Dual Diagnosis with Psychosis

With the right support, we can and do recover. The Dual Diagnosis Hub can help everyone to find the best dual diagnosis support and resources available.

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What is psychosis and how common is it?

With the right support, we can and do recover. The Dual Diagnosis Hub can help everyone to find the best dual diagnosis support and resources available.

What is psychosis?

The term ‘psychosis’ is used to describe when a person loses touch with reality. Young people can behave very differently when they are feeling stressed, confused or very upset. In fact, these are rarely signs of mental illness. Psychosis is usually more severe and disabling.

How common is it?

‘Psychosis’ can affect people of all ages, but becomes increasingly common as people reach young adulthood.

What causes it?

When a person has a psychotic episode, it can be a signal of an underlying illness. You can have a ‘psychotic breakdown’ after a stressful event like losing a close friend or relative. It can also be the result of a physical illness like a severe infection, the use of illegal drugs like cannabis, or a severe mental illness like schizophrenia or bipolar disorder. Sometimes it is difficult to know what caused the illness.


When a person has psychosis, they may have unusual thoughts and experiences. These may appear suddenly, or develop gradually over time. They may have one or more of the following symptoms:

  • Unusual beliefs called delusions. These unshakeable beliefs are obviously untrue to others, but may not be to the young person themselves. For example, when a young person is ill, they may think that there is a plot to harm them, or that they are being spied on by the TV, or being taken over by aliens. Sometimes they may feel they are a special person or have special powers. 
  • Thought disorder is when they are not able to think straight. It may be difficult to understand what they are saying; their ideas may seem jumbled, but it is more than being muddled or confused.
  • Unusual experiences called hallucinations are when they can see, hear, smell or feel something that isn’t really there. The most common hallucination people experience is hearing voices. In psychosis, hallucinations are totally real to the person having them. This can be very frightening and can make them believe that they are being watched or picked on.

Having these strange thoughts and experiences can affect a young person at school, home or when with friends. They may find it difficult to concentrate and enjoy what they normally did. It can even affect their sleep, appetite and physical health. 

What are the treatments for psychosis?

Medications called ‘antipsychotics’ are an important part of treatment. They may need to be taken for a long time in order to stay well. As with medication of any kind, there may be side-effects; the psychiatrist will be able to advise on what they are and what can be done to help. The risk of side-effects needs to be balanced against the risk of the damaging effects of the illness on a young person’s life.

Some of the medicines for the treatment of psychosis are ‘unlicensed’ in children and young people. This does not mean they do not work for young people, but simply that the drug company has not applied for a license. If you are worried about this, you should speak to the doctor or pharmacist.  Further information is also available from the Royal College of Paediatrics and Child Health.

If the psychosis is related to drug use or underlying physical problems, your child may need specific help and treatment to manage this.

Other forms of treatment in addition to medicine are also important. Talking treatments can be helpful. The whole family will need help to understand more about the illness, to cope successfully, and to help prevent the illness coming back. 


This resource provides information, not advice.  

The content in this resource is provided for general information only. It is not intended to, and does not, amount to advice which you should rely on. It is not in any way an alternative to specific advice. 

You must therefore obtain the relevant professional or specialist advice before taking, or refraining from, any action based on the information in this resource.

If you have questions about any medical matter, you should consult your doctor or other professional healthcare provider without delay.  

If you think you are experiencing any medical condition, you should seek immediate medical attention from a doctor or other professional healthcare provider.  

Although we make reasonable efforts to compile accurate information in our resources and to update the information in our resources, we make no representations, warranties or guarantees, whether express or implied, that the content in this resource is accurate, complete or up to date. 

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Psychosis explained simply - An Introduction to Drug-Indcued Psychosis

Recovery Stories by People with Psychosis

Useful Books on Psychosis

With the right support, we can and do recover. The Dual Diagnosis Hub can help everyone to find the best dual diagnosis support and resources available.

The Dialectical Behavior Therapy Skills Workbook for Psychosis: Manage Your Emotions, Reduce Symptoms, and Get Back to Your Life

Powerful and effective skills to help you manage psychosis, take charge of your emotions, and get back to living your life.

Based in dialectical behavior therapy (DBT), this first-of-its-kind workbook offers real skills to help you balance your emotions and stay grounded in reality. You’ll find self-assessments, worksheets, and guided activities to help you understand your symptoms and manage them in day-to-day life. You’ll also gain self-awareness, learn to navigate difficult or stressful situations, and discover healthier ways of interacting with others.

If you have a history of psychosis or suffer from psychotic spectrum disorder, you know how difficult it can be. You may experience paranoia, auditory hallucinations, and emotional dysregulation. In addition, you may feel alienated from your friends and family if they have trouble understanding what you’re going through. The good news is that you can move beyond the stigma of psychosis, regain hope, and rebuild your life. This compassionate workbook will help you get started.

In this workbook, you’ll learn the core skills of DBT to help you feel better:

  • Mindfulness
  • Distress tolerance
  • Emotion regulation
  • Interpersonal effectiveness


You’ll also find important information on relapse prevention—including warning signs to watch out for, what to do if you have another episode, and an extensive resource list to help you manage your symptoms. And finally, you’ll find a wealth of practical tools that can be used every day for long-lasting psychosis recovery.

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