www.michiganmedicine.org\/about-us\/health-advancement)\n\n[Mission](https:\/\/www.michiganmedicine.org\/michigan-medicine-mission)\n\nCommunity\n\n[Community](https:\/\/www.michiganmedicine.org\/community)\n\n[Community Health Services](https:\/\/www.michiganmedicine.org\/community\/community-health-services)\n\n[Arts in Health](https:\/\/www.michiganmedicine.org\/community\/arts-health-home)\n\n[Community Health Planning & Investment](https:\/\/www.michiganmedicine.org\/community\/community-health-planning-and-investment)\n\n[Life-Saving Donations](https:\/\/www.michiganmedicine.org\/community\/life-saving-donations-home)\n\n[Osher Lifelong Learning Institute (OLLI)](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute)\n\n[Sponsorship](https:\/\/www.michiganmedicine.org\/community\/community-sponsorship)\n\n[Environmental, Social & Governance](https:\/\/www.michiganmedicine.org\/community\/environmental-social-governance)\n\nGiving\n\n[Giving](https:\/\/www.michiganmedicine.org\/giving)\n\n[Areas to Support](https:\/\/www.michiganmedicine.org\/giving\/areas-support)\n\n[Campaign](https:\/\/www.michiganmedicine.org\/giving\/look-to-michigan)\n\n[Ways to Give](https:\/\/www.michiganmedicine.org\/giving\/ways-give)\n\n[Get Involved](https:\/\/www.michiganmedicine.org\/giving\/giving-get-involved)\n\n[Fundraising Events](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events)\n\n[About the Office of Development](https:\/\/www.michiganmedicine.org\/giving\/about-michigan-medicine-office-development)\n\nNews & Stories\n\n[News & Stories](https:\/\/www.michiganmedicine.org\/news-and-stories-michigan-medicine)\n\n[Health Lab](https:\/\/www.michiganmedicine.org\/health-lab)\n\n[Medicine at Michigan](https:\/\/www.michiganmedicine.org\/medicine-at-michigan)\n\n[Michigan Answers](https:\/\/www.michiganmedicine.org\/michigan-answers)\n\n[Michigan Medicine Podcast Network](https:\/\/www.michiganmedicine.org\/podcasts)\n\n[Press Room](https:\/\/www.michiganmedicine.org\/news-stories\/michigan-medicine-press-room)\n\n- [About Us](https:\/\/www.michiganmedicine.org\/about-us)\n  \n  - 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[Community Health Needs Assessment (CHNA)](https:\/\/www.michiganmedicine.org\/community\/community-health-planning-investment\/community-health-needs-assessment-implementation-plan-chna)\n    - [Community Outreach and Engagement Programs](https:\/\/www.michiganmedicine.org\/community\/community-health-planning-investment\/community-outreach-and-engagement-programs)\n  - [Life-Saving Donations](https:\/\/www.michiganmedicine.org\/community\/life-saving-donations-home)\n    \n    - [Donate Blood](https:\/\/www.michiganmedicine.org\/community\/life-saving-donations\/donate-blood-save-lives)\n    - [Share Your Story](https:\/\/www.michiganmedicine.org\/community\/life-saving-donations\/share-your-life-saving-donation-story)\n    - [Become a Volunteer](https:\/\/www.michiganmedicine.org\/community\/life-saving-donations\/become-wolverines-life-volunteer)\n  - [Osher Lifelong Learning Institute (OLLI)](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute)\n    \n    - [About Osher Lifelong Learning Institute](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute-olli\/about-osher-lifelong-learning-institute)\n    - [Donate Now to OLLI](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute-olli\/donate-now-olli)\n    - [Join OLLI](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute-olli\/join-olli)\n    - [OLLI Programs and Activities](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute-olli\/olli-programs-and-activities)\n    - [OLLI Volunteer Information](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute-olli\/olli-volunteer-information)\n      \n      - [OLLI Volunteer Roles](https:\/\/www.michiganmedicine.org\/community\/osher-lifelong-learning-institute-olli\/olli-volunteer-information\/olli-volunteer-roles)\n  - [Sponsorship](https:\/\/www.michiganmedicine.org\/community\/community-sponsorship)\n    \n    - [Frequently Asked Questions About Sponsorship](https:\/\/www.michiganmedicine.org\/community\/sponsorship\/frequently-asked-questions-about-sponsorship)\n  - [Environmental, Social & Governance](https:\/\/www.michiganmedicine.org\/community\/environmental-social-governance)\n    \n    - [Environmental Sustainability & Carbon Neutrality](https:\/\/www.michiganmedicine.org\/community\/environmental-social-governance\/environmental-sustainability-carbon-neutrality)\n- [Giving](https:\/\/www.michiganmedicine.org\/giving)\n  \n  - [Areas to Support](https:\/\/www.michiganmedicine.org\/giving\/areas-support)\n    \n    - [Medical School Scholarships](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-medical-school-scholarships)\n    - [Rogel Cancer Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-rogel-cancer-center)\n      \n      - [Forbes Institute for Cancer Discovery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/rogel-cancer-center\/giving-forbes-institute-cancer-discovery)\n      - [Rogel and Blondy Center for Pancreatic Cancer](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/rogel-cancer-center\/giving-rogel-and-blondy-center-pancreatic-cancer)\n      - [Ronald Weiser Center for Prostate Cancer](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/rogel-cancer-center\/giving-ronald-weiser-center-prostate-cancer)\n      - [Weiser Family Center for Breast Cancer](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/rogel-cancer-center\/giving-weiser-family-center-breast-cancer)\n    - [A. Alfred Taubman Medical Research Institute](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-alfred-taubman-medical-research-institute)\n    - [Alumni Class Giving](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/medical-school-alumni-class-giving)\n    - [Anesthesiology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-anesthesiology)\n    - [Biological Chemistry](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-biological-chemistry)\n    - [Biomedical Engineering](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-biomedical-engineering)\n    - [CSI Singapore-Rogel Cancer Center partnership](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-csi-singapore-rogel-cancer-center-partnership)\n    - [Cardiac Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-cardiac-surgery)\n    - [Cell & Developmental Biology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-cell-developmental-biology)\n    - [Chad Carr Pediatric Brain Tumor Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-chad-carr-pediatric-brain-tumor-center)\n    - [Community Health Services](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services)\n      \n      - [Adolescent Health Initiative](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/adolescent-health-initiative)\n      - [Ann Arbor Meals on Wheels](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/ann-arbor-meals-wheels)\n      - [Housing Bureau for Seniors](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/housing-bureau-seniors)\n      - [Osher Lifelong Learning Institute (OLLI)](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/osher-lifelong-learning-institute)\n      - [Regional Alliance for Healthy Schools](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/regional-alliance-healthy-schools)\n      - [Silver Club Memory Programs](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/silver-club-memory-programs)\n      - [Turner African American Services Council](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/turner-african-american-services-council)\n      - [Turner Senior Wellness Program](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/turner-senior-wellness-program)\n      - [Volunteer Services](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/community-health-services\/volunteer-services)\n    - [Computational Medicine & Bioinformatics](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-gilbert-s-omenn-department-computational-medicine-and-bioinformatics)\n    - [Congenital Heart Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-congenital-heart-center)\n    - [Dermatology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-dermatology)\n    - [Eisenberg Family Depression Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-eisenberg-family-depression-center)\n    - [Elizabeth Weiser Caswell Diabetes Institute](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-caswell-diabetes-institute)\n    - [Emergency Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-emergency-medicine)\n    - [Environmental, Social & Governance](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-environmental-social-governance)\n    - [Family Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-family-medicine)\n    - [Fast Forward Medical Innovation](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-fast-forward-medical-innovation)\n    - [Frankel Cardiovascular Center (CVC)](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-frankel-cardiovascular-center)\n    - [Giving to C.S. Mott Children's Hospital](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-cs-mott-childrens-hospital)\n    - [Heinz C. Prechter Bipolar Research Program](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-heinz-c-prechter-bipolar-research-program)\n    - [Human Genetics](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-human-genetics)\n    - [Institute for Healthcare Policy & Innovation](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-institute-healthcare-policy-innovation)\n    - [Internal Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-internal-medicine)\n      \n      - [Allergy and Clinical Immunology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-allergy-and-clinical-immunology)\n      - [MEND](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-mend)\n      - [Nephrology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-nephrology)\n      - [Pulmonary and Critical Care Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-pulmonary-and-critical-care-medicine)\n      - [Rheumatology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-rheumatology)\n      - [Cardiology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-cardiology)\n      - [Gastroenterology\/Hepatology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-gastroenterologyhepatology)\n      - [General Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-general-medicine)\n      - [Genetic Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-genetic-medicine)\n      - [Geriatric and Palliative Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-geriatric-and-palliative-medicine)\n      - [Infectious Diseases](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-infectious-diseases)\n      - [Hematology\/Oncology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-hematologyoncology)\n      - [Hospital Medicine](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/internal-medicine\/giving-hospital-medicine)\n    - [Kresge Hearing Research Institute](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-kresge-hearing-research-institute)\n    - [Learning Health Sciences](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-learning-health-sciences)\n    - [Mary H. Weiser Food Allergy Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-mary-h-weiser-food-allergy-center)\n    - [Medical School Student Programs](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-medical-school-student-programs)\n    - [Michigan Alzheimer's Disease Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-michigan-alzheimers-disease-center)\n    - [Michigan Neuroscience Institute](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-michigan-neuroscience-institute)\n    - [Microbiology & Immunology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-microbiology-immunology)\n    - [Molecular & Integrative Physiology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-molecular-integrative-physiology)\n    - [Nathan and Catherine Forbes Sports Medicine Institute](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-nathan-and-catherine-forbes-sports-medicine-institute)\n    - [Neurology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-neurology)\n    - [Neuroscience Graduate Program](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-neuroscience-graduate-program)\n    - [Neurosurgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-neurosurgery)\n    - [Nursing](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-nursing-michigan)\n    - [Obstetrics & Gynecology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-obstetrics-gynecology)\n    - [Office of Graduate and Postdoctoral Studies](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-office-graduate-and-postdoctoral-studies)\n    - [Office of Patient Experience](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-office-patient-experience)\n    - [Ophthalmology and Visual Sciences](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-ophthalmology-and-visual-sciences)\n    - [Orthopaedic Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-orthopaedic-surgery)\n    - [Otolaryngology-Head and Neck Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-otolaryngology-head-and-neck-surgery)\n    - [Pathology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-pathology)\n    - [Pediatrics](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-pediatrics)\n    - [Pharmacology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-pharmacology)\n    - [Physical Medicine & Rehabilitation](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-physical-medicine-rehabilitation)\n    - [Psychiatry](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-psychiatry)\n    - [Radiation Oncology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-radiation-oncology)\n    - [Radiology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-radiology)\n    - [Social Work](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-social-work)\n    - [Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-surgery)\n      \n      - [General Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-general-surgery)\n      - [Oral and Maxillofacial Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-section-oral-and-maxillofacial-surgery)\n      - [Pediatric Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-section-pediatric-surgery)\n      - [Plastic Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-plastic-surgery)\n      - [Thoracic Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-thoracic-surgery)\n      - [Transplant Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-transplant-surgery)\n      - [Vascular Surgery](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/surgery\/giving-vascular-surgery)\n    - [Transplant Center](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-transplant-center)\n    - [Urology](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-urology)\n    - [Von Voigtlander Women's Hospital](https:\/\/www.michiganmedicine.org\/giving\/areas-support\/giving-von-voigtlander-womens-hospital)\n  - [Campaign](https:\/\/www.michiganmedicine.org\/giving\/look-to-michigan)\n  - [Ways to Give](https:\/\/www.michiganmedicine.org\/giving\/ways-give)\n    \n    - [Annual & Recurring Gifts](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/annual-and-recurring-gifts)\n    - [Corporate and Foundation Gifts](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/corporate-and-foundation-gifts)\n    - [Cryptocurrency](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/cryptocurrency)\n    - [Donor Advised Funds](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/donor-advised-funds)\n    - [Endowments](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/endowments)\n    - [Estate & Planned Gifts](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/estate-and-planned-gifts)\n    - [In-Kind Gifts](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/kind-gifts)\n      \n      - [In-Kind Gifts to C.S. Mott Children's Hospital](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/kind-gifts\/cs-mott-childrens-hospital-kind-giving)\n        \n        - [Giving Library](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/kind-gifts\/kind-gifts-cs-mott-childrens-hospital\/giving-library)\n        - [Mott Toy Store](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/kind-gifts\/kind-gifts-cs-mott-childrens-hospital\/mott-toy-store)\n        - [Toy and Safety Guidelines](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/kind-gifts\/cs-mott-childrens-hospital-kind-giving#toy-safety-guidelines)\n    - [Memorial or Tribute Gifts](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/memorial-or-tribute-gifts)\n    - [Stocks and Securities](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/stocks-and-securities)\n    - [Wire and ACH Payments](https:\/\/www.michiganmedicine.org\/giving\/ways-give\/wire-and-ach-payments)\n  - [Get Involved](https:\/\/www.michiganmedicine.org\/giving\/giving-get-involved)\n  - [Fundraising Events](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events)\n    \n    - [Big Hearts for Seniors](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/big-hearts-seniors)\n      \n      - [Auction](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/big-hearts-seniors\/auction)\n      - [Committee](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/big-hearts-seniors\/big-hearts-seniors-committee)\n      - [Sponsors](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/big-hearts-seniors\/2026-sponsors)\n      - [Sponsorship Opportunities](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/big-hearts-seniors\/big-hearts-seniors-sponsorship-opportunities)\n    - [The Woodson Fund Events](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/woodson-fund-events)\n      \n      - [Event on Main](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/woodson-fund-events\/event-main)\n      - [Golf on Main](https:\/\/www.michiganmedicine.org\/fundraising-events\/woodson-fund-events\/golf-main)\n      - [Sponsors](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/woodson-fund-events\/2026-event-main-golf-main-sponsors)\n      - [Sponsorship Opportunities](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/events-that-inspire-hope\/sponsorship-opportunities)\n    - [Women's Health Luncheon](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/womens-health-luncheon)\n      \n      - [Committee](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/womens-health-luncheon\/womens-health-luncheon-committee)\n      - [Sponsorship Opportunities](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/womens-health-luncheon\/sponsorship-opportunities)\n      - [Sponsors](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/womens-health-luncheon\/sponsors)\n    - [Mott Golf Classic](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/mott-golf-classic)\n      \n      - [Committee Members](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/mott-golf-classic\/committee-members)\n      - [Sponsorship Levels](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/mott-golf-classic\/sponsorship-levels)\n      - [2025 Sponsors](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/mott-golf-classic\/2025-sponsors)\n      - [Contact Information](https:\/\/www.michiganmedicine.org\/giving\/fundraising-events\/mott-golf-classic\/contact-information)\n  - [About the Office of Development](https:\/\/www.michiganmedicine.org\/giving\/about-michigan-medicine-office-development)\n- [News & Stories](https:\/\/www.michiganmedicine.org\/news-and-stories-michigan-medicine)\n  \n  - [Health Lab](https:\/\/www.michiganmedicine.org\/health-lab)\n  - [Medicine at Michigan](https:\/\/www.michiganmedicine.org\/medicine-at-michigan)\n    \n    - [All Stories](https:\/\/www.michiganmedicine.org\/news-stories\/medicine-michigan\/medicine-michigan-all-stories)\n      \n      - 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[Health Lab Podcast](https:\/\/www.michiganmedicine.org\/health-lab-podcast)\n    - [Michigan Answers](https:\/\/www.michiganmedicine.org\/michigan-answers-podcast)\n    - [Michigan Medicine Presents](https:\/\/www.michiganmedicine.org\/michigan-medicine-presents)\n    - [Michigan Medicine Surgery Sessions](https:\/\/www.michiganmedicine.org\/michigan-surgery-sessions)\n    - [Minding Memory](https:\/\/www.michiganmedicine.org\/minding-memory)\n    - [The Fundamentals](https:\/\/www.michiganmedicine.org\/news-stories\/michigan-medicine-podcast-network\/fundamentals)\n    - [Well-Being at Michigan Medicine](https:\/\/www.michiganmedicine.org\/well-being-michigan-medicine)\n  - [Press Room](https:\/\/www.michiganmedicine.org\/news-stories\/michigan-medicine-press-room)\n    \n    - [Clips for Broadcast Media](https:\/\/www.michiganmedicine.org\/news-stories\/press-room\/clips-broadcast-media)\n    - [Contact the Media Team](https:\/\/www.michiganmedicine.org\/news-stories\/press-room\/contact-media-team)\n    - [Patient Privacy and HIPAA](https:\/\/www.michiganmedicine.org\/news-stories\/press-room\/patient-privacy-and-hipaa)\n    - [Research News](https:\/\/www.michiganmedicine.org\/news-stories\/press-room\/research-news)\n\n# When reality fails: What to know about psychosis\nEarly care can make a big difference for teens and young adults who hear, see or think things that aren’t real.\n\nJune 13, 2025 4:00 PM\n\nAuthor \\| [Kara Gavin](https:\/\/www.michiganmedicine.org\/author\/kara-gavin)\n\n![Collage woman pink face confetti and mind](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/article_main_image\/public\/blog\/Collage-Woman-Face-Confetti-Mind_1.jpg?h=bfaa3d24&itok=7ArWx229)\n\n*Originally published June 9, 2022. Updated June 13, 2025 with new information.*\n\nHearing voices. Seeing imaginary people and animals. Feeling paranoid. Thinking others can hear their thoughts.\n\nA teen or young adult experiencing these sensations might get really scared or confused.\n\nThey might think it's something to hide.\n\nThey might try to ignore it and hope it goes away.\n\nAnd they might worry that if they tell a parent, a teacher, a doctor or a friend what's going on, they'll just get laughed at, called crazy or shunned.\n\nWhich is exactly why more people need to know about psychosis, say University of Michigan experts.\n\nThat's the collective term used for these types of experiences, all of which involve a lapse in the brain's \"reality check\" function.\n\nAbout 100,000 teens and young adults experience their first signs of psychosis each year.\n\n> There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes.\n> \n> [Stephan Taylor, M.D.](https:\/\/www.uofmhealth.org\/profile\/53\/stephan-f-taylor-md)\n\nMore awareness could mean more young people with psychosis get into treatment quickly. And that can make a big difference in their immediate mental health and their long-term futures, say psychiatrist [Stephan Taylor, M.D.](https:\/\/www.uofmhealth.org\/profile\/53\/stephan-f-taylor-md), professor and interim chair of Michigan Medicine's Department of Psychiatry.\n\nHe did a [public video chat about this topic](https:\/\/www.youtube.com\/watch?v=TMo_RkYV37s&feature=youtu.be) as part of a Mental Health Awareness Month event with former U-M clinical psychologist [Ivy Tso, Ph.D.](https:\/\/www.uofmhealth.org\/profile\/3319\/ivy-fei-tso-phd)\n\nTaylor and his colleagues run the [Program for Risk Evaluation and Prevention Early Psychosis Clinic](https:\/\/medicine.umich.edu\/dept\/psychiatry\/programs\/prep), called PREP for short.\n\nIt's one of a [growing number of such clinics across the country](https:\/\/nationalepinet.org\/epinet-clinics\/), and also part of a [national index of early psychosis clincis](https:\/\/strong365.org\/early-psychosis-directory).\n\nPsychologist Adrienne Lapidos, Ph.D., another member of the PREP team who is a clinical associate professor of psychiatry, recently launched a [free online course about psychosis](https:\/\/www.coursera.org\/learn\/understanding-psychosis) aimed at health care providers but open to anyone with an interest in learning about the topic. Called Understanding Psychosis, it aims to fill a critical gap in health care education.\n\n### What to know about psychosis\n#### 1\\. It takes many forms – and starts in teen\/young adult years\nA voice occasionally whispering in someone's head.\n\nA faint fleeting shadow glimpsed out of the corner of an eye. A nagging, unshakeable feeling that others are out to get you or want to harm you.\n\nBeing convinced that someone is monitoring what you're thinking or is even controlling you.\n\nSymptoms of psychosis like these most often start in people between the ages of 14 and 30.\n\nThe hallucinations and delusions may be subtle at first but can worsen over time.\n\nAt first, a person may be able to tell that the distorted perceptions aren't real.\n\nBut this ability can fade as they start to lose the power to make an accurate mental model of their reality.\n\n\"They may believe things that are out of sync with other peoples' beliefs or have disorganization of their thoughts that lead them to say things that don't make sense or have confusion about things that should not be confusing,\" said Taylor.\n\n#### 2\\. Psychosis is like a fever: it can happen with many conditions\nPeople can develop fevers as part of infections caused by many kinds of bacteria or viruses.\n\nAnd psychosis symptoms can happen as part of many mental health conditions.\n\nHaving psychosis symptoms could mean someone has schizophrenia – which is the condition that many people think of first with such symptoms.\n\nBut hallucinations, delusions and other psychosis signs could also happen as part of depression, bipolar disorder, post-traumatic stress disorder, autism spectrum disorder or borderline personality disorder.\n\nIn older adults, they can be part of dementia, Alzheimer's disease and Parkinson's disease, among others.\n\nAnd sometimes, people can have mild psychosis symptoms without having a diagnosable mental health condition at all.\n\n\"We didn't previously accept that people could experience voices or delusions and be perfectly functioning members of society without any distress,\" said Taylor.\n\n\"Now we see that in some people, it can be just another dimension of human experience.\n\nBut for people seen in the PREP clinic, symptoms usually interfere with someone's life, education, relationships or ability to work.\n\nThey can cause someone to withdraw from others, to stop eating or even to refuse to see a mental health professional if voices in their head tell them not to.\n\nThey can even cause a person to think about harming themselves or others.\n\nThat's why, said Tso, \"Psychosis can indicate more severe mental illness, so we need to take it seriously,\" by doing a complete evaluation that considers the psychosis symptoms in conjunction with other symptoms.\n\n#### 3\\. There's no one cause for psychosis – but many risk factors\nThe Michigan Medicine PREP team does research to explore the roots of psychosis, as part of a worldwide effort to learn more and develop targeted treatments.\n\nSo far, research at U-M and other research centers has shown that:\n\n- Risk of psychosis is higher in people who have family members who have it, such as parents. But even in identical twins, one can have psychosis and the other – whose DNA is a near-perfect copy – does not. And in general, there is no one gene variation, or collection of genetic factors, that 'cause' mild or severe psychosis. \"Hundreds or thousands of genes can set up vulnerability to schizophrenia,\" said Taylor.\n- The age of onset of psychosis coincides with the ages when the brain is undergoing many changes on its way to maturity.\n- Brain changes can happen in people whose psychosis goes untreated. \"The more relapses and episodes a person has, the more we see that it can permanently change their brain function and structure,\" said Tso. \"And that is something we might not be able to reverse later on even with medication.\" Unfortunately, these changes are very subtle, and there's no specific change in the brain that can be seen on a scan and diagnose schizophrenia or other conditions in a single individual.\n- Intense stress, whether from an early-life trauma, pregnancy or birth complications, intense loneliness, or the onset of adult responsibilities and pressures, have been linked to the risk of psychosis as a trigger for underlying vulnerability.\n- Inflammation, post-infection or autoimmune reactions, where the body's defense systems attack brain tissue, have also been implicated in some, less common forms of psychosis.\n\nThe U-M team is [always looking for people with the condition to volunteer for their studies](https:\/\/umhealthresearch.org\/studies\/HUM00123648) – as well as people who don't have psychosis but want to help with the search for answers by acting as comparisons.\n\nThe U-M team and their counterparts at the [academic network called EPINET](https:\/\/nationalepinet.org\/) are pursuing many more research questions about psychosis.\n\n#### 4\\. The earlier someone gets treatment, the better\nExperts worldwide recommend that no more than three to six months go by between the first signs of psychosis, and the start of treatment.\n\nBut in the United States, that gap averages three years.\n\nGetting more people in to see a specialist who can evaluate them, and recommend next steps, is an urgent need nationwide, says Taylor.\n\nNearly as important as getting started is sticking with the effort to find what will work for the individual.\n\nThat's true within many mental health conditions.\n\nIn order to get someone started on the path to care, Tso says, more people need to know what to look for and what to do.\n\n\"Often the signs are noticed by the people closest to the young person experiencing symptoms,\" she said.\n\n\"If we want to detect it early, then we need to make sure the community is aware of symptoms,\" and the importance of connecting with a school counselor or medical provider who can reach out to specialists.\n\nHowever, while almost all counselors and medical professionals will work with people with psychosis over the course of their careers, many could improve their knowledge and skills related to this population.\n\nLapidos says a better understanding of the psychosis spectrum by health care professionals can lead to early detection and appropriate referrals to specialty care.\n\n“During a first episode of psychosis, the person affected and their family often feel hopeless and afraid. But there is always hope. Recovery is real and it happens all the time,” she said.\n\n“If medical professionals can convey that sense of hope, and place appropriate and timely referrals to specialty care when needed, they can make a huge difference in the trajectory of someone’s life.”\n\n\"There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes,\" Taylor said.\n\n\"When intervention happens early, people get better – though not right away all the time.\"\n\n#### 5\\. Medications work for most; adding talk therapy helps more\nThe group of medications called antipsychotics can quell the psychosis symptoms of about two-thirds of people who take one of them.\n\nThe medications start to have an effect within a week after they start, says Taylor.\n\nThose who don't get help from just one drug can often have success when another is added by an experienced prescriber.\n\nBut getting the dose right, and finding a medication whose side effects are acceptable, can take time and patience.\n\nWeight gain, diabetes and movement-related side effects can result from many of the medications, so the minimum dose that quiets a person's symptoms is best.\n\nResearch is under way to find better medications, and ways to tailor the choice of medication to a person's unique brain mechanisms – but will take time.\n\nIn the meantime, it's important for people taking these medications to take them consistently as directed and to communicate with their provider about side effects.\n\nAnd that can be hard for a young person who may resist being diagnosed with a serious mental illness.\n\nForms of talk therapy such as cognitive behavioral therapy have also proven very effective – both when done one-on-one with a trained therapist, and in group settings, says Tso.\n\nThese can help patients come to terms with having an illness and assist with the kinds of issues that medications often cannot, including social engagement, and skills to improve focus and other cognitive functions.\n\nAdding other supports to help people with psychosis navigate school, work, relationships and life skills has also been proven to improve long-term outcomes, the U-M experts say.\n\nThe PREP Clinic, and others like it nationally, seek to offer this kind of wraparound support.\n\nBut it's not always paid for by insurance companies.\n\n#### 6\\. Violent acts by people experiencing psychosis are rare and mostly impulsive\nThe U-M experts are concerned about the popular perception and media depictions of people with serious mental illness as far more prone to violence than other people.\n\nThis is inaccurate, they say.\n\nIn fact, someone with psychosis is more likely to be a victim of a violent act than to commit one.\n\nBut when someone with uncontrolled psychosis does act in a violent way, it's often a spontaneous, impulsive outburst or physical struggle, not a premeditated act or planned attack, says Taylor.\n\nScapegoating people with any sort of mental illness after violent tragedies such as mass shootings is dangerous, he says, and can increase the already damaging stigma around seeking help.\n\n#### 7\\. Beware the risk of suicide and self-harm\nHaving psychosis does increase the risk that someone might attempt suicide or put themselves in potentially dangerous situations.\n\nSo, it's critical for patients, and those around them, to understand this risk and take steps to reduce it.\n\n\"We know that there are very high rates of suicide in people with psychosis, compared with the general population,\" says Tso. \"Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time.\"\n\nTaylor notes that sometimes, people with psychosis do things that put them in danger, such as going out in extremely cold weather without a coat or even a shirt.\n\nTheir illness keeps them from having insight into the potential harm, and they may even need help from family, friends, health professionals or police to get to safety.\n\nHaving a safety plan ahead of time, which patients and their loved ones can create with their treatment providers, can make a big difference when someone has suicidal thoughts or makes an attempt to end their life.\n\nThis can include having the national [Suicide & Crisis Lifeline](https:\/\/988lifeline.org\/) number, 988, memorized or saved on their phone and written down in prominent places.\n\nAnyone can call or text 988 from a mobile phone, or use webchat on the lifeline's website, to receive help 24 hours a day, seven days a week with any kind of mental health or substance use crisis.\n\nOther crisis plans can include setting up a list of people who the person can confide in when they're having suicidal thoughts or impulses, and who know what to do or can check on them regularly.\n\nPeople at higher risk of suicide and their trusted contacts should also know how to reach their therapist's office or other treatment provider at all hours and know where the nearest psychiatric emergency treatment center is located or how to contact it for advice.\n\nRemoving firearms and other potentially lethal means from the home or locking them away out of sight (with ammunition stored separately in the case of firearms) is also important.\n\nThe impulsive nature of many suicides, especially among young people, makes this important for families of young people with many forms of mental illness.\n\n***\n## More Articles About:\nBrain Health\n\nAdolescent Psychiatric Treatment\n\nAdult Psychiatric Treatment\n\nMental Illness\n\nPharmacy\n\nMental Health\n\n![Health Lab word mark overlaying blue cells](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/article_sidebar\/public\/2026-03\/HL%20Article%20Tag.jpg?h=0afd8502&itok=VtvrqoOD)\n\n## Health Lab\nExplore a variety of health care news & stories by visiting the Health Lab home page for more articles.\n\n### Media Contact\n![](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/2022-10\/u-hospital-spring_large_1130x635.jpg)\n\n### Public Relations\nDepartment of Communication at Michigan Medicine\n\n[MichmedMedia@med.umich.edu](mailto:MichmedMedia@med.umich.edu)\n\n[734-764-2220](tel:734-764-2220)\n\n### In This Story\n![Stephan F. Taylor](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/square_1_1\/public\/2026-01\/stephan_f_taylor_0.jpg?h=d94c4b90&itok=RylR597t)\n\n### Stephan F Taylor\nProfessor\n\n![Adrienne Lapidos](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/square_1_1\/public\/2025-12\/adrienne_lapidos.jpg?h=d94c4b90&itok=NmnsQeeT)\n\n### Adrienne Lapidos, PhD, ABPP\nClinical Associate Professor\n\n### Related\n![lights of different colors in a circular pattern](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/blog\/lights_of_different_colors_in_a_circular_pattern.jpg?h=bfaa3d24&itok=1aIKXKah)\n\nHealth Lab\n\n#### Distorted Reality: What to Do About Early Signs of Psychosis\nSeeing, hearing or perceiving things that aren’t really there may seem like something to hide, but seeking help early can make a big difference.\n\n![](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/blog\/Mich-SuicideLongTerm%2520%25281%2529.jpg?h=bfaa3d24&itok=ZDkdVdX0)\n\nHealth Lab\n\n#### Fewer Deaths Among Adults Who Got Extra Support as Suicidal Teens\nA new study suggests long-term impacts of an approach that encourages involvement of caring adults in the lives of at-risk adolescents.\n\n## Stay Informed\nWant top health & research news weekly? Sign up for Health Lab’s newsletters today\\!\n\nSubscribe\n\nSubscribe\n\n## Featured News & Stories\n![Minding memory above a microphone on a blue background](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/2023-06\/mm_networkpage.jpg?h=51c0859a&itok=W6-1uQXk)\n\nMinding Memory\n\n### Convoys of Caregiving: Arab American Families Living with Dementia\nIn this episode, Matt & Lauren speak with Kristine Ajrouch, PhD - a new member of our CAPRA leadership team. Kristine is a Research Professor at the Institute for Social Research whose work focuses on aging, health, immigration and family in the United Statues and the Middle East; social networks over the life course; and Arab American identity and well-being. Kristine discusses a recent article that examined an intervention to improve outcomes among Arab American caregivers who provide care to a family member living with dementia. She also shares what this work teaches us about caregiving as a family system rather than the responsibility of a single individual.\n\n![teacher with students at table looking at laptop in library ](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/2026-03\/teacher-mentor-students-library-studying.jpg?h=f0fb51a5&itok=Zmgn4E7S)\n\nHealth Lab\n\n### What’s the equivalent of a wheelchair for a person with schizophrenia?\nThree experts, including a Michigan Medicine physician, talks about what psychiatric rehabilitation looks like in the community and for patients.\n\n![Teen girl sitting on floor next to her bed looking at a smartphone, with icons from social media apps layered over her as she frowns](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/2026-03\/teen_girl_social_media_icons_copy.jpg?h=f0fb51a5&itok=W7UxWdc0)\n\nHealth Lab\n\n### How to improve mental health safety on social media – not just for young people\nWith social media companies losing or settling court cases about their products' impact on young peoples' mental health, experts offer tips for reducing impacts for those who use the platforms.\n\n![](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/blog\/UMH_L_Sepsis%25401x.jpg?h=bfaa3d24&itok=i4Wbz8i1)\n\nHealth Lab\n\n### Surviving sepsis: New guidelines harness life saving evidence for treating adults\nAn updated clinical guideline for treating sepsis in adults emphasizes pre-hospital care and judicious use of antibiotics and antifungals\n\n![Minding Memory with a microphone and a shadow of a microphone on a blue background](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/2023-05\/MEM_900x1200.jpg?h=9b0ae1d9&itok=IPCQhXyT)\n\nMinding Memory\n\n### Neighborhood Income and Cognitive Health\nWelcome back to Minding Memory! In today’s episode, Lauren & Matt speak with Dr. Laura Zahodne – a professor of psychology at the University of Michigan and an affiliate of the Institute for Social Research. She's a clinical neuropsychologist by training and studies how psychosocial experiences shape late life, cognitive health, and risk of neurodegenerative disease. Also, a new member of our CAPRA leadership team! In this episode, we’ll get to know Laura a little better and talk with her about one of her research studies, the Neighborhood Racial Income Inequality in Cognitive Health, which looks at the association between racial income differences and a variety of cognitive measures.\n\n![kids hugging legs with jeans on green light blue striped shirt white sneakers next to person with green shirt writing on white notepad](https:\/\/www.michiganmedicine.org\/sites\/default\/files\/styles\/card\/public\/2026-03\/child-couch-therapy-session-clipboard-.jpg?h=f0fb51a5&itok=HcnKp0Pp)\n\nHealth Lab\n\n### A new way to close the pediatric mental health gap\nInnovative model successfully improves access to pediatric psychiatric health care, while training future pediatricians to manage common mental health conditions, new data suggests.\n\n[Facebook](https:\/\/www.michiganmedicine.org\/#facebook)\n\n[X](https:\/\/www.michiganmedicine.org\/#x)\n\n[Email](https:\/\/www.michiganmedicine.org\/#email)\n\n[Bluesky](https:\/\/www.michiganmedicine.org\/#bluesky)\n\n[Share](https:\/\/www.addtoany.com\/share#url=https%3A%2F%2Fwww.michiganmedicine.org%2Fhealth-lab%2Fwhen-reality-fails-what-know-about-psychosis&title=When%20reality%20fails%3A%20What%20to%20know%20about%20psychosis)\n\n[Facebook](https:\/\/www.michiganmedicine.org\/#facebook)\n\n[X](https:\/\/www.michiganmedicine.org\/#x)\n\n[Email](https:\/\/www.michiganmedicine.org\/#email)\n\n[Bluesky](https:\/\/www.michiganmedicine.org\/#bluesky)\n\n[Share](https:\/\/www.addtoany.com\/share#url=https%3A%2F%2Fwww.michiganmedicine.org%2Fhealth-lab%2Fwhen-reality-fails-what-know-about-psychosis&title=When%20reality%20fails%3A%20What%20to%20know%20about%20psychosis)\n\n![logo](https:\/\/www.michiganmedicine.org\/themes\/custom\/outline_frontend\/mm-logo-white-text.svg)\n\nWe transform lives through bold discovery, compassionate care and innovative education.\n\n- [Michigan Medicine](https:\/\/www.michiganmedicine.org\/)\n  \n  - [About](https:\/\/www.michiganmedicine.org\/about-us)\n  - [Mission](https:\/\/www.michiganmedicine.org\/michigan-medicine-mission)\n  - [Community](https:\/\/www.michiganmedicine.org\/community)\n  - [Giving](https:\/\/www.michiganmedicine.org\/giving)\n  - [News & Stories](https:\/\/www.michiganmedicine.org\/news-and-stories-michigan-medicine)\n- [Patient Care](https:\/\/www.uofmhealth.org\/)\n  \n  - [Find a Doctor](https:\/\/www.uofmhealth.org\/find-a-doctor)\n  - [Patient & Visitor Guide](https:\/\/www.uofmhealth.org\/patients-visitors)\n  - [Patient Portal Login](https:\/\/www.myuofmhealth.org\/MyChart-PRD\/Authentication\/Login)\n- [Research](https:\/\/medresearch.umich.edu\/)\n  \n  - [Clinical Trials](https:\/\/medresearch.umich.edu\/clinical-studies)\n  - [Research Labs](https:\/\/medresearch.umich.edu\/labs-departments\/labs)\n  - [Research Centers](https:\/\/medresearch.umich.edu\/labs-departments\/centers)\n  - [Cores and Resources](https:\/\/medresearch.umich.edu\/office-research\/cores-resources)\n- [Education](https:\/\/medschool.umich.edu\/)\n  \n  - [Programs & Admissions](https:\/\/medschool.umich.edu\/programs-admissions)\n  - [Our Community](https:\/\/medschool.umich.edu\/our-community)\n  - [Departments, Centers & Offices](https:\/\/medschool.umich.edu\/departments-centers-offices)\n  - [About the Medical School](https:\/\/medschool.umich.edu\/about-university-michigan-medical-school \"About the University of Michigan Medical School\")\n  - [Intranet](https:\/\/umhealth.sharepoint.com\/sites\/msa)\n\nYour gift changes lives. It’s never been easier to make an impact.\n\nMake a Gift\n\nAccelerate your career. Advance world health.\n\nCareers at Michigan Medicine\n\nReport Sexual Misconduct, Discrimination and Harassment\n\n## Global Footer Secondary Navigation\n© Copyright 1995-2026 Regents of the University of Michigan\n\nAccessibility Statement\n\nCommunication Preferences\n\nDisclaimer\n\nInternet Privacy\n\nPatient Privacy\n\nU-M Non-Discrimination\n\nDepartment of Communication\n\nHealth Information Technology & Services\n\nMichigan Medicine Finance\n\n[Jump back to top](https:\/\/www.michiganmedicine.org\/health-lab\/when-reality-fails-what-know-about-psychosis#main-content)\n\n✓\n\nThanks for sharing\\!\n\n[AddToAny](https:\/\/www.addtoany.com\/ \"Share Buttons\")\n\n[More…](https:\/\/www.michiganmedicine.org\/health-lab\/when-reality-fails-what-know-about-psychosis#addtoany \"Show all\")","attrs_readable_markdown":"### What to know about psychosis\n#### 1\\. It takes many forms – and starts in teen\/young adult years\nA voice occasionally whispering in someone's head.\n\nA faint fleeting shadow glimpsed out of the corner of an eye. A nagging, unshakeable feeling that others are out to get you or want to harm you.\n\nBeing convinced that someone is monitoring what you're thinking or is even controlling you.\n\nSymptoms of psychosis like these most often start in people between the ages of 14 and 30.\n\nThe hallucinations and delusions may be subtle at first but can worsen over time.\n\nAt first, a person may be able to tell that the distorted perceptions aren't real.\n\nBut this ability can fade as they start to lose the power to make an accurate mental model of their reality.\n\n\"They may believe things that are out of sync with other peoples' beliefs or have disorganization of their thoughts that lead them to say things that don't make sense or have confusion about things that should not be confusing,\" said Taylor.\n\n#### 2\\. Psychosis is like a fever: it can happen with many conditions\nPeople can develop fevers as part of infections caused by many kinds of bacteria or viruses.\n\nAnd psychosis symptoms can happen as part of many mental health conditions.\n\nHaving psychosis symptoms could mean someone has schizophrenia – which is the condition that many people think of first with such symptoms.\n\nBut hallucinations, delusions and other psychosis signs could also happen as part of depression, bipolar disorder, post-traumatic stress disorder, autism spectrum disorder or borderline personality disorder.\n\nIn older adults, they can be part of dementia, Alzheimer's disease and Parkinson's disease, among others.\n\nAnd sometimes, people can have mild psychosis symptoms without having a diagnosable mental health condition at all.\n\n\"We didn't previously accept that people could experience voices or delusions and be perfectly functioning members of society without any distress,\" said Taylor.\n\n\"Now we see that in some people, it can be just another dimension of human experience.\n\nBut for people seen in the PREP clinic, symptoms usually interfere with someone's life, education, relationships or ability to work.\n\nThey can cause someone to withdraw from others, to stop eating or even to refuse to see a mental health professional if voices in their head tell them not to.\n\nThey can even cause a person to think about harming themselves or others.\n\nThat's why, said Tso, \"Psychosis can indicate more severe mental illness, so we need to take it seriously,\" by doing a complete evaluation that considers the psychosis symptoms in conjunction with other symptoms.\n\n#### 3\\. There's no one cause for psychosis – but many risk factors\nThe Michigan Medicine PREP team does research to explore the roots of psychosis, as part of a worldwide effort to learn more and develop targeted treatments.\n\nSo far, research at U-M and other research centers has shown that:\n\n- Risk of psychosis is higher in people who have family members who have it, such as parents. But even in identical twins, one can have psychosis and the other – whose DNA is a near-perfect copy – does not. And in general, there is no one gene variation, or collection of genetic factors, that 'cause' mild or severe psychosis. \"Hundreds or thousands of genes can set up vulnerability to schizophrenia,\" said Taylor.\n- The age of onset of psychosis coincides with the ages when the brain is undergoing many changes on its way to maturity.\n- Brain changes can happen in people whose psychosis goes untreated. \"The more relapses and episodes a person has, the more we see that it can permanently change their brain function and structure,\" said Tso. \"And that is something we might not be able to reverse later on even with medication.\" Unfortunately, these changes are very subtle, and there's no specific change in the brain that can be seen on a scan and diagnose schizophrenia or other conditions in a single individual.\n- Intense stress, whether from an early-life trauma, pregnancy or birth complications, intense loneliness, or the onset of adult responsibilities and pressures, have been linked to the risk of psychosis as a trigger for underlying vulnerability.\n- Inflammation, post-infection or autoimmune reactions, where the body's defense systems attack brain tissue, have also been implicated in some, less common forms of psychosis.\n\nThe U-M team is [always looking for people with the condition to volunteer for their studies](https:\/\/umhealthresearch.org\/studies\/HUM00123648) – as well as people who don't have psychosis but want to help with the search for answers by acting as comparisons.\n\nThe U-M team and their counterparts at the [academic network called EPINET](https:\/\/nationalepinet.org\/) are pursuing many more research questions about psychosis.\n\n#### 4\\. The earlier someone gets treatment, the better\nExperts worldwide recommend that no more than three to six months go by between the first signs of psychosis, and the start of treatment.\n\nBut in the United States, that gap averages three years.\n\nGetting more people in to see a specialist who can evaluate them, and recommend next steps, is an urgent need nationwide, says Taylor.\n\nNearly as important as getting started is sticking with the effort to find what will work for the individual.\n\nThat's true within many mental health conditions.\n\nIn order to get someone started on the path to care, Tso says, more people need to know what to look for and what to do.\n\n\"Often the signs are noticed by the people closest to the young person experiencing symptoms,\" she said.\n\n\"If we want to detect it early, then we need to make sure the community is aware of symptoms,\" and the importance of connecting with a school counselor or medical provider who can reach out to specialists.\n\nHowever, while almost all counselors and medical professionals will work with people with psychosis over the course of their careers, many could improve their knowledge and skills related to this population.\n\nLapidos says a better understanding of the psychosis spectrum by health care professionals can lead to early detection and appropriate referrals to specialty care.\n\n“During a first episode of psychosis, the person affected and their family often feel hopeless and afraid. But there is always hope. Recovery is real and it happens all the time,” she said.\n\n“If medical professionals can convey that sense of hope, and place appropriate and timely referrals to specialty care when needed, they can make a huge difference in the trajectory of someone’s life.”\n\n\"There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes,\" Taylor said.\n\n\"When intervention happens early, people get better – though not right away all the time.\"\n\n#### 5\\. Medications work for most; adding talk therapy helps more\nThe group of medications called antipsychotics can quell the psychosis symptoms of about two-thirds of people who take one of them.\n\nThe medications start to have an effect within a week after they start, says Taylor.\n\nThose who don't get help from just one drug can often have success when another is added by an experienced prescriber.\n\nBut getting the dose right, and finding a medication whose side effects are acceptable, can take time and patience.\n\nWeight gain, diabetes and movement-related side effects can result from many of the medications, so the minimum dose that quiets a person's symptoms is best.\n\nResearch is under way to find better medications, and ways to tailor the choice of medication to a person's unique brain mechanisms – but will take time.\n\nIn the meantime, it's important for people taking these medications to take them consistently as directed and to communicate with their provider about side effects.\n\nAnd that can be hard for a young person who may resist being diagnosed with a serious mental illness.\n\nForms of talk therapy such as cognitive behavioral therapy have also proven very effective – both when done one-on-one with a trained therapist, and in group settings, says Tso.\n\nThese can help patients come to terms with having an illness and assist with the kinds of issues that medications often cannot, including social engagement, and skills to improve focus and other cognitive functions.\n\nAdding other supports to help people with psychosis navigate school, work, relationships and life skills has also been proven to improve long-term outcomes, the U-M experts say.\n\nThe PREP Clinic, and others like it nationally, seek to offer this kind of wraparound support.\n\nBut it's not always paid for by insurance companies.\n\n#### 6\\. Violent acts by people experiencing psychosis are rare and mostly impulsive\nThe U-M experts are concerned about the popular perception and media depictions of people with serious mental illness as far more prone to violence than other people.\n\nThis is inaccurate, they say.\n\nIn fact, someone with psychosis is more likely to be a victim of a violent act than to commit one.\n\nBut when someone with uncontrolled psychosis does act in a violent way, it's often a spontaneous, impulsive outburst or physical struggle, not a premeditated act or planned attack, says Taylor.\n\nScapegoating people with any sort of mental illness after violent tragedies such as mass shootings is dangerous, he says, and can increase the already damaging stigma around seeking help.\n\n#### 7\\. Beware the risk of suicide and self-harm\nHaving psychosis does increase the risk that someone might attempt suicide or put themselves in potentially dangerous situations.\n\nSo, it's critical for patients, and those around them, to understand this risk and take steps to reduce it.\n\n\"We know that there are very high rates of suicide in people with psychosis, compared with the general population,\" says Tso. \"Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time.\"\n\nTaylor notes that sometimes, people with psychosis do things that put them in danger, such as going out in extremely cold weather without a coat or even a shirt.\n\nTheir illness keeps them from having insight into the potential harm, and they may even need help from family, friends, health professionals or police to get to safety.\n\nHaving a safety plan ahead of time, which patients and their loved ones can create with their treatment providers, can make a big difference when someone has suicidal thoughts or makes an attempt to end their life.\n\nThis can include having the national [Suicide & Crisis Lifeline](https:\/\/988lifeline.org\/) number, 988, memorized or saved on their phone and written down in prominent places.\n\nAnyone can call or text 988 from a mobile phone, or use webchat on the lifeline's website, to receive help 24 hours a day, seven days a week with any kind of mental health or substance use crisis.\n\nOther crisis plans can include setting up a list of people who the person can confide in when they're having suicidal thoughts or impulses, and who know what to do or can check on them regularly.\n\nPeople at higher risk of suicide and their trusted contacts should also know how to reach their therapist's office or other treatment provider at all hours and know where the nearest psychiatric emergency treatment center is located or how to contact it for advice.\n\nRemoving firearms and other potentially lethal means from the home or locking them away out of sight (with ammunition stored separately in the case of firearms) is also important.\n\nThe impulsive nature of many suicides, especially among young people, makes this important for families of young people with many forms of mental illness.","meta_canonical":null}

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Meta Title	When reality fails: What to know about psychosis
Meta Description	Delusions, hearing voices, hallucinations, and other symptoms of psychosis can be treated and the earlier treatment begins, the better
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Boilerpipe Text	What to know about psychosis 1. It takes many forms – and starts in teen/young adult years A voice occasionally whispering in someone's head. A faint fleeting shadow glimpsed out of the corner of an eye. A nagging, unshakeable feeling that others are out to get you or want to harm you. Being convinced that someone is monitoring what you're thinking or is even controlling you. Symptoms of psychosis like these most often start in people between the ages of 14 and 30. The hallucinations and delusions may be subtle at first but can worsen over time. At first, a person may be able to tell that the distorted perceptions aren't real. But this ability can fade as they start to lose the power to make an accurate mental model of their reality. "They may believe things that are out of sync with other peoples' beliefs or have disorganization of their thoughts that lead them to say things that don't make sense or have confusion about things that should not be confusing," said Taylor. 2. Psychosis is like a fever: it can happen with many conditions People can develop fevers as part of infections caused by many kinds of bacteria or viruses. And psychosis symptoms can happen as part of many mental health conditions. Having psychosis symptoms could mean someone has schizophrenia – which is the condition that many people think of first with such symptoms. But hallucinations, delusions and other psychosis signs could also happen as part of depression, bipolar disorder, post-traumatic stress disorder, autism spectrum disorder or borderline personality disorder. In older adults, they can be part of dementia, Alzheimer's disease and Parkinson's disease, among others. And sometimes, people can have mild psychosis symptoms without having a diagnosable mental health condition at all. "We didn't previously accept that people could experience voices or delusions and be perfectly functioning members of society without any distress," said Taylor. "Now we see that in some people, it can be just another dimension of human experience. But for people seen in the PREP clinic, symptoms usually interfere with someone's life, education, relationships or ability to work. They can cause someone to withdraw from others, to stop eating or even to refuse to see a mental health professional if voices in their head tell them not to. They can even cause a person to think about harming themselves or others. That's why, said Tso, "Psychosis can indicate more severe mental illness, so we need to take it seriously," by doing a complete evaluation that considers the psychosis symptoms in conjunction with other symptoms. 3. There's no one cause for psychosis – but many risk factors The Michigan Medicine PREP team does research to explore the roots of psychosis, as part of a worldwide effort to learn more and develop targeted treatments. So far, research at U-M and other research centers has shown that: Risk of psychosis is higher in people who have family members who have it, such as parents. But even in identical twins, one can have psychosis and the other – whose DNA is a near-perfect copy – does not. And in general, there is no one gene variation, or collection of genetic factors, that 'cause' mild or severe psychosis. "Hundreds or thousands of genes can set up vulnerability to schizophrenia," said Taylor. The age of onset of psychosis coincides with the ages when the brain is undergoing many changes on its way to maturity. Brain changes can happen in people whose psychosis goes untreated. "The more relapses and episodes a person has, the more we see that it can permanently change their brain function and structure," said Tso. "And that is something we might not be able to reverse later on even with medication." Unfortunately, these changes are very subtle, and there's no specific change in the brain that can be seen on a scan and diagnose schizophrenia or other conditions in a single individual. Intense stress, whether from an early-life trauma, pregnancy or birth complications, intense loneliness, or the onset of adult responsibilities and pressures, have been linked to the risk of psychosis as a trigger for underlying vulnerability. Inflammation, post-infection or autoimmune reactions, where the body's defense systems attack brain tissue, have also been implicated in some, less common forms of psychosis. The U-M team is always looking for people with the condition to volunteer for their studies – as well as people who don't have psychosis but want to help with the search for answers by acting as comparisons. The U-M team and their counterparts at the academic network called EPINET are pursuing many more research questions about psychosis. 4. The earlier someone gets treatment, the better Experts worldwide recommend that no more than three to six months go by between the first signs of psychosis, and the start of treatment. But in the United States, that gap averages three years. Getting more people in to see a specialist who can evaluate them, and recommend next steps, is an urgent need nationwide, says Taylor. Nearly as important as getting started is sticking with the effort to find what will work for the individual. That's true within many mental health conditions. In order to get someone started on the path to care, Tso says, more people need to know what to look for and what to do. "Often the signs are noticed by the people closest to the young person experiencing symptoms," she said. "If we want to detect it early, then we need to make sure the community is aware of symptoms," and the importance of connecting with a school counselor or medical provider who can reach out to specialists. However, while almost all counselors and medical professionals will work with people with psychosis over the course of their careers, many could improve their knowledge and skills related to this population. Lapidos says a better understanding of the psychosis spectrum by health care professionals can lead to early detection and appropriate referrals to specialty care. “During a first episode of psychosis, the person affected and their family often feel hopeless and afraid. But there is always hope. Recovery is real and it happens all the time,” she said. “If medical professionals can convey that sense of hope, and place appropriate and timely referrals to specialty care when needed, they can make a huge difference in the trajectory of someone’s life.” "There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes," Taylor said. "When intervention happens early, people get better – though not right away all the time." 5. Medications work for most; adding talk therapy helps more The group of medications called antipsychotics can quell the psychosis symptoms of about two-thirds of people who take one of them. The medications start to have an effect within a week after they start, says Taylor. Those who don't get help from just one drug can often have success when another is added by an experienced prescriber. But getting the dose right, and finding a medication whose side effects are acceptable, can take time and patience. Weight gain, diabetes and movement-related side effects can result from many of the medications, so the minimum dose that quiets a person's symptoms is best. Research is under way to find better medications, and ways to tailor the choice of medication to a person's unique brain mechanisms – but will take time. In the meantime, it's important for people taking these medications to take them consistently as directed and to communicate with their provider about side effects. And that can be hard for a young person who may resist being diagnosed with a serious mental illness. Forms of talk therapy such as cognitive behavioral therapy have also proven very effective – both when done one-on-one with a trained therapist, and in group settings, says Tso. These can help patients come to terms with having an illness and assist with the kinds of issues that medications often cannot, including social engagement, and skills to improve focus and other cognitive functions. Adding other supports to help people with psychosis navigate school, work, relationships and life skills has also been proven to improve long-term outcomes, the U-M experts say. The PREP Clinic, and others like it nationally, seek to offer this kind of wraparound support. But it's not always paid for by insurance companies. 6. Violent acts by people experiencing psychosis are rare and mostly impulsive The U-M experts are concerned about the popular perception and media depictions of people with serious mental illness as far more prone to violence than other people. This is inaccurate, they say. In fact, someone with psychosis is more likely to be a victim of a violent act than to commit one. But when someone with uncontrolled psychosis does act in a violent way, it's often a spontaneous, impulsive outburst or physical struggle, not a premeditated act or planned attack, says Taylor. Scapegoating people with any sort of mental illness after violent tragedies such as mass shootings is dangerous, he says, and can increase the already damaging stigma around seeking help. 7. Beware the risk of suicide and self-harm Having psychosis does increase the risk that someone might attempt suicide or put themselves in potentially dangerous situations. So, it's critical for patients, and those around them, to understand this risk and take steps to reduce it. "We know that there are very high rates of suicide in people with psychosis, compared with the general population," says Tso. "Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time." Taylor notes that sometimes, people with psychosis do things that put them in danger, such as going out in extremely cold weather without a coat or even a shirt. Their illness keeps them from having insight into the potential harm, and they may even need help from family, friends, health professionals or police to get to safety. Having a safety plan ahead of time, which patients and their loved ones can create with their treatment providers, can make a big difference when someone has suicidal thoughts or makes an attempt to end their life. This can include having the national Suicide & Crisis Lifeline number, 988, memorized or saved on their phone and written down in prominent places. Anyone can call or text 988 from a mobile phone, or use webchat on the lifeline's website, to receive help 24 hours a day, seven days a week with any kind of mental health or substance use crisis. Other crisis plans can include setting up a list of people who the person can confide in when they're having suicidal thoughts or impulses, and who know what to do or can check on them regularly. People at higher risk of suicide and their trusted contacts should also know how to reach their therapist's office or other treatment provider at all hours and know where the nearest psychiatric emergency treatment center is located or how to contact it for advice. Removing firearms and other potentially lethal means from the home or locking them away out of sight (with ammunition stored separately in the case of firearms) is also important. The impulsive nature of many suicides, especially among young people, makes this important for families of young people with many forms of mental illness.
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[Get Involved](https://www.michiganmedicine.org/community/arts-health/get-involved-arts-health) - [Exhibit or Perform](https://www.michiganmedicine.org/community/arts-health/get-involved/exhibit-or-perform-arts-health) - [Make Art Now](https://www.michiganmedicine.org/community/arts-health/get-involved/make-art-now) - [Volunteer](https://www.michiganmedicine.org/community/arts-health/get-involved/volunteer-arts-health) - [Donate](https://www.michiganmedicine.org/community/arts-health/get-involved/donate-arts-health) - [Programs & Services](https://www.michiganmedicine.org/community/arts-health/arts-programs-and-services) - [Performances & Events](https://www.michiganmedicine.org/community/arts-health/programs-services/performances-and-events) - [Watch a Concert Now](https://www.michiganmedicine.org/community/arts-health/programs-services/performances-events/watch-concert-now) - [Art Exhibits](https://www.michiganmedicine.org/community/arts-health/programs-services/art-exhibits) - [Permanent Art Collection](https://www.michiganmedicine.org/community/arts-health/programs-services/art-exhibits/permanent-art-collection) - [Art Purchase](https://www.michiganmedicine.org/community/arts-health/programs-services/art-exhibits/art-purchase) - [Community Art](https://www.michiganmedicine.org/community/arts-health/programs-services/art-exhibits/community-art) - [Exhibiting Artist Info](https://www.michiganmedicine.org/community/arts-health/programs-services/art-exhibits/how-exhibit) - [Gallery Diagrams & Info](https://www.michiganmedicine.org/community/arts-health/programs-services/art-exhibits/exhibiting-artist-info/gallery-diagrams-and-info) - [Patient Services](https://www.michiganmedicine.org/community/arts-health/programs-services/arts-health-patient-services) - [Art Cart Posters](https://www.michiganmedicine.org/community/arts-health/programs-services/patient-services/art-cart-posters) - [Bedside Art Program](https://www.michiganmedicine.org/community/arts-health/programs-services/patient-services/bedside-art-program) - [Bedside Music Program](https://www.michiganmedicine.org/community/arts-health/programs-services/patient-services/bedside-music-program) - [Bedside Story Studio](https://www.michiganmedicine.org/community/arts-health/programs-services/patient-services/bedside-story-studio) - [Arts Wellness Resources](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources) - [Art Resources](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/art-resources) - [Hospital Arts Projects](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/art-resources/hospital-arts-projects) - [Coloring Books](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/art-resources/hospital-arts-projects/coloring-books) - [Comfort Legacy Kits](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/art-resources/hospital-arts-projects/comfort-legacy-kits) - [Hamsa Hands](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/art-resources/hospital-arts-projects/hamsa-hands) - [Music Resources](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/music-resources) - [Nature Resources](https://www.michiganmedicine.org/community/arts-health/arts-wellness-resources/nature-resources) - [Life Sciences Orchestra](https://www.michiganmedicine.org/community/arts-health/life-sciences-orchestra) - [About the Life Sciences Orchestra](https://www.michiganmedicine.org/community/arts-health/life-sciences-orchestra/about-life-sciences-orchestra) - [Give to the Life Sciences Orchestra](https://www.michiganmedicine.org/community/arts-health/life-sciences-orchestra/give-life-sciences-orchestra) - [Join the Life Sciences Orchestra](https://www.michiganmedicine.org/community/arts-health/life-sciences-orchestra/join-life-sciences-orchestra) - [Community Health Planning & Investment](https://www.michiganmedicine.org/community/community-health-planning-and-investment) - [About Community Health Planning and Investment](https://www.michiganmedicine.org/community/community-health-planning-investment/about-community-health-planning-and-investment) - [Community Health Investments](https://www.michiganmedicine.org/community/community-health-planning-investment/community-health-investments) - [Community Health Needs Assessment (CHNA)](https://www.michiganmedicine.org/community/community-health-planning-investment/community-health-needs-assessment-implementation-plan-chna) - [Community Outreach and Engagement Programs](https://www.michiganmedicine.org/community/community-health-planning-investment/community-outreach-and-engagement-programs) - [Life-Saving Donations](https://www.michiganmedicine.org/community/life-saving-donations-home) - [Donate Blood](https://www.michiganmedicine.org/community/life-saving-donations/donate-blood-save-lives) - [Share Your Story](https://www.michiganmedicine.org/community/life-saving-donations/share-your-life-saving-donation-story) - [Become a Volunteer](https://www.michiganmedicine.org/community/life-saving-donations/become-wolverines-life-volunteer) - [Osher Lifelong Learning Institute (OLLI)](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute) - [About Osher Lifelong Learning Institute](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute-olli/about-osher-lifelong-learning-institute) - [Donate Now to OLLI](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute-olli/donate-now-olli) - [Join OLLI](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute-olli/join-olli) - [OLLI Programs and Activities](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute-olli/olli-programs-and-activities) - [OLLI Volunteer Information](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute-olli/olli-volunteer-information) - [OLLI Volunteer Roles](https://www.michiganmedicine.org/community/osher-lifelong-learning-institute-olli/olli-volunteer-information/olli-volunteer-roles) - [Sponsorship](https://www.michiganmedicine.org/community/community-sponsorship) - [Frequently Asked Questions About Sponsorship](https://www.michiganmedicine.org/community/sponsorship/frequently-asked-questions-about-sponsorship) - [Environmental, Social & Governance](https://www.michiganmedicine.org/community/environmental-social-governance) - [Environmental Sustainability & Carbon Neutrality](https://www.michiganmedicine.org/community/environmental-social-governance/environmental-sustainability-carbon-neutrality) - [Giving](https://www.michiganmedicine.org/giving) - [Areas to Support](https://www.michiganmedicine.org/giving/areas-support) - [Medical School Scholarships](https://www.michiganmedicine.org/giving/areas-support/giving-medical-school-scholarships) - [Rogel Cancer Center](https://www.michiganmedicine.org/giving/areas-support/giving-rogel-cancer-center) - [Forbes Institute for Cancer Discovery](https://www.michiganmedicine.org/giving/areas-support/rogel-cancer-center/giving-forbes-institute-cancer-discovery) - [Rogel and Blondy Center for Pancreatic Cancer](https://www.michiganmedicine.org/giving/areas-support/rogel-cancer-center/giving-rogel-and-blondy-center-pancreatic-cancer) - [Ronald Weiser Center for Prostate Cancer](https://www.michiganmedicine.org/giving/areas-support/rogel-cancer-center/giving-ronald-weiser-center-prostate-cancer) - [Weiser Family Center for Breast Cancer](https://www.michiganmedicine.org/giving/areas-support/rogel-cancer-center/giving-weiser-family-center-breast-cancer) - [A. Alfred Taubman Medical Research Institute](https://www.michiganmedicine.org/giving/areas-support/giving-alfred-taubman-medical-research-institute) - [Alumni Class Giving](https://www.michiganmedicine.org/giving/areas-support/medical-school-alumni-class-giving) - [Anesthesiology](https://www.michiganmedicine.org/giving/areas-support/giving-anesthesiology) - [Biological Chemistry](https://www.michiganmedicine.org/giving/areas-support/giving-biological-chemistry) - [Biomedical Engineering](https://www.michiganmedicine.org/giving/areas-support/giving-biomedical-engineering) - [CSI Singapore-Rogel Cancer Center partnership](https://www.michiganmedicine.org/giving/areas-support/giving-csi-singapore-rogel-cancer-center-partnership) - [Cardiac Surgery](https://www.michiganmedicine.org/giving/areas-support/giving-cardiac-surgery) - [Cell & Developmental Biology](https://www.michiganmedicine.org/giving/areas-support/giving-cell-developmental-biology) - [Chad Carr Pediatric Brain Tumor Center](https://www.michiganmedicine.org/giving/areas-support/giving-chad-carr-pediatric-brain-tumor-center) - [Community Health Services](https://www.michiganmedicine.org/giving/areas-support/community-health-services) - [Adolescent Health Initiative](https://www.michiganmedicine.org/giving/areas-support/community-health-services/adolescent-health-initiative) - [Ann Arbor Meals on Wheels](https://www.michiganmedicine.org/giving/areas-support/community-health-services/ann-arbor-meals-wheels) - [Housing Bureau for Seniors](https://www.michiganmedicine.org/giving/areas-support/community-health-services/housing-bureau-seniors) - [Osher Lifelong Learning Institute (OLLI)](https://www.michiganmedicine.org/giving/areas-support/community-health-services/osher-lifelong-learning-institute) - [Regional Alliance for Healthy Schools](https://www.michiganmedicine.org/giving/areas-support/community-health-services/regional-alliance-healthy-schools) - [Silver Club Memory Programs](https://www.michiganmedicine.org/giving/areas-support/community-health-services/silver-club-memory-programs) - [Turner African American Services Council](https://www.michiganmedicine.org/giving/areas-support/community-health-services/turner-african-american-services-council) - [Turner Senior Wellness Program](https://www.michiganmedicine.org/giving/areas-support/community-health-services/turner-senior-wellness-program) - [Volunteer Services](https://www.michiganmedicine.org/giving/areas-support/community-health-services/volunteer-services) - [Computational Medicine & Bioinformatics](https://www.michiganmedicine.org/giving/areas-support/giving-gilbert-s-omenn-department-computational-medicine-and-bioinformatics) - [Congenital Heart Center](https://www.michiganmedicine.org/giving/areas-support/giving-congenital-heart-center) - [Dermatology](https://www.michiganmedicine.org/giving/areas-support/giving-dermatology) - [Eisenberg Family Depression Center](https://www.michiganmedicine.org/giving/areas-support/giving-eisenberg-family-depression-center) - [Elizabeth Weiser Caswell Diabetes Institute](https://www.michiganmedicine.org/giving/areas-support/giving-caswell-diabetes-institute) - [Emergency Medicine](https://www.michiganmedicine.org/giving/areas-support/giving-emergency-medicine) - [Environmental, Social & Governance](https://www.michiganmedicine.org/giving/areas-support/giving-environmental-social-governance) - [Family Medicine](https://www.michiganmedicine.org/giving/areas-support/giving-family-medicine) - [Fast Forward Medical Innovation](https://www.michiganmedicine.org/giving/areas-support/giving-fast-forward-medical-innovation) - [Frankel Cardiovascular Center (CVC)](https://www.michiganmedicine.org/giving/areas-support/giving-frankel-cardiovascular-center) - [Giving to C.S. Mott Children's Hospital](https://www.michiganmedicine.org/giving/areas-support/giving-cs-mott-childrens-hospital) - [Heinz C. Prechter Bipolar Research Program](https://www.michiganmedicine.org/giving/areas-support/giving-heinz-c-prechter-bipolar-research-program) - [Human Genetics](https://www.michiganmedicine.org/giving/areas-support/giving-human-genetics) - [Institute for Healthcare Policy & Innovation](https://www.michiganmedicine.org/giving/areas-support/giving-institute-healthcare-policy-innovation) - [Internal Medicine](https://www.michiganmedicine.org/giving/areas-support/giving-internal-medicine) - [Allergy and Clinical Immunology](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-allergy-and-clinical-immunology) - [MEND](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-mend) - [Nephrology](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-nephrology) - [Pulmonary and Critical Care Medicine](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-pulmonary-and-critical-care-medicine) - [Rheumatology](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-rheumatology) - [Cardiology](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-cardiology) - [Gastroenterology/Hepatology](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-gastroenterologyhepatology) - [General Medicine](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-general-medicine) - [Genetic Medicine](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-genetic-medicine) - [Geriatric and Palliative Medicine](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-geriatric-and-palliative-medicine) - [Infectious Diseases](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-infectious-diseases) - [Hematology/Oncology](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-hematologyoncology) - [Hospital Medicine](https://www.michiganmedicine.org/giving/areas-support/internal-medicine/giving-hospital-medicine) - [Kresge Hearing Research Institute](https://www.michiganmedicine.org/giving/areas-support/giving-kresge-hearing-research-institute) - [Learning Health Sciences](https://www.michiganmedicine.org/giving/areas-support/giving-learning-health-sciences) - [Mary H. Weiser Food Allergy Center](https://www.michiganmedicine.org/giving/areas-support/giving-mary-h-weiser-food-allergy-center) - [Medical School Student Programs](https://www.michiganmedicine.org/giving/areas-support/giving-medical-school-student-programs) - [Michigan Alzheimer's Disease Center](https://www.michiganmedicine.org/giving/areas-support/giving-michigan-alzheimers-disease-center) - [Michigan Neuroscience Institute](https://www.michiganmedicine.org/giving/areas-support/giving-michigan-neuroscience-institute) - [Microbiology & Immunology](https://www.michiganmedicine.org/giving/areas-support/giving-microbiology-immunology) - [Molecular & Integrative Physiology](https://www.michiganmedicine.org/giving/areas-support/giving-molecular-integrative-physiology) - [Nathan and Catherine Forbes Sports Medicine Institute](https://www.michiganmedicine.org/giving/areas-support/giving-nathan-and-catherine-forbes-sports-medicine-institute) - [Neurology](https://www.michiganmedicine.org/giving/areas-support/giving-neurology) - [Neuroscience Graduate Program](https://www.michiganmedicine.org/giving/areas-support/giving-neuroscience-graduate-program) - [Neurosurgery](https://www.michiganmedicine.org/giving/areas-support/giving-neurosurgery) - [Nursing](https://www.michiganmedicine.org/giving/areas-support/giving-nursing-michigan) - [Obstetrics & Gynecology](https://www.michiganmedicine.org/giving/areas-support/giving-obstetrics-gynecology) - [Office of Graduate and Postdoctoral Studies](https://www.michiganmedicine.org/giving/areas-support/giving-office-graduate-and-postdoctoral-studies) - [Office of Patient Experience](https://www.michiganmedicine.org/giving/areas-support/giving-office-patient-experience) - [Ophthalmology and Visual Sciences](https://www.michiganmedicine.org/giving/areas-support/giving-ophthalmology-and-visual-sciences) - [Orthopaedic Surgery](https://www.michiganmedicine.org/giving/areas-support/giving-orthopaedic-surgery) - [Otolaryngology-Head and Neck Surgery](https://www.michiganmedicine.org/giving/areas-support/giving-otolaryngology-head-and-neck-surgery) - [Pathology](https://www.michiganmedicine.org/giving/areas-support/giving-pathology) - [Pediatrics](https://www.michiganmedicine.org/giving/areas-support/giving-pediatrics) - [Pharmacology](https://www.michiganmedicine.org/giving/areas-support/giving-pharmacology) - [Physical Medicine & Rehabilitation](https://www.michiganmedicine.org/giving/areas-support/giving-physical-medicine-rehabilitation) - [Psychiatry](https://www.michiganmedicine.org/giving/areas-support/giving-psychiatry) - [Radiation Oncology](https://www.michiganmedicine.org/giving/areas-support/giving-radiation-oncology) - [Radiology](https://www.michiganmedicine.org/giving/areas-support/giving-radiology) - [Social Work](https://www.michiganmedicine.org/giving/areas-support/giving-social-work) - [Surgery](https://www.michiganmedicine.org/giving/areas-support/giving-surgery) - [General Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-general-surgery) - [Oral and Maxillofacial Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-section-oral-and-maxillofacial-surgery) - [Pediatric Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-section-pediatric-surgery) - [Plastic Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-plastic-surgery) - [Thoracic Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-thoracic-surgery) - [Transplant Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-transplant-surgery) - [Vascular Surgery](https://www.michiganmedicine.org/giving/areas-support/surgery/giving-vascular-surgery) - [Transplant Center](https://www.michiganmedicine.org/giving/areas-support/giving-transplant-center) - [Urology](https://www.michiganmedicine.org/giving/areas-support/giving-urology) - [Von Voigtlander Women's Hospital](https://www.michiganmedicine.org/giving/areas-support/giving-von-voigtlander-womens-hospital) - [Campaign](https://www.michiganmedicine.org/giving/look-to-michigan) - [Ways to Give](https://www.michiganmedicine.org/giving/ways-give) - [Annual & Recurring Gifts](https://www.michiganmedicine.org/giving/ways-give/annual-and-recurring-gifts) - [Corporate and Foundation Gifts](https://www.michiganmedicine.org/giving/ways-give/corporate-and-foundation-gifts) - [Cryptocurrency](https://www.michiganmedicine.org/giving/ways-give/cryptocurrency) - [Donor Advised Funds](https://www.michiganmedicine.org/giving/ways-give/donor-advised-funds) - [Endowments](https://www.michiganmedicine.org/giving/ways-give/endowments) - [Estate & Planned Gifts](https://www.michiganmedicine.org/giving/ways-give/estate-and-planned-gifts) - [In-Kind Gifts](https://www.michiganmedicine.org/giving/ways-give/kind-gifts) - [In-Kind Gifts to C.S. Mott Children's Hospital](https://www.michiganmedicine.org/giving/ways-give/kind-gifts/cs-mott-childrens-hospital-kind-giving) - [Giving Library](https://www.michiganmedicine.org/giving/ways-give/kind-gifts/kind-gifts-cs-mott-childrens-hospital/giving-library) - [Mott Toy Store](https://www.michiganmedicine.org/giving/ways-give/kind-gifts/kind-gifts-cs-mott-childrens-hospital/mott-toy-store) - [Toy and Safety Guidelines](https://www.michiganmedicine.org/giving/ways-give/kind-gifts/cs-mott-childrens-hospital-kind-giving#toy-safety-guidelines) - [Memorial or Tribute Gifts](https://www.michiganmedicine.org/giving/ways-give/memorial-or-tribute-gifts) - [Stocks and Securities](https://www.michiganmedicine.org/giving/ways-give/stocks-and-securities) - [Wire and ACH Payments](https://www.michiganmedicine.org/giving/ways-give/wire-and-ach-payments) - [Get Involved](https://www.michiganmedicine.org/giving/giving-get-involved) - [Fundraising Events](https://www.michiganmedicine.org/giving/fundraising-events) - [Big Hearts for Seniors](https://www.michiganmedicine.org/giving/fundraising-events/big-hearts-seniors) - [Auction](https://www.michiganmedicine.org/giving/fundraising-events/big-hearts-seniors/auction) - [Committee](https://www.michiganmedicine.org/giving/fundraising-events/big-hearts-seniors/big-hearts-seniors-committee) - [Sponsors](https://www.michiganmedicine.org/giving/fundraising-events/big-hearts-seniors/2026-sponsors) - [Sponsorship Opportunities](https://www.michiganmedicine.org/giving/fundraising-events/big-hearts-seniors/big-hearts-seniors-sponsorship-opportunities) - [The Woodson Fund Events](https://www.michiganmedicine.org/giving/fundraising-events/woodson-fund-events) - [Event on Main](https://www.michiganmedicine.org/giving/fundraising-events/woodson-fund-events/event-main) - [Golf on Main](https://www.michiganmedicine.org/fundraising-events/woodson-fund-events/golf-main) - [Sponsors](https://www.michiganmedicine.org/giving/fundraising-events/woodson-fund-events/2026-event-main-golf-main-sponsors) - 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June 13, 2025 4:00 PM Author \\| [Kara Gavin](https://www.michiganmedicine.org/author/kara-gavin) ![Collage woman pink face confetti and mind](https://www.michiganmedicine.org/sites/default/files/styles/article_main_image/public/blog/Collage-Woman-Face-Confetti-Mind_1.jpg?h=bfaa3d24&itok=7ArWx229) Originally published June 9, 2022. Updated June 13, 2025 with new information. Hearing voices. Seeing imaginary people and animals. Feeling paranoid. Thinking others can hear their thoughts. A teen or young adult experiencing these sensations might get really scared or confused. They might think it's something to hide. They might try to ignore it and hope it goes away. And they might worry that if they tell a parent, a teacher, a doctor or a friend what's going on, they'll just get laughed at, called crazy or shunned. Which is exactly why more people need to know about psychosis, say University of Michigan experts. That's the collective term used for these types of experiences, all of which involve a lapse in the brain's "reality check" function. About 100,000 teens and young adults experience their first signs of psychosis each year. > There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes. > > [Stephan Taylor, M.D.](https://www.uofmhealth.org/profile/53/stephan-f-taylor-md) More awareness could mean more young people with psychosis get into treatment quickly. And that can make a big difference in their immediate mental health and their long-term futures, say psychiatrist [Stephan Taylor, M.D.](https://www.uofmhealth.org/profile/53/stephan-f-taylor-md), professor and interim chair of Michigan Medicine's Department of Psychiatry. He did a [public video chat about this topic](https://www.youtube.com/watch?v=TMo_RkYV37s&feature=youtu.be) as part of a Mental Health Awareness Month event with former U-M clinical psychologist [Ivy Tso, Ph.D.](https://www.uofmhealth.org/profile/3319/ivy-fei-tso-phd) Taylor and his colleagues run the [Program for Risk Evaluation and Prevention Early Psychosis Clinic](https://medicine.umich.edu/dept/psychiatry/programs/prep), called PREP for short. It's one of a [growing number of such clinics across the country](https://nationalepinet.org/epinet-clinics/), and also part of a [national index of early psychosis clincis](https://strong365.org/early-psychosis-directory). Psychologist Adrienne Lapidos, Ph.D., another member of the PREP team who is a clinical associate professor of psychiatry, recently launched a [free online course about psychosis](https://www.coursera.org/learn/understanding-psychosis) aimed at health care providers but open to anyone with an interest in learning about the topic. Called Understanding Psychosis, it aims to fill a critical gap in health care education. ### What to know about psychosis #### 1\. It takes many forms – and starts in teen/young adult years A voice occasionally whispering in someone's head. A faint fleeting shadow glimpsed out of the corner of an eye. A nagging, unshakeable feeling that others are out to get you or want to harm you. Being convinced that someone is monitoring what you're thinking or is even controlling you. Symptoms of psychosis like these most often start in people between the ages of 14 and 30. The hallucinations and delusions may be subtle at first but can worsen over time. At first, a person may be able to tell that the distorted perceptions aren't real. But this ability can fade as they start to lose the power to make an accurate mental model of their reality. "They may believe things that are out of sync with other peoples' beliefs or have disorganization of their thoughts that lead them to say things that don't make sense or have confusion about things that should not be confusing," said Taylor. #### 2\. Psychosis is like a fever: it can happen with many conditions People can develop fevers as part of infections caused by many kinds of bacteria or viruses. And psychosis symptoms can happen as part of many mental health conditions. Having psychosis symptoms could mean someone has schizophrenia – which is the condition that many people think of first with such symptoms. But hallucinations, delusions and other psychosis signs could also happen as part of depression, bipolar disorder, post-traumatic stress disorder, autism spectrum disorder or borderline personality disorder. In older adults, they can be part of dementia, Alzheimer's disease and Parkinson's disease, among others. And sometimes, people can have mild psychosis symptoms without having a diagnosable mental health condition at all. "We didn't previously accept that people could experience voices or delusions and be perfectly functioning members of society without any distress," said Taylor. "Now we see that in some people, it can be just another dimension of human experience. But for people seen in the PREP clinic, symptoms usually interfere with someone's life, education, relationships or ability to work. They can cause someone to withdraw from others, to stop eating or even to refuse to see a mental health professional if voices in their head tell them not to. They can even cause a person to think about harming themselves or others. That's why, said Tso, "Psychosis can indicate more severe mental illness, so we need to take it seriously," by doing a complete evaluation that considers the psychosis symptoms in conjunction with other symptoms. #### 3\. There's no one cause for psychosis – but many risk factors The Michigan Medicine PREP team does research to explore the roots of psychosis, as part of a worldwide effort to learn more and develop targeted treatments. So far, research at U-M and other research centers has shown that: - Risk of psychosis is higher in people who have family members who have it, such as parents. But even in identical twins, one can have psychosis and the other – whose DNA is a near-perfect copy – does not. And in general, there is no one gene variation, or collection of genetic factors, that 'cause' mild or severe psychosis. "Hundreds or thousands of genes can set up vulnerability to schizophrenia," said Taylor. - The age of onset of psychosis coincides with the ages when the brain is undergoing many changes on its way to maturity. - Brain changes can happen in people whose psychosis goes untreated. "The more relapses and episodes a person has, the more we see that it can permanently change their brain function and structure," said Tso. "And that is something we might not be able to reverse later on even with medication." Unfortunately, these changes are very subtle, and there's no specific change in the brain that can be seen on a scan and diagnose schizophrenia or other conditions in a single individual. - Intense stress, whether from an early-life trauma, pregnancy or birth complications, intense loneliness, or the onset of adult responsibilities and pressures, have been linked to the risk of psychosis as a trigger for underlying vulnerability. - Inflammation, post-infection or autoimmune reactions, where the body's defense systems attack brain tissue, have also been implicated in some, less common forms of psychosis. The U-M team is [always looking for people with the condition to volunteer for their studies](https://umhealthresearch.org/studies/HUM00123648) – as well as people who don't have psychosis but want to help with the search for answers by acting as comparisons. The U-M team and their counterparts at the [academic network called EPINET](https://nationalepinet.org/) are pursuing many more research questions about psychosis. #### 4\. The earlier someone gets treatment, the better Experts worldwide recommend that no more than three to six months go by between the first signs of psychosis, and the start of treatment. But in the United States, that gap averages three years. Getting more people in to see a specialist who can evaluate them, and recommend next steps, is an urgent need nationwide, says Taylor. Nearly as important as getting started is sticking with the effort to find what will work for the individual. That's true within many mental health conditions. In order to get someone started on the path to care, Tso says, more people need to know what to look for and what to do. "Often the signs are noticed by the people closest to the young person experiencing symptoms," she said. "If we want to detect it early, then we need to make sure the community is aware of symptoms," and the importance of connecting with a school counselor or medical provider who can reach out to specialists. However, while almost all counselors and medical professionals will work with people with psychosis over the course of their careers, many could improve their knowledge and skills related to this population. Lapidos says a better understanding of the psychosis spectrum by health care professionals can lead to early detection and appropriate referrals to specialty care. “During a first episode of psychosis, the person affected and their family often feel hopeless and afraid. But there is always hope. Recovery is real and it happens all the time,” she said. “If medical professionals can convey that sense of hope, and place appropriate and timely referrals to specialty care when needed, they can make a huge difference in the trajectory of someone’s life.” "There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes," Taylor said. "When intervention happens early, people get better – though not right away all the time." #### 5\. Medications work for most; adding talk therapy helps more The group of medications called antipsychotics can quell the psychosis symptoms of about two-thirds of people who take one of them. The medications start to have an effect within a week after they start, says Taylor. Those who don't get help from just one drug can often have success when another is added by an experienced prescriber. But getting the dose right, and finding a medication whose side effects are acceptable, can take time and patience. Weight gain, diabetes and movement-related side effects can result from many of the medications, so the minimum dose that quiets a person's symptoms is best. Research is under way to find better medications, and ways to tailor the choice of medication to a person's unique brain mechanisms – but will take time. In the meantime, it's important for people taking these medications to take them consistently as directed and to communicate with their provider about side effects. And that can be hard for a young person who may resist being diagnosed with a serious mental illness. Forms of talk therapy such as cognitive behavioral therapy have also proven very effective – both when done one-on-one with a trained therapist, and in group settings, says Tso. These can help patients come to terms with having an illness and assist with the kinds of issues that medications often cannot, including social engagement, and skills to improve focus and other cognitive functions. Adding other supports to help people with psychosis navigate school, work, relationships and life skills has also been proven to improve long-term outcomes, the U-M experts say. The PREP Clinic, and others like it nationally, seek to offer this kind of wraparound support. But it's not always paid for by insurance companies. #### 6\. Violent acts by people experiencing psychosis are rare and mostly impulsive The U-M experts are concerned about the popular perception and media depictions of people with serious mental illness as far more prone to violence than other people. This is inaccurate, they say. In fact, someone with psychosis is more likely to be a victim of a violent act than to commit one. But when someone with uncontrolled psychosis does act in a violent way, it's often a spontaneous, impulsive outburst or physical struggle, not a premeditated act or planned attack, says Taylor. Scapegoating people with any sort of mental illness after violent tragedies such as mass shootings is dangerous, he says, and can increase the already damaging stigma around seeking help. #### 7\. Beware the risk of suicide and self-harm Having psychosis does increase the risk that someone might attempt suicide or put themselves in potentially dangerous situations. So, it's critical for patients, and those around them, to understand this risk and take steps to reduce it. "We know that there are very high rates of suicide in people with psychosis, compared with the general population," says Tso. "Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time." Taylor notes that sometimes, people with psychosis do things that put them in danger, such as going out in extremely cold weather without a coat or even a shirt. Their illness keeps them from having insight into the potential harm, and they may even need help from family, friends, health professionals or police to get to safety. Having a safety plan ahead of time, which patients and their loved ones can create with their treatment providers, can make a big difference when someone has suicidal thoughts or makes an attempt to end their life. This can include having the national [Suicide & Crisis Lifeline](https://988lifeline.org/) number, 988, memorized or saved on their phone and written down in prominent places. Anyone can call or text 988 from a mobile phone, or use webchat on the lifeline's website, to receive help 24 hours a day, seven days a week with any kind of mental health or substance use crisis. Other crisis plans can include setting up a list of people who the person can confide in when they're having suicidal thoughts or impulses, and who know what to do or can check on them regularly. People at higher risk of suicide and their trusted contacts should also know how to reach their therapist's office or other treatment provider at all hours and know where the nearest psychiatric emergency treatment center is located or how to contact it for advice. Removing firearms and other potentially lethal means from the home or locking them away out of sight (with ammunition stored separately in the case of firearms) is also important. The impulsive nature of many suicides, especially among young people, makes this important for families of young people with many forms of mental illness. *** ## More Articles About: Brain Health Adolescent Psychiatric Treatment Adult Psychiatric Treatment Mental Illness Pharmacy Mental Health ![Health Lab word mark overlaying blue cells](https://www.michiganmedicine.org/sites/default/files/styles/article_sidebar/public/2026-03/HL%20Article%20Tag.jpg?h=0afd8502&itok=VtvrqoOD) ## Health Lab Explore a variety of health care news & stories by visiting the Health Lab home page for more articles. ### Media Contact ![](https://www.michiganmedicine.org/sites/default/files/2022-10/u-hospital-spring_large_1130x635.jpg) ### Public Relations Department of Communication at Michigan Medicine [MichmedMedia@med.umich.edu](mailto:MichmedMedia@med.umich.edu) [734-764-2220](tel:734-764-2220) ### In This Story ![Stephan F. Taylor](https://www.michiganmedicine.org/sites/default/files/styles/square_1_1/public/2026-01/stephan_f_taylor_0.jpg?h=d94c4b90&itok=RylR597t) ### Stephan F Taylor Professor ![Adrienne Lapidos](https://www.michiganmedicine.org/sites/default/files/styles/square_1_1/public/2025-12/adrienne_lapidos.jpg?h=d94c4b90&itok=NmnsQeeT) ### Adrienne Lapidos, PhD, ABPP Clinical Associate Professor ### Related ![lights of different colors in a circular pattern](https://www.michiganmedicine.org/sites/default/files/styles/card/public/blog/lights_of_different_colors_in_a_circular_pattern.jpg?h=bfaa3d24&itok=1aIKXKah) Health Lab #### Distorted Reality: What to Do About Early Signs of Psychosis Seeing, hearing or perceiving things that aren’t really there may seem like something to hide, but seeking help early can make a big difference. ![](https://www.michiganmedicine.org/sites/default/files/styles/card/public/blog/Mich-SuicideLongTerm%2520%25281%2529.jpg?h=bfaa3d24&itok=ZDkdVdX0) Health Lab #### Fewer Deaths Among Adults Who Got Extra Support as Suicidal Teens A new study suggests long-term impacts of an approach that encourages involvement of caring adults in the lives of at-risk adolescents. ## Stay Informed Want top health & research news weekly? Sign up for Health Lab’s newsletters today\! Subscribe Subscribe ## Featured News & Stories ![Minding memory above a microphone on a blue background](https://www.michiganmedicine.org/sites/default/files/styles/card/public/2023-06/mm_networkpage.jpg?h=51c0859a&itok=W6-1uQXk) Minding Memory ### Convoys of Caregiving: Arab American Families Living with Dementia In this episode, Matt & Lauren speak with Kristine Ajrouch, PhD - a new member of our CAPRA leadership team. Kristine is a Research Professor at the Institute for Social Research whose work focuses on aging, health, immigration and family in the United Statues and the Middle East; social networks over the life course; and Arab American identity and well-being. Kristine discusses a recent article that examined an intervention to improve outcomes among Arab American caregivers who provide care to a family member living with dementia. She also shares what this work teaches us about caregiving as a family system rather than the responsibility of a single individual. ![teacher with students at table looking at laptop in library ](https://www.michiganmedicine.org/sites/default/files/styles/card/public/2026-03/teacher-mentor-students-library-studying.jpg?h=f0fb51a5&itok=Zmgn4E7S) Health Lab ### What’s the equivalent of a wheelchair for a person with schizophrenia? Three experts, including a Michigan Medicine physician, talks about what psychiatric rehabilitation looks like in the community and for patients. ![Teen girl sitting on floor next to her bed looking at a smartphone, with icons from social media apps layered over her as she frowns](https://www.michiganmedicine.org/sites/default/files/styles/card/public/2026-03/teen_girl_social_media_icons_copy.jpg?h=f0fb51a5&itok=W7UxWdc0) Health Lab ### How to improve mental health safety on social media – not just for young people With social media companies losing or settling court cases about their products' impact on young peoples' mental health, experts offer tips for reducing impacts for those who use the platforms. ![](https://www.michiganmedicine.org/sites/default/files/styles/card/public/blog/UMH_L_Sepsis%25401x.jpg?h=bfaa3d24&itok=i4Wbz8i1) Health Lab ### Surviving sepsis: New guidelines harness life saving evidence for treating adults An updated clinical guideline for treating sepsis in adults emphasizes pre-hospital care and judicious use of antibiotics and antifungals ![Minding Memory with a microphone and a shadow of a microphone on a blue background](https://www.michiganmedicine.org/sites/default/files/styles/card/public/2023-05/MEM_900x1200.jpg?h=9b0ae1d9&itok=IPCQhXyT) Minding Memory ### Neighborhood Income and Cognitive Health Welcome back to Minding Memory! In today’s episode, Lauren & Matt speak with Dr. Laura Zahodne – a professor of psychology at the University of Michigan and an affiliate of the Institute for Social Research. She's a clinical neuropsychologist by training and studies how psychosocial experiences shape late life, cognitive health, and risk of neurodegenerative disease. Also, a new member of our CAPRA leadership team! In this episode, we’ll get to know Laura a little better and talk with her about one of her research studies, the Neighborhood Racial Income Inequality in Cognitive Health, which looks at the association between racial income differences and a variety of cognitive measures. ![kids hugging legs with jeans on green light blue striped shirt white sneakers next to person with green shirt writing on white notepad](https://www.michiganmedicine.org/sites/default/files/styles/card/public/2026-03/child-couch-therapy-session-clipboard-.jpg?h=f0fb51a5&itok=HcnKp0Pp) Health Lab ### A new way to close the pediatric mental health gap Innovative model successfully improves access to pediatric psychiatric health care, while training future pediatricians to manage common mental health conditions, new data suggests. 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Readable Markdown	### What to know about psychosis #### 1\. It takes many forms – and starts in teen/young adult years A voice occasionally whispering in someone's head. A faint fleeting shadow glimpsed out of the corner of an eye. A nagging, unshakeable feeling that others are out to get you or want to harm you. Being convinced that someone is monitoring what you're thinking or is even controlling you. Symptoms of psychosis like these most often start in people between the ages of 14 and 30. The hallucinations and delusions may be subtle at first but can worsen over time. At first, a person may be able to tell that the distorted perceptions aren't real. But this ability can fade as they start to lose the power to make an accurate mental model of their reality. "They may believe things that are out of sync with other peoples' beliefs or have disorganization of their thoughts that lead them to say things that don't make sense or have confusion about things that should not be confusing," said Taylor. #### 2\. Psychosis is like a fever: it can happen with many conditions People can develop fevers as part of infections caused by many kinds of bacteria or viruses. And psychosis symptoms can happen as part of many mental health conditions. Having psychosis symptoms could mean someone has schizophrenia – which is the condition that many people think of first with such symptoms. But hallucinations, delusions and other psychosis signs could also happen as part of depression, bipolar disorder, post-traumatic stress disorder, autism spectrum disorder or borderline personality disorder. In older adults, they can be part of dementia, Alzheimer's disease and Parkinson's disease, among others. And sometimes, people can have mild psychosis symptoms without having a diagnosable mental health condition at all. "We didn't previously accept that people could experience voices or delusions and be perfectly functioning members of society without any distress," said Taylor. "Now we see that in some people, it can be just another dimension of human experience. But for people seen in the PREP clinic, symptoms usually interfere with someone's life, education, relationships or ability to work. They can cause someone to withdraw from others, to stop eating or even to refuse to see a mental health professional if voices in their head tell them not to. They can even cause a person to think about harming themselves or others. That's why, said Tso, "Psychosis can indicate more severe mental illness, so we need to take it seriously," by doing a complete evaluation that considers the psychosis symptoms in conjunction with other symptoms. #### 3\. There's no one cause for psychosis – but many risk factors The Michigan Medicine PREP team does research to explore the roots of psychosis, as part of a worldwide effort to learn more and develop targeted treatments. So far, research at U-M and other research centers has shown that: - Risk of psychosis is higher in people who have family members who have it, such as parents. But even in identical twins, one can have psychosis and the other – whose DNA is a near-perfect copy – does not. And in general, there is no one gene variation, or collection of genetic factors, that 'cause' mild or severe psychosis. "Hundreds or thousands of genes can set up vulnerability to schizophrenia," said Taylor. - The age of onset of psychosis coincides with the ages when the brain is undergoing many changes on its way to maturity. - Brain changes can happen in people whose psychosis goes untreated. "The more relapses and episodes a person has, the more we see that it can permanently change their brain function and structure," said Tso. "And that is something we might not be able to reverse later on even with medication." Unfortunately, these changes are very subtle, and there's no specific change in the brain that can be seen on a scan and diagnose schizophrenia or other conditions in a single individual. - Intense stress, whether from an early-life trauma, pregnancy or birth complications, intense loneliness, or the onset of adult responsibilities and pressures, have been linked to the risk of psychosis as a trigger for underlying vulnerability. - Inflammation, post-infection or autoimmune reactions, where the body's defense systems attack brain tissue, have also been implicated in some, less common forms of psychosis. The U-M team is [always looking for people with the condition to volunteer for their studies](https://umhealthresearch.org/studies/HUM00123648) – as well as people who don't have psychosis but want to help with the search for answers by acting as comparisons. The U-M team and their counterparts at the [academic network called EPINET](https://nationalepinet.org/) are pursuing many more research questions about psychosis. #### 4\. The earlier someone gets treatment, the better Experts worldwide recommend that no more than three to six months go by between the first signs of psychosis, and the start of treatment. But in the United States, that gap averages three years. Getting more people in to see a specialist who can evaluate them, and recommend next steps, is an urgent need nationwide, says Taylor. Nearly as important as getting started is sticking with the effort to find what will work for the individual. That's true within many mental health conditions. In order to get someone started on the path to care, Tso says, more people need to know what to look for and what to do. "Often the signs are noticed by the people closest to the young person experiencing symptoms," she said. "If we want to detect it early, then we need to make sure the community is aware of symptoms," and the importance of connecting with a school counselor or medical provider who can reach out to specialists. However, while almost all counselors and medical professionals will work with people with psychosis over the course of their careers, many could improve their knowledge and skills related to this population. Lapidos says a better understanding of the psychosis spectrum by health care professionals can lead to early detection and appropriate referrals to specialty care. “During a first episode of psychosis, the person affected and their family often feel hopeless and afraid. But there is always hope. Recovery is real and it happens all the time,” she said. “If medical professionals can convey that sense of hope, and place appropriate and timely referrals to specialty care when needed, they can make a huge difference in the trajectory of someone’s life.” "There's a lot of good evidence that intervention that occurs early -- as soon as symptoms start to appear and disrupt a young person's life – has benefits in longer term outcomes," Taylor said. "When intervention happens early, people get better – though not right away all the time." #### 5\. Medications work for most; adding talk therapy helps more The group of medications called antipsychotics can quell the psychosis symptoms of about two-thirds of people who take one of them. The medications start to have an effect within a week after they start, says Taylor. Those who don't get help from just one drug can often have success when another is added by an experienced prescriber. But getting the dose right, and finding a medication whose side effects are acceptable, can take time and patience. Weight gain, diabetes and movement-related side effects can result from many of the medications, so the minimum dose that quiets a person's symptoms is best. Research is under way to find better medications, and ways to tailor the choice of medication to a person's unique brain mechanisms – but will take time. In the meantime, it's important for people taking these medications to take them consistently as directed and to communicate with their provider about side effects. And that can be hard for a young person who may resist being diagnosed with a serious mental illness. Forms of talk therapy such as cognitive behavioral therapy have also proven very effective – both when done one-on-one with a trained therapist, and in group settings, says Tso. These can help patients come to terms with having an illness and assist with the kinds of issues that medications often cannot, including social engagement, and skills to improve focus and other cognitive functions. Adding other supports to help people with psychosis navigate school, work, relationships and life skills has also been proven to improve long-term outcomes, the U-M experts say. The PREP Clinic, and others like it nationally, seek to offer this kind of wraparound support. But it's not always paid for by insurance companies. #### 6\. Violent acts by people experiencing psychosis are rare and mostly impulsive The U-M experts are concerned about the popular perception and media depictions of people with serious mental illness as far more prone to violence than other people. This is inaccurate, they say. In fact, someone with psychosis is more likely to be a victim of a violent act than to commit one. But when someone with uncontrolled psychosis does act in a violent way, it's often a spontaneous, impulsive outburst or physical struggle, not a premeditated act or planned attack, says Taylor. Scapegoating people with any sort of mental illness after violent tragedies such as mass shootings is dangerous, he says, and can increase the already damaging stigma around seeking help. #### 7\. Beware the risk of suicide and self-harm Having psychosis does increase the risk that someone might attempt suicide or put themselves in potentially dangerous situations. So, it's critical for patients, and those around them, to understand this risk and take steps to reduce it. "We know that there are very high rates of suicide in people with psychosis, compared with the general population," says Tso. "Some people, especially with untreated psychosis, hear voices that tell them things to do or say negative things, and this can be very distressing if it goes on for a long time." Taylor notes that sometimes, people with psychosis do things that put them in danger, such as going out in extremely cold weather without a coat or even a shirt. Their illness keeps them from having insight into the potential harm, and they may even need help from family, friends, health professionals or police to get to safety. Having a safety plan ahead of time, which patients and their loved ones can create with their treatment providers, can make a big difference when someone has suicidal thoughts or makes an attempt to end their life. This can include having the national [Suicide & Crisis Lifeline](https://988lifeline.org/) number, 988, memorized or saved on their phone and written down in prominent places. Anyone can call or text 988 from a mobile phone, or use webchat on the lifeline's website, to receive help 24 hours a day, seven days a week with any kind of mental health or substance use crisis. Other crisis plans can include setting up a list of people who the person can confide in when they're having suicidal thoughts or impulses, and who know what to do or can check on them regularly. People at higher risk of suicide and their trusted contacts should also know how to reach their therapist's office or other treatment provider at all hours and know where the nearest psychiatric emergency treatment center is located or how to contact it for advice. Removing firearms and other potentially lethal means from the home or locking them away out of sight (with ammunition stored separately in the case of firearms) is also important. The impulsive nature of many suicides, especially among young people, makes this important for families of young people with many forms of mental illness.
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