Early psychosis is disruptive and frightening—not only for the person experiencing it, but also for family members and friends trying to understand what is happening and find appropriate care. Javier Ortiz Orendain, MD, describes psychosis as a “breakdown in shared understanding of reality,” in which a person may experience hallucinations – perceiving things others do not – or delusions, which are strongly held beliefs that are not grounded in reality
Ortiz Orendain is a psychiatrist and assistant professor at The <a href="https://healthylife7.com/2026-olympia-university-will-be-a-masterclass-in-fitness-and-health/” title=”2026 Olympia University Will Be a Masterclass in Fitness and Health”>University of New Mexico School of Medicine and director of New Mexico’s only First Episode Psychosis Program (FEP). He said schizophrenia and bipolar disorder are the two common conditions that cause psychosis, as well as drug-induced psychosis and medical conditions such as brain tumors or inflammation of the brain, which require different forms of treatment.
The peak onset of early psychosis is typically in a patient’s early 20s, which can be especially destabilizing as many young people have left their families for college and life on their own, and they are not always surrounded by the people who know them best. That’s why spotting the signs and early intervention are crucial, Ortiz Orendain said. Early diagnosis and treatment can significantly improve outcomes, helping many people return to school, work and relationships while reducing the long-term impact of psychosis.
The goals of the care are driven mostly by patients. Our mission is that we can keep people with psychosis living among us, right with us, without dysfunction and having meaningful lives with the people they love
– Javier Ortiz Orendain, MD, Psychiatrist & Assistant Professor, UNM School of Medicine and Director, First Episode Psychosis Program
Recognizing the Signs of Early Psychosis
The onset of psychosis can be insidious, building up over time.
“The people who will best understand that someone is in psychosis will be those who are familiar with the individual,” Ortiz Orendain said. “They will notice that there will be a change in both their personality and their ability to function.”
Classic signs to watch for include:
- Isolating
- Acting suspicious
- Talking to themselves
- Disorganized thinking
- Clear deterioration in their ability to function
“Research shows that the duration of untreated psychosis is a clear marker of prognosis of how well someone is going to do,” he said. “But psychosis is so disruptive and so disabling that the longer your life trajectory gets altered, the harder it is to get you back. Early intervention can hopefully prevent the chaos and destruction that psychosis can bring to a person’s life.”
Contact Early First Episode Psychosis (FEP) Program:
Call 1 (888) NM–EARLY (1-888-663-2759) to learn more about psychosis. If you are seeking treatment, visit the UNM Psychiatric Center on the University of New Mexico Health Sciences campus. Referrals are accepted from anyone in the community, including self-referrals. To learn more about psychosis click here.
Psychosis Treatment and Recovery
A comprehensive approach to treating psychosis brings together diagnostics and pharmacological treatment, usually with antipsychotics, psychotherapy, social services, career counseling, support for families, food and insurance access
FEP treats patients from ages 15 to 30 who are in their first year of illness. Patients with chronic mental illness who need ongoing treatment or follow-up care are referred to the UNM COPE Clinic
A goal of both programs is its commitment to access, said Ortiz Orendain, and returning each person seeking care to the lives they were living before psychosis
“We have many pathways to care, so people can come from all sorts of places,” adding that most patients come from the hospital. “Really, we feel very lucky when a patient does not come from the hospital, because that means that they found us before. And so, if they come referred from their families, schools, another outpatient kind of therapist, then they found us before they ended up in the hospital or in jail. We think of that as a success.”
People can also utilize the walk-in clinic at the UNM Psychiatric Center, which is open daily from 7 a.m. to 6 p.m. as well as 24-hour emergency services accessible by calling 505-272-2920
“Recovery is a transformative journey, so hopefully the person is going to be someone who is more resilient, has grown and has learned what psychosis is and how to manage it,” Ortiz Orendain said. “Some people will have very basic goals of not needing to be in the hospital, to being able to live with their family. For others, it will be finishing college, having a job or living independently. We are patient-centered that way, where the goals of the care are driven mostly by patients. Our mission is that we can keep people with psychosis living among us, right with us, without dysfunction and having meaningful lives with the people they love.”
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