Family and Caregiver Schizophrenia Discussion Forum

Dilated pupils and psychosis

When my son’s anxiety was really high his pupils would widen greatly. This also happened when he was having hallucinations. And we began to recognize hallucinations and their onset by his pupil dilation.


One person recently asked a question related to this on fb. I couldn’t believe how many replies! Wow…I find validation when I don’t expect to. For me…it was, well, surprising.

Question: what signs do you see that tell you the person is starting to have a break?

Response after response, most with only two words:

“the eyes”

Some people described darkness, dialation or blinking.

this is just another reason why parents need to talk to one another about this dx.
Thanks everyone…


I didn’t really realize what I was dealing with when my husband’s psychosis hit so I didn’t take notice of that aspect. However I do find it very interesting, I have daughters (3) that were diagnosed with ADHD when young and their eyes all were largely dilated when off of medications. Interesting that SZ has that similar eye reaction. I wonder if there are other mental illnesses in which this is true.

My sons eyes have always given him away too. I remember reading that during a state of psychosis, the Automatic Nervous System is triggered and the “fight or flight” response is activated which can result in dilated pupils, which could explain the mania response as well. I can always tell if he is anxious by the size of his pupils.


Yeeesss! It’s been really weird and unsettling for me to see. Huge black eyes.


Yup - that is all I can say.


My mothers eyes change color when she is in certain episodes. When she’s well her eyes are a pale blue , during certain episodes her eyes turn to a blue green. Ppl don’t believe me but I have vivid memories of this as a child.

IMy son attacked me with a knife during his second break. One of the vivid memories of that night were his eyes- dark and blazing at the same time. In hindsight (!) his eyes were the giveaway and I didn’t recognize that.

My mother had bipolar one and her eyes changed when she had psychosis. I remember being terrified to look in her eyes even when she was alright. Her regular looking eyes always seemed scary to me because I thought they could change any second.

1 Like

Yes !! I understand… I still go through this with mom. Although I am grown , those inner fears that have developed during childhood are still very present. Learning to deal with moods in those around me can be quite unsettling , I guess due to the extreme personality changes I have endured.

1 Like

I have seen that look too many times to count. Huge very black almost dead eyes. No light or brightness in them. They almost dont look real. Very eerie to me and sometimes evil looking. All this when things are going very bad and in psychosis state. I have seen catatonic state and very similar eyes also. Oh and his vision is better than mine. Interesting! I never thought how similar th e dilation was

1 Like

hello, ways to make eyes look bigger. Very helpful to the must attractive eyes to make.

My brother gets the exact way you are describing. When he is in a manic episode his pupils fully dilate and his head has a slight tremor to it and when he talks it’s very shaky and loud. His eyes will look completely black.

I have been diagnosed with skitzoeffective, and my eyes dialate like that when I’m nearing the the end of the month approaching my shot, or If I stop getting meds. Honestly from my perspective I’ll notice my eyes look like that and I actually think its kind of cool. Its deffinitely a sign of mania or psychosis, but in my particular case I’m usually at a state of hyper clarity and awareness, and find myself not being depressed like usual, and invested into my hobbies and playing my guitar and writing music. Then I get my shot and crash and get suicidal and my pupils get smaller than normal. Usually in my case people often annoy the crap out of me telling me how unstable I am and that I’m wacked out of my mind, but most of it is often placebo because you look different to them, so I’ll try to explain that I’m calm and not having any delusions and tbh, most of the people around me seem like they are the ones acting stupid or crazy about it and overreacting. Some people have full blown delusions and dont have any grip on reality, but for me I usually just reach a state of hyperawareness or even enlightenment. You cant really explain how your thoughts work to someone who doesnt have those experiences, they will never be able to comprehend it, not even psychiatrists. That’s why so many people fight being controlled and medicated, because in some cases the effects of mania are highly desired, especially in people who spend there lives disabled from antipsychotics.

Hi Jordan, Thank you for writing this and helping us understand what you go through.

I am the person who became afraid her mother’s eyes. This happened after she beat me badly enough to break my collar bone. I was four years old and had no way of understanding that she was very ill when she did this. My mother died by suicide when I was in my teens.

I get what you are saying and I understand that what my mother did, the majority of people with these ililnesses do not do. The only time I think “control” should be taken over a person with SMI is when they are endangering themselves or other people. I believe in voluntary treatment and social support, with or without medication.

1 Like

I agree, sometimes hospitization is necessary. But I’ve never been violent in that respect, I’ve only had suicidal thoughts. The most prominent “episode” I’ve had was beleiving myself to be a God, but little could anyone understand that I set myself out to do so intentionally through magickal practice and alchemy. My family are all Christian, so they could never understand how someone could be mentally healthy and practice anything other than christianity. So now I’m so depressed on medication that I litterally cant even have a religion. It’s been a lifes pursuit of knowledge for me on many different subjects because I didn’t have a good experience at school and didnt get an interest in learning untill later in life, nore did I have the freedom to explore religion for myself untill I was an adult. I’ve been living a life that I cant choose for myself since birth, and I’m 26 years old. Every time I try to leave home they lock me I’m the hospital and no one believes anything you say in there.

I am so sorry. I can’t even think of anything else to write. What a terrible way to be treated.