Apr 19 / 2021

Psychotic break: definition, causes, symptoms and treatment

Who can suffer a psychotic break and how to act in such a case?

"Psychotic break" is one of those terms belonging to the world of psychiatry and clinical psychology that have entered popular culture but, at the same time, have done so with a somewhat distorted definition: few people without formal training in the field of mental health are clear about this concept.

For this reason, throughout this article we will see what a psychotic break isits characteristics and the type of pathologies in which it appears.

What is a psychotic break?

The psychotic disorders are severe mental illnesses in which the person loses contact with reality. One of the characteristic symptoms of this type of psychopathologies is the occurrence of psychotic outbreaksThis concept will be explored throughout this article.

A psychotic break is a temporary rupture of reality, and during this period of time the sufferer does not distinguish whether what is happening is real or fictitious.During this period of time, the person who suffers it does not distinguish whether what is happening to him/her is real or fictitious. Images or thoughts appear in their mind as if everything were authentic. They may think that the whole world is against them and wants to do away with them or, on the other hand, they may hear voices inside them telling them to commit suicide.

The psychotic break should be treated with drugs and psychological help should be sought as soon as possible.

Who can suffer from it?

But... what causes a psychotic break? It seems that there is a certain genetic predisposition to suffer from it.which, together with environmental factors, can trigger the presence of psychotic outbreaks. In illnesses such as schizophrenia or paranoid disorder it is possible that, if the patient does not take medication, several psychotic outbreaks may occur during his or her lifetime.

This break with reality can occur for different reasons, and not only with these two psychotic disorders. Some patients with bipolar disorder or borderline personality disorder may also experience a psychotic break. In some cases, even people who have never had a psychotic break may experience a single break after a very stressful emotional situation or from the use of drugs such as marijuana or hallucinogens.

Symptoms

In cases of patients with psychotic disorders, medication is necessary to avoid these episodes.. But, in general, it is complicated to anticipate and prevent it. Usually, family members themselves seek help when the psychotic break itself is present, and patients are usually admitted temporarily until the symptoms have subsided.

However, there are certain signs that may indicate this type of there are certain signs that may indicate this type of behavior:

The individual exhibits social withdrawal behaviorThe individual may stop going to work or school.
Changes in dressing and habitsChanges in dress and habits, as well as a neglect of appearance and hygiene.
The person shows a disorganized behaviorThe person shows a disorganized, unusual, that seems lacking of sense, strange and extravagant.
It presents strange ideas that do not seem to have any relation with reality. Although it does not share this type of thoughts with everybody, it can that it is commented to some close people.

Difference between delusions and hallucinations

Delusions and hallucinations, both present in the psychotic break, are not the same and are not expressed in the same way.. The former are usually manifested in delusional or paranoid disorder, while the latter are typical of schizophrenia.

But what exactly differentiates them? Delusions are false beliefs. That is, erroneous beliefs of reality about an existing fact or object. They are, in other words, a distortion of an external stimulus that is present. For example, when someone suffers from delusions he may be walking through a shopping mall and believe that the people he passes are spying on him and then give the information to the police.

On the other hand, hallucinations are false perceptions, such as hearing, seeing or feeling something that does not really exist.. Patients with this condition actually hear or see things, but those objects or voices are not really there, they are inventions of the mind. For example, an individual with hallucinations may believe that they are talking to them through the electrical outlets in their home.

What is the difference with dissociative episodes?

Cases of dissociation are phenomena that may be reminiscent of psychotic outbreaks.. They are mental disturbances in which the person experiences reality in a way that is dissociated from reality, in a manner similar to that which occurs in psychosis. However, usually in these cases it is not considered that hallucinations arise, but an emotionally discordant reaction to the perceived or remembered information, and that often clashes with the identity of the person.

For example, in derealization, the person feels as if everything that surrounds him/her were a lie, a decoration without much value beyond appearances. And there are also dissociative phenomena in which the faces of loved ones do not produce an emotional reaction of affection in the person.

Treatment

When a person suffers a psychotic break he/she needs immediate treatment.. Since this is a serious disorder, the patient is usually hospitalized so that he/she can receive the correct pharmacological and psychological treatment. The administration of antipsychotic drugs (e.g. haloperidol or olanzapine) is necessary to stabilize the patient, but psychological support is also essential, as it not only helps patients, but family members can also benefit from psychological help to cope with the situation. Psychotherapy is helpful in providing information, tools and support in these cases.

In some cases (e.g., substance-induced psychotic disorder), the patient does not suffer psychotic outbreaks again in his or her life.. In other cases, such as schizophrenia, psychotic breaks may recur with some frequency. It is very important to clarify that psychotic break and schizophrenia are not the same thing. Although the two terms can sometimes be confused and used synonymously, schizophrenia is a long-lasting type of psychotic disorder, whereas a psychotic break is an acute manifestation that has a short duration. The psychotic break is considered a positive symptom of schizophrenia.

Bibliographic references:

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C.: American Psychiatric Association.
Leucht, S., Arbter, D., Engel, R.R., Kissling, W., Davis, J.M. (2009). How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials. Molecular Psychiatry. 14 (4): 429 - 447.
Sims, A. (2002). Symptoms in the mind: An introduction to descriptive psychopathology (3rd ed.). Edinburgh: Elsevier Science Ltd.
Tsuang, M.T., Stone, W.S., Faraone, S.V. (2000). Toward Reformulating the Diagnosis of Schizophrenia. American Journal of Psychiatry 157 (7): 1041-1050.
Williams, P. (2012). Rethinking Madness: Towards a Paradigm Shift In Our Understanding and Treatment of Psychosis. Sky’s Edge Publishing.

(Updated at Apr 13 / 2024)