What Is A Psychotic Episode? Exploring The Definition, Symptoms, And Treatments

Psychotic episodes and disorders are often misunderstood by the people experiencing them, as well as their friends and family members. When you or a loved one begins to exhibit symptoms of psychosis, it can be confusing and perhaps even frightening. However, understanding what a psychotic episode is, why it might occur, and what it can look like may help you manage these challenges more readily. You can also learn about your options for treatment, which can help you navigate symptoms with confidence. Online therapy may be a helpful source of professional support.

What is an episode?

The term “psychotic episode” generally refers to a single incident of psychosis where a person’s thoughts and perceptions are disrupted, often making it difficult for them to discern what is and isn't real. By contrast, a psychotic disorder is a mental health condition that typically involves repeated instances of psychosis over time.

The onset of psychotic episodes usually occurs during the transition from adolescence to young adulthood. However, a psychotic episode in young children can also occur and may indicate non-psychotic mental health conditions. 

Older adults may experience psychosis due to degenerative neurological diseases like dementia and Alzheimer’s. Other adults might experience symptoms due to certain mental health conditions, like depression and anxiety.

What does psychosis look like? Exploring signs and symptoms

As with most mental health conditions, psychosis can look different for everyone who experiences it. Still, through decades of psychological studies, researchers have compiled a list of common symptoms linked to a disconnection from reality. 

Hallucinations

Psychosis can cause a person to have interactions with stimuli that don’t exist. These manifestations of the mind may stimulate one or more of the five senses— sight, sound, taste, touch, and smell—and can be disorienting or frightening. 

It can be critical to note that these hallucinations often feel and appear real to the person experiencing them. If someone is unaware of their mental illness, it can be challenging to convince them that what they’re perceiving doesn't align with reality because it feels so authentic.

Auditory hallucinations tend to be experienced most often, with most individuals reporting hearing incoherent sounds or voices others do not perceive. Depending on the type and severity of the psychosis, some people may have combination hallucinations with visual and auditory elements that command, taunt, threaten, or otherwise influence the person experiencing them. 

Delusions

Delusions can be thought of as unshakable beliefs in things that aren’t true. While these sorts of ideas and convictions may seem strange to others, they can make perfect sense to someone experiencing delusions. 

If they are unaware of their mental illness, a person experiencing psychosis may not have the perspective to understand that their perception doesn't match reality. For example, during a psychotic episode, a person may become convinced they can monitor thoughts through the television or believe themselves to be a target of a conspiracy.  

Disorganized or confused thinking and speech

Psychosis can make it difficult to think straight and communicate rationally. It may also make it challenging to use a linear thought process. Thoughts and speech may jump from one topic to the next without a logical connection and before even finishing an idea, often making it harder for others to understand their meaning. 

Negative symptoms

Some people experiencing psychosis may talk, move, and think more slowly than usual. They may also lose interest in things they previously cared about, feel fatigued, and show a marked lack of emotional response as they attempt to function in daily life.

Catatonia

Some severe cases of psychosis can interfere with a person’s ability to respond to or interact with their surroundings. This phenomenon, known as catatonia, may look like little to no awareness or reaction to stimuli. It might also cause unpredictable, erratic behavioral responses.

What causes these episodes?

Individual psychotic episodes can be triggered by personal circumstances, such as a major life change, but they may also stem from causes such as:

• Neurochemical imbalances

• Untreated mental health symptoms from psychotic and mood disorders

• Witnessing or experiencing a traumatic event

• Alcohol, recreational drugs, and substance use

• Some prescription medications

• Some physical, hormonal, and neurological illnesses and injuries

Mental health disorders linked to psychosis

Psychosis isn’t always caused by disorders like schizophrenia, which can be characterized by psychotic symptoms, but it often stems from conditions that alter how a person experiences reality. 

Schizophrenia

Schizophrenia often develops after an initial schizophrenia episode, signaling a critical moment for recognizing early psychosis. This disorder's key symptoms include false beliefs and hallucinations.

Schizoaffective disorder

Schizoaffective disorder combines the hallucinations or delusions characteristic of schizophrenia with mood disorder symptoms, such as bipolar disorder or severe depression. This mix underscores the complex nature of psychotic illnesses, where other symptoms of mood disorders play a significant role.

Schizophreniform disorder

In Schizophreniform disorder, individuals experience symptoms similar to schizophrenia but for a shorter duration. Typically, these symptoms last between one and six months, distinguishing it from the longer duration observed in schizophrenia.

Schizotypal personality disorder (STPD)

Schizotypal personality disorder is a mental health condition in which people feel extremely uncomfortable in social situations, have strange beliefs or thoughts, and often act in unusual ways. They might see or believe things that others don't, making it hard for them to make friends or get close to people.

Postpartum (postnatal)

Postpartum (postnatal) psychosis highlights how childbirth, which can be a very stressful event, can trigger severe psychiatric symptoms and place new mothers at a higher risk of mental health challenges. This condition often requires immediate early treatment to safeguard both mother and baby.

Delusional disorder 

Delusional disorder is a type of psychotic disorder involving psychosis characterized by the presence of one or more delusions. These delusions persist for at least one month, and the condition does not usually impair cognitive function or behavior. The causes of delusional disorder are not clearly understood, but genetic, biological, and environmental factors may play a role.

Brief psychotic disorder

Brief psychotic disorder is a mental health condition that involves psychosis, characterized by a sudden onset of symptoms. These symptoms can include delusions, hallucinations, or disorganized speech and typically last from one day to one month. The exact causes of brief psychotic disorder are not well understood, but it may be triggered by extreme stress or trauma.

Medical condition or injury-induced psychotic disorder

Physical illness or a head injury may lead to symptoms of psychosis, with neurological disorders often having a direct impact on mental health. These causes of psychosis often require a comprehensive approach to treatment.

Bipolar disorder

Bipolar disorder episodes can encompass severe depression and mania, with some episodes involving psychosis. Psychosis typically occurs during manic episodes of bipolar disorder, though they can also arise out of depressive episodes. Symptoms can fluctuate, from periods of euphoria and overactivity to devastating lows, which can greatly affect a person’s life.

Major depressive disorder

Major depressive disorder with psychotic features presents severe depression alongside psychosis. In major depressive disorder with psychotic symptoms, individuals may experience hallucinations or delusions in addition to profound feelings of sadness and hopelessness.

Extreme, prolonged mental stress

Extreme, prolonged mental stress can precipitate an episode of psychosis in individuals, particularly those with a family history or other predisposing factors, making stress a notable cause of psychosis. Identifying these stressors as warning signs can aid in prevention and treatment.

More than half the people living with schizophrenia and other psychotic disorders may be unaware of their own mental health condition. However, with consistent, ongoing therapy and adherence to a comprehensive treatment plan, individuals can develop their sense of self-insight, learn to identify when warning signs of psychosis symptoms emerge, and seek early treatment. 

How are psychotic disorders treated?

The primary treatment option for psychotic episodes is usually psychotherapy with a licensed mental health professional. In therapy, a provider might utilize techniques like:

• Cognitive behavioral therapy (CBT), which generally helps patients examine the link between their thoughts and feelings to reshape harmful patterns 

• Family therapy, which can help families learn how to support one another, communicate effectively, and work together to manage symptoms

• Couples therapy, which typically teaches partners to understand and support each other, communicating their needs and feelings

Antipsychotic medications can also help by controlling neurochemical imbalances to manage symptoms of a psychotic episode. Never start or stop an antipsychotic medicine without the guidance of a licensed medical professional.

Similarly, transcranial direct current stimulation (TDCS) over the left frontotemporal cortex has been shown to have dramatic effects and can be an effective method of treating psychosis. While treatment may not work the same for all patients, gentle electrical brain stimulation can lead to longer positive treatment outcomes if a patient doesn’t respond to other methods.

Finally, inpatient psychosis treatment programs at a hospital or psychiatric facility may be necessary in extreme cases where the patient poses a danger to themselves or others. A qualified mental health worker can help individuals recognize their symptoms and work through the psychotic episode until they regain their cognitive, emotional, and behavioral balance. 

Seeking support for a psychotic disorder

Psychotherapy is often a crucial part of a psychosis treatment plan, and the earlier a person starts treatment, the more likely their outcome will be successful. It may be beneficial to consider working with a licensed therapist online through a virtual therapy platform like BetterHelp to find healthy, practical ways to manage psychotic symptoms and learn to live with complex mental health conditions. When you pursue therapy online, you can avail of professional care at a time and location that makes sense for your needs and schedule.

While more research may be needed investigating the efficacy of online therapy for treating psychosis, existing studies suggest that online and in-person therapy tend to be equally effective.

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