Drug-Induced Psychosis in Teens

Over the past few months, I have noticed an increase in teenaged patients with psychotic symptoms. Some were so severe as to require inpatient hospitalization. I wanted to take this opportunity to educate families about this often-misunderstood mental health condition and its causes. 

What is psychosis?
Psychosis affects how your brain processes information and causes you to lose touch with reality. Patients may see, hear, or believe things that are not real. It usually affects people for the first time in their late teenage years or early adulthood. It is a symptom, rather than a disease in and of itself. 

What causes psychosis?
Having a psychotic disorder such as schizophrenia or bipolar disorder is one way psychotic episodes emerge. Those without one of these conditions can exhibit psychotic behavior. While its precise causes are still unknown, several situations increase a person’s risk of having a psychotic episode. Genetics, trauma (like the death of a loved one or a sexual assault), major depression, brain illness (like a stroke, tumor, or dementia), or brain trauma (like a car accident) are risk factors. 

One of the most significant preventable risk factors for psychosis is drug use. The amount and type of drug required to trigger a substance-induced psychosis can vary between individual cases. Hallucinogens (LSD, mushrooms), and amphetamine drugs (cocaine, MDMA, ecstasy) all raise your risk for a psychotic episode. Recent research has also shown that THC increases the risk for a psychotic episode in adolescents. In my experience, THC oil, and other concentrated THC products such as dabs, greatly increase the risk for a psychotic episode. We believe this effect is likely due to the ability of individuals to consume high amounts at a time and the various ingredients used to make “street dabs” (not made or sold by a dispensary or cannabis professional) such as butane, pesticides, or Vitamin E oil. 

What’s the take away?
Research is still being conducted on the effect of THC on the developing brain; however, clinicians and scientists advise against its use in children and adolescents. Avoid using drugs, especially dabs and hallucinogens. 

What are the warning signs?
Psychosis shares many warning signs with other common mental health conditions, like depression. A drop in grades or job performance, trouble thinking or concentrating, a lack of attention to hygiene, and isolating from friends and family can all be warning signs of a psychotic episode.

What is a psychotic episode?
Individuals who experience a psychotic episode will often have auditory hallucinations, most commonly in the form of voices speaking to them. Less commonly they have visual hallucinations, often distorting the shapes of objects. People with psychosis can become paranoid about the intentions of other people. They also often have bizarre beliefs that are impossible or do not change when proven to be incorrect. Common bizarre delusions are believing you are controlled by some outside entity, believing you have magical powers, or believing you are involved with, or being persecuted by, some large organization such as the FBI or the CIA. 

How long does it last?
Most of the time, a drug-induced psychosis resolves once the triggering substance is no longer being used. Unfortunately, as we have seen in ours and many other communities, some people continue to experience psychotic symptoms for months, years, or indefinitely even after they are no longer using. In the dab-related cases I have seen lately, symptoms are difficult to treat and result in psychiatric hospitalizations and a lower quality of life. 

Where can I get help?
Discontinue substance use right away, if you are using them. Help is available. Seeking treatment from a psychologist, psychiatrist, or social worker is important. Local professionals can help rule out the possible medical or other causes of psychosis. Getting help early can help avoid symptoms negatively affecting your schoolwork, career, and relationships. The longer someone is psychotic, the greater the length of time and level of treatment that is required. Counseling together with medicines can help manage psychosis. Call 802-442-5491 for immediate assistance. 

Rachel Darby, PMHNP-BC, is a nurse practitioner at United Counseling Service in Bennington, VT.