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What You Need to Know About PTSD and Psychosis

Post-traumatic stress disorder (PTSD) is a mental health condition caused by exposure to trauma or severe stress, characterized by hyperarousal, avoidance symptoms, re-experiencing symptoms and severe stress, along with psychotic symptoms according to professionals and therapists.

Meaning: PTSD and psychosis often occur together. Not all the time — not every case of PTSD is a psychotic-related case, and certainly, this article is not seeking to strike fear in the hearts of those with PTSD or for the loved ones of those with PTSD to be concerned about psychosis. But it is seeking to educate about the possibility of a connection between psychosis and PTSD because it is a lot more common than people know or have come to believe.

PTSD-related psychosis is a widely misunderstood issue and I’d like to educate people further, particularly because PTSD is common and psychosis can develop if PTSD is left untreated, if it worsens or the trauma is pervasive and complex PTSD is present. It is often a reason for misdiagnosis of other psychotic disorders, when really the reason is trauma-related and is instead PTSD-related psychosis.


I was hospitalized for PTSD-related psychosis. It is a cause near to my heart because I know what it is like to hear voices or become someone you are not, all due to a trauma you have experienced. I know what it is like to not know why it is happening, and have it deeply affect both your life and the lives of those around you.

An expert in PTSD, whom I have spoken with on this subject, said she believes individuals with PTSD often hear voices or experience psychosis directly related to their trauma (or traumas), and that this psychotic behavior will surface in times where they feel threatened, afraid, fearful or triggered. Working directly on the trauma(s) will address these symptoms in addition to necessary medications.

According to a research study at the University of Manitoba, Columbia University and the University of Regina, of just over 5000 people across the United States, 52 percent experience positive psychotic symptoms with PTSD.

In this study, the most common symptoms in those with PTSD and psychosis were:

1. Believing people are following or spying on them.

2. Seeing something others could not see.

3. Having unusual feelings inside or outside of their bodies, such as touch when no one was there.

4. Believing they could hear others thoughts.

5. Being bothered by some strange smell.

6. Believing their thoughts were being controlled by some other power or force.

Flashbacks and dissociation, which occur commonly in PTSD, also share some features of psychosis. They have been compared to the psychosis featured in PTSD but are not the same thing. In a severe flashback, a person may actually experience things that are consistent with hallucinations (smell, sight, tactile features, etc.) and believe they are re-experiencing the event from which they were traumatized. A PTSD flashback is typically caused by a trigger associated with the event.

However, PTSD psychosis is different than a flashback. In PTSD-related psychosis, this can mean the psychosis is triggered by trauma-related events, events that remind the person of the trauma or just periods of high stress.

It has been years since I was hospitalized for psychosis and related PTSD, but like the experts claim, in times I am stressed or feel triggered I do still experience some varied symptoms. I know how to handle them now and they do not interfere with my life anymore, but I remember how scary it was to not know and not understand what was happening.

I hope that, in the near future, there is a greater understanding of the connection between PTSD and psychosis, because for people to recover themselves there needs to be better and faster care available. This won’t be possible until more is known and it can be talked about openly.

If you have PTSD, it is important to know the typical symptoms of psychosis. If you start experiencing anything out of the ordinary, get additional support for yourself before it worsens. Tell your family members if you can about what you are experiencing, and make sure they are aware of your triggers, how to support you and how to support your PTSD recovery. Make your voice heard so you can get the best help possible and be on a quick road to recovery. PTSD is a scary issue and can often feel isolating, but speaking up — while difficult — is the best thing to do.

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Photo by Mike Wilson on Unsplash