Understanding Reactive Psychosis
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.”
Brief psychotic disorder vs. schizophrenia
Brief psychotic disorder and schizophrenia tend to share several symptoms. 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 brief psychotic disorder has been identified and diagnosed, paying attention for any symptoms after the standard duration period has subsided can be beneficial, as this could be indicative of schizophrenia or another underlying condition.
Treatment and therapy
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.
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.
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.
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