What psychosis looks like
People may hear voices or see things others do not, hold fixed beliefs that are not shared by their culture, feel that they are being watched or controlled, or speak in a disorganised way. Behaviour may become withdrawn, agitated or unpredictable.
Psychosis can occur in schizophrenia, bipolar disorder, severe depression, substance use, medical illness and some neurological conditions. The first step is a careful diagnostic assessment, not assuming a single cause.
Related: Psychiatry → · Dr. Ruja Shrestha profile → · All conditions →
Assessment and safety
The assessment reviews the onset and duration of symptoms, mood, substance use, medical history, family history and previous treatment. Risk of self-harm, suicide, aggression and vulnerability is assessed directly.
If there is immediate danger to the person or others, or the person cannot care for themselves, emergency or inpatient care is needed. Urgent medical causes such as infection, delirium or drug toxicity must be excluded.
- Clarify the symptom pattern and duration
- Screen for mood disorders, substance use and medical causes
- Assess suicide, self-harm and aggression risk
- Involve family or caregivers with the patient's consent where possible
Treatment and relapse prevention
Antipsychotic medication is the mainstay of treatment for most psychotic disorders, chosen according to symptoms, side-effect profile and medical history. Psychotherapy, family psychoeducation, vocational support and treatment of co-occurring conditions are added as needed.
Relapse prevention includes understanding early warning signs, maintaining treatment, managing sleep and substance use, and having a clear crisis plan. Recovery is not only symptom control; it includes function, relationships and quality of life.
Access and booking
Appointments are at Mind Wellness Center, Durbar Marg area, Kathmandu. Call +977-9747736624 or use /book-appointment. Telepsychiatry is available for appropriate follow-up and for patients who cannot attend in person. This is not an emergency service.