Psychotic symptoms persist or recur and are not limited to clear mood episodes.
Persistent psychosis
Schizophrenia-spectrum psychosis
Schizophrenia is a long-term condition that can affect perception, thought organization, motivation, emotion, and functioning. Psychosis is one part of the condition, not the person’s identity.
How the theme may appear
Espionage, surveillance, or mission content in this pattern
Espionage themes may include being monitored, thought broadcasting, implanted devices, external control, voices described as agents or handlers, and ordinary events interpreted as personal signals.
Content is not diagnosis
The words “CIA,” “spyware,” “handler,” “coded message,” “AI mission,” or “government investigation” do not identify a disorder by themselves. Clinicians examine the form of the belief, associated symptoms, functional change, evidence, and course.
Clinical clues
Patterns a clinician may explore
These are prompts for assessment, not criteria you should apply to yourself or another person.
There may be disorganized speech or behavior, social withdrawal, reduced motivation, or declining work and self-care.
Auditory hallucinations, ideas of reference, and passivity or control experiences may reinforce the surveillance narrative.
Course, function, and associated symptoms matter more than the espionage content itself.
Do not wait
Seek urgent help when
- Commands to harm, an intent to confront a perceived persecutor, severe agitation, inability to eat or drink, or rapidly worsening functioning.
- New neurological or medical warning signs still require urgent medical evaluation even when a psychiatric diagnosis already exists.
Questions that distinguish causes
What a thorough assessment may ask
- Duration and recurrence
- Disorganization and negative symptoms
- Function before and after onset
- Mood episodes
- Medical and substance exclusions
Helpful direction
Care steps commonly worth discussing
- Seek coordinated psychiatric care that addresses psychosis, cognition, functioning, physical health, and recovery goals.
- Ask about family education, cognitive-behavioral therapy for psychosis, supported education or employment, and peer support.
- Track medication benefits and adverse effects with the prescriber rather than changing treatment abruptly.
- Create a relapse plan around sleep change, increasing isolation, rising certainty, voices, and reduced self-care.
Reduce escalation
What can make the situation worse
- Debating the belief aggressively or confirming an unverified surveillance narrative.
- Interpreting every unusual belief as evidence of dangerousness; assess specific behavior and access to means instead.
- Reducing the person to a diagnosis or assuming meaningful recovery is impossible.
Continue with the next task
Related site guides
Supporting someone
Use communication that respects distress without arguing with or confirming an unverified claim.
Open guide →Prepare for an assessment
Build a precise timeline of onset, sleep, mood, experiences, substances, medicines, physical symptoms, AI use, and safety.
Open guide →Possible causes and clinical assessment
See why one theme can arise from several different psychiatric, medical, or substance-related causes.
Open guide →Urgent help
Use crisis and emergency guidance when there is immediate danger, severe self-neglect, or inability to stay safe.
Open guide →
External starting points
Browse resource packs
Trusted resources related to Schizophrenia spectrum
Schizophrenia
National Institute of Mental Health
Symptoms, treatment, and research information.
Schizophrenia fact sheet
World Health Organization
Global facts, treatment, human rights, and service gaps.
What is schizophrenia?
American Psychiatric Association
Patient and family overview from the U.S. psychiatric professional association.
Psychosis and schizophrenia in adults: prevention and management
NICE
Evidence-based clinical guideline for adults.
Team-Based Treatment Is Better for First-Episode Psychosis
National Institute of Mental Health
Plain-language summary of research on coordinated, recovery-oriented team care for a first episode of psychosis.
RAISE-ing the Standard of Care for Schizophrenia
National Institute of Mental Health
NIMH overview of the expansion of coordinated specialty care for first-episode psychosis in the United States.