How Long Does Psychosis Last? 

Psychosis is a group of symptoms that involves a disconnect from reality. This can include:

• Experiencing physical sensations due to no tangible cause, such as feeling like there are bugs crawling on one’s skin
• Having beliefs that are not based in reality, often called delusions or false beliefs
• Speech that isn’t appropriate for the situation or doesn’t make sense

People can also experience other symptoms along with psychosis, including anxiety, lack of motivation, intense emotions, and general difficulty functioning in most aspects of their lives.

People experiencing psychosis can demonstrate some of the following warning signs and symptoms:

• Being uneasy with others, having paranoid ideas, or unwarranted suspiciousness
• Difficulty thinking in a clear and logical way 
• Spending more time alone and withdrawing from relationships 
• Overly intense or unusual ideas
• A lack of feeling emotions, or emotions that seem unusual
• Sleep disturbances, which can involve trouble falling and staying asleep 
• Trouble distinguishing fantasy from reality
• Difficulty communicating, or speech that is confusing or nonsensical 
• Major and sudden changes in fulfilling responsibilities and care for self, including neglecting hygiene and poor performance at work or school 
• Catatonia, or being unresponsive and unable to move

Additionally, people experiencing psychosis are at a higher risk of being a danger to their own safety and that of others, and have a higher risk of suicide than the general population. The good news is that this risk decreases when they receive treatment. 

Experiencing psychosis can be quite scary for the person it happens to and those who care about them. There are also many unknowns that people encounter after experiencing symptoms for the first time. There are a variety of psychosis-related disorders and ways that people experience symptoms. 

How Long Does Psychosis Usually Last?

The experience of psychosis duration and recovery varies drastically by type of diagnosis and other contributing factors. Psychosis is associated with a number of mental health diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) published by the American Psychiatric Association, also called the DSM. This includes:

• Schizophrenia
• Schizotypal personality disorder
• Delusional disorder
• Brief psychotic disorder
• Schizophreniform disorder,
• Schizoaffective disorder
• Substance/medication-induced psychotic disorder
• Psychotic disorder due to another medical condition
• Bipolar disorders
• Depressive disorders

Each of these diagnoses has its own timeline, variety of symptoms, and ways the disorder impacts people’s lives.

If people’s experience of psychosis is acute vs chronic, as well as the first episode psychosis recovery time, will vary depending on the underlying condition, as well as other factors, which we discuss below. Here are a few of the most common types of psychosis-related disorders and how long the symptoms tend to last.

Brief Psychotic Disorder: Recovery Within One Month

Brief psychotic disorder typically lasts more than one day and less than a month. After one month, the person experiences a full remission, or they go back to feeling like they did before the symptoms started. It’s important to note that recurrence of symptoms in the future is possible.

Schizophrenia-Related Psychosis: Six Months or Longer Episodes

One difference between brief psychotic disorder vs schizophrenia is the duration of symptoms. The psychotic symptoms associated with schizophrenia last at least a month, and signs of the symptoms occur at least six months. 

Substance-Induced Psychosis: Varies Depending on the Substance

Many medications and recreational drugs can cause psychosis. The duration and severity vary drastically between substances, and if the use is ongoing. Every person is unique in their level of risk of being impacted. Research on the link between substance use and the development of a long-term psychotic disorder is still developing, but some correlations are being made. 

Factors That Influence How Long Psychosis Lasts

There are many causes of psychosis, as well as risk factors that increase the likelihood of developing a psychosis-related disorder or experiencing a shorter form of psychosis. It’s most widely understood that a combination of genetics and brain development and structure is the main cause of psychosis.

Several risk factors contribute to the severity of symptoms and their impact. It’s widely thought that the more risk factors one experiences, and how impactful those risk factors are, add to the person’s risk level. 

Experiences of trauma, particularly in childhood, are known to increase one’s risk. Additionally, the more trauma and abuse one experiences, the higher one’s risk is. This can include bullying, sexual abuse and assault, and abuse (emotional, physical, neglect). 

Some of the additional notable risk factors include:

• Childhood exposure to certain viruses and immune system responses
• Insomnia
• Substance use, and particularly tobacco and cannabis use
• Anxiety and depression
• Some health problems can be the cause of psychosis in older adults
• High or low birth weight
• Maternal stress or infections
• Parental use of alcohol and drugs
• Living in densely populated urban areas or under resourced rural areas
• Air pollution
• Being a member of a minoritized group and experiencing prejudice and discrimination based on one’s race, ethnic group, or immigrant status
• Negative interactions with the police
• Lower socioeconomic status and unstable housing; growing up in an under resourced neighborhood and experiencing poverty as a child

Treatment Approaches and Supports

Psychotic episode length and treatment needs vary by person and the particular condition they have, making individualized treatment necessary for recovery. 

Early Treatment and Intervention

Early intervention is key. The sooner someone experiencing psychosis accesses treatment, the better the long-term prognosis. With early intervention, some of the worst symptoms of psychosis-related disorders can be prevented, and lives can be saved. 

Therapy

There are many types of therapy that can be helpful for people who have experienced psychosis. Cognitive behavioural therapy for psychosis (CBTp) has long been the gold standard.

Emerging research suggests that it is more effective than treatment as usual, and that approaches tailored to each person’s unique needs and situation are the most beneficial. Research has shown that individual therapy can help reduce the risk of suicide for people who have experienced psychosis.

Medications

There are many medications that are used in the treatment of psychosis-related disorders. Consultation with a psychiatric provider can help determine if and which medications are best suited to your needs.

Comprehensive Support

For psychotic spectrum disorders, comprehensive treatment and support is vital. Care management, vocational services, and other interventions to address social determinants of health play a key role in people’s recovery.

Social and Peer Recovery

Family involvement and support can play a large role in supporting the entire family and aid in the recovery of the family member experiencing psychosis. 

Peer support can be a powerful source of meaningful connection and community. Individuals who participate in peer recovery programs tend to remain in treatment for a longer period, which has a positive impact on their outcomes.

When to Seek Professional Help and What to Expect

If you suspect that you or a loved one is experiencing psychosis, consultation with a healthcare provider is recommended.

Your primary care provider or a mental health professional can do an assessment to help identify if the experience is psychosis, and if so, what type, and the recommended plan for treatment. Mental Health America offers a free self-assessment screening tool to help people decide if consultation with a healthcare provider is a good choice for them.

People should also expect that their treatment team is respectful, kind, and compassionate. Everyone who seeks treatment for mental health concerns deserves to feel safe, supported, have an active role in decision-making, and to work with a provider that’s a good fit for them.

It is especially true that people experiencing psychosis need a therapeutic environment that is calm and safe. In fact, the alliance one has with their provider can be a crucial factor in treatment success. 

Conclusion

There are many good reasons to have hope for recovery if you or a loved one is experiencing psychosis or a psychosis-related mental health condition. Treatment advances, improved provider training, and increased community and peer recovery supports have led to better outcomes and many people reaching remission. 

If you or a loved one may be experiencing psychosis or is experiencing a mental health crisis, reach out to the team at Willow Health today.

Our patients meet with both a psychotherapist and a psychiatric medication provider for an assessment to create an individualized care plan tailored to meet each person’s needs. We offer same or next business day appointments to ensure people experiencing a mental health crisis get the timely care they need. 

Sources and Resources 

National Alliance on Mental Illness (NAMI) 

Psychosis & Schizophrenia Test – Free, quick, & confidential 

Understanding Psychosis - National Institute of Mental Health (NIMH) 

Diagnostic and Statistical Manual of Mental Disorders (DSM) | Psychiatry Online 

Brief Psychotic Disorder - StatPearls - NCBI Bookshelf 

Types, prevalence and gender differences of childhood trauma in first-episode psychosis. What is the evidence that childhood trauma is related to symptoms and functional outcomes in first episode psychosis? A systematic review - ScienceDirect 

Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions | Psychological Medicine | Cambridge Core 

Psychosis - StatPearls - NCBI Bookshelf 

Early intervention in psychosis: concepts, evidence and future directions - PMC 

Family-focused therapy for individuals at high clinical risk for psychosis: A confirmatory efficacy trial 

Cognitive behavioural therapy for psychosis: The end of the line or time for a new approach? - Newman‐Taylor - 2024 - Psychology and Psychotherapy: Theory, Research and Practice - Wiley Online Library 

‍Individual psychotherapy can reduce suicidal ideation in first episode psychosis: Further findings from the 2‐year follow‐up of the ‘Parma Early Psychosis’ programme - Pelizza - 2022 - Clinical Psychology & Psychotherapy - Wiley Online Library