Selena Gomez Opens Up About Her Experience With Psychosis: What Experts Want You to Know

During a 2016 world tour to promote her album Revival, singer and actress Selena Gomez struggled with depression and anxiety triggered by lupus. She ultimately canceled the tour after 55 performances.

In 2018, Gomez experienced an episode of psychosis, a condition in which someone loses contact with reality. She later revealed her story in the 2022 Apple TV+ documentary Selena Gomez: My Mind and Me.

The documentary, based on video taken over six years, takes a close, often raw look at high and low moments for Gomez during that time. The singer has stated that her main goal in making the documentary was to help normalize talking about mental health.

Gomez eventually recovered and afterward received a diagnosis of bipolar disorder, which her doctors say triggered the episode of psychosis. She then began treatment, which included medication.

Here, experts explain what psychosis is, potential signs and symptoms, and how it’s diagnosed and treated.

“Patients may interpret the word 'psychosis' as a personal failing, rather than as part of an illness. It can be a lot to take in,” says Dr. Wang. “Often, psychiatrists will use the term ‘psychosis’ or ‘psychotic episode’ to talk among themselves, but when speaking with a patient, they may be more likely to refer to the episode as an unusual experience or thinking."

Wang applauds Gomez for speaking out about her experience: “Stigma is such a problem that it often prevents people from seeking help,” he says.

Hallucinations

Someone experiencing psychosis can have hallucinations, meaning they hear or see things that aren’t there. This can often appear as if they are responding to something happening internally rather than in the world around them, says Dr. Swartz.

For instance, instead of talking to someone next to them, someone may seem to be paying attention to conversations with people or ideas in their head that aren't connected to the world around them.

Gomez remembers very little about her episode, other than finding herself in a mental health treatment facility, she says in the documentary.

“If anybody saw what I saw in the state that she was in at the mental hospital, they wouldn’t have recognized her at all,” said Gomez’s friend Raquelle. “I just remember it being very chaotic, and she was hearing all of these voices — they just kept getting louder and louder. I was devastated because psychosis can last anywhere from days to weeks to months to years.”

Delusions

People can also have what are called “ideas of reference,” says Swartz, which means they perceive meaning where there is none. “They may hear a song and believe it has messages specifically for them or about them, beyond just connecting with it emotionally.”

They may also experience what healthcare providers call “thought insertion” or “broadcasting,” says Swartz. This is the belief that someone else is putting thoughts into your brain that aren’t your own. It can also manifest as people reading your thoughts, the feeling that you're somehow communicating your thoughts to other people, or believing that you're involved in complicated plots.

Psychosis Signs and Symptoms

• Behavior changes such as emotional disruption, anxiety, or lack of motivation
• Feeling suspicious, paranoid, or uneasy around others
• A sudden decline in job or school performance
• Spending more time alone than usual
• Unusual and intense ideas or feelings, or no feelings at all
• Decline in self-care or personal hygiene
• Difficulty separating reality from fantasy
• Trouble communicating or confused speech

• Schizophrenia
• Schizoaffective disorder
• Bipolar disorder
• Major depression

In some cases, symptoms that resemble psychosis may be triggered by external factors, like misuse of alcohol, prescription medications, or recreational drugs.

Like in Gomez’s case, psychosis can be a symptom of bipolar disorder.

In bipolar disorder, manic episodes often alternate with episodes of depression. They can last weeks or months separated by periods of neutral moods, when a person isn’t experiencing any symptoms, according to Wang.

Psychosis can happen in either a manic or depressive episode. However, some people with bipolar disorder never experience an episode of psychosis, adds Wang.

Manic Episode

• Elevated or irritable mood
• Increased energy
• Exaggerated self-confidence
• Racing thoughts
• Decreased need for sleep
• Engaging in dangerous or impulsive activities such as speeding while driving, overspending, or sexual indiscretions

Major Depressive Episode

• Feeling sad, empty, worthless, or tearful
• Loss of interest or pleasure in activities once enjoyed
• Appetite changes that lead to weight loss or gain
• Not sleeping enough or oversleeping
• Restlessness
• Slowed behavior
• Fatigue or lack of energy
• Difficulty thinking, concentrating, or making decisions
• Suicidal thoughts or behaviors

The type of treatment will depend on what's causing the episode, says Swartz. “Treatment can change over time, especially for bipolar disorders, where specific medications may be more beneficial,” she says.

For bipolar disorder, like in Gomez’s case, the mainstay of treatment is mood-stabilizing medication, which is very effective for managing symptoms, says Wang.

Some evidence-based forms of psychotherapy have also been shown to reduce the symptoms and risks of manic and depressive episodes in bipolar disorder, says Swartz. These can include cognitive behavioral therapy, family-based psychotherapy, or other forms of therapy.

• Psychosis is when someone loses the ability to distinguish between reality and false beliefs or hallucinations. It can occur with several mental health conditions, including bipolar disorder.
• Symptoms of psychosis include seeing or hearing things that aren't there, conversing with internal voices, and holding false beliefs that aren't grounded in reality.
• Treatment for psychosis depends on the underlying cause but can include antipsychotic or mood-stabilizing medications and psychotherapy techniques to manage symptoms.
• Seeking medical attention is crucial if you or someone you know experiences symptoms of psychosis. Stories like Gomez's help destigmatize mental health struggles and inspire open dialogue about treatment.