Which warning signs point to a psychosis?

According to the BIÖG, in psychosis a person temporarily loses touch with reality and develops hallucinations and delusions. The BIÖG points out that people who use cannabis develop psychosis more often than people who do not. Gesundheitsinformation.de describes how acute psychoses often announce themselves weeks or months in advance: those affected are restless and tense, sleep poorly, and have problems with concentration and memory. This article explains what you can watch for, which role cannabis plays and when you should seek medical help.

What psychosis is

Gesundheitsinformation.de names as essential symptoms hallucinations such as hearing voices, delusions such as paranoia, the feeling that one’s own experience and thinking are being controlled by others, and disjointed thoughts or confused speech. Psychoses usually occur in temporary phases. A psychosis is a serious illness. It needs medical support and does not belong in the hands of friends alone.

According to Gesundheitsinformation.de, the complaints, causes and course are often very different.

Why cannabis affects the risk

The BIÖG names the more frequent occurrence of psychoses in people who use cannabis. The link is statistical, and causation is not proven. How high the risk is in an individual case depends on several factors, and a precise figure for one person cannot be given.

This warning applies particularly to young people, because their brain is in an important stage of development. The BIÖG writes that young people should not use cannabis at all for health reasons, because important maturation processes take place in the brain until around the age of 25.

Warning signs to take seriously

According to Gesundheitsinformation.de, possible early signs and symptoms are:

• poor sleep, restlessness and tension,
• problems with concentration and memory,
• slight hallucinations or the feeling of being watched and influenced by others,
• hearing voices or paranoia,
• disjointed thoughts or confused speech.

This list does not replace a medical diagnosis. Individual points, such as poor sleep, also occur without psychosis. They help you classify changes and prepare the conversation with a specialist.

What to do if you notice warning signs

If you notice warning signs in yourself, speak to a trusted person and see a doctor. A GP can refer you to specialists. In acute danger or severe confusion, call the emergency number 112.

If you are worried about someone close to you, approach them gently and ask how they are. Pressure and reproaches rarely help. You can also get help for yourself, for example from a counselling service for relatives.

Use, medication and medical advice

The DHS writes that existing mental illnesses can worsen with heavy cannabis use and that dormant psychoses can break out again. Anyone who has a mental illness, or knows of a psychosis in the family, should therefore discuss their use with a doctor, including when taking medication regularly.

Where you can find support

For help with use, you can find support at suchtberatung.digital and in the Suchthilfeverzeichnis of the Deutsche Hauptstelle für Suchtfragen. Anonymously you can reach the Sucht & Drogen Hotline on 01806 313031 (calls are charged, daily 8 a.m. to midnight). Information on effects and risks is offered by drugcom.de. In acute crises, the emergency number 112 is part of first aid.

Terms: risk, cause and trigger

An increased risk means that an event occurs more often in one group than in another. It does not mean that every person who uses cannabis develops a psychosis. On the current information, cannabis is one factor among several. Drugcom describes it as a possible stress factor where there is existing vulnerability, and Gesundheitsinformation.de names, among other things, drug use, sleep disorders, psychological stress and traumatic experiences.

The BIÖG writes that where there is an inborn predisposition to psychosis, even small amounts of cannabis could be enough to trigger one. Whether one belongs to that group cannot readily be said.

What helps in the first few days

When changes occur, provide a calm, protected setting. Mindzone advises staying calm with acutely psychotic people and not arguing about delusional content or trying to convince them with facts.

The next step after that is medical clarification. A GP can assess whether specialist treatment is needed.

Because the DHS says cannabis can worsen existing mental illnesses, it makes sense not to use cannabis during this phase. Whether the changes subside will be clarified by the doctor over time.

Common misunderstandings

According to Gesundheitsinformation.de, some affected people experience a psychotic phase only once or a few times, while others have lasting complaints. Whether this applies to you or to someone else can only be clarified by a medical examination. According to the site, acute psychoses often announce themselves long in advance, and relatives usually also notice that something is changing.

What you can do now

• Note warning signs in yourself or a person close to you, with the date.
• See a doctor if the changes persist or worry you.
• In acute danger, call the emergency number and do not stay alone.
• Check your own use honestly, and ask a counselling service if you are unsure.

How depression and anxiety can be classified in connection with cannabis is explained in the article on cannabis, depression and anxiety. Which pre-existing conditions increase the risk is shown in the article on risk factors for psychosis. The state of the research on psychosis risk is summarised in the article on the research situation on psychosis risk.