What is a psychotic episode?
01What are the symptoms of a psychotic episode?
02What causes psychotic episodes?
03How can counselling help psychotic episodes sufferers?
04Popular borderline personality disorder FAQs
05Getting Support
06The experience of psychosis is called a “psychotic episode”. A psychotic episode is losing touch with reality and seeing and hearing things that aren’t really there or believing things that aren’t true, like seriously believing you control the weather.
1% of people will have a psychotic episode in their lifetime. They can happen to anyone of any age. If you or someone you know is experiencing a psychotic episode, you should seek immediate medical attention.
An acute psychotic episode is when a psychotic episode gets very severe, and the person experiencing it is out of touch with reality and is preoccupied only with hallucinations and delusions as part of the psychotic episode.
To friends and family, this appears as a sudden onset of an uncharacteristic mood and bizarre behaviour. Acute psychosis is a serious mental health crisis and a psychiatric emergency.
Call 999 for immediate help if you or a family member is experiencing acute psychotic episodes. The condition tends to develop slowly, so it might not be obvious right away.
How long does a psychotic episode last? A psychotic episode can begin subtly, like hearing voices - but you can ignore them, and then they may progress over a few weeks to the acute stage, when you can’t ignore or drown out the voices, for example.
A psychotic episode can also be a one-time event and associated with other conditions, such as dementia, brain injury, medication side-effects, and drug abuse or withdrawal.
Correct care and treatment will allow a person who suffers from a psychotic episode to recover in a few weeks, depending on its cause, or weeks, or even days.
Psychotic episodes are associated with borderline personality disorder (BPD). A borderline personality disorder sufferer can experience particularly intense feelings that may be hard to cope with.
This can include uncontrollable anger, fear of abandonment, feeling isolated, feeling stressed, and even suicidal thoughts. Stress can aggravate the symptoms of BPD, resulting in a psychotic episode.
If this is indeed the case, treatment should be sought initially for the immediate psychosis, and then to manage BPD and avoid relapse in the future.
Each person’s symptoms of psychotic episodes will vary depending on their circumstances and experiences. However, clinicians tend to categorize symptoms into two main categories: hallucinations and delusions.
A clinical professional may diagnose a psychotic episode if you experience any of the following symptoms:
Sensory Hallucinations:
• You hear voices. This symptom is the most common, and the voices can be strange or familiar, whispering or shouting, and can be especially negative and disturbing.
• You see things that only you can see.
• You feel someone or something touching you who is not actually there.
• You smell things that other people cannot smell.
Delusions:
• You feel you are being watched or spied on when this is not the case.
• You believe strangers or people you know are out to kill you.
• You believe someone is monitoring your thoughts.
• You believe you have special powers.
Stress and other mental health conditions such as borderline personality disorder can cause psychotic episodes. Psychotic episodes can quickly and easily be recognized by personality changes, such as erratic behaviour, frantic thinking, and paranoid emotions. They may not act the same way as they normally do, might confuse you with someone else, and may not react to you kindly at all. Psychosis increases the risk of self-harm and suicide, so if you are concerned that you or someone close to you is experiencing a psychotic episode, pay attention to unexplained cuts, burns, and bruises around the wrists, arms, and thighs.
Psychotic episodes can be caused by a variety of factors. Psychotic episodes can be triggered by extreme stress alone, or by underlying neurological conditions, such as dementia or brain injury. Alternatively, drug abuse or getting very drunk or high on hard, hallucinogenic drugs, such as cocaine, speed and LSD, can bring about a psychotic episode. Sometimes substance withdrawal brings it on. It is also possible to get postnatal psychosis, a type of acute postnatal depression that affects 0.1% of mothers, especially if the mother has a mental health problem.
Psychosis and psychotic episodes are thought to be caused by disruption to dopamine in the brain. It ties all of the triggers of psychotic episodes together: every one of them impacts dopamine function in the brain. Dopamine is a chemical that the brain uses to convey information from one cell to another and it’s linked with thinking things are important, significant, and interesting. Medicines that reduce the effects of dopamine in the brain also reduce psychotic episodes, their severity and occurrence.
Counselling can provide a safe and relaxing environment for someone recovering from a psychotic episode to explore their emotions and experiences. Talking to a qualified therapist can help you gain a better understanding of your thoughts and feelings, allowing you to discuss any important issues with the right support. A therapist can help resolve everyday issues, as well as suggest ways to positively change your attitude and behaviours.
Talking therapies have been used widely on the road to recovery from psychotic episodes. Cognitive behavioural therapy (CBT) is a talking therapy that is often used to treat people recovering from psychosis and reduces stress while improving resilience, functioning and coping by developing your understanding of difficult emotions and how they affect daily life and working on your perceptions, beliefs, and reasoning.
Trauma therapy is a mode of therapy frequently applied to patients recovering from psychosis because trauma, combined with other factors, is what often brings them about. Psychosis is often the mind’s way of dealing with and processing trauma, which is why psychotherapy and other forms of counselling are helpful. Through these types of talking therapies, the therapist will guide you through unpacking the symptoms and causes of your psychosis so that you can learn to cope with the difficult hallucinations and delusions that come with it.
If you are experiencing an emergency mental health crisis, emergency mental health services may be more beneficial than counselling. Visit the Samaritans website for more information on what to do in a mental health crisis. In emergency situations, dial 999.
Are there different types of psychotic episodes?
Psychosis is an umbrella term for episodes where the sufferer loses touch with reality and experiences hallucinations or delusions that are not real. Psychoses can be classified as “delusional” or “hallucinatory”, and or “acute” in their most severe form. However, since the causes of psychotic episodes differ (including drug abuse and withdrawal, stress, trauma or neurological conditions) there may be different categories of psychotic episodes: for example, withdrawal-induced psychosis or stress-induced psychosis.
Are psychotic episodes more common in young people?
Anyone of any age or gender can have a psychotic episode. 1% of people will have a psychotic episode in their lifetime. Research has identified that almost twice as many hospital admissions for first-time psychotic episodes are from those between the ages of 15 and 29 as those between 30 and 59. It is believed that people are more likely to experience their first severe episode of psychosis younger in life, but it’s more likely that predisposing conditions such as drug addiction and withdrawal, stress, trauma or neurological conditions have a far greater impact than an individual’s age or gender.
How can I help a friend or relative experiencing a psychotic episode?
You can identify a psychotic episode better in a friend or loved one by the sudden onset of an uncharacteristic mood and bizarre behaviour. Acute psychosis is a serious mental health crisis and a psychiatric emergency. Call 999 for immediate help if you or someone you know is experiencing acute psychosis. The condition usually builds over a couple of weeks, so there should be a backstory to this condition and you should be aware that they are not themselves, and they might not react to you kindly or at all.