How to Help Someone Suffering a Psychotic Break

During a psychotic episode, the patient requires support to reconnect with reality and feel understood. We're going to tell you how to deal with this situation.

Written and verified by the psychologist Elena Sanz.

Last update: 07 June, 2023

Imagine suddenly losing touch with reality, perceiving stimuli that aren’t really there, or experiencing strange and unreal thoughts. This is what happens during psychosis. It’s a distressing situation that prevents the sufferer from functioning properly in their daily life. Given the seriousness of this disorder, it’s useful to know how to help someone suffering a psychotic break.

You might never find yourself in this situation. However, it’s worth noting that such episodes can also be experienced by people without any underlying mental disorder.

A psychotic break

Let’s start by clarifying that psychosis isn’t a disorder in itself. In fact, according to clinical psychology, it’s a mental state produced within the framework of different psychological disorders. It’s characterized by a split or loss of contact with reality. This generates alterations in perception, thoughts, and behavior.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) mentions several conditions in which psychosis is present. For example, schizophrenia, delusional disorder, and schizoaffective disorder, among others. This publication also mentions the brief psychotic disorder, otherwise known as an isolated psychotic outbreak.

A psychotic break includes the main symptoms of psychosis but is limited to a period ranging from one day to one month. Contrary to what happens with other diagnoses, after this period, the episode usually resolves and the sufferer returns to normal functioning.

This means that a psychotic outbreak is usually experienced as an occasional and isolated incidence. However, it’s also possible that it might recur or arise due to an underlying mental disorder. In either case, its main symptoms include delusions, hallucinations, and disorganized language. There may also be catatonic behavior.

What to do in the face of a psychotic outbreak

During this episode, the sufferer disconnects from reality and has serious difficulties in functioning in their daily routine. In many cases, they also experience significant anguish or psychological discomfort. So how can you help someone suffering a psychotic break? According to a guide prepared by the Andalusian Health Service (2021), the following guidelines should be followed.

Pay attention to early warning signs

Before the psychotic outbreak appears, the individual may exhibit certain unusual signs and behaviors that alert them and allow them to seek help in time. Therefore it’s helpful to be vigilant.

They might show apathy, isolation, mood swings, or sleep and appetite disturbances. However, the symptoms that should set your alarm bells ringing are strange perceptions (visual or auditory), anomalous beliefs or ideas (such as thinking that people are against them), or the feeling that everything is less real than before.

Be available and empathetic

To help someone suffering a psychotic break, you need to understand the situation they’re experiencing and how complicated and distressing it might be for them. They’ll usually feel confused and disoriented, which may lead them to act unpredictably. Remember that, for them, everything they’re feeling and going through is real. Therefore, if you suggest it isn’t, they might become defensive or shut down.

You should try and speak calmly, using short and simple sentences, in a private environment, with few distracting stimuli. Express your concern without judging or attacking them. Try to make them feel understood and take an interest in how they feel.

Facilitate their contact with reality

You must help the sufferer regain contact with reality. Grounding exercises can be useful. This is suggested by the non-profit organization, Mental Health America.

These exercises consist of using the five senses to reconnect with the here and now. For example, offer them a hot meal or drink, show them objects that they can observe in detail, let them smell different oils, or talk about the weather or what their posture is like at that moment.

Offer them practical help

Beyond the emotional, you might need to offer to help them with tasks such as accompanying them to certain appointments and activities, reminding them to take their medication, or supporting their decision-making. Remember, for the individual in this situation, functioning normally and carrying out their usual tasks is complicated.

Seek professional accompaniment

A psychotic break is difficult to manage and always requires the guidance of a health professional. During the acute phase, it may even be necessary to call the emergency services. Certainly, in the medium and long term, the intervention of psychiatry, clinical psychology, and other specialties is essential to prevent relapse or control the progression of the disease (Center for Addiction and Mental Health, 2015).

As stated in a publication from the Early Psychosis Prevention & Intervention Center, the sufferer may be reluctant to take medication, undergo psychotherapy, or accept hospitalization. Therefore, their relatives can help by making them see the benefits that this will bring and supporting them during the process.

In fact, if you’re a relative of someone suffering a psychotic break, you might want to seek professional care for yourself. After all, the situation may also be upsetting and stressful for you. Therefore, having guidance and a safe space to talk about it could be helpful.

Helping a sufferer of a psychotic break requires knowledge and calm

Finally, in order to help a sufferer of a psychotic break, you must be well informed on the subject. Understanding what psychosis is, how an outbreak can manifest itself, and what its causes are will help to alleviate any fear you feel in the face of the uncertainty of what’s happening.

Also, staying calm is key, particularly if the sufferer is close to you because it’s the only way you can transmit peace of mind and security to them. To achieve this, we recommend you consult with a professional who can provide you with the essential information, clear up your doubts, disprove any myths, and support you while you help your loved one.