Diagnosis, antipsychotic treatment, relapse prevention, and the long-term follow-up these conditions need. Families are usually part of the work, with the patient's consent.
Psychosis means losing the shared thread of what is real — hearing voices others cannot, holding beliefs that are not shared and cannot be argued away, or thought that has become difficult to follow. It is frightening, and it is treatable.
Often the first signs are quieter than people expect: withdrawal, dropping out of a course, sleeping through the day, a growing conviction that something is going on. Families usually sense it months before anyone names it.
Almost always it is a parent, sibling or spouse who makes the first call.
He stopped going to college four months ago. He says the neighbours are recording him.
Mother, son aged 21She is talking to someone when there is nobody there. She gets angry if we mention it.
Brother, sister aged 24He was well for two years. He stopped the medicine in March and now it has come back.
Wife, husband aged 33Nobody causes schizophrenia, and nobody catches it. It emerges from a combination of inherited vulnerability and events acting on a brain still maturing.
Inherited risk sets the threshold. Stress, sleep loss, and in particular cannabis in adolescence can bring symptoms forward in someone already vulnerable. This is why age of onset clusters in the late teens and twenties.
This was believed for decades and caused enormous unnecessary guilt. It is not supported by evidence. Families do not cause schizophrenia — though how a family responds does affect how well someone recovers, which is why they are included in the work.
Of everything in psychiatry, this is the condition where the delay between onset and treatment matters most.
With consent, family are usually seen as well. Insight is often reduced during an episode, which means the account from home is not a supplement but a necessary part of the picture.
Substance-induced psychosis, thyroid disease, autoimmune conditions, epilepsy and certain medicines all produce psychotic symptoms. Bloods and sometimes imaging come before a diagnosis is settled.
Whether someone is safe at home, able to eat and sleep, and whether in-person or inpatient care is needed. Where it is, you will be told plainly rather than managed at a distance.
Antipsychotic medication is the foundation, chosen for the side-effect profile a particular person can live with — because the medicine that is actually taken is the one that works. Weight, metabolic markers and movement side effects are monitored, not ignored.
Around it: a plan for relapse signs, support for the family in how to respond, and gradual work on returning to study or employment. Long-acting injections are an option for people who find daily tablets hard to sustain.
A first assessment for suspected psychosis is usually better done in person, and acute episodes need in-person or hospital care. Video review works well for someone stable on established treatment. If an online consultation is not the right setting, you will be told that rather than sold one.
Includes the written diagnosis and treatment plan. Family may join with the patient's consent. Reviews are ₹800.
Yes. Reduced insight is a symptom, not refusal. Book a consultation in your own name first to discuss how to approach it — that is a legitimate use of an appointment and often more productive than a forced first visit.
Older antipsychotics often did. Modern options vary considerably, and sedation is usually a sign the dose or the drug needs changing rather than something to be endured. Say so at review — it is one of the commonest reasons people stop taking medicine.
Many people do. It usually works better as a graded return than a sudden one, and the plan is built around what the person actually wants to go back to rather than a general target.
There is an inherited component, but having an affected sibling does not mean another child will develop it — the great majority do not. What is worth knowing is which early signs to take seriously, and that is something to discuss directly.
Where psychosis occurs in mood episodes
Cannabis and psychosis
Review of existing treatment
Call Tele-MANAS 14416 — free, 24 hours. If someone is in immediate danger, call 112.