On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can judge how urgently specialist care is needed and help arrange it; diagnosis and treatment are by a specialist mental health team.
- What it is: psychosis means losing some contact with reality: hallucinations, such as hearing voices, delusions, and confused thinking. Schizophrenia is a long-term condition and a type of psychosis.
- How common: 1 in 300 people worldwide live with schizophrenia, and psychosis often starts between the late teens and the mid-20s.
- Recovery: early treatment works better. At least 1 in 3 people with schizophrenia recover fully, and many more manage it well with treatment.
- Emergency: call 112 if someone may harm themselves or others, is very agitated, has stopped eating and drinking, or is confused with a high temperature or after a head injury.
Do not book a video appointment if you, or the person you are worried about, may harm themselves or someone else, have thoughts of suicide that you might act on, are very agitated, have stopped eating and drinking, or are suddenly confused, especially with a high temperature or after a head injury. Call 112 or go to an emergency department.
Can an online doctor help with psychosis?
No, psychosis is not treated online. It is diagnosed and treated by a mental health specialist, usually an early intervention team or a community mental health team, and a severe episode may need hospital care. What a doctor by video can do is talk through what you, or someone close to you, is experiencing, look for causes such as drugs, alcohol, medicines or a physical illness, judge how urgently specialist care is needed, and help arrange it. If anyone may be harmed, call 112.
How an online consultation helps with possible psychosis
- Urgency made clear: Whether this needs an emergency department, an urgent mental health assessment or a referral, and what to say when you get there.
- Causes looked for: Cannabis and other drugs, alcohol, medicines, lack of sleep and physical illnesses can all cause psychosis, and some need treating straight away.
- Help for families: How to support someone who may not believe they are unwell, and how to get them seen.
- Support alongside specialist care: Questions about side effects, sleep and physical health, while the specialist team leads the treatment.
What the doctor checks in an online assessment of possible psychosis
The doctor asks about safety first, then about the experiences themselves. The doctor asks about:
- Safety: thoughts of suicide or self-harm, any risk to others, and whether the person is eating, drinking and sleeping.
- The experiences: voices or other hallucinations, beliefs that others do not share, and how thinking and speech have changed.
- When it started: suddenly over hours or days, or gradually over weeks and months.
- Drugs, alcohol and medicines: including cannabis, stimulants, stopping alcohol, and steroids or other prescriptions.
- Physical health: a high temperature, a head injury, recent childbirth, thyroid problems or a neurological condition.
- Mood and history: very high or very low mood, earlier episodes, and psychosis, schizophrenia or bipolar disorder in the family.
A relative or friend can join the call with the person’s agreement, and can describe changes the person may not notice. Before the call, note when things changed and list every medicine and substance taken.
What are the symptoms of psychosis?
The main symptoms are hallucinations, delusions and confused thinking or speech. People in a psychotic episode are often unaware that what they are experiencing is not real, which can make them frightened or distressed.
Swipe sideways to compare →
| Symptom | What it means | Examples |
|---|---|---|
| Hallucinations | Seeing, hearing, feeling, smelling or tasting things that do not exist outside the mind | Hearing voices, the most common; seeing colours, shapes or people; feeling touched when nobody is there |
| Delusions | An unshakeable belief in something untrue, held with complete conviction | Believing someone is plotting to harm you, or that you have special power or authority |
| Confused thinking and speech | Thoughts that race or jump, making speech hard to follow | Rapid, constant speech, switching topic mid-sentence, a sudden loss of the train of thought |
| Negative symptoms (in schizophrenia) | Withdrawal from the world | Losing interest in everyday activities, seeming flat, neglecting self-care, avoiding friends |
Early warning signs
Before a first episode, there are often gradual changes, which can be mistaken for a phase:
- suspicion, paranoid ideas or unease with others
- trouble thinking clearly, or confused speech
- withdrawing and spending much more time alone
- unusual or very intense ideas, strange feelings, or a lack of feelings
- less care with hygiene and appearance
- disturbed sleep
- a sudden drop in work or study performance
What happens in a psychotic episode?
In an acute episode the symptoms are at their most severe. The person may hear voices, feel watched or threatened, or find their thoughts hard to organise, and they may not think they need help. Most people who have psychotic episodes are not a danger to others, and schizophrenia does not mean a split personality.
Psychosis or schizophrenia: what is the difference?
Psychosis is a set of symptoms, not a diagnosis on its own. Schizophrenia is a long-term condition in which psychosis is a main feature, often with episodes of severe symptoms and periods with few or none. Psychosis can also be part of other conditions, or be triggered by substances or illness:
Swipe sideways to compare →
| Cause | What is typical | Read more |
|---|---|---|
| Schizophrenia | Psychosis with withdrawal and loss of interest; it may develop slowly, often from the teenage years | This page |
| Bipolar disorder | Psychosis during a severe high (mania) or low | Bipolar disorder |
| Severe depression | Psychosis with very low mood | Depression |
| Drugs and alcohol | Psychosis during or after using drugs, or when stopping heavy drinking | Substance abuse |
| Medicines | A side effect of some prescribed medicines | This page |
| Physical illness | Dementia, a brain tumour, infections of the brain, thyroid problems, a head injury | Confusion |
| Childbirth | Postpartum psychosis, usually in the first weeks after birth: a medical emergency | Mental health in pregnancy |
| Severe stress, trauma or lack of sleep | Psychosis after a traumatic experience or a period of severe stress | PTSD |
Sudden confusion, drowsiness or agitation, especially with a high temperature or after a head injury, can be delirium from a physical illness, which is a medical emergency.
What causes psychosis, and who gets it?
There is usually no single cause. Psychosis seems to come from a mix of genetic risk, differences in brain development, and stress or trauma, and it can be triggered by drugs, alcohol, medicines, lack of sleep or a physical illness. It often starts between the late teens and the mid-20s, but can start at any age.
- How common: 15 to 100 people in every 100,000 develop psychosis each year.
- Schizophrenia: 1 in 300 people worldwide live with it, about 27 million, and 1 in 206 adults aged 20 and over.
- Genes: schizophrenia seems to come from a combination of genetic and environmental factors; having a close relative with it raises the risk, but most people with a relative who has it never develop it.
Cannabis and psychosis in Europe
A study of first-episode psychosis at 11 sites across Europe found that people who used cannabis daily were about 3 times more likely to have psychosis than people who had never used it, and daily users of high-potency cannabis about 5 times more likely. About 30% of new cases in London and 50% in Amsterdam were linked to high-potency cannabis.
How is psychosis treated, and can you recover?
Psychosis is treated with antipsychotic medicine and talking therapy, with practical support with work, studies or housing. A first episode is usually treated by an early intervention team, and longer-term care by a community mental health team. Many people recover, though symptoms can return, and good management lowers the chance of a severe relapse.
Swipe sideways to compare →
| Treatment | What it involves | What to expect |
|---|---|---|
| Antipsychotic medicine | Usually the first treatment; tablets, or slow-release injections every 1 to 4 weeks | Anxiety can ease within hours; psychotic symptoms over several days or weeks. Side effects can include drowsiness, weight gain, restlessness and dizziness |
| Cognitive behavioural therapy for psychosis | Sessions with a therapist to understand the experiences and work towards your own goals | Offered even if you decline medicine |
| Family intervention | Meetings with the family about the condition, support and problem-solving | Usually over 3 months or more |
| Early intervention team | A team for people with a first episode: assessment, medicine, therapy and practical support | Referrals are often accepted from the person, a friend or a relative |
| Hospital care | For a severe episode, or when someone cannot be kept safe at home | For as long as needed, then care at home |
Never stop an antipsychotic suddenly: stopping is done gradually with the specialist, because a sudden stop can bring the symptoms back. The risk of relapse is high if medicine is stopped within 1 to 2 years of a first episode.
Can schizophrenia be cured?
At least 1 in 3 people with schizophrenia recover fully, and many others live well with treatment, with periods of few or no symptoms. People with schizophrenia die on average 9 years earlier than others, often of heart, metabolic or infectious diseases, so regular physical health checks are part of good care. More than 2 in 3 people with psychosis worldwide do not receive specialist care, which is why getting a referral matters.
What might the doctor recommend for possible psychosis?
What happens next depends on how unwell the person is, how quickly things changed, and whether anyone is at risk. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Risk of harm to self or others, severe agitation, or not eating and drinking | Emergency care | No | Call 112 now |
| Sudden confusion with a high temperature, after a head injury or with drowsiness | Emergency assessment for a physical cause | No | Call 112 now |
| New voices or suspicious beliefs, without immediate risk | Urgent specialist mental health assessment | Yes, to assess | Urgently, for the specialist assessment |
| Gradual withdrawal, odd beliefs or a drop in functioning over months | Assessment, and a referral to an early intervention team | Yes, to assess | For the specialist assessment |
| Psychotic symptoms after cannabis or other drugs | Stopping the drug, and a specialist assessment | Yes, to assess | If symptoms continue or are severe |
| Diagnosed psychosis with signs of a relapse | Contact with your specialist team | Partly | The team reviews treatment |
| A relative or friend worried about someone | Advice on how to help and how to get them seen | Yes | If the person is at risk: call 112 |
Worried about voices, strange beliefs or someone close to you? A doctor can tell you in one consultation how urgently to get help.
See available times →Living with psychosis: what helps
What you can do yourself
- Get help early: early treatment works better. You can ask a doctor for a referral, and early intervention teams often accept referrals from the person, a friend or a relative.
- Take prescribed medicine as agreed, and talk to the team before changing it.
- Avoid cannabis and other drugs, and keep alcohol low.
- Protect your sleep, and learn the early signs of an episode with the people close to you.
- Talk about the condition with people you trust.
If you are supporting someone
- Ask what they are experiencing, and listen without arguing.
- Encourage them to see a doctor; if they do not believe they are unwell, you can seek help on their behalf.
- Help with practical tasks, and ask their care team about family intervention.
- Look after yourself: carers’ groups and support services can help.
Prescription treatment
A prescription is never issued without a consultation. Antipsychotic medicines are started and adjusted by a psychiatrist or the specialist mental health team, never online. Benzodiazepines and other sedatives are controlled medicines and are never prescribed online. A doctor by video can review medicines that may be contributing, and may treat a separate problem when it is safe to do so. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Waiting for it to pass on its own. Arguing with someone about their beliefs. Cannabis and other drugs, which make symptoms worse. Stopping antipsychotics suddenly.
Special situations
After childbirth
Postpartum psychosis usually starts in the first few weeks after birth, with high or low mood, confusion, hallucinations or delusions. It is a medical emergency: call 112. The mental health in pregnancy pages cover the time before and after birth.
Older adults
New hallucinations or confusion in older age can come from dementia, an infection or a medicine, rather than a mental health condition. Sudden confusion is an emergency; the confusion page explains the difference.
While travelling in Europe
Lack of sleep, jet lag, alcohol and drugs can trigger an episode in someone at risk. Carry enough medicine and a list of what you take, and if someone becomes acutely unwell abroad, call 112.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When psychosis is assessed online, and when you need in-person care
Assessed online: early or unclear symptoms without immediate risk, the causes worth checking, how urgently to get specialist care, advice for relatives and friends, and questions alongside specialist treatment.
In-person care: the diagnosis, antipsychotic treatment and therapy by a specialist team, any risk to the person or others, sudden confusion, and postpartum psychosis.
When to get in-person care
Call 112 or go to an emergency department now for:
- a risk that someone may harm themselves or another person
- thoughts of suicide that the person might act on, or self-harm
- severe agitation, or behaviour that puts anyone in danger
- not eating or drinking, or being unable to look after themselves
- sudden confusion, especially with a high temperature, drowsiness or after a head injury
- hallucinations, confusion or very high or low mood in the weeks after childbirth
Get medical advice the same day for:
- hearing voices, or new beliefs that others do not share, for the first time
- early signs of a relapse in someone with a diagnosis
- severe restlessness, stiffness or other side effects after starting an antipsychotic
- days of very high energy with little or no sleep
You can also find a free, confidential crisis helpline in your country at findahelpline.com.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about what is happening: describe the experiences and when they started, mention any drugs, alcohol or medicines, and a relative can join with consent.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Unusual experiences can have more than one cause. Tick what you are going through to see each page that mentions it. A doctor can talk it through with you on a video call. If you or someone else is in danger now, call 112.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Bipolar Disorder can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about psychosis and schizophrenia
What is psychosis?
Psychosis means losing some contact with reality. It can involve hallucinations, such as hearing voices, delusions, which are firm beliefs that others do not share, and confused thinking or speech. It is a set of symptoms that can have several causes.
What is schizophrenia?
Schizophrenia is a long-term mental health condition and a type of psychosis. It causes hallucinations and delusions, and often withdrawal, loss of interest and neglect of self-care. It does not mean a split personality.
How do you know if you are in psychosis?
Often you do not: people in a psychotic episode are often unaware that their experiences are not real. Hearing voices, feeling watched or threatened, or racing, muddled thoughts are signs, and so is others telling you they are worried. See a doctor promptly.
What triggers psychosis?
Severe stress, trauma, lack of sleep, cannabis and other drugs, stopping heavy drinking, some prescribed medicines, physical illnesses and childbirth can all trigger psychosis, usually in someone who is already vulnerable.
Can you recover from psychosis?
Yes. Many people recover, especially with early treatment, though symptoms can come back. At least 1 in 3 people with schizophrenia recover fully, and many others live well with treatment.
How long does a psychotic episode last?
There is no fixed length. With treatment, anxiety can ease within hours and psychotic symptoms over several days or weeks. In schizophrenia, episodes of severe symptoms can be followed by periods with few or no symptoms.
Is schizophrenia genetic?
Partly. Schizophrenia seems to come from a combination of genetic and environmental factors, such as stress or drug use. Having a close relative with it raises the risk, but most people with an affected relative never develop it.
Can cannabis cause psychosis?
Cannabis can trigger psychosis and is linked to a higher risk. In a European study, daily users were about 3 times more likely to have psychosis than people who had never used it, and daily users of high-potency cannabis about 5 times more likely.
Can psychosis be prevented?
Not always, because genes and brain development play a part, but the risk and the harm can be reduced: avoiding cannabis, especially in the teenage years, lowers the risk of psychosis in people who are vulnerable; so do regular sleep, managing stress and getting help early for anxiety or low mood. Most important is acting on early warning signs, such as withdrawing, suspiciousness or unusual beliefs, because early intervention teams treat a first episode of psychosis sooner.
How can I help a friend or relative with psychosis?
If someone has psychosis, listen without arguing about their beliefs, encourage them to see a doctor, and seek help on their behalf if they do not believe they are unwell. Call 112 if anyone may be harmed. Carers’ groups can support you too.
Are people with schizophrenia dangerous?
Schizophrenia does not usually cause someone to be violent, and most people who have psychotic episodes are not a danger to others. People with psychosis are at higher risk of harming themselves, which is why safety is always asked about.
Can an online doctor prescribe antipsychotics?
No. Antipsychotics for psychosis are started and adjusted by a psychiatrist or a specialist mental health team, never online. A doctor by video can assess the situation, look for causes and help arrange urgent specialist care.
- Psychosis: overview, NHS, National Health Service (UK), reviewed 5 September 2023.
- Psychosis: symptoms, NHS, National Health Service (UK), reviewed 5 September 2023.
- Psychosis: treatment, NHS, National Health Service (UK), reviewed 5 September 2023.
- Schizophrenia: overview, NHS, National Health Service (UK), reviewed 13 April 2023.
- Schizophrenia: symptoms, NHS, National Health Service (UK), reviewed 13 April 2023.
- Schizophrenia: fact sheet, WHO, World Health Organization, 11 September 2026.
- Understanding psychosis, NIMH, US National Institute of Mental Health, 2023.
- Psychosis, Rethink Mental Illness (UK), updated September 2025.
- Psychosis, Cleveland Clinic (US), updated May 2022.
- High potency cannabis linked to higher rates of psychosis (EU-GEI study, The Lancet Psychiatry), King’s College London, March 2019.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
Related conditions
Speak to a doctor about psychosis over video, usually within 15 minutes
Licensed doctors · open daily 7am–11pm CEST · exact price before payment
See available times →