Reactive Psychosis: Symptoms And Treatment
Have you recently experienced a highly stressful or traumatic event and noticed a sense of detachment from reality, accompanied by delusions or hallucinations? You could be experiencing a mental health condition sometimes called reactive psychosis, also known as brief psychotic disorder.
The sudden onset of reactive psychosis after a traumatic event is a mental health emergency and usually requires in-person mental health support. In most cases, the symptoms of brief psychotic disorder can be managed with prescription antipsychotic medication and therapy. Continuing to attend therapy even after the acute phase of psychosis has passed can be helpful in order to decrease the chance of another episode occurring.
What is reactive psychosis?
Reactive psychosis is usually characterized by the sudden onset of a major disturbance in one’s mental health and connection to reality, typically in response to a traumatic event or distressing experience. While reactive psychosis can vary in duration, psychotic episodes categorized as brief psychotic disorder tend to last between one day and one month.
Reactive psychosis often emerges in individuals with a predisposition to the condition. This could be due to genetics or a pre-existing personality or mood disorder.
The symptoms of reactive psychosis are usually marked by an overall detachment from reality, making the condition similar to other psychotic disorders, such as schizophrenia. Some of the symptoms of brief psychotic disorder include the following:
Sudden odd or unusual behavior
Delusions
Hallucinations
Catatonia
Scattered thoughts
Speech that is difficult for others to understand
Reactive psychosis or brief psychotic disorder can differ from other psychotic and schizophrenia spectrum disorders in that the beginning of the psychotic episode can usually be traced to a specific traumatic event.
What causes brief reactive psychosis?
Brief psychotic disorder that emerges following a traumatic event or stressor can be called “brief reactive psychosis.”
While updated research may be necessary, the disorder is often preceded by overwhelming fear or threat of imminent destruction. For example, brief reactive psychosis may occur in response to the following:
Extreme social isolation
Imprisonment
Hospitalization
Bereavement (death of a loved one)
Intense sexual or interpersonal conflicts, such as abuse, assault, or other life-altering events
Additionally, studies show a potential link between psychosis and immigration, suggesting that brief reactive psychosis may be “associated with cumulative social disadvantage during different phases of migration.”
While reactive psychosis can sometimes co-occur with the presence of other psychotic disorders, brief reactive psychosis is usually a trauma response that subsides over time.
Brief psychotic disorder vs. schizophrenia
Brief psychotic disorder and schizophrenia tend to have several symptoms in common. Both mental health conditions can be characterized by delusions, hallucinations, scattered and fragmented thoughts and speech, and unusual behavior.
While brief reactive psychosis can be among the early signs of a long-term disorder, such as schizoaffective disorder or schizophrenia, this is not always the case.
The key difference between brief psychotic disorder and schizophrenia is usually symptom length. While brief psychotic disorder typically lasts anywhere from one day to 30 days, schizophrenia tends to be a long-term psychotic disorder that, while manageable, lasts throughout one’s life after diagnosis. While the two disorders may have much in common, a diagnosis of brief psychotic disorder is not always indicative of underlying schizophrenia.
A study found that 56% of those who are diagnosed with brief psychotic disorder never develop other psychotic disorders, while approximately 22% may go on to develop schizophrenia. Once a brief psychotic disorder has been identified and diagnosed, paying attention to any symptoms after the standard duration period has subsided can be beneficial, as this could be indicative of schizophrenia or another underlying condition.
Treatment for psychotic symptoms
No single test may diagnose reactive psychosis or brief psychotic disorder. Instead, a process of elimination is normally implemented to diagnose the condition. Once a diagnosis of brief reactive psychosis has been established, antipsychotic medications can be administered to lessen the impact of symptoms. These medications must be prescribed and monitored by a psychiatrist or doctor.
The benefits of mental health care through online therapy
In addition to medication, therapy can also be part of recovery. While in-person care may be necessary during the acute phase of the psychotic episode, individuals may choose to attend therapy online during the recovery period. Online therapy may offer more convenience and flexibility than its in-person counterpart, as well as the option to customize the therapy experience by choosing between video conference, phone call, and online chat for each session.
What the research says about the effectiveness of online therapy
According to a 2023 systematic review and meta-analysis, technology-based interventions like online therapy “are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis,” suggesting that online therapy may be a valid form of treatment for individuals who have experienced reactive psychosis.
Takeaway
Reactive psychosis is a serious mental health disorder usually triggered by a traumatic experience or major stressor. While the symptoms of reactive psychosis tend to be similar to those of schizophrenia, brief reactive psychosis typically subsides in less than one month. If you suspect you are experiencing brief psychotic disorder, you can seek treatment from a licensed professional. Symptoms that last for more than one month may be indicative of a different underlying mental health condition and may warrant further professional support. Antipsychotic medication and online or in-person therapy may ease the symptoms of brief reactive psychosis.
Questions to ask your therapist about psychosis, schizophrenia, and bipolar disorder
What causes reactive psychosis?
Brief reactive psychosis typically occurs in response to a specific traumatic event or marked stressor, including hospitalization, social isolation, imprisonment, bereavement, abuse, natural disaster, or other life-altering events. Reports show a higher incidence of brief psychotic disorders in developing countries compared to industrialized countries, likely because these populations may be under more extreme stress. Another theory suggests that people with poor coping skills might be more at risk for developing this type of psychosis.
What is the difference between a psychotic disorder and bipolar disorder?
Psychotic disorders are severe mental illnesses that generally cause a loss of contact with reality, like schizophrenia, schizophreniform disorder, and postpartum psychosis. Symptoms vary but can include delusions, hallucinations, disorganized speech, catatonic behavior, false beliefs, and disorganized thinking.
Bipolar disorder is classified as a mood disorder that causes extreme shifts in thinking, behavior, energy, and mood. When in a manic state, people with bipolar disorder may indulge in risky activities, like reckless driving or spending large amounts of money. People with this condition can also develop psychotic features, which can make it difficult to distinguish the manic phase from a psychotic illness.
The primary difference between the two is that bipolar disorder is characterized by mood swings between mania and depression while psychotic disorders feature persistent psychotic symptoms.
What forms of treatment reduce psychotic symptoms?
There are multiple approaches to treating psychosis, and the exact treatment plan will depend on the person and the underlying cause. Antipsychotic drugs, both atypical and typical antipsychotics, are the most common types of medication for treating psychosis symptoms, but other medications, like anti-depressants, can also be used depending on the cause of the psychotic behavior and the person’s psychiatric history.
Working with a mental health professional can also be beneficial. Talk therapy can help identify and treat conditions that may be contributing to these symptoms.
In severe cases, in-patient treatment may be needed, particularly if the person may be a danger to themselves or others.
What is the prognosis for brief reactive psychosis?
People with brief reactive psychosis can experience complete remission of their symptoms. In fact, by definition, symptoms should go away on their own in less than one month. That said, future relapses may occur if there is another stressful event, and outcomes may be worse for individuals diagnosed with bipolar disorder..
Is a psychotic disorder a mental illness?
Yes, a psychotic disorder is considered a mental illness. There are multiple physical and mental health conditions that can cause psychotic symptoms. To get an accurate diagnosis, someone exhibiting symptoms may have to undergo a physical examination and laboratory testing to rule out any physical health conditions. If a physical exam and lab work indicate that there is no medical condition, a mental health professional can perform psychological testing and develop a differential diagnosis for what may be causing psychotic symptoms. This testing will likely include a family history to determine if the symptoms have a genetic link.
What are five common psychotic symptoms?
There are multiple symptoms of psychosis. Someone with psychotic symptoms might experience hallucinations and see things or hear voices that aren’t there. They may also experience delusions, confused and disturbed thoughts, disorganized thinking, and mood swings. Those who have a postpartum onset may have experienced symptoms immediately after birth to up to about six weeks after having a baby.
How long does psychosis last in bipolar disorder?
How long bipolar psychosis lasts varies from one person to the next. Symptoms can last for days to months, depending on the severity and whether the person receives prompt treatment.
What is sudden-onset psychosis?
Sudden onset psychosis is what symptoms occur abruptly without any previous signs of a mental illness. It can be caused by significant stress, substance use, certain medical conditions, or it can occur for no reason at all.
Is temporary psychosis a serious mental health condition?
Yes, even temporary psychosis, like reactive psychosis or nonaffective acute remitting psychosis, is considered a serious mental illness. While symptoms typically resolve over a period of several weeks to months, transient psychotic disorders may be a sign of another mental health condition, like a personality disorder or affective disorder. Patient and family education can be key to managing symptoms and help prevent patients from relapse.
What triggers psychosis?
Psychosis results from a combination of a variety of factors, including brain development, genetics, and exposure to major stress or apparent trauma. It can be a symptom of a mental health condition, an isolated incident, or it can result from other factors like medications, drugs, or sleep deprivation.
Some research has found the lifetime prevalence of psychotic disorders is around 3% and that psychotic symptoms were most commonly associated with depression, anxiety, panic disorders, and substance use disorders, in that order.
What are the warning signs of psychosis?
Changes in behavior can be an early manifestation in the diagnostic trajectory of psychosis. According to the American Psychiatric Association, some warning signs to look for include the following:
- Paranoia
- Apathy
- Suspiciousness
- Social withdrawal
- Illogical thinking
- Mood changes
- Lack of emotions
- Sleep problems
- Appetite changes
- Unusual behavior
- Drop in school or work performance
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