Changes in Behaviour

When people are experiencing a psychosis, they behave in ways that are different from the ways in which they would usually behave. Often they will lack motivation and will be very lethargic- wanting only to sit around. People will often have trouble starting projects, or completing projects they have started. Individuals may not look after themselves as well as they usually do and may neglect their personal hygiene, or stop tidying up after themselves. Other individuals become very active, and seem unable to sit still. People may also find it very difficult to manage their responsibilities such as work, their finances, or study. Sometimes people can behave recklessly, impulsively, aggressively, or may engage in inappropriate sexual behaviour. Some of the other symptoms described above can also have an effect on behaviour, e.g. people experiencing a delusion that their food is contaminated they may not eat. Sometimes people may show unusual facial expressions, or may make the same movements repeatedly. Movements, odd facial expressions or talking as if addressing someone who isn't there, are usually in response to hallucinations or delusions.

Changes in emotions

Frequently people who are experiencing a psychotic episode express emotions differently from the way they usually would. Some individuals seem to have trouble experiencing the usual range of emotions, and may speak in a flat, emotionless way. People who are experiencing a psychosis often see the world as uninteresting and can feel quite removed from people and their usual daily activities. People may also express emotions that don't fit the situation, e.g. they may laugh when describing a sad event. Mood swings can also occur, and people may feel very excited or depressed in a way that is not appropriate to their situation or environment. Such people are described as experiencing or showing emotional incongruity or incongruity of emotion.

Changes in understanding and awareness

A difficulty grasping what is going on or changes in understanding are most often seen when people have a severe disease of the brain. People with these disorders may not understand fully what is said to them or appreciate the significance of a situation or event. The may have no awareness of the time, date or place they are in. They may often fail to know or recognize relatives and loved ones and, in severe cases, may not know who they themselves are.
Not all people will experience all of these symptoms, and the kind of symptoms experienced and their severity will vary from person to person. It is important for friends and family to remember that:

• experiencing psychotic symptoms is very distressing, scary and confusing;
• people do not choose to experience these symptoms;
• the symptoms are not signs of laziness, character flaws or weaknesses; and
• the symptoms are not a ploy to gain attention.

These symptoms are part of genuine psychiatric disorders that require immediate medical assistance.