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What is a Psychotic Break, and When Does it Happen?

What is a Psychotic Break

The words “psychotic” and “break” are both scary when being used to describe someone’s mental state. Together, they sound even scarier. But just how scary is a psychotic break, and why does it happen?

What frightens onlookers about someone who is showing symptoms of psychosis is that the person seems to have separated from reality. The world we know and see and hear is not the world they know and see and hear. It makes the person themselves seem foreign, and we may remember the stories we’ve heard about people with psychosis turning violent toward the people they love. 

So let’s start with a definition, and then we’ll separate facts about psychosis from fiction. 

What is a Psychotic Break, or Psychosis?

When someone experiences psychosis, their usual thought patterns and perceptions are disrupted. This may make it seem as if they’re in a different reality. Symptoms include the following:

  • Delusions (believing something that is not true, such as that someone is trying to kill you or that your spouse cheated on you, etc.)
  • Hallucinations (sensing things that aren’t there, such as hearing voices or seeing apparitions)
  • Incoherent speech (talking excessively, leaving sentences incomplete and jumping from one topic to the next, or talking “nonsense”)

According to Yale School of Medicine, psychosis typically occurs in young adults, of which about 3 in 100 will experience a psychotic episode at some point in their lives. In most cases, people fully recover; 25% never have another episode, while about 50% may have a second episode but still live normal lives. 

What Causes a Psychotic Break, and Are There Warning Signs?

Psychosis can have several causes. It can be a symptom of a mental health disorder like bipolar disorder, schizophrenia, or severe depression. Or, it can be a symptom of dementia in older adults. But psychosis can also happen to people without physical or mental illness. It can be prompted by sleep deprivation, extreme stress, trauma, certain medications, and substance misuse. 

Contrary to what you might have thought, it is possible to detect warning signs of psychosis. Someone who is heading toward a psychotic break may demonstrate the following:

  • A big drop in grades or job performance
  • Trouble thinking clearly or concentrating
  • Suspiciousness of or uneasiness with others
  • A decline in self-care or personal hygiene
  • Withdrawal from family and friends
  • Strong and inappropriate emotions or complete lack of emotion

Granted, these symptoms could indicate many issues aside from psychosis, and if it’s a teenager in question, it can be tricky to distinguish these signs from typical teenage behavior. If you’re seeing these behaviors in someone you love, don’t jump to alarming conclusions–but DO consult with a doctor.  

And Now, Fact Versus Fiction

Because of cultural biases and stereotypes around mental illness–and because of media portrayals–many people think that someone undergoing a psychotic break is dangerous and is in some basic way different from other people. 

NAMI, the National Alliance on Mental Illness, offers two important counterpoints to the way we misunderstand psychosis. 

First, anyone can have a psychotic break. The experience of psychosis is frightening and confusing. It does not make the person “crazy” or a “psycho.” Psychosis is not the same as psychopathy, the mental illness characterized by reduced empathy and antisocial behavior.  

Second, psychosis does not make you violent. In fact, people with serious mental illness or psychosis are more likely to be victims of crimes than perpetrators. NAMI clarifies: “However, for the small portion who may use violence, it is other risk factors that are more likely to be related, such as gender and prior violence, not the experience of psychosis itself.”

Treatment for Psychotic Breaks

Someone who has experienced a psychotic break for the first time will be assessed for underlying physical or mental health disorders. They may be prescribed antipsychotic medication and be referred to talk therapy. If a mental health disorder is diagnosed, the person will be treated for that disorder, again usually through a combination of medication, individual and group therapy, and social and/or educational interventions. 

If you suspect that your loved one may be showing signs of psychosis, reach out to Highland Hospital in West Virginia. Our compassionate team will be able to offer a complete assessment and recommendations for treatment. 

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