During a psychotic episode, individuals are unable to think clearly and reasonably, and lose touch with reality. A psychosis affects different people differently, but there are five main groups of symptoms that people can experience during a psychotic episode.

Thinking problems

During a psychotic episode, people may have difficulty concentrating and are unable to think clearly. Their thoughts may come and go very quickly, or their thinking might slow down and, in some cases, almost stop. Having a conversation with people experiencing a psychosis can be difficult, as they may jump from topic to topic, and sentences may not make sense. Sometimes they may talk strangely; they may make up new words, or they may use words just because they rhyme with each other. Some people may talk very little and usually people show some lack of insight into these things or any awareness that anything is wrong.

Delusions

It is common for a person experiencing a psychosis to have delusions. Delusions are false beliefs, held with total conviction, and not a normal part of the person's cultural or religious environment - i.e. not shared by other people from the same religious or cultural group. The person is firmly convinced of the truth of the delusion, and even the most logical discussion will not budge the false idea. Delusions are usually hard for family and friends to understand. Types of delusions are outlined below.

• Persecutory delusions. These delusions are the most common, and usually the individual believes that he/she (or someone close) are being persecuted, spied on, tormented, or followed, e.g. the person might believe that a government agency is following him/her.
• Referential delusions. These are also common delusions, and usually the individual believes that events, objects, the behaviour of others, or other information in the environment (such as television or radio content, songs, or billboards) contain messages which are specifically meant for him/her, e.g. the person might believe that the nightly weather forecast or a particular news contains a special message or is made just for him/her and no one else.
• Grandiose delusions. Individuals believe that they have extraordinary abilities or powers, or that they are somebody very important, e.g. related to royalty, or are friends with famous people. They may believe that they are chosen by God, or that they are very rich, or more powerful or more intelligent than other people.
• Religious delusions. These delusions have a strong religious theme, e.g. the person may believe that he/she is receiving instructions from God.
• Somatic delusions. Individuals believe that something odd is happening within their body, or that they have a disease, despite medical evidence that indicates that nothing is wrong. They may believe that a part of their body is missing, or has been changed in some way.
• Delusions of control. Individuals believe that others are controlling their mind or body. People may believe that thoughts have been inserted into their mind by an external force, or they may believe that their private thoughts are being broadcast, so that others can hear them. Sometimes people believe that their thoughts are being removed or 'stolen' from their mind by an external force, and they may blame this on other people.
• Depressive delusions. Here the sufferer is convinced that they are very bad or worthless people (and may even confess to crimes they have not committed). Guilt may be enormous over trivial or imagined errors. They may think their bodies are rotting or disappearing, or that they have no family or children or money (when they do have these things) or that there is only emptiness inside their head or body. Such delusions of 'having nothing' are often referred to as nihilistic delusions.
  
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