An Overview of Psychotic Disorders in Teens

People who have psychotic disorders often begin showing symptoms during the late teenage years. Determining that your teen is having delusions, or false, fixed beliefs, can be difficult. After all, many neurotypical children, teens, and adults believe things that might be false. For example, some people believe that they will get the flu if they go out with wet hair. While this is not true, thinking so does not mean that someone is suffering from delusions. Read on to learn more about what types of disorders cause delusional thinking, what delusions actually are, other symptoms of psychotic disorders, and what the future might hold if your teen is diagnosed with one.

Types of Psychotic Disorders

There are several different types of psychotic disorders. Some of them might sound familiar to you, while there are others you might not have heard of before.

Schizophrenia

Schizophrenia is one that most people have heard of. It is a disorder that causes severe hallucinations and delusions which interfere with daily life. It’s just about impossible for someone with schizophrenia to manage the tasks of day-to-day living if they are not receiving some form of treatment. Unfortunately, many people with this disorder believe that their doctors are trying to harm them or that they do not need to take their medication, so this creates quite a challenge.

Brief Psychotic Disorder

Brief psychotic disorder is a condition that comes on suddenly and often resolves just as suddenly. During the time that the person is affected, they suffer from delusions and strange behaviors.

Delusional Disorder

Delusional disorder entails one particular delusion that persists for many weeks, months, or years. It’s often not severe enough to impact day-to-day living.

Delusions & Hallucinations

Delusions

A delusion is a symptom of a mental health disorder.

There are delusions that are bizarre and those that are non-bizarre.

Non-Bizarre – These are delusions that could reasonably happen. For example, someone might get the feeling that someone is following them without actually seeing anyone.

Bizarre – These are delusions that could not realistically happen and it’s not anything that would be accepted by someone else as a possibility. For example, someone might believe that an alien has taken over their thoughts and body movements.

Either of these types of delusions can be part of a psychotic disorder, but bizarre delusions are, understandably, more concerning.

Hallucinations

A hallucination happens only in a person with schizophrenia or a psychotic disorder.

Some hallucinations are considered normal experiences. These are the ones which occur when falling asleep or waking up. An example of a normal hallucination is when you hear music playing as you fall asleep.

If your teen is hearing discernible voices, however, that is a delusion that needs to be investigated and that might be a symptom of a psychotic disorder.

Hallucinations can be auditory, visual, olfactory, gustatory, and tactile. The most common form of hallucinations is auditory.

An example of a hallucination that someone with a psychotic disorder might have is smelling gas or some other odor that no one else smells and that they think will cause them harm. Or they might think they detect the taste of a poisonous substance in their food, despite others not being able to taste it.

Other Symptoms of Psychotic Disorders

In addition to the delusions themselves, psychotic disorders often cause other types of symptoms. One common symptom, particularly in those who have schizophrenia, is speaking in words that don’t go together. Speech patterns can be very chaotic and not make sense to anyone else.

The following symptoms might be prevalent in a teen with psychotic disorder:

  • They might stop keeping up with his or her personal hygiene
  • They might walk slowly or in an uncoordinated way
  • They might often behave as though they’re confused
  • They might drop friendships and stop communicating with people

These are often due to the individual feeling frightened and confused. They don’t know what is real and what isn’t, and as the condition worsens, they further lose their grip on reality and their symptoms might become more troubling.

Treatments and Outlook

One of the most important parts of treatment for someone with a psychotic disorder is getting the right type of psychotherapy. Because someone with delusions does not believe that they are not real, it’s important that the therapist does not try to convince the patient that they are not based in reality. This could lead the teen or adult patient to decide that the therapist is wrong and “just like everyone else.”

The same situation applies to medication. Since a person with delusional thinking generally thinks that they are correct in their assessment, they don’t usually take kindly to the suggestion that medication is needed. Some teens and adults with psychotic disorder will even think that their doctors are trying to drug them or poison them for some nefarious purpose.

If a therapist can create and maintain a trusting relationship with the patient, he or she might be able to convince them to continue with therapy and maybe to take antipsychotic medication. Because psychotic disorders vary in their severity, the outlook depends on how severe the case is. Someone with a non-bizarre delusion that does not impact daily life might be able to live a normal life without much assistance. On the other hand, someone who has several bizarre delusions who cannot function properly has a much tougher road ahead.

If you believe that your teen is developing a psychotic disorder, you should take them to their primary care physician. The condition is rare, so it’s possible that there is a physical cause to blame for erratic behavior. It’s also possible that anxiety or another more common (and usually less severe) mental health condition is to blame. If there is nothing physically wrong, the doctor will refer you and your teen to a mental health specialist. If a psychotic disorder is suspected, be sure to ask for one who is experienced with adolescents with a psychotic disorder to avoid having your teen shut down due to the therapist questioning his or her claims and beliefs. Also, consider getting counseling for yourself, because caring for someone with this type of disorder can be overwhelming and stressful.

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An Overview of Psychotic Disorders in Teens

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Lucy Nguyen

Lucy Nguyen, LMFT
Clinical Reviewer

Lucy Nguyen is the Executive Director at Paradigm Treatment, overseeing all clinical treatment programs across the organization's southwestern region. Her extensive experience includes working with young adults in private practice, serving as a therapist for children and teens with emotional and behavioral needs, and acting as a behavior interventionist for teens with developmental disorders. Lucy integrates cognitive-behavioral approaches with mindfulness and compassion in her work, and she is also EMDR-trained. She holds a Master of Science in Counseling from California State University, Fullerton, and a Bachelor’s degree in Psychology and Social Behavior from the University of California, Irvine.

People who have psychotic disorders often begin showing symptoms during the late teenage years. Determining that your teen is having delusions, or false, fixed beliefs, can be difficult. After all, many neurotypical children, teens, and adults believe things that might be false. For example, some people believe that they will get the flu if they go out with wet hair. While this is not true, thinking so does not mean that someone is suffering from delusions. Read on to learn more about what types of disorders cause delusional thinking, what delusions actually are, other symptoms of psychotic disorders, and what the future might hold if your teen is diagnosed with one.

Types of Psychotic Disorders

There are several different types of psychotic disorders. Some of them might sound familiar to you, while there are others you might not have heard of before.

Schizophrenia

Schizophrenia is one that most people have heard of. It is a disorder that causes severe hallucinations and delusions which interfere with daily life. It’s just about impossible for someone with schizophrenia to manage the tasks of day-to-day living if they are not receiving some form of treatment. Unfortunately, many people with this disorder believe that their doctors are trying to harm them or that they do not need to take their medication, so this creates quite a challenge.

Brief Psychotic Disorder

Brief psychotic disorder is a condition that comes on suddenly and often resolves just as suddenly. During the time that the person is affected, they suffer from delusions and strange behaviors.

Delusional Disorder

Delusional disorder entails one particular delusion that persists for many weeks, months, or years. It’s often not severe enough to impact day-to-day living.

Delusions & Hallucinations

Delusions

A delusion is a symptom of a mental health disorder.

There are delusions that are bizarre and those that are non-bizarre.

Non-Bizarre - These are delusions that could reasonably happen. For example, someone might get the feeling that someone is following them without actually seeing anyone.

Bizarre - These are delusions that could not realistically happen and it’s not anything that would be accepted by someone else as a possibility. For example, someone might believe that an alien has taken over their thoughts and body movements.

Either of these types of delusions can be part of a psychotic disorder, but bizarre delusions are, understandably, more concerning.

Hallucinations

A hallucination happens only in a person with schizophrenia or a psychotic disorder.

Some hallucinations are considered normal experiences. These are the ones which occur when falling asleep or waking up. An example of a normal hallucination is when you hear music playing as you fall asleep.

If your teen is hearing discernible voices, however, that is a delusion that needs to be investigated and that might be a symptom of a psychotic disorder.

Hallucinations can be auditory, visual, olfactory, gustatory, and tactile. The most common form of hallucinations is auditory.

An example of a hallucination that someone with a psychotic disorder might have is smelling gas or some other odor that no one else smells and that they think will cause them harm. Or they might think they detect the taste of a poisonous substance in their food, despite others not being able to taste it.

Other Symptoms of Psychotic Disorders

In addition to the delusions themselves, psychotic disorders often cause other types of symptoms. One common symptom, particularly in those who have schizophrenia, is speaking in words that don’t go together. Speech patterns can be very chaotic and not make sense to anyone else.

The following symptoms might be prevalent in a teen with psychotic disorder:

  • They might stop keeping up with his or her personal hygiene
  • They might walk slowly or in an uncoordinated way
  • They might often behave as though they’re confused
  • They might drop friendships and stop communicating with people

These are often due to the individual feeling frightened and confused. They don’t know what is real and what isn’t, and as the condition worsens, they further lose their grip on reality and their symptoms might become more troubling.

Treatments and Outlook

One of the most important parts of treatment for someone with a psychotic disorder is getting the right type of psychotherapy. Because someone with delusions does not believe that they are not real, it’s important that the therapist does not try to convince the patient that they are not based in reality. This could lead the teen or adult patient to decide that the therapist is wrong and “just like everyone else.”

The same situation applies to medication. Since a person with delusional thinking generally thinks that they are correct in their assessment, they don’t usually take kindly to the suggestion that medication is needed. Some teens and adults with psychotic disorder will even think that their doctors are trying to drug them or poison them for some nefarious purpose.

If a therapist can create and maintain a trusting relationship with the patient, he or she might be able to convince them to continue with therapy and maybe to take antipsychotic medication. Because psychotic disorders vary in their severity, the outlook depends on how severe the case is. Someone with a non-bizarre delusion that does not impact daily life might be able to live a normal life without much assistance. On the other hand, someone who has several bizarre delusions who cannot function properly has a much tougher road ahead.

If you believe that your teen is developing a psychotic disorder, you should take them to their primary care physician. The condition is rare, so it’s possible that there is a physical cause to blame for erratic behavior. It’s also possible that anxiety or another more common (and usually less severe) mental health condition is to blame. If there is nothing physically wrong, the doctor will refer you and your teen to a mental health specialist. If a psychotic disorder is suspected, be sure to ask for one who is experienced with adolescents with a psychotic disorder to avoid having your teen shut down due to the therapist questioning his or her claims and beliefs. Also, consider getting counseling for yourself, because caring for someone with this type of disorder can be overwhelming and stressful.

Related Articles

Teens With Psychotic Illnesses Are More At Risk for Suicide

Psychosis and Brief Psychotic Disorder in Teens

Teen Brief Psychotic Disorder: A Short and Stress-Related Experience of Psychosis

Psychiatric Treatment at Paradigm

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