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Early recognition of psychoses and bipolar disorders

What are the first signs of a psychosis?

abbildungMany symptoms that occur during an acute psychosis can appear in a weakened form already beforehand and are thus important early warning signs. However, the very first signs of a psychosis are frequently difficult to recognize. In hindsight, many people realize that an unusual behaviour had commenced long before the onset of the psychosis. These first signs are often attributed to puberty, drug abuse or mere laziness, arrogance or the absence of cooperation. Listed below are some typical early symptoms of a psychosis.

Possible early signs of a psychosis


Change in essential nature

  • Anxiety, nervousness, irritability
  • Increased sensitivity, oversensitivity, irritability
  • Sleeping disturbances (excessive sleeping or going without sleep)
  • Diminished appetite
  • Self-neglect, wearing bizarre clothes
  • Sudden lack of interest, initiative, energy

Change of feelings

Depression, flattened feelings or mood swings
Anxieties – in particular fear of being harmed or threatened

Change in efficiency / productivity

  • Limited ability to work under pressure, above all in times of stress
  • Concentration disturbances, increased distractibility
  • Buckling in productivity

Change in the social area

  • Distrust
  • Social withdrawal, isolation
  • Problems in relationships, breaking off contacts
  • Change in interests
  • Sudden unusual interests, for example for religious or supernatural matters, magic etc.

Change in perception and experience

  • Unusual perceptions, e.g. more intensive or changed perception of noises and colours; feeling that oneself or one's surroundings are changed; the feeling that one can see, hear, taste or smell things that other persons cannot perceive
  • Peculiar ideas; unusual experience, e.g. self-referencing [Eigenbeziehung] (one relates experiences or actions and/or statements by other people to oneself); the feeling of being watched; experiences of manipulation (the feeling that other persons could control, steer or have access to one’s own thoughts)