UNC Health Care
Teen walking with scary shadow behind him

4 Things to Know About Psychosis in Teenagers

It’s perfectly normal for teenagers to sometimes be upset, disillusioned or just plain angry. The teen years are difficult for many—that’s not a newsflash.

But at what point should teenage behavior cause concerns that there’s a mental health problem, perhaps even a serious one like psychosis?

Psychosis is a brain disorder characterized by hallucinations, delusions and confused thinking, in which sufferers have a difficult time distinguishing what is real from what is not. About 3 percent of Americans will experience psychosis at some point in their lives. And each year, about 100,000 adolescents and young adults experience their first episode of psychosis, according to the National Institute of Mental Health.  

Here’s what to know about psychosis in teens.

Teenage psychotic disorders can be hard to spot.

Early symptoms can be indistinguishable from an anxiety disorder, depression or drug use,” says psychiatrist Karen Graham, MD, a professor at the UNC School of Medicine. They include depressed mood, anxiety, irritability, sleep changes, social withdrawal, trouble concentrating, a drop in school performance or personal hygiene, and displaying either very strong emotions or no emotions.

It’s critical to get help as soon as possible.

“Early treatment of a psychotic episode is very important to give the individual the best chance of recovering fully,” Dr. Graham says. “The longer the duration of untreated psychosis, the worse the outcome.” Treatment includes antipsychotic medication along with individual and family therapy.

Risk factors for a teenager developing psychosis are varied.

They include heavy marijuana use, a family history of a psychotic disorder in a parent or sibling, chronic inflammation, older age of father at birth and some pregnancy complications while the child was in utero.

People who are psychotic are rarely violent.

It’s a misconception that people dealing with psychosis are dangerous,” Dr. Graham says. “In fact, people with psychotic illness are more likely to be the victims of violence than the perpetrator.”

If you’re worried about a teen in your life, talk to a doctor or mental health professional. A good place to start is with a provider who already knows the teenager, so that he or she can assess changes in personality and determine if further help is needed.


If you’re concerned someone is showing signs of a psychotic disorder, you can call OASIS for advice or a psychiatric evaluation at (919) 962-1401.