What Happens When Psychosis Is Left Untreated?

Psychosis is a set of symptoms that may have no known cause, that may be a part of mental illness, or that may be caused by a medical condition or substance abuse.

The symptoms are characteristic of being out of touch with reality. Psychosis causes changes in perceptions and thought that don’t align with what is real. Examples of psychosis symptoms include:

• Hallucinations – Hearing, seeing, smelling, or feeling things that aren’t real
• Delusions – Persistent false beliefs, which don’t change even in the face of evidence to the contrary
• Dissociation or derealization – A sense of being separate or outside other people or one’s own body
• Disordered thinking – Difficulty thinking or concentrating, racing and jumping thoughts, incoherent speech
• Mood changes – Unusual changes in mood, from aggression or anger to depression or anxiety, flat affect, or otherwise inappropriate emotional responses

Psychosis is a symptom of certain mental illnesses like schizophrenia and bipolar disorder. It can also be caused by depression. Medical conditions like dementia, brain tumors, or epilepsy may also trigger episodes of psychosis, as can substance abuse.

Regardless of the cause of psychosis there is a potential for very serious complications. When psychosis treatment is delayed the risk is greater and the consequences can be more severe. Untreated psychosis symptoms can impact all areas of a person’s life, leading to significant impairment at work, at home, at school, in relationships, and with society at large. People with psychosis may not be able to take care of themselves properly.

Some specific examples of what can happen when this condition or these symptoms are left untreated include:

• Inability to keep a job
• Poor academic performance or dropping out of school
• Financial problems
• Homelessness
• Substance abuse and substance use disorders
• Legal problems or even incarceration
• Hospitalization
• Damaged or lost relationships
• Social isolation
• Violence, as a victim or perpetrator
• Co-occurring mental illnesses, like depression or anxiety disorders
• New or worsening medical conditions
• Self-harm
• Suicide

Studies have shown that the earlier treatment is initiated for psychosis, the better the long-term outcomes for the patient. The duration of untreated psychosis, or DUP, is measured as the time from the beginning of psychotic symptoms to the time a person starts treatment for those symptoms or a diagnosed condition.

There is strong evidence that treatment for psychosis is more effective the shorter the DUP is. Patients treated sooner see better improvement in symptoms, have a better quality of life after treatment, and have improved functioning, as compared to those who have long DUPs. In the U.S., the average DUP is longer than what is considered to be acceptable by international standards.

With this evidence in mind, it is very important for anyone going through psychosis to get screened and treated as soon as possible. For the person experiencing psychotic symptoms it isn’t easy to recognize that anything is wrong or that treatment is needed. Family and friends close to these individuals need to be aware of signs of psychosis and to be ready to intervene and get help if necessary for the best outcomes.

Treatment begins with understanding the underlying cause. When that can be identified and managed it is easier to resolve psychosis symptoms. In general, psychosis treatment includes therapy that helps a person learn to change his or her abnormal thoughts and behaviors, and antipsychotic medications. In some cases hospitalization may be necessary to stabilize the patient and ensure safety.

Psychosis can be very serious, regardless of what is causing the symptoms. The best outcomes result from immediate treatment, and when not treated psychosis can lead to illness, injuries, legal and financial difficulties, and even death. Help someone you care about who may be struggling with psychotic symptoms and get professional evaluation and treatment as soon as possible.