Potential Causes
Psychosis is not a diagnosis in itself—it’s a set of symptoms that can emerge from a variety of underlying causes. A first episode of psychosis may be triggered by mental health disorders, medical conditions, substance use, or even environmental stressors. Understanding the cause is key to determining the best course of treatment.
While psychosis can affect people of any age, it most commonly emerges in adolescence or young adulthood, a time of rapid brain development and increased vulnerability to both internal and external influences. The most frequent cause of first episode psychosis in young people is a psychiatric disorder such as schizophrenia. However, there are many other contributing factors, and in some cases, multiple causes may overlap.
FEP Triggers
The use of substances—particularly marijuana, especially high-potency strains—has been increasingly linked to the onset of psychosis in young people. Cannabis-induced psychosis may involve paranoia, hallucinations, and confusion, and in some individuals, can trigger long-term psychiatric conditions.
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Schizophrenia is a chronic mental health condition that often begins with a first episode of psychosis. Early symptoms may include hallucinations, delusional thinking, disorganized speech, and a loss of connection with reality. Other related conditions, such as schizoaffective disorder or brief psychotic disorder, can also lead to similar symptoms, especially in young adults.
Certain medical issues—such as epilepsy, brain injuries, infections like encephalitis, or autoimmune disorders—can cause psychotic symptoms. Additionally, some medications or exposure to toxins can disrupt brain function and lead to a psychotic episode. A thorough medical evaluation is often necessary to rule out these causes.
Experiencing severe trauma—especially in childhood or adolescence—can lead to psychotic symptoms in some individuals. This may include dissociation, hearing voices, or intense paranoia as the brain attempts to cope with overwhelming stress. Trauma-related psychosis is often connected to conditions like Post-Traumatic Stress Disorder (PTSD) or Complex PTSD, and may require specialized trauma-informed care.
