Exploring The Definition, Symptoms, And Treatments Of A Psychotic Break

Many people may hear the term “psychotic break” and conjure the image of straitjackets and psychiatric institutions. While inpatient treatment can sometimes be necessary for instances of psychosis, this misconception can lead to a more significant misunderstanding of precisely what a psychotic break is, how to recognize it, and what its typical treatments are. In general, a psychotic break involves a disconnection from reality, and it’s often related to underlying mental health conditions. Psychosis is frequently treated with medication and therapy, and online therapy may be a helpful resource for those who are not in the acute stage of psychosis to potentially prevent or manage future psychotic breaks.

What is a psychotic break

The term psychotic break usually refers specifically to an episode or incident of psychosis. According to the National Library of Medicine, psychosis can be defined as a collection of psychological symptoms associated with a disconnection from reality, with primary indicators including hallucinations, disorganized or confused thinking or speech, and delusions. 

During a psychotic break, a person usually has trouble differentiating between what’s real and what’s not. It can be critical to note that someone experiencing a psychotic episode may hallucinate things that affect any of their five senses, and these hallucinations typically appear and feel very real to them.

Updating the language of a psychotic break

While the term “mental breakdown” was sometimes previously used to describe a psychotic break, current language has largely evolved. It tends to be both more accurate and more inclusive to describe psychosis as a mental health crisis, often caused by an undiagnosed or untreated mental or physical health condition. 

Psychiatric conditions that may cause psychotic breaks

Experiencing a psychotic break often indicates the presence of an underlying psychotic disorder, a category of mental health conditions that usually involve symptoms associated with a loss of connection to reality. 

Several psychiatric, physical, and neurological conditions can lead to a psychotic break, including the following:

• Schizophrenia
• Schizoaffective disorder
• Delusional disorder
• Brief psychotic disorder
• Postpartum psychosis
• Medication or substance-induced psychosis
• Psychosis due to medical condition or injury
• Bipolar depression disorder
• Severe episode of major depressive disorder
• Extreme mental stress

Understanding the causes of a psychotic break

In general, psychosis isn’t considered to be a mental health condition by itself. Instead, it can be seen as a collection of psychological symptoms that can be caused by a complex interaction of circumstances. 

Some of the potential causes of a psychotic break can include:

• Genetics: Certain genetic conditions can predispose a person toward psychotic disorders like schizophrenia or bipolar disorder, both of which generally have an inherited component. However, a family history doesn’t necessarily mean you will experience psychosis. 
• Brain differences: Individual differences in the physical makeup of the brain, along with the production and function of neurochemicals, can influence psychosis in various ways, from amplifying the effects of medications to putting you at a higher risk for mental health conditions. 
• Head trauma and brain injury: Physical head trauma and traumatic brain injuries can cause psychosis and psychotic symptoms. 
• Witnessing or experiencing a traumatic event: Emotional trauma can also contribute to a psychotic break. Many people who have witnessed or experienced a traumatic event also exhibit symptoms of psychosis. 
• Alcohol or substance use: Alcohol and other substance use can cause a psychotic break or exacerbate psychotic symptoms. An increased risk of psychosis has been linked to the use of alcohol, LSD, cannabis, cocaine, amphetamines, and other substances. 
• Physical, psychological, or neurological medical conditions: Neurological conditions like Alzheimer’s disease, physical illnesses like stroke or encephalitis, and psychological conditions like bipolar disorder can lead to a psychotic break. 
• Extreme mental stress: Stress can affect the human body in numerous ways. For example, a severely stressful event can lead to a psychotic episode. The mental, physical, and emotional effects of stress can be cumulative, building up over time. Chronic, extreme stress can also lead to psychosis. 

Recognizing the early signs of a psychotic break

While the early warning signs of a psychotic break can differ for everyone, those listed below tend to be the most common prodromal symptoms associated with an impending disconnection from reality. Taking notes of your early signs and symptoms can help your mental healthcare provider make an accurate diagnosis. 

• Trouble concentrating or thinking
• A sudden drop in performance or function at work or school
• A decline in self-care and personal hygiene
• Social isolation and lack of interest in social contact
• Intense mood swings and emotional reactions not tied to one’s circumstances
• A distinct lack of emotions or emotional responses in situations that would call for them

What does a psychotic break in the context of mental illness look like?

The exact symptoms, disorganized thoughts, and erratic behaviors can look different for each person experiencing a psychotic break. However, through decades of research, psychologists have identified some common symptoms many people report during a psychotic break. Two of the most common symptoms are usually hallucinations and delusions.

Hallucinations

Someone experiencing hallucinations may perceive the sight, sound, smell, touch, or taste of something that isn’t there. While others can understand that these experiences aren’t rooted in reality, they usually seem very real to the person having the hallucination. Hallucinations often involve sensory experiences and may present in one of the following ways: 

• Auditory — Studies show auditory hallucinations tend to be the most common type. Many people with psychosis report incoherent sounds or distinct voices. 
• Visual — Some people have visual hallucinations during a psychotic break. Visual and auditory hallucinations can occur together and may appear to outside observers as if an individual is having a spirited conversation with someone who isn’t there. 

Delusions

Many people experience an unshakable conviction in something untrue during a psychotic break. Delusions can lead to someone experiencing a psychotic break believing that they have superpowers or that the government is targeting them for experiments. Some other types of delusions include: 

• Erotomanic delusions — Believing that someone is in love with them
• Thought broadcasting — The belief that someone is reading their thoughts or getting into their head
• Delusions of grandeur — The unbreakable conviction that they have special powers or must complete some incredible task

Other symptoms of a psychotic break

Beyond hallucinations and delusions, other symptoms of a psychotic break might include: 

• Disorganized thoughts or speech: A person with psychosis may have trouble thinking straight, holding a rational conversation, or determining the difference between what's real and not. They may jump from subject to subject without finishing their thoughts or making sense. 
• Catatonia: The disconnection from reality may cause someone in a psychotic break to be catatonic or unresponsive to the world around them. Catatonia is typically characterized by abnormal behaviors and communication, as well as withdrawal from others.
• Confused, erratic behavior: Someone experiencing a psychotic break often demonstrates unpredictable, confused, or erratic behavior. They may lack awareness of their surroundings and act out in harmful, threatening, or otherwise confusing ways.
• Negative symptoms: Psychosis can cause a general decline in mental health and function. Individuals might experience a loss of interest in previously enjoyed activities and withdraw from others. They may also display decreased speed with their speech, movement, energy levels, and emotional reactions.

What are the mental health treatments for a psychotic break?

Depending on the cause of a psychotic break, treatment plans can vary. However, the most common elements usually involve medications, such as antipsychotics, and psychotherapy treatments with a licensed mental health professional. Please note that only a licensed medical professional can prescribe medication.

Cognitive behavioral therapy (CBT) can be a popular treatment for psychosis because it usually helps individuals explore the link between how they think and the way they feel. It may also enable them to recognize and reshape harmful patterns in their thoughts, behaviors, or feelings.

How to support someone experiencing a psychotic break

Is a loved one of yours experiencing psychosis? While this situation can be challenging, here are some ways you can help:

• Offer continued support and resources toward treatment.
• Emphasize the importance of ongoing therapy and medication.
• Check on them and offer practical support.
• Take notes about symptoms and attend treatment with them.

Resources for psychotic breaks and mental health crises

If you or a loved one has experienced a psychotic break or is showing early warning signs of psychosis, you can contact these organizations for additional information or access the following supportive resources to make it through a mental health crisis:

• Contact the Crisis Text Line by texting HOME to 741741.
• Call the NAMI Helpline at 800-950-NAMI (6264).
• The National Suicide Prevention Lifeline can be reached at 988 and is available 24/7.
• Reach out to your local community’s mental health programs.
• Consider attending virtual and in-person mental health support groups.

Benefits of online therapy for managing symptoms of psychosis and mental illness

Recognizing and working through a mental health crisis can be challenging to do on your own. If you or someone you love is exhibiting the early signs of a psychotic break, consider speaking to a qualified therapist through a virtual platform like BetterHelp. With online therapy, you can receive advice and support from your home or anywhere else you have a stable internet connection. Being able to remain in a safe, familiar environment while speaking to a professional may help you feel more at ease while opening up about your thoughts, feelings, and experiences. 

Please note that individuals experiencing acute psychosis may require in-person care.

Effectiveness of online therapy for mental health and addressing a psychotic episode 

Research has shown that online interventions can be useful for managing and treating the symptoms associated with psychosis. In one study, researchers assessed the efficacy of mindfulness‐based interventions (MBIs) for people with psychosis. At the conclusion of the 12-session study, they found that individuals with a schizophrenia spectrum diagnosis typically experienced a reduction in symptoms of depression, anxiety, and distressing voices. Similar outcomes were discovered in face-to-face mindfulness programs designed for the same purpose. MBIs normally work by using mindfulness practices concentrated on concepts like non-judgment, compassion, and objectivity.