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1. Shard Calculation

Query:

Response:

Calculated Shard: 157 (from laksa084)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa157.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.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525","crawl_time":1776306680,"first_indexed_time":1517875440,"http_code":200,"src_unparsed":"com,verywellmind!www,\/relationship-between-ptsd-and-psychotic-symptoms-2797525 s443","src_root_hash":"10064058272378209957","history_drop_reason":null,"meta_title":"PTSD With Psychosis: The Relationship, Symptoms, & Treatments","meta_descriptions":["People with PTSD sometimes experience symptoms of psychosis. Learn about how they are related and what you can do to cope when you have PTSD with psychosis."],"attrs_boilerpipe_text":"Key Takeaways\nPTSD can sometimes lead to psychotic symptoms like hallucinations and delusions.\nPTSD with psychosis affects an estimated 2.5% of people with PTSD.\nIt's important to seek medical help if you have symptoms like delusions or suicidal thoughts.\nPost-traumatic stress disorder\n(PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms:\nre-experiencing\nsymptoms, avoidance symptoms, negative changes in mood and brain function, and\nhyperarousal symptoms\n.\nHowever, PTSD can also sometimes occur with psychosis.\nPsychosis\ninvolves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior.\nPTSD with psychosis is a lesser-known and often misunderstood form of the condition. When it happens, the boundaries between the memory of the trauma, the fear that it causes, and reality become blurred. While this symptom is not as widely recognized as some other trauma symptoms, it affects an estimated 2.5% of people with PTSD.\nBelow, learn more about the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment.\nThe Connection Between PTSD and Psychosis\nWhile PSTD and psychosis are typically seen as separate conditions, research has shown that severe trauma can sometimes lead to psychotic symptoms. In fact, psychotic symptoms might be related to the severity of an individual's PTSD symptoms. The more PTSD symptoms you're experiencing, the greater the likelihood you will also have psychosis.\nIn such cases, the brain's response to overwhelming stress can go beyond anxiety and flashbacks, showing up with symptoms like hallucinations, delusions, and distorted thinking.\nPTSD frequently involves dissociation, which may explain co-occurring psychosis. Frequent dissociation may increase a person's risk of developing psychotic symptoms.\nWhile PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD.\nCertain types of trauma may be more likely to trigger psychosis.\nTraumatic events\nthat increase the risk of developing PTSD with psychosis include:\nBeing involved in a natural disaster\nSeeing someone injured or killed\nExperiencing shock as a result of a traumatic event that happened to a loved one\nOther risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use.\nRecap\nSome symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis\nalong\nwith PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior.\nComplications of PTSD and Psychosis\nWhen people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process.\nPsychosis-Related PTSD\nResearch has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD.\nPeople with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, including \nsuicidal thoughts\n, suicide attempts, and more significant overall distress. It's essential for everyone with PTSD and their loved ones to know the\nrisk factors and warning signs of suicide\n.\nIf you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or\nflat affect\n, you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors.\nIf you are having suicidal thoughts, contact the \nNational Suicide Prevention Lifeline\n at \n988\n for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.\nDiagnosis of PTSD and Psychosis\nTo diagnose PTSD with psychosis, doctors will evaluate an individual's symptoms, perform physical and lab tests to rule out other conditions, and review the individual's medical history. This allows them to assess symptoms of PTSD and psychosis.\nFlashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including:\nDuring a\nflashback\n, you might temporarily lose connection with your present situation, being transported back in time to a traumatic event in your memory. If you have a severe flashback, you may see, hear, or smell things that others do not—which is consistent with a hallucination. Flashbacks often occur during periods of high stress and can be very frightening to the person experiencing them.\nDissociation\nis when you feel disconnected from your body.\nYou may have no memory of what was going on around you or what you were doing for some time. The experience of dissociating is similar to a daydream, but unlike a normal daydream, it's very disruptive to your life.\nPsychosis Symptoms\nTo make a diagnosis, a doctor will also note the presence of psychotic symptoms.\nPsychotic symptoms\ncan be divided into two groups: positive symptoms and negative symptoms. However, this doesn't mean some psychotic symptoms are good and some are bad.\nPositive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.\nPositive psychotic symptoms\nare characterized by the presence of unusual feelings, thoughts, or behaviors.\nThis includes experiences such as\nhallucinations\nor\ndelusions\n.\nHallucinations\nrefer to sensations of something that isn't really there. They can be auditory, visual, tactile, olfactory, and\/or gustatory.\nAuditory hallucinations\ninvolve an experience of hearing voices or sounds that are not there.\nVisual hallucinations\nwould involve seeing something that isn't real.\nTactile hallucinations\noccur when you feel something that isn't there.\nOlfactory and gustatory hallucinations\noccur when you smell or taste something that is not present.\nDelusions\nare ideas that you believe are true despite the fact that they may be unlikely or odd. For example, you might believe that the CIA is spying on you or that aliens are controlling your behaviors or thoughts.\nDisorganized behaviors\nare also very common with psychosis. You may, for example, use made-up words, speak in unintelligible ways, or stand in an odd pose.\nNegative psychotic symptoms\nare characterized by the absence of an experience. For example, you might not be emotionally expressive, you might have difficulty speaking or not speak for days on end (alogia), or be unable to accomplish simple tasks or activities, such as getting dressed in the morning.\nRelated Conditions\nIn addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap.\nMental health conditions that can have positive and negative psychotic symptoms include:\nBipolar disorder\nDelusional disorder\nMajor depressive disorder with psychotic features\nSchizoaffective disorder\nSchizophrenia\nSchizophreniform disorder\nSome people\n have both schizophrenia and PTSD\n. Research has shown that traumatic experiences are more common among people with\nschizophrenia\nthan in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD.\nIt might not be surprising that many people living with schizophrenia have experienced trauma, and that the two conditions may be more closely related than previously thought.\nRecap\nPTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia.\nTreatment of PTSD and Psychosis\nIf you or someone you care about has PTSD and is experiencing psychotic symptoms, reaching out for help is crucial. The right treatment can improve functioning and reduce the risk of developing psychotic symptoms linked to untreated PTSD.\nTreatment is essential and may involve psychotherapy, medication, or a combination.\nTreatment options include:\nPsychotherapy\n: Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis.\nAddressing PTSD symptoms\nin treatment can also result in a reduction of psychotic symptoms.\nMedications\n: Positive psychotic symptoms can sometimes be effectively managed through medication. However, some researchers suggest that there is currently not enough evidence to recommend using\nsecond-generation antipsychotics\n(SGA) to treat PTSD with secondary psychotic features.\nTreatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example,\nexposure therapy for PTSD\nmay not be the best treatment for someone with schizophrenia, as it could worsen their symptoms.\nStudies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important.\nCoping With PTSD and Psychosis\nFor those experiencing symptoms of PTSD, psychosis, or both, seeking support from a qualified mental health professional is an essential first step. In addition to professional care, there are also coping strategies people can use to support their functioning and mental well-being.\nCaring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions.\nGet social support\n: Having support from loved ones can also help you better manage symptoms of PTSD with psychosis. Talk to trusted loved ones about your conditions and look for ways they can provide practical and emotional support.\nPractice self-care\n: Take care of yourself physically and mentally. Getting adequate sleep, eating a balanced diet, and engaging in regular activity can be helpful.\nWatch for triggers\n: Certain situations, people, or events can trigger symptoms of PTSD, which can exacerbate psychotic symptoms. Being aware of\nPTSD triggers\nand utilizing ways to manage them can help minimize the risk of experiencing flashbacks, dissociation, and other symptoms.\nManage stress\n: Stress can trigger or worsen psychotic symptoms, so it is crucial to reduce stress levels and utilize effective relaxation techniques.\nThe experience of psychotic symptoms may tell the story of how severe a person's PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor.","attrs_markdown":"[Skip to content](https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525#skip-to-content)\n\nMenu\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n  - [Addiction](https:\/\/www.verywellmind.com\/addiction-overview-4581803)\n  - [Depression](https:\/\/www.verywellmind.com\/depression-4157261)\n  - [ADHD](https:\/\/www.verywellmind.com\/adhd-overview-4581801)\n  - [Anxiety](https:\/\/www.verywellmind.com\/anxiety-7508391)\n  - [Bipolar Disorder](https:\/\/www.verywellmind.com\/bipolar-disorder-4157274)\n  - [PTSD](https:\/\/www.verywellmind.com\/ptsd-4157229)\n  - [View All](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [Therapy](https:\/\/www.verywellmind.com\/therapy-4581775)\n  - [Therapy Center](https:\/\/www.verywellmind.com\/therapy-7092217)\n  - [When To See a Therapist](https:\/\/www.verywellmind.com\/how-to-know-when-it-s-time-to-see-a-therapist-5077040)\n  - 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[Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n  - [Meet Our Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n  - [Crisis Support](https:\/\/www.verywellmind.com\/crisis-support-6666353)\n\nSearch\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n  - [Addiction](https:\/\/www.verywellmind.com\/addiction-overview-4581803)\n  - [Depression](https:\/\/www.verywellmind.com\/depression-4157261)\n  - [ADHD](https:\/\/www.verywellmind.com\/adhd-overview-4581801)\n  - [Anxiety](https:\/\/www.verywellmind.com\/anxiety-7508391)\n  - [Bipolar Disorder](https:\/\/www.verywellmind.com\/bipolar-disorder-4157274)\n  - [PTSD](https:\/\/www.verywellmind.com\/ptsd-4157229)\n  - [View All](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [Therapy](https:\/\/www.verywellmind.com\/therapy-4581775)\n  - [Therapy Center](https:\/\/www.verywellmind.com\/therapy-7092217)\n  - [When To See a Therapist](https:\/\/www.verywellmind.com\/how-to-know-when-it-s-time-to-see-a-therapist-5077040)\n  - [Types of Therapy](https:\/\/www.verywellmind.com\/how-to-choose-the-best-type-of-therapy-for-you-6500320)\n  - [Best Online Therapy](https:\/\/www.verywellmind.com\/best-online-therapy-4691206)\n  - [Best Couples Therapy](https:\/\/www.verywellmind.com\/best-online-marriage-counseling-4691952)\n  - [View All](https:\/\/www.verywellmind.com\/therapy-4581775)\n- [Living Well](https:\/\/www.verywellmind.com\/living-well-7510832)\n  - [Managing Stress](https:\/\/www.verywellmind.com\/stress-management-overview-4581770)\n  - [Meditation](https:\/\/www.verywellmind.com\/meditation-and-mindfulness-4581783)\n  - [Sleep and Dreaming](https:\/\/www.verywellmind.com\/sleep-and-dreaming-4157166)\n  - [Understanding Emotions](https:\/\/www.verywellmind.com\/emotions-4157165)\n  - [Self-Improvement](https:\/\/www.verywellmind.com\/self-improvement-4157212)\n  - [View All](https:\/\/www.verywellmind.com\/living-well-7510832)\n- [Relationships](https:\/\/www.verywellmind.com\/relationships-4157190)\n  - [Healthy Relationships](https:\/\/www.verywellmind.com\/strengthening-relationships-4162997)\n  - [Dating](https:\/\/www.verywellmind.com\/dating-tips-and-strategies-7511571)\n  - [Intimacy](https:\/\/www.verywellmind.com\/sex-and-relationships-7511610)\n  - [View All](https:\/\/www.verywellmind.com\/relationships-4157190)\n- [Psychology](https:\/\/www.verywellmind.com\/psychology-4157187)\n  - [Theories](https:\/\/www.verywellmind.com\/theories-of-psychology-4157184)\n  - [Student Resources](https:\/\/www.verywellmind.com\/student-resources-overview-4581768)\n  - [Personality Types](https:\/\/www.verywellmind.com\/the-myers-briggs-type-indicator-2795583)\n  - [View All](https:\/\/www.verywellmind.com\/psychology-4157187)\n- [Trending](https:\/\/www.verywellmind.com\/news-latest-research-and-trending-topics-4846421)\n  - [Quizzes](https:\/\/www.verywellmind.com\/quizzes-8609222)\n  - [Guided Meditations](https:\/\/www.verywellmind.com\/guided-meditations-8609227)\n  - [Verywell Mind Insights](https:\/\/www.verywellmind.com\/mental-health-data-insights-5185693)\n  - [2024 Verywell Mind 25](https:\/\/www.verywellmind.com\/the-verywell-mind-25-2024-7484480)\n  - [Mental Health in the Classroom](https:\/\/www.verywellmind.com\/mental-health-in-the-classroom-survey-7569880)\n  - [View All](https:\/\/www.verywellmind.com\/news-latest-research-and-trending-topics-4846421)\n\n[More in PTSD](https:\/\/www.verywellmind.com\/ptsd-4157229)\n\n- [Symptoms and Diagnosis](https:\/\/www.verywellmind.com\/ptsd-symptoms-and-diagnosis-4157228)\n- [Causes](https:\/\/www.verywellmind.com\/ptsd-causes-4157225)\n- [Treatment](https:\/\/www.verywellmind.com\/ptsd-treatment-4157226)\n- [Living With](https:\/\/www.verywellmind.com\/living-with-ptsd-4157224)\n\n[View More](https:\/\/www.verywellmind.com\/ptsd-4157229)\n\n- [About Us](https:\/\/www.verywellmind.com\/about-us-5184564)\n- [Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n- [Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n- [Crisis Support](https:\/\/www.verywellmind.com\/crisis-support-6666353)\n\nVerywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.\n\nⒸ 2026 People Inc. — All rights reserved\n\n# What It's Like to Live With PTSD With Psychosis\nThe overlap between trauma and psychotic symptoms\n\nBy\n\n[Matthew Tull, PhD](https:\/\/www.verywellmind.com\/matthew-tull-phd-2797109)\n\n[Matthew Tull, PhD](https:\/\/www.verywellmind.com\/matthew-tull-phd-2797109)\n\nMatthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.\n\nLearn about our  [editorial process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n\nUpdated on December 07, 2025\n\nMedically reviewed\n\nVerywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. [Learn more](https:\/\/www.verywellmind.com\/review-board-4796494).\n\nby\n\n[Daniel B. Block, MD](https:\/\/www.verywellmind.com\/daniel-block-md-4779186)\n\n![Block]()\n\n![Block](https:\/\/www.verywellmind.com\/thmb\/bqppKq4IVUTVsPMClzJADd5fs14=\/200x200\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/block-8924ca72ff94426d940e8f7e639e3942.jpg)\n\nMedically reviewed by [Daniel B. Block, MD](https:\/\/www.verywellmind.com\/daniel-block-md-4779186)\n\nDaniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.\n\nLearn about our  [Medical Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n\n![Reflective young man looking down, portrait](https:\/\/www.verywellmind.com\/thmb\/q1F4BNTG4FZ2lqZF4rBtdOkwhdQ=\/1500x0\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/GettyImages-73427467web-56e1ecc93df78c5ba056afe7.jpg)\n\n![Reflective young man looking down, portrait](https:\/\/www.verywellmind.com\/thmb\/q1F4BNTG4FZ2lqZF4rBtdOkwhdQ=\/1500x0\/filters:no_upscale\\(\\):max_bytes\\(150000\\):strip_icc\\(\\)\/GettyImages-73427467web-56e1ecc93df78c5ba056afe7.jpg)\n\nFrank van Groen \/ LOOK-foto \/ Getty Images\n\nTable of Contents\n\nView All\n\nTable of Contents\n\n- [Understanding the Connection](https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-the-connection-between-ptsd-and-psychosis)\n- [Complications](https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-complications-of-ptsd-and-psychosis)\n- [Diagnosis](https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-diagnosis-of-ptsd-and-psychosis)\n- [Treatment](https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-treatment-of-ptsd-and-psychosis)\n- [Coping](https:\/\/www.verywellmind.com\/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-coping-with-ptsd-and-psychosis)\n\nClose\n\n### Key Takeaways\n- PTSD can sometimes lead to psychotic symptoms like hallucinations and delusions.\n- PTSD with psychosis affects an estimated 2.5% of people with PTSD.\n- It's important to seek medical help if you have symptoms like delusions or suicidal thoughts.\n\n[Post-traumatic stress disorder](https:\/\/www.verywellmind.com\/ptsd-4157229) (PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms: [re-experiencing](https:\/\/www.verywellmind.com\/re-experiencing-2797325) symptoms, avoidance symptoms, negative changes in mood and brain function, and [hyperarousal symptoms](https:\/\/www.verywellmind.com\/hyperarousal-2797362).\n\nHowever, PTSD can also sometimes occur with psychosis. [Psychosis](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) involves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior.\n\nPTSD with psychosis is a lesser-known and often misunderstood form of the condition. When it happens, the boundaries between the memory of the trauma, the fear that it causes, and reality become blurred. While this symptom is not as widely recognized as some other trauma symptoms, it affects an estimated 2.5% of people with PTSD.\n\nBelow, learn more about the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment.\n\n## The Connection Between PTSD and Psychosis\nWhile PSTD and psychosis are typically seen as separate conditions, research has shown that severe trauma can sometimes lead to psychotic symptoms. In fact, psychotic symptoms might be related to the severity of an individual's PTSD symptoms. The more PTSD symptoms you're experiencing, the greater the likelihood you will also have psychosis.\n\nIn such cases, the brain's response to overwhelming stress can go beyond anxiety and flashbacks, showing up with symptoms like hallucinations, delusions, and distorted thinking.\n\nPTSD frequently involves dissociation, which may explain co-occurring psychosis. Frequent dissociation may increase a person's risk of developing psychotic symptoms.\n\nWhile PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD.\n\nCertain types of trauma may be more likely to trigger psychosis. [Traumatic events](https:\/\/www.verywellmind.com\/ptsd-causes-and-risk-factors-2797397) that increase the risk of developing PTSD with psychosis include:\n\n- Being involved in a natural disaster\n- Seeing someone injured or killed\n- Experiencing shock as a result of a traumatic event that happened to a loved one\n\nOther risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use.\n\n### Recap\nSome symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis *along* with PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior.\n\n[Flashbacks and Dissociation in PTSD](https:\/\/www.verywellmind.com\/coping-with-flashbacks-2797574)\n\n## Complications of PTSD and Psychosis\nWhen people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process.\n\n### Psychosis-Related PTSD\nResearch has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD.\n\nPeople with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, including [suicidal thoughts](https:\/\/www.verywellmind.com\/suicidal-ideation-380609), suicide attempts, and more significant overall distress. It's essential for everyone with PTSD and their loved ones to know the [risk factors and warning signs of suicide](https:\/\/www.verywellmind.com\/suicide-warning-signs-and-risk-factors-1067525).\n\nIf you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or [flat affect](https:\/\/www.verywellmind.com\/flattened-affect-2953086), you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors.\n\nIf you are having suicidal thoughts, contact the [National Suicide Prevention Lifeline](https:\/\/suicidepreventionlifeline.org\/) at **988** for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.\n\n## Diagnosis of PTSD and Psychosis\nTo diagnose PTSD with psychosis, doctors will evaluate an individual's symptoms, perform physical and lab tests to rule out other conditions, and review the individual's medical history. This allows them to assess symptoms of PTSD and psychosis.\n\nFlashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including:\n\n**During a** [**flashback**](https:\/\/www.verywellmind.com\/coping-with-flashbacks-2797574), you might temporarily lose connection with your present situation, being transported back in time to a traumatic event in your memory. If you have a severe flashback, you may see, hear, or smell things that others do not—which is consistent with a hallucination. Flashbacks often occur during periods of high stress and can be very frightening to the person experiencing them.\n\n[**Dissociation**](https:\/\/www.verywellmind.com\/dissociation-2797292)is when you feel disconnected from your body. You may have no memory of what was going on around you or what you were doing for some time. The experience of dissociating is similar to a daydream, but unlike a normal daydream, it's very disruptive to your life.\n\n### Psychosis Symptoms\nTo make a diagnosis, a doctor will also note the presence of psychotic symptoms. [Psychotic symptoms](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) can be divided into two groups: positive symptoms and negative symptoms. However, this doesn't mean some psychotic symptoms are good and some are bad.\n\nPositive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.\n\n[Positive psychotic symptoms](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) are characterized by the presence of unusual feelings, thoughts, or behaviors. This includes experiences such as [hallucinations](https:\/\/www.verywellmind.com\/what-are-hallucinations-378819) or [delusions](https:\/\/www.verywellmind.com\/delusions-types-and-role-in-psychosis-379826).\n\n- **Hallucinations** refer to sensations of something that isn't really there. They can be auditory, visual, tactile, olfactory, and\/or gustatory. *Auditory hallucinations* involve an experience of hearing voices or sounds that are not there. *Visual hallucinations* would involve seeing something that isn't real. *Tactile hallucinations* occur when you feel something that isn't there. *Olfactory and gustatory hallucinations* occur when you smell or taste something that is not present.\n- **Delusions** are ideas that you believe are true despite the fact that they may be unlikely or odd. For example, you might believe that the CIA is spying on you or that aliens are controlling your behaviors or thoughts.\n- **Disorganized behaviors** are also very common with psychosis. You may, for example, use made-up words, speak in unintelligible ways, or stand in an odd pose.\n\n[Negative psychotic symptoms](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) are characterized by the absence of an experience. For example, you might not be emotionally expressive, you might have difficulty speaking or not speak for days on end (alogia), or be unable to accomplish simple tasks or activities, such as getting dressed in the morning.\n\n### Related Conditions\nIn addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap.\n\nMental health conditions that can have positive and negative psychotic symptoms include:\n\n- [Bipolar disorder](https:\/\/www.verywellmind.com\/bipolar-disorder-symptoms-and-diagnosis-379962)\n- [Delusional disorder](https:\/\/www.verywellmind.com\/delusional-disorder-symptoms-causes-and-treatment-6826265)\n- Major depressive disorder with psychotic features\n- [Schizoaffective disorder](https:\/\/www.verywellmind.com\/what-is-schizoaffective-disorder-4171702)\n- [Schizophrenia](https:\/\/www.verywellmind.com\/the-internal-experience-of-schizophrenia-2953095)\n- [Schizophreniform disorder](https:\/\/www.verywellmind.com\/what-is-schizophreniform-disorder-5208704)\n\nSome people [have both schizophrenia and PTSD](https:\/\/www.verywellmind.com\/ptsd-treatment-2797659). Research has shown that traumatic experiences are more common among people with [schizophrenia](https:\/\/www.verywellmind.com\/schizophrenia-4157221) than in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD. It might not be surprising that many people living with schizophrenia have experienced trauma, and that the two conditions may be more closely related than previously thought.\n\n### Recap\nPTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia.\n## Treatment of PTSD and Psychosis\nIf you or someone you care about has PTSD and is experiencing psychotic symptoms, reaching out for help is crucial. The right treatment can improve functioning and reduce the risk of developing psychotic symptoms linked to untreated PTSD.\n\nTreatment is essential and may involve psychotherapy, medication, or a combination.\n\nTreatment options include:\n\n- **Psychotherapy**: Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis. [Addressing PTSD symptoms](https:\/\/www.verywellmind.com\/ptsd-treatment-2797659) in treatment can also result in a reduction of psychotic symptoms.\n- **Medications**: Positive psychotic symptoms can sometimes be effectively managed through medication. However, some researchers suggest that there is currently not enough evidence to recommend using [second-generation antipsychotics](https:\/\/www.verywellmind.com\/atypical-antipsychotics-379663) (SGA) to treat PTSD with secondary psychotic features.\n\nTreatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example, [exposure therapy for PTSD](https:\/\/www.verywellmind.com\/exposure-therapy-for-ptsd-2797654) may not be the best treatment for someone with schizophrenia, as it could worsen their symptoms.\n\nStudies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important.\n\n## Coping With PTSD and Psychosis\nFor those experiencing symptoms of PTSD, psychosis, or both, seeking support from a qualified mental health professional is an essential first step. In addition to professional care, there are also coping strategies people can use to support their functioning and mental well-being.\n\nCaring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions.\n\n- **Get social support**: Having support from loved ones can also help you better manage symptoms of PTSD with psychosis. Talk to trusted loved ones about your conditions and look for ways they can provide practical and emotional support.\n- **Practice self-care**: Take care of yourself physically and mentally. Getting adequate sleep, eating a balanced diet, and engaging in regular activity can be helpful.\n- **Watch for triggers**: Certain situations, people, or events can trigger symptoms of PTSD, which can exacerbate psychotic symptoms. Being aware of [PTSD triggers](https:\/\/www.verywellmind.com\/ptsd-triggers-and-coping-strategies-2797557) and utilizing ways to manage them can help minimize the risk of experiencing flashbacks, dissociation, and other symptoms.\n- **Manage stress**: Stress can trigger or worsen psychotic symptoms, so it is crucial to reduce stress levels and utilize effective relaxation techniques.\n\nThe experience of psychotic symptoms may tell the story of how severe a person's PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor.\n\nIf you or a loved one are struggling with PTSD or psychosis, contact the [Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline](https:\/\/www.samhsa.gov\/find-help\/national-helpline) at **1-800-662-4357** for information on support and treatment facilities in your area.\n\nFor more mental health resources, see our [National Helpline Database](https:\/\/www.verywellmind.com\/national-helpline-database-4799696).\n\nRead more:\n\n- [Conditions A-Z](https:\/\/www.verywellmind.com\/conditions-a-z-4797402)\n- [PTSD](https:\/\/www.verywellmind.com\/ptsd-4157229)\n- [Symptoms and Diagnosis](https:\/\/www.verywellmind.com\/ptsd-symptoms-and-diagnosis-4157228)\n\n10 Sources\n\nVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.\n\n1. Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ. [Posttraumatic stress disorder: from diagnosis to prevention](https:\/\/dx.doi.org\/10.1186%2Fs40779-018-0179-0). *Mil Med Res*. 2018;5(1):32. Published 2018 Sep 28. doi:10.1186\/s40779-018-0179-0\n2. Hamner MB. [Psychotic symptoms in posttraumatic stress disorder](https:\/\/focus.psychiatryonline.org\/doi\/pdf\/10.1176\/foc.9.3.foc278). *FOC*. 2011;9(3):278-285.\n3. Buswell G, Haime Z, Lloyd-Evans B, Billings J. [A systematic review of PTSD to the experience of psychosis: prevalence and associated factors](https:\/\/doi.org\/10.1186\/s12888-020-02999-x). *BMC Psychiatry*. 2021;21(1):9. doi:10.1186\/s12888-020-02999-x\n4. Gibson LE, Alloy LB, Ellman LM. [Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms](https:\/\/dx.doi.org\/10.1016%2Fj.cpr.2016.08.003). *Clin Psychol Rev*. 2016;49:92–105. doi:10.1016\/j.cpr.2016.08.003\n5. Compean E, Hamner M. [Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges](https:\/\/doi.org\/10.1016\/j.pnpbp.2018.08.001). *Prog Neuropsychopharmacol Biol Psychiatry*. 2019;88:265-275. doi:10.1016\/j.pnpbp.2018.08.001\n6. Şar V. [The many faces of dissociation: opportunities for innovative research in psychiatry](https:\/\/dx.doi.org\/10.9758%2Fcpn.2014.12.3.171). *Clin Psychopharmacol Neurosci*. 2014;12(3):171–179. doi:10.9758\/cpn.2014.12.3.171\n7. Gaebel W, Zielasek J. [Focus on psychosis](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4421906\/). *Dialogues Clin Neurosci*. 2015;17(1):9–18.\n8. Lyne J, O'donoghue B, Roche E, Renwick L, Cannon M, Clarke M. [Negative symptoms of psychosis: a life course approach and implications for prevention and treatment](https:\/\/pubmed.ncbi.nlm.nih.gov\/29076240\/). *Early Interv Psychiatry.* 2018;12(4):561-571. doi: 10.1111\/eip.12501\n9. Duncan LE, Ratanatharathorn A, Aiello AE, et al. [Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences inheritability](https:\/\/dx.doi.org\/10.1038%2Fmp.2017.77). *Mol Psychiatry*. 2018;23(3):666–673. doi:10.1038\/mp.2017.77\n10. Oconghaile A, Delisi LE. [Distinguishing schizophrenia from posttraumatic stress disorder with psychosis](https:\/\/doi.org\/10.1097\/YCO.0000000000000158). *Curr Opin Psychiatry*. 2015;28(3):249-55. doi:10.1097\/YCO.0000000000000158\n\nBy [Matthew Tull, PhD](https:\/\/www.verywellmind.com\/matthew-tull-phd-2797109)   \n Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.\n\n[See Our Editorial Process](https:\/\/www.verywellmind.com\/our-editorial-process-4778006)\n\n[Meet Our Review Board](https:\/\/www.verywellmind.com\/review-board-4796494)\n\nShare Feedback\n\nWas this page helpful?\n\nThanks for your feedback\\!\n\nWhat is your feedback?\n\nHelpful\n\nReport an Error\n\nOther\n\nRelated Articles\n\n[![Muslim woman with traditional Middle Eastern modest clothes]() ![Muslim woman with traditional Middle Eastern modest 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educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.\n\nⒸ 2026 People Inc. — All rights reserved\n\nVerywell Mind is part of the [People Inc.](https:\/\/www.people.inc\/) publishing family.","attrs_readable_markdown":"### Key Takeaways\n- PTSD can sometimes lead to psychotic symptoms like hallucinations and delusions.\n- PTSD with psychosis affects an estimated 2.5% of people with PTSD.\n- It's important to seek medical help if you have symptoms like delusions or suicidal thoughts.\n\n[Post-traumatic stress disorder](https:\/\/www.verywellmind.com\/ptsd-4157229) (PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms: [re-experiencing](https:\/\/www.verywellmind.com\/re-experiencing-2797325) symptoms, avoidance symptoms, negative changes in mood and brain function, and [hyperarousal symptoms](https:\/\/www.verywellmind.com\/hyperarousal-2797362).\n\nHowever, PTSD can also sometimes occur with psychosis. [Psychosis](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) involves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior.\n\nPTSD with psychosis is a lesser-known and often misunderstood form of the condition. When it happens, the boundaries between the memory of the trauma, the fear that it causes, and reality become blurred. While this symptom is not as widely recognized as some other trauma symptoms, it affects an estimated 2.5% of people with PTSD.\n\nBelow, learn more about the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment.\n\n## The Connection Between PTSD and Psychosis\nWhile PSTD and psychosis are typically seen as separate conditions, research has shown that severe trauma can sometimes lead to psychotic symptoms. In fact, psychotic symptoms might be related to the severity of an individual's PTSD symptoms. The more PTSD symptoms you're experiencing, the greater the likelihood you will also have psychosis.\n\nIn such cases, the brain's response to overwhelming stress can go beyond anxiety and flashbacks, showing up with symptoms like hallucinations, delusions, and distorted thinking.\n\nPTSD frequently involves dissociation, which may explain co-occurring psychosis. Frequent dissociation may increase a person's risk of developing psychotic symptoms.\n\nWhile PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD.\n\nCertain types of trauma may be more likely to trigger psychosis. [Traumatic events](https:\/\/www.verywellmind.com\/ptsd-causes-and-risk-factors-2797397) that increase the risk of developing PTSD with psychosis include:\n\n- Being involved in a natural disaster\n- Seeing someone injured or killed\n- Experiencing shock as a result of a traumatic event that happened to a loved one\n\nOther risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use.\n\n### Recap\nSome symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis *along* with PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior.\n## Complications of PTSD and Psychosis\nWhen people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process.\n\n### Psychosis-Related PTSD\nResearch has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD.\n\nPeople with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, including [suicidal thoughts](https:\/\/www.verywellmind.com\/suicidal-ideation-380609), suicide attempts, and more significant overall distress. It's essential for everyone with PTSD and their loved ones to know the [risk factors and warning signs of suicide](https:\/\/www.verywellmind.com\/suicide-warning-signs-and-risk-factors-1067525).\n\nIf you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or [flat affect](https:\/\/www.verywellmind.com\/flattened-affect-2953086), you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors.\n\nIf you are having suicidal thoughts, contact the [National Suicide Prevention Lifeline](https:\/\/suicidepreventionlifeline.org\/) at **988** for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.\n\n## Diagnosis of PTSD and Psychosis\nTo diagnose PTSD with psychosis, doctors will evaluate an individual's symptoms, perform physical and lab tests to rule out other conditions, and review the individual's medical history. This allows them to assess symptoms of PTSD and psychosis.\n\nFlashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including:\n\n**During a** [**flashback**](https:\/\/www.verywellmind.com\/coping-with-flashbacks-2797574), you might temporarily lose connection with your present situation, being transported back in time to a traumatic event in your memory. If you have a severe flashback, you may see, hear, or smell things that others do not—which is consistent with a hallucination. Flashbacks often occur during periods of high stress and can be very frightening to the person experiencing them.\n\n[**Dissociation**](https:\/\/www.verywellmind.com\/dissociation-2797292)is when you feel disconnected from your body. You may have no memory of what was going on around you or what you were doing for some time. The experience of dissociating is similar to a daydream, but unlike a normal daydream, it's very disruptive to your life.\n\n### Psychosis Symptoms\nTo make a diagnosis, a doctor will also note the presence of psychotic symptoms. [Psychotic symptoms](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) can be divided into two groups: positive symptoms and negative symptoms. However, this doesn't mean some psychotic symptoms are good and some are bad.\n\nPositive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships.\n\n[Positive psychotic symptoms](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) are characterized by the presence of unusual feelings, thoughts, or behaviors. This includes experiences such as [hallucinations](https:\/\/www.verywellmind.com\/what-are-hallucinations-378819) or [delusions](https:\/\/www.verywellmind.com\/delusions-types-and-role-in-psychosis-379826).\n\n- **Hallucinations** refer to sensations of something that isn't really there. They can be auditory, visual, tactile, olfactory, and\/or gustatory. *Auditory hallucinations* involve an experience of hearing voices or sounds that are not there. *Visual hallucinations* would involve seeing something that isn't real. *Tactile hallucinations* occur when you feel something that isn't there. *Olfactory and gustatory hallucinations* occur when you smell or taste something that is not present.\n- **Delusions** are ideas that you believe are true despite the fact that they may be unlikely or odd. For example, you might believe that the CIA is spying on you or that aliens are controlling your behaviors or thoughts.\n- **Disorganized behaviors** are also very common with psychosis. You may, for example, use made-up words, speak in unintelligible ways, or stand in an odd pose.\n\n[Negative psychotic symptoms](https:\/\/www.verywellmind.com\/what-is-psychosis-p2-379828) are characterized by the absence of an experience. For example, you might not be emotionally expressive, you might have difficulty speaking or not speak for days on end (alogia), or be unable to accomplish simple tasks or activities, such as getting dressed in the morning.\n\n### Related Conditions\nIn addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap.\n\nMental health conditions that can have positive and negative psychotic symptoms include:\n\n- [Bipolar disorder](https:\/\/www.verywellmind.com\/bipolar-disorder-symptoms-and-diagnosis-379962)\n- [Delusional disorder](https:\/\/www.verywellmind.com\/delusional-disorder-symptoms-causes-and-treatment-6826265)\n- Major depressive disorder with psychotic features\n- [Schizoaffective disorder](https:\/\/www.verywellmind.com\/what-is-schizoaffective-disorder-4171702)\n- [Schizophrenia](https:\/\/www.verywellmind.com\/the-internal-experience-of-schizophrenia-2953095)\n- [Schizophreniform disorder](https:\/\/www.verywellmind.com\/what-is-schizophreniform-disorder-5208704)\n\nSome people [have both schizophrenia and PTSD](https:\/\/www.verywellmind.com\/ptsd-treatment-2797659). Research has shown that traumatic experiences are more common among people with [schizophrenia](https:\/\/www.verywellmind.com\/schizophrenia-4157221) than in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD. It might not be surprising that many people living with schizophrenia have experienced trauma, and that the two conditions may be more closely related than previously thought.\n\n### Recap\nPTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia.\n## Treatment of PTSD and Psychosis\nIf you or someone you care about has PTSD and is experiencing psychotic symptoms, reaching out for help is crucial. The right treatment can improve functioning and reduce the risk of developing psychotic symptoms linked to untreated PTSD.\n\nTreatment is essential and may involve psychotherapy, medication, or a combination.\n\nTreatment options include:\n\n- **Psychotherapy**: Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis. [Addressing PTSD symptoms](https:\/\/www.verywellmind.com\/ptsd-treatment-2797659) in treatment can also result in a reduction of psychotic symptoms.\n- **Medications**: Positive psychotic symptoms can sometimes be effectively managed through medication. However, some researchers suggest that there is currently not enough evidence to recommend using [second-generation antipsychotics](https:\/\/www.verywellmind.com\/atypical-antipsychotics-379663) (SGA) to treat PTSD with secondary psychotic features.\n\nTreatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example, [exposure therapy for PTSD](https:\/\/www.verywellmind.com\/exposure-therapy-for-ptsd-2797654) may not be the best treatment for someone with schizophrenia, as it could worsen their symptoms.\n\nStudies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important.\n\n## Coping With PTSD and Psychosis\nFor those experiencing symptoms of PTSD, psychosis, or both, seeking support from a qualified mental health professional is an essential first step. In addition to professional care, there are also coping strategies people can use to support their functioning and mental well-being.\n\nCaring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions.\n\n- **Get social support**: Having support from loved ones can also help you better manage symptoms of PTSD with psychosis. Talk to trusted loved ones about your conditions and look for ways they can provide practical and emotional support.\n- **Practice self-care**: Take care of yourself physically and mentally. Getting adequate sleep, eating a balanced diet, and engaging in regular activity can be helpful.\n- **Watch for triggers**: Certain situations, people, or events can trigger symptoms of PTSD, which can exacerbate psychotic symptoms. Being aware of [PTSD triggers](https:\/\/www.verywellmind.com\/ptsd-triggers-and-coping-strategies-2797557) and utilizing ways to manage them can help minimize the risk of experiencing flashbacks, dissociation, and other symptoms.\n- **Manage stress**: Stress can trigger or worsen psychotic symptoms, so it is crucial to reduce stress levels and utilize effective relaxation techniques.\n\nThe experience of psychotic symptoms may tell the story of how severe a person's PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor.","meta_canonical":null}

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Boilerpipe Text	Key Takeaways PTSD can sometimes lead to psychotic symptoms like hallucinations and delusions. PTSD with psychosis affects an estimated 2.5% of people with PTSD. It's important to seek medical help if you have symptoms like delusions or suicidal thoughts. Post-traumatic stress disorder (PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms: re-experiencing symptoms, avoidance symptoms, negative changes in mood and brain function, and hyperarousal symptoms . However, PTSD can also sometimes occur with psychosis. Psychosis involves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior. PTSD with psychosis is a lesser-known and often misunderstood form of the condition. When it happens, the boundaries between the memory of the trauma, the fear that it causes, and reality become blurred. While this symptom is not as widely recognized as some other trauma symptoms, it affects an estimated 2.5% of people with PTSD. Below, learn more about the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment. The Connection Between PTSD and Psychosis While PSTD and psychosis are typically seen as separate conditions, research has shown that severe trauma can sometimes lead to psychotic symptoms. In fact, psychotic symptoms might be related to the severity of an individual's PTSD symptoms. The more PTSD symptoms you're experiencing, the greater the likelihood you will also have psychosis. In such cases, the brain's response to overwhelming stress can go beyond anxiety and flashbacks, showing up with symptoms like hallucinations, delusions, and distorted thinking. PTSD frequently involves dissociation, which may explain co-occurring psychosis. Frequent dissociation may increase a person's risk of developing psychotic symptoms. While PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD. Certain types of trauma may be more likely to trigger psychosis. Traumatic events that increase the risk of developing PTSD with psychosis include: Being involved in a natural disaster Seeing someone injured or killed Experiencing shock as a result of a traumatic event that happened to a loved one Other risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use. Recap Some symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis along with PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior. Complications of PTSD and Psychosis When people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process. Psychosis-Related PTSD Research has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD. People with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, including suicidal thoughts , suicide attempts, and more significant overall distress. It's essential for everyone with PTSD and their loved ones to know the risk factors and warning signs of suicide . If you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or flat affect , you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. Diagnosis of PTSD and Psychosis To diagnose PTSD with psychosis, doctors will evaluate an individual's symptoms, perform physical and lab tests to rule out other conditions, and review the individual's medical history. This allows them to assess symptoms of PTSD and psychosis. Flashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including: During a flashback , you might temporarily lose connection with your present situation, being transported back in time to a traumatic event in your memory. If you have a severe flashback, you may see, hear, or smell things that others do not—which is consistent with a hallucination. Flashbacks often occur during periods of high stress and can be very frightening to the person experiencing them. Dissociation is when you feel disconnected from your body. You may have no memory of what was going on around you or what you were doing for some time. The experience of dissociating is similar to a daydream, but unlike a normal daydream, it's very disruptive to your life. Psychosis Symptoms To make a diagnosis, a doctor will also note the presence of psychotic symptoms. Psychotic symptoms can be divided into two groups: positive symptoms and negative symptoms. However, this doesn't mean some psychotic symptoms are good and some are bad. Positive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships. Positive psychotic symptoms are characterized by the presence of unusual feelings, thoughts, or behaviors. This includes experiences such as hallucinations or delusions . Hallucinations refer to sensations of something that isn't really there. They can be auditory, visual, tactile, olfactory, and/or gustatory. Auditory hallucinations involve an experience of hearing voices or sounds that are not there. Visual hallucinations would involve seeing something that isn't real. Tactile hallucinations occur when you feel something that isn't there. Olfactory and gustatory hallucinations occur when you smell or taste something that is not present. Delusions are ideas that you believe are true despite the fact that they may be unlikely or odd. For example, you might believe that the CIA is spying on you or that aliens are controlling your behaviors or thoughts. Disorganized behaviors are also very common with psychosis. You may, for example, use made-up words, speak in unintelligible ways, or stand in an odd pose. Negative psychotic symptoms are characterized by the absence of an experience. For example, you might not be emotionally expressive, you might have difficulty speaking or not speak for days on end (alogia), or be unable to accomplish simple tasks or activities, such as getting dressed in the morning. Related Conditions In addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap. Mental health conditions that can have positive and negative psychotic symptoms include: Bipolar disorder Delusional disorder Major depressive disorder with psychotic features Schizoaffective disorder Schizophrenia Schizophreniform disorder Some people have both schizophrenia and PTSD . Research has shown that traumatic experiences are more common among people with schizophrenia than in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD. It might not be surprising that many people living with schizophrenia have experienced trauma, and that the two conditions may be more closely related than previously thought. Recap PTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia. Treatment of PTSD and Psychosis If you or someone you care about has PTSD and is experiencing psychotic symptoms, reaching out for help is crucial. The right treatment can improve functioning and reduce the risk of developing psychotic symptoms linked to untreated PTSD. Treatment is essential and may involve psychotherapy, medication, or a combination. Treatment options include: Psychotherapy : Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis. Addressing PTSD symptoms in treatment can also result in a reduction of psychotic symptoms. Medications : Positive psychotic symptoms can sometimes be effectively managed through medication. However, some researchers suggest that there is currently not enough evidence to recommend using second-generation antipsychotics (SGA) to treat PTSD with secondary psychotic features. Treatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example, exposure therapy for PTSD may not be the best treatment for someone with schizophrenia, as it could worsen their symptoms. Studies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important. Coping With PTSD and Psychosis For those experiencing symptoms of PTSD, psychosis, or both, seeking support from a qualified mental health professional is an essential first step. In addition to professional care, there are also coping strategies people can use to support their functioning and mental well-being. Caring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions. Get social support : Having support from loved ones can also help you better manage symptoms of PTSD with psychosis. Talk to trusted loved ones about your conditions and look for ways they can provide practical and emotional support. Practice self-care : Take care of yourself physically and mentally. Getting adequate sleep, eating a balanced diet, and engaging in regular activity can be helpful. Watch for triggers : Certain situations, people, or events can trigger symptoms of PTSD, which can exacerbate psychotic symptoms. Being aware of PTSD triggers and utilizing ways to manage them can help minimize the risk of experiencing flashbacks, dissociation, and other symptoms. Manage stress : Stress can trigger or worsen psychotic symptoms, so it is crucial to reduce stress levels and utilize effective relaxation techniques. The experience of psychotic symptoms may tell the story of how severe a person's PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor.
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Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Ⓒ 2026 People Inc. — All rights reserved # What It's Like to Live With PTSD With Psychosis The overlap between trauma and psychotic symptoms By [Matthew Tull, PhD](https://www.verywellmind.com/matthew-tull-phd-2797109) [Matthew Tull, PhD](https://www.verywellmind.com/matthew-tull-phd-2797109) Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our [editorial process](https://www.verywellmind.com/our-editorial-process-4778006) Updated on December 07, 2025 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. [Learn more](https://www.verywellmind.com/review-board-4796494). by [Daniel B. Block, MD](https://www.verywellmind.com/daniel-block-md-4779186) ![Block]() ![Block](https://www.verywellmind.com/thmb/bqppKq4IVUTVsPMClzJADd5fs14=/200x200/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/block-8924ca72ff94426d940e8f7e639e3942.jpg) Medically reviewed by [Daniel B. Block, MD](https://www.verywellmind.com/daniel-block-md-4779186) Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our [Medical Review Board](https://www.verywellmind.com/review-board-4796494) ![Reflective young man looking down, portrait](https://www.verywellmind.com/thmb/q1F4BNTG4FZ2lqZF4rBtdOkwhdQ=/1500x0/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/GettyImages-73427467web-56e1ecc93df78c5ba056afe7.jpg) ![Reflective young man looking down, portrait](https://www.verywellmind.com/thmb/q1F4BNTG4FZ2lqZF4rBtdOkwhdQ=/1500x0/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/GettyImages-73427467web-56e1ecc93df78c5ba056afe7.jpg) Frank van Groen / LOOK-foto / Getty Images Table of Contents View All Table of Contents - [Understanding the Connection](https://www.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-the-connection-between-ptsd-and-psychosis) - [Complications](https://www.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-complications-of-ptsd-and-psychosis) - [Diagnosis](https://www.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-diagnosis-of-ptsd-and-psychosis) - [Treatment](https://www.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-treatment-of-ptsd-and-psychosis) - [Coping](https://www.verywellmind.com/relationship-between-ptsd-and-psychotic-symptoms-2797525#toc-coping-with-ptsd-and-psychosis) Close ### Key Takeaways - PTSD can sometimes lead to psychotic symptoms like hallucinations and delusions. - PTSD with psychosis affects an estimated 2.5% of people with PTSD. - It's important to seek medical help if you have symptoms like delusions or suicidal thoughts. [Post-traumatic stress disorder](https://www.verywellmind.com/ptsd-4157229) (PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms: [re-experiencing](https://www.verywellmind.com/re-experiencing-2797325) symptoms, avoidance symptoms, negative changes in mood and brain function, and [hyperarousal symptoms](https://www.verywellmind.com/hyperarousal-2797362). However, PTSD can also sometimes occur with psychosis. [Psychosis](https://www.verywellmind.com/what-is-psychosis-p2-379828) involves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior. PTSD with psychosis is a lesser-known and often misunderstood form of the condition. When it happens, the boundaries between the memory of the trauma, the fear that it causes, and reality become blurred. While this symptom is not as widely recognized as some other trauma symptoms, it affects an estimated 2.5% of people with PTSD. Below, learn more about the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment. ## The Connection Between PTSD and Psychosis While PSTD and psychosis are typically seen as separate conditions, research has shown that severe trauma can sometimes lead to psychotic symptoms. In fact, psychotic symptoms might be related to the severity of an individual's PTSD symptoms. The more PTSD symptoms you're experiencing, the greater the likelihood you will also have psychosis. In such cases, the brain's response to overwhelming stress can go beyond anxiety and flashbacks, showing up with symptoms like hallucinations, delusions, and distorted thinking. PTSD frequently involves dissociation, which may explain co-occurring psychosis. Frequent dissociation may increase a person's risk of developing psychotic symptoms. While PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD. Certain types of trauma may be more likely to trigger psychosis. [Traumatic events](https://www.verywellmind.com/ptsd-causes-and-risk-factors-2797397) that increase the risk of developing PTSD with psychosis include: - Being involved in a natural disaster - Seeing someone injured or killed - Experiencing shock as a result of a traumatic event that happened to a loved one Other risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use. ### Recap Some symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis along with PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior. [Flashbacks and Dissociation in PTSD](https://www.verywellmind.com/coping-with-flashbacks-2797574) ## Complications of PTSD and Psychosis When people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process. ### Psychosis-Related PTSD Research has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD. People with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, including [suicidal thoughts](https://www.verywellmind.com/suicidal-ideation-380609), suicide attempts, and more significant overall distress. It's essential for everyone with PTSD and their loved ones to know the [risk factors and warning signs of suicide](https://www.verywellmind.com/suicide-warning-signs-and-risk-factors-1067525). If you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or [flat affect](https://www.verywellmind.com/flattened-affect-2953086), you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors. If you are having suicidal thoughts, contact the [National Suicide Prevention Lifeline](https://suicidepreventionlifeline.org/) at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. ## Diagnosis of PTSD and Psychosis To diagnose PTSD with psychosis, doctors will evaluate an individual's symptoms, perform physical and lab tests to rule out other conditions, and review the individual's medical history. This allows them to assess symptoms of PTSD and psychosis. Flashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including: During a [flashback](https://www.verywellmind.com/coping-with-flashbacks-2797574), you might temporarily lose connection with your present situation, being transported back in time to a traumatic event in your memory. If you have a severe flashback, you may see, hear, or smell things that others do not—which is consistent with a hallucination. Flashbacks often occur during periods of high stress and can be very frightening to the person experiencing them. [Dissociation](https://www.verywellmind.com/dissociation-2797292)is when you feel disconnected from your body. You may have no memory of what was going on around you or what you were doing for some time. The experience of dissociating is similar to a daydream, but unlike a normal daydream, it's very disruptive to your life. ### Psychosis Symptoms To make a diagnosis, a doctor will also note the presence of psychotic symptoms. [Psychotic symptoms](https://www.verywellmind.com/what-is-psychosis-p2-379828) can be divided into two groups: positive symptoms and negative symptoms. However, this doesn't mean some psychotic symptoms are good and some are bad. Positive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships. [Positive psychotic symptoms](https://www.verywellmind.com/what-is-psychosis-p2-379828) are characterized by the presence of unusual feelings, thoughts, or behaviors. This includes experiences such as [hallucinations](https://www.verywellmind.com/what-are-hallucinations-378819) or [delusions](https://www.verywellmind.com/delusions-types-and-role-in-psychosis-379826). - Hallucinations refer to sensations of something that isn't really there. They can be auditory, visual, tactile, olfactory, and/or gustatory. Auditory hallucinations involve an experience of hearing voices or sounds that are not there. Visual hallucinations would involve seeing something that isn't real. Tactile hallucinations occur when you feel something that isn't there. Olfactory and gustatory hallucinations occur when you smell or taste something that is not present. - Delusions are ideas that you believe are true despite the fact that they may be unlikely or odd. For example, you might believe that the CIA is spying on you or that aliens are controlling your behaviors or thoughts. - Disorganized behaviors are also very common with psychosis. You may, for example, use made-up words, speak in unintelligible ways, or stand in an odd pose. [Negative psychotic symptoms](https://www.verywellmind.com/what-is-psychosis-p2-379828) are characterized by the absence of an experience. For example, you might not be emotionally expressive, you might have difficulty speaking or not speak for days on end (alogia), or be unable to accomplish simple tasks or activities, such as getting dressed in the morning. ### Related Conditions In addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap. Mental health conditions that can have positive and negative psychotic symptoms include: - [Bipolar disorder](https://www.verywellmind.com/bipolar-disorder-symptoms-and-diagnosis-379962) - [Delusional disorder](https://www.verywellmind.com/delusional-disorder-symptoms-causes-and-treatment-6826265) - Major depressive disorder with psychotic features - [Schizoaffective disorder](https://www.verywellmind.com/what-is-schizoaffective-disorder-4171702) - [Schizophrenia](https://www.verywellmind.com/the-internal-experience-of-schizophrenia-2953095) - [Schizophreniform disorder](https://www.verywellmind.com/what-is-schizophreniform-disorder-5208704) Some people [have both schizophrenia and PTSD](https://www.verywellmind.com/ptsd-treatment-2797659). Research has shown that traumatic experiences are more common among people with [schizophrenia](https://www.verywellmind.com/schizophrenia-4157221) than in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD. It might not be surprising that many people living with schizophrenia have experienced trauma, and that the two conditions may be more closely related than previously thought. ### Recap PTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia. ## Treatment of PTSD and Psychosis If you or someone you care about has PTSD and is experiencing psychotic symptoms, reaching out for help is crucial. The right treatment can improve functioning and reduce the risk of developing psychotic symptoms linked to untreated PTSD. Treatment is essential and may involve psychotherapy, medication, or a combination. Treatment options include: - Psychotherapy: Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis. [Addressing PTSD symptoms](https://www.verywellmind.com/ptsd-treatment-2797659) in treatment can also result in a reduction of psychotic symptoms. - Medications: Positive psychotic symptoms can sometimes be effectively managed through medication. However, some researchers suggest that there is currently not enough evidence to recommend using [second-generation antipsychotics](https://www.verywellmind.com/atypical-antipsychotics-379663) (SGA) to treat PTSD with secondary psychotic features. Treatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example, [exposure therapy for PTSD](https://www.verywellmind.com/exposure-therapy-for-ptsd-2797654) may not be the best treatment for someone with schizophrenia, as it could worsen their symptoms. Studies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important. ## Coping With PTSD and Psychosis For those experiencing symptoms of PTSD, psychosis, or both, seeking support from a qualified mental health professional is an essential first step. In addition to professional care, there are also coping strategies people can use to support their functioning and mental well-being. Caring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions. - Get social support: Having support from loved ones can also help you better manage symptoms of PTSD with psychosis. Talk to trusted loved ones about your conditions and look for ways they can provide practical and emotional support. - Practice self-care: Take care of yourself physically and mentally. Getting adequate sleep, eating a balanced diet, and engaging in regular activity can be helpful. - Watch for triggers: Certain situations, people, or events can trigger symptoms of PTSD, which can exacerbate psychotic symptoms. Being aware of [PTSD triggers](https://www.verywellmind.com/ptsd-triggers-and-coping-strategies-2797557) and utilizing ways to manage them can help minimize the risk of experiencing flashbacks, dissociation, and other symptoms. - Manage stress: Stress can trigger or worsen psychotic symptoms, so it is crucial to reduce stress levels and utilize effective relaxation techniques. The experience of psychotic symptoms may tell the story of how severe a person's PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor. If you or a loved one are struggling with PTSD or psychosis, contact the [Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline](https://www.samhsa.gov/find-help/national-helpline) at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our [National Helpline Database](https://www.verywellmind.com/national-helpline-database-4799696). Read more: - [Conditions A-Z](https://www.verywellmind.com/conditions-a-z-4797402) - [PTSD](https://www.verywellmind.com/ptsd-4157229) - [Symptoms and Diagnosis](https://www.verywellmind.com/ptsd-symptoms-and-diagnosis-4157228) 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](https://www.verywellmind.com/our-editorial-process-4778006) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 1. Miao XR, Chen QB, Wei K, Tao KM, Lu ZJ. [Posttraumatic stress disorder: from diagnosis to prevention](https://dx.doi.org/10.1186%2Fs40779-018-0179-0). Mil Med Res. 2018;5(1):32. Published 2018 Sep 28. doi:10.1186/s40779-018-0179-0 2. Hamner MB. [Psychotic symptoms in posttraumatic stress disorder](https://focus.psychiatryonline.org/doi/pdf/10.1176/foc.9.3.foc278). FOC. 2011;9(3):278-285. 3. Buswell G, Haime Z, Lloyd-Evans B, Billings J. [A systematic review of PTSD to the experience of psychosis: prevalence and associated factors](https://doi.org/10.1186/s12888-020-02999-x). BMC Psychiatry. 2021;21(1):9. doi:10.1186/s12888-020-02999-x 4. Gibson LE, Alloy LB, Ellman LM. [Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms](https://dx.doi.org/10.1016%2Fj.cpr.2016.08.003). Clin Psychol Rev. 2016;49:92–105. doi:10.1016/j.cpr.2016.08.003 5. Compean E, Hamner M. [Posttraumatic stress disorder with secondary psychotic features (PTSD-SP): Diagnostic and treatment challenges](https://doi.org/10.1016/j.pnpbp.2018.08.001). Prog Neuropsychopharmacol Biol Psychiatry. 2019;88:265-275. doi:10.1016/j.pnpbp.2018.08.001 6. Şar V. [The many faces of dissociation: opportunities for innovative research in psychiatry](https://dx.doi.org/10.9758%2Fcpn.2014.12.3.171). Clin Psychopharmacol Neurosci. 2014;12(3):171–179. doi:10.9758/cpn.2014.12.3.171 7. Gaebel W, Zielasek J. [Focus on psychosis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421906/). Dialogues Clin Neurosci. 2015;17(1):9–18. 8. Lyne J, O'donoghue B, Roche E, Renwick L, Cannon M, Clarke M. [Negative symptoms of psychosis: a life course approach and implications for prevention and treatment](https://pubmed.ncbi.nlm.nih.gov/29076240/). Early Interv Psychiatry. 2018;12(4):561-571. doi: 10.1111/eip.12501 9. Duncan LE, Ratanatharathorn A, Aiello AE, et al. [Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences inheritability](https://dx.doi.org/10.1038%2Fmp.2017.77). Mol Psychiatry. 2018;23(3):666–673. doi:10.1038/mp.2017.77 10. Oconghaile A, Delisi LE. [Distinguishing schizophrenia from posttraumatic stress disorder with psychosis](https://doi.org/10.1097/YCO.0000000000000158). Curr Opin Psychiatry. 2015;28(3):249-55. doi:10.1097/YCO.0000000000000158 By [Matthew Tull, PhD](https://www.verywellmind.com/matthew-tull-phd-2797109) Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. [See Our Editorial Process](https://www.verywellmind.com/our-editorial-process-4778006) [Meet Our Review Board](https://www.verywellmind.com/review-board-4796494) Share Feedback Was this page helpful? Thanks for your feedback\! What is your feedback? 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Readable Markdown	### Key Takeaways - PTSD can sometimes lead to psychotic symptoms like hallucinations and delusions. - PTSD with psychosis affects an estimated 2.5% of people with PTSD. - It's important to seek medical help if you have symptoms like delusions or suicidal thoughts. [Post-traumatic stress disorder](https://www.verywellmind.com/ptsd-4157229) (PTSD) is a condition that can occur after someone has experienced a traumatic event. It involves four clusters of symptoms: [re-experiencing](https://www.verywellmind.com/re-experiencing-2797325) symptoms, avoidance symptoms, negative changes in mood and brain function, and [hyperarousal symptoms](https://www.verywellmind.com/hyperarousal-2797362). However, PTSD can also sometimes occur with psychosis. [Psychosis](https://www.verywellmind.com/what-is-psychosis-p2-379828) involves losing connection with reality, which can lead to symptoms such as delusions, hallucinations, and incoherent behavior. PTSD with psychosis is a lesser-known and often misunderstood form of the condition. When it happens, the boundaries between the memory of the trauma, the fear that it causes, and reality become blurred. While this symptom is not as widely recognized as some other trauma symptoms, it affects an estimated 2.5% of people with PTSD. Below, learn more about the connection between PTSD and psychosis and how having both conditions can affect diagnosis and treatment. ## The Connection Between PTSD and Psychosis While PSTD and psychosis are typically seen as separate conditions, research has shown that severe trauma can sometimes lead to psychotic symptoms. In fact, psychotic symptoms might be related to the severity of an individual's PTSD symptoms. The more PTSD symptoms you're experiencing, the greater the likelihood you will also have psychosis. In such cases, the brain's response to overwhelming stress can go beyond anxiety and flashbacks, showing up with symptoms like hallucinations, delusions, and distorted thinking. PTSD frequently involves dissociation, which may explain co-occurring psychosis. Frequent dissociation may increase a person's risk of developing psychotic symptoms. While PTSD and psychosis are separate conditions, research suggests that there is evidence that PTSD with secondary psychotic features (PTSD-SP) might be a distinct form of PTSD. Certain types of trauma may be more likely to trigger psychosis. [Traumatic events](https://www.verywellmind.com/ptsd-causes-and-risk-factors-2797397) that increase the risk of developing PTSD with psychosis include: - Being involved in a natural disaster - Seeing someone injured or killed - Experiencing shock as a result of a traumatic event that happened to a loved one Other risk factors that can increase the likelihood of psychosis include schizophrenia, other mental disorders, physical illness, and substance use. ### Recap Some symptoms of PTSD share common features with psychosis, but it is also possible to experience psychosis along with PTSD. Experiencing symptoms of severe PTSD can elevate this risk. Possible complications of having both conditions include an increased risk of depression, self-harm, and suicidal behavior. ## Complications of PTSD and Psychosis When people have PTSD with psychosis, they can experience different types of psychotic symptoms alongside other symptoms of PTSD. This can include having positive and negative psychotic symptoms, flashbacks, and dissociation. This can complicate both the diagnosis and treatment process. ### Psychosis-Related PTSD Research has also shown that experiencing psychosis is traumatic, which can lead to psychosis-related PTSD. One systematic review found that 14% and 47% of people with psychosis develop this type of PTSD. People with PTSD who experience psychotic symptoms, as compared to those with PTSD who do not, might be at greater risk for several mental health concerns, including [suicidal thoughts](https://www.verywellmind.com/suicidal-ideation-380609), suicide attempts, and more significant overall distress. It's essential for everyone with PTSD and their loved ones to know the [risk factors and warning signs of suicide](https://www.verywellmind.com/suicide-warning-signs-and-risk-factors-1067525). If you experience psychotic symptoms such as delusions, disorganized thinking, hallucinations, or [flat affect](https://www.verywellmind.com/flattened-affect-2953086), you should consult a medical professional immediately. You should also seek help immediately if you experience suicidal thoughts or behaviors. If you are having suicidal thoughts, contact the [National Suicide Prevention Lifeline](https://suicidepreventionlifeline.org/) at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. ## Diagnosis of PTSD and Psychosis To diagnose PTSD with psychosis, doctors will evaluate an individual's symptoms, perform physical and lab tests to rule out other conditions, and review the individual's medical history. This allows them to assess symptoms of PTSD and psychosis. Flashbacks and dissociation commonly occur with PTSD. While they are not psychotic symptoms, they share some features with psychosis, including: During a [flashback](https://www.verywellmind.com/coping-with-flashbacks-2797574), you might temporarily lose connection with your present situation, being transported back in time to a traumatic event in your memory. If you have a severe flashback, you may see, hear, or smell things that others do not—which is consistent with a hallucination. Flashbacks often occur during periods of high stress and can be very frightening to the person experiencing them. [Dissociation](https://www.verywellmind.com/dissociation-2797292)is when you feel disconnected from your body. You may have no memory of what was going on around you or what you were doing for some time. The experience of dissociating is similar to a daydream, but unlike a normal daydream, it's very disruptive to your life. ### Psychosis Symptoms To make a diagnosis, a doctor will also note the presence of psychotic symptoms. [Psychotic symptoms](https://www.verywellmind.com/what-is-psychosis-p2-379828) can be divided into two groups: positive symptoms and negative symptoms. However, this doesn't mean some psychotic symptoms are good and some are bad. Positive symptoms refer to an experience, such as hallucinations, while negative symptoms refer to the inability to show emotions, apathy, difficulties talking, and withdrawing from social situations and relationships. [Positive psychotic symptoms](https://www.verywellmind.com/what-is-psychosis-p2-379828) are characterized by the presence of unusual feelings, thoughts, or behaviors. This includes experiences such as [hallucinations](https://www.verywellmind.com/what-are-hallucinations-378819) or [delusions](https://www.verywellmind.com/delusions-types-and-role-in-psychosis-379826). - Hallucinations refer to sensations of something that isn't really there. They can be auditory, visual, tactile, olfactory, and/or gustatory. Auditory hallucinations involve an experience of hearing voices or sounds that are not there. Visual hallucinations would involve seeing something that isn't real. Tactile hallucinations occur when you feel something that isn't there. Olfactory and gustatory hallucinations occur when you smell or taste something that is not present. - Delusions are ideas that you believe are true despite the fact that they may be unlikely or odd. For example, you might believe that the CIA is spying on you or that aliens are controlling your behaviors or thoughts. - Disorganized behaviors are also very common with psychosis. You may, for example, use made-up words, speak in unintelligible ways, or stand in an odd pose. [Negative psychotic symptoms](https://www.verywellmind.com/what-is-psychosis-p2-379828) are characterized by the absence of an experience. For example, you might not be emotionally expressive, you might have difficulty speaking or not speak for days on end (alogia), or be unable to accomplish simple tasks or activities, such as getting dressed in the morning. ### Related Conditions In addition to PTSD, positive and negative psychotic symptoms can occur in other mental health conditions. It can sometimes be difficult to distinguish between them, as the symptoms can overlap. Mental health conditions that can have positive and negative psychotic symptoms include: - [Bipolar disorder](https://www.verywellmind.com/bipolar-disorder-symptoms-and-diagnosis-379962) - [Delusional disorder](https://www.verywellmind.com/delusional-disorder-symptoms-causes-and-treatment-6826265) - Major depressive disorder with psychotic features - [Schizoaffective disorder](https://www.verywellmind.com/what-is-schizoaffective-disorder-4171702) - [Schizophrenia](https://www.verywellmind.com/the-internal-experience-of-schizophrenia-2953095) - [Schizophreniform disorder](https://www.verywellmind.com/what-is-schizophreniform-disorder-5208704) Some people [have both schizophrenia and PTSD](https://www.verywellmind.com/ptsd-treatment-2797659). Research has shown that traumatic experiences are more common among people with [schizophrenia](https://www.verywellmind.com/schizophrenia-4157221) than in the general population. A 2018 study found a significant genetic overlap between schizophrenia and PTSD. It might not be surprising that many people living with schizophrenia have experienced trauma, and that the two conditions may be more closely related than previously thought. ### Recap PTSD and psychosis have overlapping symptoms that can make diagnosis more challenging. Doctors will evaluate symptoms, including flashbacks, dissociation, and psychosis, to make a diagnosis. They also have to rule out other conditions that feature psychotic symptoms. Some people may experience PTSD and other conditions such as schizophrenia. ## Treatment of PTSD and Psychosis If you or someone you care about has PTSD and is experiencing psychotic symptoms, reaching out for help is crucial. The right treatment can improve functioning and reduce the risk of developing psychotic symptoms linked to untreated PTSD. Treatment is essential and may involve psychotherapy, medication, or a combination. Treatment options include: - Psychotherapy: Research suggests that psychotherapy can be effective in treating PTSD with co-occurring psychosis. [Addressing PTSD symptoms](https://www.verywellmind.com/ptsd-treatment-2797659) in treatment can also result in a reduction of psychotic symptoms. - Medications: Positive psychotic symptoms can sometimes be effectively managed through medication. However, some researchers suggest that there is currently not enough evidence to recommend using [second-generation antipsychotics](https://www.verywellmind.com/atypical-antipsychotics-379663) (SGA) to treat PTSD with secondary psychotic features. Treatment is also essential if a person has co-occurring PTSD and schizophrenia. However, having both disorders can complicate the treatment process. For example, [exposure therapy for PTSD](https://www.verywellmind.com/exposure-therapy-for-ptsd-2797654) may not be the best treatment for someone with schizophrenia, as it could worsen their symptoms. Studies have found that well-thought-out treatment can reduce the symptoms of PTSD. For those with PTSD and schizophrenia, finding a mental health provider who is familiar with treating both conditions is important. ## Coping With PTSD and Psychosis For those experiencing symptoms of PTSD, psychosis, or both, seeking support from a qualified mental health professional is an essential first step. In addition to professional care, there are also coping strategies people can use to support their functioning and mental well-being. Caring for yourself, finding support, and being aware of PTSD triggers can be helpful when managing symptoms of both conditions. - Get social support: Having support from loved ones can also help you better manage symptoms of PTSD with psychosis. Talk to trusted loved ones about your conditions and look for ways they can provide practical and emotional support. - Practice self-care: Take care of yourself physically and mentally. Getting adequate sleep, eating a balanced diet, and engaging in regular activity can be helpful. - Watch for triggers: Certain situations, people, or events can trigger symptoms of PTSD, which can exacerbate psychotic symptoms. Being aware of [PTSD triggers](https://www.verywellmind.com/ptsd-triggers-and-coping-strategies-2797557) and utilizing ways to manage them can help minimize the risk of experiencing flashbacks, dissociation, and other symptoms. - Manage stress: Stress can trigger or worsen psychotic symptoms, so it is crucial to reduce stress levels and utilize effective relaxation techniques. The experience of psychotic symptoms may tell the story of how severe a person's PTSD is and how well they are coping with it. If symptoms are severe or worsening, it is essential to talk to your doctor.
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