A psychotic break is the first onset of psychotic symptoms or the sudden onset of symptoms after remission. During the break, you lose touch with reality and develop disturbed thoughts and perceptions. A psychotic break is also called a psychotic episode of psychosis.
Approximately one in three individuals experience psychosis in their lifetime. Many have only one episode, while others may have ongoing symptoms. A psychotic break can affect people of all ages and backgrounds. However, the risk is higher in females and individuals with first-degree relatives with a history of psychosis.
Early medical intervention improves your quality of life if you have psychosis. Timely detection and treatment ensure that psychotic episodes don’t worsen. The risk of relapse and the period you are asymptomatic also reduces with early treatment.
Is psychotic break the same as psychosis?
No, “psychosis” and “psychotic break” are not exactly the same thing.
“Psychosis” is a broad term used to describe a symptom or group of symptoms that affect a person’s thoughts, emotions, and behavior. People who experience psychosis may have hallucinations (hearing, seeing, or feeling things that aren’t there), delusions (false beliefs that are not based in reality), disordered thinking, and changes in emotions and behavior. Psychosis can be a symptom of several mental health conditions, including schizophrenia, bipolar disorder, and depression with psychosis.
Watch the following video to hear from David Harewood, as he explains what psychosis is like to experience, in a fly-on-the-wall documentary from the BBC.
On the other hand, “psychotic break” is a term used to describe a sudden onset of symptoms of psychosis, often in people who have no prior history of mental illness. This can be a traumatic and confusing experience for the individual and those around them. A psychotic break can be a result of various factors, such as substance abuse, extreme stress, sleep deprivation, or a medical condition.
Understanding psychotic breaks
Various categories of psychotic breaks have different triggers and present a range of symptoms.
Symptoms of a psychotic break
You can experience one or more of the signs below during a psychotic break.
A psychotic break makes you sense unreal things. For example, you may see fake objects, feel imagined sensations, or hear nonexistent voices. You may even experience a taste when nothing is in your mouth. Auditory hallucinations, where you hear unreal voices, are the most common in psychosis.
A delusion happens when you have a firm belief in a false thing. For instance, you may believe someone wants to hurt or kill you. You can also feel like you are an influential person or supreme being. Since you are unaware that the delusion is unreal, you may feel frightened or distressed.
Your body can become unresponsive due to the overwhelming nature of psychotic breaks. Sometimes, the unresponsiveness happens due to deep psychosis. Other times, your body does so to protect against harmful thoughts and actions.
Disorganized Thought and Behavior
Psychotic breaks can make you act or think haphazardly. Disorganized thoughts are usually evident in the following:
- Rapid and constant speech
- A sudden loss in your train of thought that makes you abruptly pause a conversation or activity
- Disturbed speech
- Abrupt changes in topic
Disorganized thoughts also make concentration difficult.
Different types of psychotic breaks
Psychosis varies based on the cause, duration, and other elements. Some categories of psychotic breaks include:
Brief psychotic disorder
Short, sudden episodes of psychotic behavior are known as brief psychotic disorders. The episodes are usually a response to a stressful situation, e.g., the death of a loved one. Most brief psychotic disorders last less than a month and don’t reoccur.
Major depressive order
A major depressive order is a mood disorder that causes persistent sadness or interest loss. Possible causes include a combination of psychological, social, and biological distress. The condition usually manifests in fatigue, sleep problems, and appetite changes.
As the name suggests, postpartum psychosis disrupts your sense of reality after you give birth. The condition is serious and usually treated as a medical emergency. In severe cases, you may attempt to harm yourself or your newborn.
Medicinal or illicit drugs that change your brain chemistry can cause psychosis. Cocaine, cannabis, opium, and amphetamines are some common drugs that induce psychosis. Drug-related psychosis is usually more intense than other forms of psychosis.
Triggers of a psychotic break
A psychotic break can be a consequence of the following conditions.
Reality can sleep away from you during the manic phase of bipolar disorder. During a manic episode, you experience extreme elation and high energy. For instance, you may believe you have special powers and engage in dangerous behavior. Psychotic breaks can also happen during the depressive phase, where you have low mood and concentration difficulties.
Schizophrenia usually makes it hard to discern reality from unreality. You also experience hallucinations and delusions, which disconnect you from reality. The lack of discernment of real and false events can make you act on unreal beliefs.
Trauma and extreme stress
Traumatic experiences like assault and near-death accidents can overwhelm your brain. The event can make you unable to process your emotions or cope. In turn, you lose understanding of situations and detach from reality.
Brain tumors, strokes, Parkinson’s, and HIV are some illnesses that can cause psychosis. The diseases can induce physical and psychological distress, pushing your mind to its limits. Psychotic breaks can also happen as a symptom of underlying mental health illnesses.
Impact of psychotic breaks on daily life
A psychotic break disrupts your physical, social, and emotional life in the following ways.
During psychotic breaks, you struggle to remember the steps for hygienic activities. The intrusive or racing thoughts make you unable to complete tasks. You may not also understand the necessity of laundry, baths, and other sanitary activities.
Disrupts sleep patterns
The hallucinations, delusions, and anxieties of psychosis disrupt the circadian rhythm. Sometimes, you become restless and get an urge to move your arms and legs. As a result, you experience insomnia, hypersomnia, or excessive sleepiness.
A psychotic break can make you forget the importance of balanced meals. Your focus shifts from a healthy lifestyle to nonbeneficial or harmful thoughts. Often, you don’t realize the nutritional inadequacies, so you develop deficiencies and imbalances. Some medications used to treat psychosis can also interfere with your appetite.
You may no longer recognize your loved ones during a psychotic break. The paranoia causes you to fear and mistrust your friends, family, and colleagues. In addition, the distorted view of reality makes communication and corporation difficult.
Validating the signs of a psychotic break
Psychotic signs are usually confused with other medical and behavioral conditions. To avoid confusion, explore some psychosis myths and how the situation differs from other mental illnesses.
Common myths about psychotic breaks
The sudden nature of psychotic breaks usually throws confusion about the condition. Here are four such misconceptions and the associated facts.
❌ Psychosis is associated with split personalities
Psychotic breaks don’t alter your personality or cause you to develop fragmented identities. Dissociative identity disorder (DID) causes two or more distinct natures in one person. Yet, psychosis doesn’t involve or trigger DID. Instead, your reaction to the altered reality is consistent with your personality.
❌ Persons with psychosis are psychopaths
Psychosis is a short-term condition that recovers upon treatment. Conversely, a psychopath is a personality disorder that makes one lack empathy and become manipulative. Psychopaths can be violent and pose a threat to others. However, if you have psychosis, you are more likely to harm yourself than others.
❌ People with psychosis are dangerous
Psychotic symptoms can make you behave bizarrely as you struggle to process your experience. Other people can find the behavior scary because you’re disconnected from reality. Nonetheless, psychosis is more likely to make you withdraw and harm yourself and not others.
❌ Psychosis is a behavioral problem
The myth above stems from when psychosis was thought to result from demonic influence. But, like many mental health problems, your behavior has nothing to do with psychosis. The condition isn’t something you can snap out of or fix. You aren’t more likely to develop psychosis because of poor character.
Importance of seeking professional help
Professionals usually offer the appropriate guidance and medication. So, get expert help to enjoy the following benefits.
To identify underlying issues
The ideal way to identify the reason for a psychotic break is to get medical help. First, professionals perform a comprehensive evaluation to identify underlying conditions. You then access solutions that manage the root cause and reduce the risk of recurrence.
To get the appropriate treatment plan
Professional help provides a formal diagnosis and treatment plans tailored to your needs. For example, a professional distinguishes between physical symptoms and mental issues. You also get referrals to other mental health experts, e.g., psychologists and psychiatrists. The combined effort provides all the help you need for a speedy recovery.
To get emotional support
Professional provides a safe space to work through your thoughts and feelings. Besides appropriate medication, you get strategies and guidelines on how to cope. Professionals also help you access social services where you get emotional support from a community.
To provide a safe environment for optimal care
Besides treatment, professionals educate your family and friends on how to help you. In turn, you get support at home and in the hospital. Management also becomes easier when people around you are more educated than fearful.
Differential diagnosis with other mental health conditions
The differential diagnosis of psychosis reduces the attribution of psychosis to a psychiatric disorder. Below are four mental health conditions and how each differs from psychotic breaks.
Psychosis involves a disconnect from reality, while bipolar disorder creates alternate periods of high and low moods. Psychotic episodes can occur during the mania or depression phases of bipolar disorder. Nonetheless, psychosis in people with bipolar disorder is part of an episode, not a separate one.
Psychotic breaks involve a sudden change in mental state and other psychotic symptoms. On the other hand, a mental breakdown is a period of intense mental distress. Psychotic breaks tend to have more extreme symptoms than mental breakdowns. Nervous breakdowns are more drawn-out but can still cause excessive emotions.
Besides a disconnect from reality, psychosis can make you see or hear unreal things. On the other hand, dissociation is a disconnect from one’s emotions, memories, and sense of identity. Psychotic breaks can lead to dissociation, but the two are distinct processes. Also, psychotic breaks are usually more severe and intense than dissociation.
Episodes of psychotic breaks are usually of short duration. In contrast, schizophrenia is a chronic disorder with persistent symptoms. Schizophrenia lasts longer and can cause significant distress and impairment in your life. Also, whereas the onset of psychotic breaks is usually sudden, schizophrenia usually has a gradual onset.
Steps to take when seeking help
The following steps will help you work on yourself while you seek professional help.
Call a helpline for immediate help
A mental health helpline / hotline provides a safe and secure way to receive help. The tool allows you to access mental health professionals that can offer advice and support. You also receive emotional support, crisis intervention, and referrals to mental health services.
Avoid alcohol and drug abuse
Substance abuse worsens existing mental health issues and can trigger psychotic episodes. Furthermore, alcohol and drugs can reduce the effectiveness of treatment. Avoiding illicit drugs helps you maintain better control of your mental health. You also focus more on your treatment and reduce the chances of additional episodes.
Embrace lifestyle changes
Stress-inducing circumstances can cause intense distress, which results in psychotic breaks. Lifestyle changes like regular exercise and a healthy diet can reduce stress levels. Sleep deprivation can also heighten the risk of psychotic episodes. So, get enough sleep to rest from daily stresses and reduce the risk of psychosis.
Create a support system
A support system allows for early intervention of psychotic breaks. Community members can recognize signs of psychotic episodes and seek timely medical help. A community also provides support for you to remain calm in stressful situations. Finally, the community environment offers a space to express your needs and seek help.
Best treatment options for psychotic breaks
You can use medicinal drugs, therapies, and other mental practices to treat psychosis.
Medications for treating psychotic breaks
Prescription drugs come in antipsychotics, anti-anxiety medication, antidepressants, etc.
Most medications for psychotic breaks usually come in the form of antipsychotics. Antipsychotics block the effect of dopamine to reduce psychotic symptoms. The drug can come in injections, tablets, dry powder, or capsules.
Antipsychotics can either be typical or atypical. The primary difference between the two is that atypical antipsychotics block dopamine. Conversely, typical antipsychotics affect dopamine and serotonin levels.
The above conventional antibiotics were developed in the 1950s. Doctors still prescribe the medication when newer versions prove ineffective. Unfortunately, typical antipsychotics usually pose a higher risk of side effects.
Experts developed atypical antipsychotics in response to the side effects of typical antipsychotics. Thus, atypical antipsychotics are less likely to produce extreme side effects. If side effects occur, you will likely experience mild signs like dizziness, dry mouth, and blurred vision.
Anti-anxiety disorders are prevalent among people with psychotic disorders. Anti-anxiety medications come in handy to treat symptoms of anxiety and psychotic agitation. Some antidepressants can also effectively treat anxiety that results from psychotic breaks.
Psychotherapy for managing symptoms
Talking therapies reduce the intensity and anxiety caused by psychotic breaks. Here are several possible treatments to consider.
Coordinated Special Care (CSC)
CSC is effective for early psychosis or the first instance of delusions or hallucinations. The therapy addresses different aspects of your life, e.g., peer support and case Management. You also get help to improve family relations and increase social connection.
After psychotic breaks, you may rely on your family members for care and support. Most family members are happy to help but don’t know how to go about the necessary care. The process may also be stressful at times. Family therapy comes in handy to explore ways to support you.
Cognitive Behavioral Therapy (CBT)
A CBT therapist helps you to understand your condition. The therapy aims to help you achieve goals that enhance speedy recovery. For instance, you can explore ways to reduce stress, return to work, or regain control.
Acceptance and Commitment Therapy (ACT)
Rather than change your feelings, ACT therapy encourages you to accept the situation. The sessions help you experience emotions but ensure you don’t believe or react to them. As a result, you separate your sense of self l from how you think. Besides, you become free to act in ways that don’t match your inner state.
Holistic and alternative treatments
Consider one of the following treatments if you prefer a different approach from the medication discussed above.
Herbal remedies are believed to bring balance to the body, mind, and spirit. Examples of traditional antipsychotic herbs include kava, valerian, and ginkgo. The herbs are said to help the body heal when combined with therapies and lifestyle changes. However, herbal medicine use is widely unregulated and not scientifically proven.
Yoga, tai chi, and other therapies that involve the mind and body help you cope with symptoms. The practices help you regulate your emotions and focus your attention. In turn, you manage your stress better, and the intensity of psychotic symptoms reduces.
Meditation reduces the negative thoughts that can contribute to psychotic breaks. You shift your focus from worries and reduce rumination, which is often a feature of psychosis. Mindfulness meditation also helps you become more aware of your thoughts and emotions. As a result, you quickly identify and respond to early signs of psychotic breaks.
Prayers, yoga, contemplation, and other forms of spirituality can help manage stress. As a form of therapy, spiritual practices connect you to a higher power. You then find peace and comfort in the supreme being you hold in esteem.
Importance of an individualized treatment plan
Treatment for psychosis isn’t a one-shoe-fits-all and varies from person to person. Here’s why a tailored and detailed plan is the ideal way to go.
Gives you the most appropriate therapies
An individualized treatment plan involves a comprehensive evaluation of your state. The plan covers your medical, psychological, and social history. Professionals use the assessment to:
- Develop a diagnosis
- Identify factors that might contribute to the psychosis
- Determine the severity of the illness
Based on the evaluation, you get a plan shaped to your needs and lifestyle.
Less treatment resistance
An individualized plan includes pharma and non-pharmacological interventions to tackle the condition. The plan addresses all aspects of your state, e.g., medication management and stress reduction. You are more likely to adapt to a comprehensive plan tailored to your needs. Also, the collaborative approach in developing the plan fosters trust and confidence.
Reduced schedule disruption
An individualized and comprehensive plan will tailor activities according to your routine. The program includes medication management, psychotherapy, and psychiatric evaluations. The psychoeducational activities happen in a way that favors your schedule. So you don’t experience significant routine changes.
A comprehensive and individualized treatment plan considers your history and preferences. The treatment incorporates various interventions, like psychotherapy, medication, and lifestyle changes. An individual plan addresses your specific pain points, resulting in a speedier recovery.
Psychotic breaks aren’t a great experience but are manageable and treatable. Early intervention is paramount to ensure psychotic breaks don’t cause negative effects. You pull through and lead a healthy and happy life with the appropriate support and care.