Symptoms of Psychosis & What to Do

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Helpful things to do when someone you care about is experiencing psychosis.

Author: BC Schizophrenia Society


Delusions & hallucinations

How a person might act:

Note: Unusual beliefs and behaviour may be part of a person's normal belief system or culture. If they are, they may have nothing to do with their mental illness.

  • Talking to voices that are not there

  • Talking about a strongly held false belief (delusion) or something they hear, see or feel that is not there (hallucination).

  • Behaving oddly because they have a false belief or are hearing, seeing or feeling something that is not really there. e.g.: avoiding water because the person thinks it is poisoned

  • Preaching because they believe they are Jesus Christ

  • Being distracted and unable to concentrate (see below as well).

Helpful things to do:
  • Avoid arguing with the person about their delusions. Delusions are extremely fixed and difficult to change

  • Connect with the emotion of the delusion or hallucination e.g. 'It must be frightening to believe that you are Jesus Christ'

  • Calm things down - reduce the number of people and noise around the person

  • Show compassion for the how the person feels about their false belief and do what you can to help where possible when the person is acutely unwell e.g.: turn off the TV if they think it is talking to them.


Being paranoid (a delusion)

How the person might act:
  • Behaving as though they are being followed, tricked or spied on

  • Being overly sensitive and suspicious

  • Behaving in a way that is goes along with what their paranoid belief

  • Being irritable

  • Being aggressive—the person could be afraid because of the delusion and may act out of that fear.

Helpful things to do:
  • Avoid arguing with the person about their delusions

  • Let them know you can understand why they would feel afraid, given the things they are thinking.

  • Show them with your body language that you are on the same side. Sit beside rather than in front of the person

  • Stay calm

  • Consider the safety of you and the person.


Disordered thinking & behaviour

How the person might act:
  • They may talk in a disorganized way, and not make much sense.

  • They might not seem to cooperate or seem 'spacey' and 'not there'

  • Have a hard time doing regular things like as making meals and keeping themselves clean

  • Dressing inappropriately or strangely e.g. lots of clothes on a hot day.

Helpful things to do:
  • Speak to the person in a clear and simple way

  • If necessary, repeat things talking slowly and allowing plenty of time for the person to answer

  • Give step-by-step instructions.


Not showing a wide range of feelings (affective flattening)

How the person might act:
  • The person's face may seem not to move or respond, or have no expression

  • The person may not meet your eye or look away

  • The person may not express much using their body.

Helpful things to do:
  • Be aware that this is a symptom of the illness; don't take it personally.

  • Try not to get frustrated or hurt that the person isn't showing their feelings much.

  • Be aware that just because the person is not showing their feelings very much, it does not mean that they are not feeling anything.


Being silent or not talking much

What the person might do:
  • Having trouble starting and keeping going with activities or getting things done

  • Sitting for a long time doing nothing

  • Not showing much interest in participating in any sort of activity

  • Not have much motivation.

Helpful things to do:
  • Understand and  acknowledge that these are again symptoms of the illness. The person is not behaving this way on purpose.

  • Try not to become frustrated with how they are acting

  • Encourage them gently to participate in activities.

This information is adapted and reprinted with the permission of the Mental Illness Fellowship of Victoria (Australia).


About the author

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The BC Schizophrenia Society helps individuals and families find their way in the mental health system. They also provide regional programs and services to help people with serious mental illnesses and their families. For more, visit or call 1-888-888-0029.