Most people present to their family doctor, school counselor/teachers, or are noted by their family/friends to be suffering from psychosis, a condition which tends to start in adolescence or early adulthood.
Their symptoms may be seeing or hearing things that others do not (hallucinations), believing in unusual things such as being irrationally suspicious of others (paranoia), talking irrationally, acting in bizarre, non-characteristic ways, having an unusual change in personality, or unexplained changes in their mood.
Many are first seen by a family doctor who subsequently refers them to a psychiatrist for further evaluation. We then take a clear holistic history, do a thorough physical examination, and order appropriate investigations to exclude medical illnesses that may cause similar symptoms. Once that is done, a diagnosis of psychosis can be made and management discussed.