Links Between Trauma and Psychosis

Psychosis is the medical term for losing touch with reality. There are several health conditions linked to psychosis and many possible causes of psychosis. One risk factor for developing psychosis is experiencing trauma, especially during childhood.^1,2

What is psychosis?

Psychosis involves experiencing a break with reality. There are 3 main symptoms of psychosis:^1,3

• Hallucinations – Seeing, hearing, or otherwise sensing things that are not real. Hallucinations feel very real to the person experiencing them.
• Delusions – Having strong, made-up beliefs that are not based in reality. For example, some people might think there is a plot to harm them.
• Disordered thinking or speaking – This may be thinking or speaking so fast that other people cannot understand.

Psychosis may occur with several mental health conditions, including:^1,2

• Schizophrenia or schizophrenia spectrum disorders
• Bipolar disorder
• Severe depression

Other possible causes for psychosis include drugs or alcohol, a brain injury, or extreme stress.^1,2

Is there a link between trauma and psychosis?

Trauma is a very stressful or frightening event. Examples of trauma include:^2-4

• Severe bullying by peers
• Neglect by parents
• Experiencing or witnessing physical or sexual abuse

Trauma can be very difficult for people to process. It is linked to an increased risk of developing many mental and physical health conditions, including psychosis.^2-4

Between 40 and 80 percent of people with psychosis have a history of trauma. People who have had more frequent trauma are even more likely to develop psychosis.^2-4

The link between childhood trauma and psychosis is especially strong. Research shows that people who experience childhood trauma may be about 3 times more likely to develop psychosis than those who do not.^2-4

What is the relationship between trauma and psychosis?

Experts do not know exactly why people who experience trauma are more likely to develop psychosis. Researchers have several theories about the link between them. But more research is needed to confirm these theories.^3,4

Some researchers believe psychosis after trauma could be a type of post-trauma symptom. Support for this theory includes the link between hallucinations and other post-trauma feelings like guilt or fear.^3,4

Some of these researchers think psychosis could fit under a post-traumatic stress disorder (PTSD) diagnosis. They call this type of reaction psychosis-related PTSD (PR-PTSD). But this is still not an accepted diagnosis.^3,4

Other researchers think emotions caused by trauma may lead to psychosis. For example, many people experience anxiety, depression, and mood swings after trauma. These researchers believe that when these negative emotions are very strong, they may lead to psychosis.^3,4

How is psychosis treated?

If you or someone you know experiences signs of psychosis, see a doctor right away. There is no test or lab that can diagnose psychosis. Doctors must rely on an exam and questioning. Diagnosing psychosis may involve identifying an underlying condition.^1-3

Treatment for psychosis may depend on the underlying condition and may include:^1,2,4

• Talk therapy – Some research shows that talk therapy may be especially helpful for psychosis caused by trauma.
• Antipsychotic medicines
• Social support – This may include housing, job, or education support.
• Lifestyle changes – This could include things like quitting drugs or alcohol.

Some people with psychosis may need to take antipsychotic medicine long-term. Others may be able to gradually reduce their dose over time. However, never stop taking a drug without talking to your doctor first.^1,2