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Psychosis Information for youth

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My story (part 1)

Now, I’m no stranger to mental illness. My mother lives with depression. My uncle and my grandmother both suffer from schizophrenia. In grade 8, I was diagnosed with depression and anxiety. However, I started noticing new things a during my last 2 years in high school. I was having a hard time handling school work and my part-time job. I had little motivation to do anything, and I had a hard time concentrating. I stopped taking care of myself and I wasn’t eating well. At first I thought it might have been the depression, but I started becoming really paranoid.

As a result, I started missing work and stopped going to class. I hid this from my parents, but my friends started to worry. I was starting to hear voices that made me just want to hide all day. Every time I watched TV, I thought the people on the shows were speaking directly to me. Luckily, I had a good friend who told my parents. At first I was upset. But looking back, I’m very happy she called them, as I really wasn’t myself.

So what is psychosis?

Psychosis is a treatable mental illness that impacts thoughts, feelings and behaviours. During a period of psychosis, people are out of touch with reality. They may have trouble telling the difference between what is real and what’s not. Psychosis can also be part of other conditions like:

  • Schizophrenia,
  • Depression
  • Bipolar disorder
  • Substance use

Psychosis involves delusions and/or hallucinations. If you have psychosis, you might be hearing things that aren’t really there. Or you might have unusual thoughts (for example, like others are ‘out to get you’). The sooner you get help, the easier the recovery will be.

Delusions: Are false beliefs that last for a long period of time. They can come in many forms. Some can be quite unusual. For example, thinking the people on the radio are talking to you personally.

Hallucinations: Are false experienced of one of the 5 senses (hearing, seeing, feeling, smelling and tasting). For example, seeing things that aren’t real.

What are some signs and symptoms of psychosis?

During psychosis, you or people around you might notice that your behaviour changes and seems a little ‘odd’. People with psychosis may:

  • Hear, see, feel, smell or taste things that aren’t there;
  • Have an unusual belief about something that other people don’t understand;
  • Feel suspicious or paranoid, as if someone is always watching;
  • Overestimate their own importance (for example, believe they are famous);
  • Have problems thinking or speaking;
  • Behave in unusual ways;
  • Withdraw or isolate themselves from others;
  • Lack energy or motivation;
  • Have trouble concentrating and paying attention;
  • Not show much emotion;
  • Have trouble doing everyday things like going to school, working, shopping or chores;
  • Have trouble sleeping;
  • Stop bathing regularly;
  • Feel as if their thoughts are speeding up or slowing down.

What causes psychosis?

Psychosis is a complex illness; there isn’t just one cause. People usually notice symptoms between the ages of 16 and 30. Males usually develop symptoms at an earlier age. Psychosis can develop from a mix of factors, like:

Family History: Psychosis is more likely if you have family members living with it, or with another mental illness. 

Brain changes: Our brains are in charge of our thoughts. So it’s not surprising that things that impact the brain could also contribute to psychosis. For example:

  • Brain injuries;
  • Changes in brain chemicals;
  • Heavy stress or trauma;
  •  Drugs (like marijuana, hallucinogens or some prescription medications).

What is a “first episode” psychosis?

Sometimes psychosis symptoms develop over a long period. Other times, symptoms happen suddenly and people around you notice right away. ‘First episode psychosis’ is the first time you have noticeable symptoms of psychosis. In some cases, psychotic-like symptoms may last only minutes or hours. Or a psychotic episode may last from days to years. Your first experience might be quite distressing for you and your family. Many people never experience another psychotic episode after the first one. But it’s really important to follow-up with a doctor as soon as possible to make sure things don’t get worse.  

How is psychosis treated?

Early Ps ychosis Intervention (EPI) The sooner you get treatment after the signs of psychosis first appear, the smoother the recovery tends to be. Early treatment increases the chance that psychotic episodes will resolve. For this reason, clinical programs like Early Psychosis Intervention clinics are available all over Canada. These programs are designed to help reduce the impact of psychosis on people’s lives and support them in steps toward recovery. Matching people with the right type of medication, counselling and support helps them reach recovery more easily.

Psychosis is often a chronic disease, which means some people will have it throughout their lives. It is treatable and manageable, though, allowing people to get on with their lives. Getting help quickly for relapses is very important for managing psychosis effectively. Some people will only have one episode in their lifetime, while others may have occasional relapses. If psychosis symptoms continue for more than 6 months, your doctor may make a diagnosis of schizophrenia.

  1. Medications

Medications are often used to help reduce symptoms. The most common types of medications are called anti-psychotic or neuroleptics. These types of medications help to control delusions and hallucinations. You may be able to stop medications in the future with the help of your doctor, if your symptoms are under control.

  1. Talk Therapy (counselling)

Support from a therapist will help you to: 

  • Manage stress more effectively;
  • Deal with your symptoms;
  • Prevent relapse;
  • Solve problems.

A therapist can also educate your family about how to support you through this experience.

  1. Practicing coping strategies

There are many strategies that you can use to cope with psychosis. These strategies work best if your friends and family know about them too, so that they can support you with doing them. 

  • Get enough sleep. In your teens, you’ll probably need about 9 hours of sleep every night.
  • Avoid too much sensory stimulation. You may find that you are very sensitive to noise, lights and other sensory stimulation.

Are you bothered by too much noise? If so, you could try:

  • Letting others know that noise bothers you;
  •  Finding a quiet place to go to, like your bedroom;
  • ‘Drowning out’ the noise that bothers you by listening to soothing nature sounds or relaxing music with your earphones;
  • Wearing ear plugs.

Are you triggered by too much light or fluorescent lights? You could try:

  • Closing your drapes so its dimmer at home;
  • Wearing a baseball cap, hoodie or sunglasses if overhead light bothers you.
  • Focus your mind. The brain can only really focus on one thing at a time. If you are getting upset because your brain is focused on the hallucinations, do something else that requires all of your attention and concentration.

Examples of activities that require attention include: 

  • Crosswords or word search puzzles;
  • Detailed jigsaw puzzles;
  • Sudoku;
  • Talking with a friend on the phone;
  • Playing solitaire;
  • Playing a video game;
  • Drawing or Doodling;
  • Reading;
  • Juggling;
  • Guided imagery (you can get these recordings for your phone or iPod);
  • Yoga;
  • Chess.
  1. Practice grounding strategies

These techniques use sensory input to bring your brain back to reality. Here are some things you can try:

  • Smell a perfume container;
  • Suck on strong mints;
  •  Chew a piece of gum;
  • Suck on a popsicle, chew ice chips;
  • Stamp your feet or clap your hands hard;
  • Do vigorous exercise;
  • Do heavy work (using muscles);
  • Take a cool shower;
  • Snap a rubber band on wrist;
  • Play with something in your hands (squeeze a ball, for example).

5-4-3-2-1” exercise. This uses both sensory input and concentration together:

  • Think about 5 things you see;
  • Think about 4 things you can touch or feel (or stomp the ground, rub your hands together, feel your pulse)
  • Think about 3 things you hear (for example, turn on music, sing out loud)
  • Think about 2 things you can smell (for example, put lotion on your hands)
  • Think about 1 thing that is positive about you.

Taking care of yourself

There are a number of things that will help you from becoming overwhelmed as you manage your symptoms. 

Get organized Stay on top of things by:

  • Trying to keep a regular schedule;
  • Planning ahead;
  • Use agendas, calendars or electronic reminders (add new tasks right away so you don’t forget);
  • Use checklists or to do lists;
  • Use visual reminders.

Slow down

Lower your expectations for yourself while you focus on recovery. Make sure you don’t take too much on right now. Focus on being content and keeping your stress level low. For example, it may be a good idea to cut down on the number of classes you’re taking, or the number of hours you’re working.

Aim for balance

Try to manage your time well. Leave yourself extra time for activities. Make sure you include time for self-care in your daily routine. Signing up for an activity like yoga, sports or art will make it easier to make sure you’re taking care of yourself. Keeping track of how well you are keeping up with your routine will give you a good sense of how you’re doing mentally.

Avoid drugs and alcohol

Avoid substances that can can make hallucinations worse. This includes alcohol, most recreational drugs, and common stimulants like caffeine drinks. 

Find supportive people

Surround yourself with awesome friends and family. Not only will they make your life a lot better, they will also help you to stay on track. They probably will be the first to notice changes in your behaviour, so don’t push them away. Instead, keep them close and involved in your life.

Practice ‘Belly Breathing’

Everyone can benefit from taking a few minutes every day to focus on breathing deeply and calmly.

  1. Sit or stand and relax your shoulders. Place one hand on your chest, and the other on your belly.
  2. Close your eyes if you’re in a place where you can do this
  3. Breathe in deeply through the nose.
  4. Expand your belly out as you breathe in. Notice how the hand on your belly moves out as you inhale. Notice how the hand on your chest stays in the same spot.
  5. Hold your breath for a brief moment and release slowly through your nose (if your nose is clear).
  6. Focus on the feeling in your belly or your nostrils as you breathe.
  7. Repeat a few times.

Mindfulness

This is paying attention, on purpose to what is happening right now, without making any judgements about what is happening. You can practice mindfulness anytime, anywhere. For example, as you’re walking outside, notice the sights, sounds, smells, and sensations. Do you feel the wind on your face? Can you smell fresh cut grass? Are squirrels chirping at each other?

Some people like to practice mindful meditation, where they sit quietly for a few minutes, and focus attention on something. They often start by focussing on their breath. There are many free guided meditations you can follow. Look for links at the end of this fact sheet. 

Basic muscle relaxation exercise

  1. Lie down or sit comfortably.
  2. Tighten all the muscles in your feet, crunching your toes up. Hold this for a few seconds, then relax while breathing out slowly. Imagine the tension flowing out of your muscles.
  3. Move to your calves, tightening and releasing the muscles as you did for your feet. Breathe out as you relax the muscle.
  4. Continue to tighten and relax other major muscle groups, working toward the top of your head:
    • Thighs
    • Buttocks
    • Back & stomach muscles
    • Hands and arms
    • Chest, shoulders and neck
    • Face and jaw.

Talk to yourself

A lot of people have shared that talking to themselves has helped reduce the hallucinations. Tell yourself positive things like, “ I am safe”, “I am ok,” “I am in control”. Remind yourself of your positive qualities and of compliments that people have given you.

Talk to others

Engage in a conversation with someone who can listen and support you without judging. Consider calling someone or a phone support line. 

My story (part 2)

My family doctor referred me to an Early Psychosis Intervention clinic and they quickly decided that I was experiencing - psychosis. I learned that it’s quite common for people with psychosis to have other mental illnesses. And with my family history, it was no real surprise. They gave me medication at first to control the paranoia and delusions I was having. I wasn’t thrilled about this at first, but it was actually quite helpful.

The year following my first episode was really hard. The challenging part was changing the way I was living my life. My counsellor helped me to gain more control over my life by reducing the stresses. No more staying up until the wee hours of the morning. No more drinking and partying. Eating a regular, healthy diet and exercising everyday gave me a good routine and helped me structure my life.

Although I had to take some time off from school, I was able to return with a reduced course load. This was a big shift for me at first. But I’m really happy with my new lifestyle. This whole experience made me realize that I need to take care of myself. I fill my time with plenty of calm and low key hobbies, like scrapbooking and photography. I make sure I don’t become too stimulated. I’ve also made some new friends along the way. And with the help of my counsellor, family and friends, I’m a lot more thankful for the simple things in life

Finding help in Ottawa 

In a crisis?

  • Child, Youth and Family 24 hour Crisis Line for Eastern Ontario, 613-260-2360 or toll-free, 1-877-377-7775
  • Ottawa Hospital (The) - Mental Health Mobile Crisis Team 613-722-6914 toll free 1-866-996-0991

Services in Ottawa

Still looking for help in Ottawa? eMental Health is a bilingual directory of mental health services and resources for Ottawa, Eastern Ontario and Canada.

Finding help in Eastern Ontario

In a crisis? Child, Youth and Family Crisis Line for Eastern Ontario, 613-260-2360 or toll-free, 1-877-377-7775

Services in Eastern Ontario

  • Renfrew County: Phoenix Centre for Children, Youth and Families, with offices in Renfrew and Pembroke. 613-735-2374 or toll-free 1-800-465-1870
  • Leeds and Grenville County: Children’s Mental Health of Leeds and Grenville, with offices in Brockville, Elgin, Gananoque and Prescott. 613-498-4844
  • Lanark County: Open Doors for Lanark Children and Youth, with offices in Carleton Place, Smiths Falls and Perth. 613-283-8260
  • Stormont, Dundas, Glengarry and Akwesasne (Cornwall Island): Single Point Access-for all child, youth, family and mental health services. Services in French and English. Main office, Cornwall, Ontario 613-938-9909 Toll free 1-888-286-KIDS (5437). Satellite office in Winchester.
  • Corn wall and area: Child and Youth Counselling Services (CYCS)- (Cornwall Community Hospital) provides assessment, therapy, and counseling. Services provided in English. Office in Cornwall 613-932-1558, limited outreach services in Winchester office.
  • To find a psychologist anywhere in Ontario: College of Psychologists of Ontario, 1-800-489-8388

Still looking for help in Eastern Ontario? eMental Health is a bilingual directory of mental health services and resources for Ottawa, Eastern Ontario and Canada.

Support

Youth Net is a mental health promotion program by youth, for youth. Offers art, snowboarding, hiking and yoga programs for youth. 

Want more information?

Useful websites

Useful books and handouts

  • Getting your life back together when you have schizophrenia, by Temes, Roberta – Oakland, CA: New Harbinger Publication, 2002.
  • Coping with schizophrenia, by Jones, Steven – Oxford: Oneworld, 2004.
  • Surviving schizophrenia: a manual for families, patients and providers , by Torrey, E. Fuller – 5th ed. – New York: Harper Collins Publishers, 2006.
  • What is Psychosis: you should know...  February 2000
  • Youth and Psychosis
  • A sibling’s Guide to Psychosis: Information, Ideas and Resources, prepared by Sharon Mulder and Elizabeth Lines, March 2005.
  • The first episode of Psychosis: A Guide for Patients and their Families by Michael T. Compton and Beth Broussard, Oxford University Press 2009
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