Understanding Psychotic Breaks
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Experiencing psychosis is not uncommon. Nearly three in 100 people have an episode at some point during their lifetime. However, many people still do not have a good understanding of psychosis. The portrayal of psychosis in media and societal stigma also creates further barriers and harm to individuals with psychosis. Individuals, families and communities who understand psychosis can better provide intervention and support.
What Is a Psychotic Break?
During a psychotic break, individuals detach from reality, and their thoughts and perception become disrupted. They may experience hallucinations or delusions and cannot determine what is real.
Psychotic Break vs. Mental Breakdown
A mental breakdown is a non-medical term for a mental health crisis. During a crisis, an individual becomes overwhelmed due to extreme stress and struggles to cope and function. This mental health crisis may include several symptoms of anxiety, depression, PTSD, withdrawal or psychosis.
A psychotic break can be labeled as a mental health crisis. However, it specifically refers to the onset or return of symptoms of psychosis.
Signs and Symptoms of a Psychotic Break
Recognizing early warning signs of a psychotic break is crucial to recovery. Delays in treatment can lead to interference with employment or school, impaired parenting, relational issues, substance use or suicide.
Early warning signs include:
- Isolating from loved ones
- Declining job or school performance
- Confusion or disorientation
- Changes in speech
- Changes in emotions, mood or behaviors
- Sleep disturbances
- Appetite change
- Reporting feeling “off” or “different”
- Deteriorating hygiene and well-being
Signs of acute psychosis include:
- Disordered thinking
- Delusions: false and irrational thoughts and beliefs
- Hallucinations: perceiving (hear, see, taste, smell, feel) things that are not real
If you or a loved one are in a life-threatening situation, contact 911. Be sure to state that it is a psychiatric emergency and ask for the crisis intervention team.
The suicide and crisis lifeline is available at 988 by call or text.
Hallucinations vs. Delusions
The terms hallucinations and delusions are often used interchangeably. However, they are two distinct symptoms.
Hallucinations are false perceptions of the senses. The individual may see, hear, smell, taste or feel things that are not there. For example, they may hear voices, see people or feel bugs crawling on their skin.
Delusions involve false and irrational beliefs. The person cannot let go of them despite evidence that they are untrue. These beliefs are not in line with one’s culture or upbringing. For example, they might believe that someone is out to get them or that they have supernatural powers.
What Can Cause a Psychotic Break?
Psychosis isn’t caused by one specific illness or event. Many different factors and conditions can contribute to the development of a psychotic episode.
- Mental Health Conditions: People often associate psychosis with schizophrenia. However, bipolar disorder, depression, postpartum psychosis and schizoaffective disorder can also lead to psychotic episodes.
- Diseases and Disorders: Physical health conditions, such as dementia, Parkinson’s disease, Huntington’s disease, HIV and epilepsy, can trigger psychosis.
- Genetics: A single gene has not been identified as the cause; however, it’s known that genes can play a role in the development of psychosis. A family history of psychosis increases an individual’s risk of developing psychosis.
- Trauma: Any trauma can trigger psychosis. Episodes are then further affected by:
- The type of trauma
- A person’s perception of aloneness during the event(s)
- If a caregiver was involved
- The individual’s age when the trauma occurred
- Brain Injuries: Damage to the brain, such as strokes and traumatic brain injuries, can trigger psychosis. Head injuries can also increase an individual’s risk of developing conditions that can lead to psychosis.
- Stress: Severe stress regarding relationships, work, finances, school and health can set off a psychotic episode.
- Substances: Alcohol and drug use can bring on an episode and withdrawal. Substances such as marijuana, LSD, amphetamines, cocaine, methamphetamine, ecstasy, psilocybin and ketamine have been identified as triggers. Even prescribed medications like those used to treat malaria can cause psychosis.
Potential Risk Factors for Developing Psychosis
Research indicates that trauma, discrimination and social exclusion/isolation increase the risk of psychosis. Trauma includes but is not limited to physical, sexual and emotional abuse, neglect, parental impairment, assault, war and living as a refugee.
How Long Does a Psychotic Break Last?
An episode’s length will depend on the type and cause of the psychosis and if and when the individual receives treatment. For example, a person can have a psychotic episode that lasts a few weeks and never experiences another episode. Psychosis caused by mental health conditions, such as schizophrenia, may be more frequent and longer lasting. The sooner a person receives treatment, the higher the likelihood of recovery.
Treating a Psychotic Break
Treatment will typically involve medication and psychotherapy. It will consider the cause and type of the psychosis and other health factors. Identifying and building social support for the individual will also be part of recovery.
Antipsychotics are prescribed to help stop the psychosis barring other health concerns, such as epilepsy and heart conditions. There are several types of these medications that reduce and manage psychotic symptoms. Individuals should work closely with their healthcare provider to monitor their symptoms and side effects when starting a new drug.
Therapy can assist individuals by providing coping skills development, education and support. Cognitive behavioral therapy is a talk therapy often used to address psychosis. Family therapy is also utilized when appropriate to help the individual and family learn to cope, communicate and address concerns regarding the psychosis and its cause.
If you or a loved one are experiencing symptoms of psychosis, help is available. The Nobu app offers free tools to help you through healing and recovery, such as guided lessons, mindfulness activities and more. You can be connected to a licensed therapist to begin teletherapy for an additional fee. Download it today in the Google Play store or Apple Store.
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- Mental Health Evaluation and Community Consultation Unit. “Early Identification of Psychosis: A Primer.” Accessed September 14, 2022.
- National Institute of Mental Health (NIMH). “Understanding Psychosis.” U.S. Department of Health and Human Services, Accessed September 14, 2022.
- National Library of Medicine. “Psychosis.” May 10, 2020. Accessed September 14, 2022.
- National Alliance on Mental Illness. “Early psychosis and psychosis.” 2020. Accessed September 14, 2022.
- Rethink Mental Illness. “Psychosis.” Accessed September 14, 2022.
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