Psychotic break: what it is, symptoms, causes and treatment

A psychotic break is a temporary change in mental state in which symptoms such as confusion, hallucinations or delusions may occur. In more serious cases, there may also be agitation and aggression, which can put the person’s life at risk.

Generally, a psychotic break is caused by psychiatric illnesses such as schizophrenia or psychotic disorders. However, it can also occur due to other diseases, such as infections or hyperthyroidism, or the use of illicit drugs, for example. Learn how to identify illicit drug use.

If you suspect a psychotic episode, it is important to see a general practitioner or psychiatrist for an evaluation. Regardless of the severity, identifying the cause is essential to initiate the most appropriate treatment and prevent new outbreaks.

Symptoms of a psychotic break

The main symptoms of a psychotic break are:

• Agitation, restlessness and/or aggressiveness;
• Sadness or excessive crying for no apparent reason;
• Thinking that you are being persecuted;
• Believing that one is being observed or heard;
• Thinking that you are capable of doing physically impossible things;
• See, hear or feel things that do not exist;
• Saying seemingly meaningless things.

Typically, a person with a psychotic break does not realize that they are having a break, even when there are clearly no explanations for the symptoms. Furthermore, during an outbreak, behavior is generally unpredictable and, in the most serious cases, can put the life of the person or those around them at risk.

If you suspect a psychotic break, it is important to consult a psychiatrist as soon as possible for an evaluation. However, in case of symptoms, such as agitation and aggression, or life-threatening symptoms, it is recommended to seek an emergency room.

How the diagnosis is made

The diagnosis of a psychotic break is usually made by a general practitioner or psychiatrist, taking into account the symptoms presented and, sometimes, information obtained from family and friends.

In addition, blood or urine tests to identify infections or drug use, and imaging tests, such as computed tomography or magnetic resonance imaging, may also be indicated to identify the cause of the outbreak.

Consult the nearest psychiatrist to assess the possibility of a psychotic break:

Possible causes

A psychotic break can be caused by:

• Psychiatric illnesses, such as schizophrenia and psychotic disorders;
• Infections, such as urinary tract infection or pneumonia;
• Metabolic imbalances, such as in the case of hyperthyroidism or hypoglycemia;
• Deficiency of vitamins such as vitamin B12 and folic acid;
• Poisoning by industrial products, such as lead;
• Medications, such as some antiallergic, antiparkinsonian and antidepressant drugs;
• Changes in minerals in the blood;
• Use of illicit drugs;
• Abstinence from alcohol or medication.

In the case of a psychotic episode, it is important to consult a psychiatrist or go to an emergency room so that the cause of the episode can be identified and the most appropriate treatment can be initiated, which may involve anything from the use of antibiotics to antipsychotic medications.

Treatment of psychotic break

Treatment for a psychotic episode is generally indicated by a general practitioner or psychiatrist and depends on the identified cause, and may involve measures such as discontinuing the causative medications or use of antibiotics, for example.

When the psychotic break is caused by a psychiatric illness, such as schizophrenia or other psychotic disorders, the doctor may prescribe antipsychotic medications, such as haloperidol, olanzapine, or risperidone, and benzodiazepines. Understand better what schizophrenia is and how it is treated.

In addition, cognitive-behavioral therapy is also generally recommended to help the person and their family members deal with these episodes.

How to help a person with a psychotic break

To help a person with a psychotic break, it is important to:

1. Ensure personal safetymaking sure that you are in a safe place, without objects or other people that could hurt you;
2. Talk with respect and understandingnot confronting the person’s ideas and trying to reassure them, to prevent the person from putting themselves at risk or hurting someone;
3. Do not shout at the person and avoid loud noisesto prevent the person with the outbreak from becoming agitated or aggressive and acting on impulse;
4. Seek help from friends and family to accompany the person until it is possible to obtain help from a doctor;
5. Consult a psychiatrist or go to an emergency room as soon as possible.

Furthermore, it is also important that the people around the person experiencing a psychotic break are safe, in case the person poses any type of threat. Therefore, in case of symptoms such as agitation or aggression, it is recommended to call medical help or seek emergency care.

How to prevent

To prevent a psychotic episode, it is important that existing illnesses, such as schizophrenia and hyperthyroidism, are adequately treated. In case of excessive alcohol consumption, it is recommended to reduce alcohol intake. Find out how alcohol abuse is treated.

When there is consumption of illicit drugs, it is recommended to stop their use and medications should not be used or suspended without medical advice. See the main treatment options for stopping drug use.