Anxiety does not directly cause psychosis. However, the conditions have some similar symptoms, and people who have had severe anxiety for an extended time may experience a psychotic episode.

It may be possible for anxiety to lead to psychosis if a person’s anxiety is particularly severe, but not all people diagnosed with anxiety will develop psychosis.

Those who have had anxiety over a prolonged period, such as during childhood, may be more at risk of having a psychotic episode.

This article looks at whether there is a link between anxiety and psychosis and what these conditions are. Additionally, it provides an overview of the symptoms of anxiety with psychotic features. It also examines the similarities and differences between the two conditions and their causes, treatments, outlook, and support.

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There appears to be a potential link between anxiety and psychosis, particularly when anxiety is persistent or severe.

Research from 2022 shows that persistently high levels of anxiety during childhood and adolescence could be a potential risk factor for psychosis.

The research also relates persistent anxiety symptoms to psychosis due to the activation of stress hormones and inflammation.

On the other hand, another 2022 studyTrusted Source of 509 ultra-high-risk individuals revealed that anxiety and depressive disorders do not appear to determine the risk of a person having a psychotic episode.

The research continues into how the two conditions relate. This may help doctors treat cases when severe anxiety triggers psychotic episodes.

Anxiety produces various symptomsTrusted Source as a response to anticipated threats.

Cognitive symptoms may include:

Physiological symptoms may include:

Behavioral symptoms may include:

  • avoidance of threat cues
  • restlessness
  • agitation
  • difficulty speaking

Affective symptoms may include:

  • nervousness
  • fear
  • impatience
  • frustration

According to the National Institute of Mental HealthTrusted Source, psychosis affects a person’s thoughts and perceptions of reality. During a psychotic episode, people have difficulty recognizing what is real and what is not.

Psychosis typically involves two major experiences: hallucinations and delusions.

Hallucinations cause people to see, hear, or feel things that are not there.

Delusions cause strong beliefs that are inconsistent with a person’s culture. For example, a person may believe that:

  • external forces are controlling their thoughts, feelings, and behaviors
  • trivial comments, events, or objects have personal significance
  • they have special powers, are on a mission, or are God

Alongside this, a person may also experience other changes, includingTrusted Source:

  • disrupted emotions
  • anxiety
  • lack of motivation
  • overall difficulty functioning

Doctors may describe psychosis as a symptom of schizophrenia. However, they can also be stand-alone conditions.

Find out more about how they differ.

A small study from 2020Trusted Source showed that symptoms of anxiety disorders are common in people with psychotic disorders.

Signs of psychosis may includeTrusted Source:

Anxiety symptoms with similar psychotic features includeTrusted Source:

  • trouble sleeping
  • difficulty concentrating or making decisions
  • irritability and restlessness
  • sense of impending danger or panic

Learn more about anxiety disorders.

Both conditions can result from psychological causes, medical conditions, medications, or past trauma.

Anxiety causes

There are different reasons a person may experience anxiety, such as:

  • past or childhood experiences or trauma
  • challenges with work, finances, or family stress
  • physical or other mental health conditions
  • certain medications causing anxiety as a side effect
  • drug and alcohol misuse

Learn more about what causes anxiety.

Psychosis causes

Psychosis may result from various factors, including psychological or other general conditions.

Psychological causes include:

Medical conditions that may cause psychosis include:

Other factors that may contribute to psychosis include:

Treatment for these conditions usually involves a variety of talk therapies and medications.

Anxiety treatment

Doctors use standard treatment approaches for anxiety, including:

  • therapy, such as guided self-help and cognitive behavioral therapy (CBT)
  • medication, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)

Find out more about anxiety treatment.

Psychosis treatment

Treatment available for psychosis includes:

The outlook for people with anxiety or psychosis depends on the individual.

Anxiety outlook

People with anxiety need long-termTrusted Source follow-up treatment, as despite drug therapy, relapse rates are high.

A person should speak with their mental health professional to receive appropriate treatment and support.

Psychosis outlook

New researchTrusted Source indicates that a person’s recovery, in terms of symptoms and functioning, varies in those with psychosis. Some may make a full recovery, whereas others may have long-term impairment.

Experts continue researching in this area to gain a better understanding of the likely outlook for people with psychosis.

There are many ways people with anxiety and psychosis can receive support.

Anxiety support

Support for anxiety includes:

  • self-help books and programs
  • talk therapies
  • charities and organizations providing therapy or other advice

The Anxiety and Depression Association of America provides resources and a list of local support groups.

Psychosis support

Support available for psychosis comprises:

  • early interventions from a team of specialists such as:
    • psychiatrists
    • psychologists
    • social and support workers
    • mental health nurses
  • community care and crisis services

Find out more about schizophrenia support groups.

There appears to be a link between anxiety and psychosis, particularly when anxiety is persistent or severe.

Anxiety symptoms have some overlaps with psychotic features, such as difficulty concentrating or making decisions, sleep difficulties, and a sense of impending danger or panic.

While anxiety may cause changes in behaviors, psychosis is not always one of them. Psychosis causes a break in reality, and although this can occur with anxiety, it does not tend to cause any noticeable changes.

Anxiety and psychosis may both result from past trauma and physical or other mental health conditions. Psychosis may also develop from other general medical conditions.

To treat anxiety and psychosis, doctors may use a combination of medication and therapy. Support is available for both through talk therapies and community and organization-led programs.