How to Support Someone Experiencing a Psychotic Episode

Psychosis can be a terrifying experience for everyone involved. Families and friends of someone having a psychotic episode may not understand what is happening or how to respond appropriately. The delusions and hallucinations associated with psychosis may seem very real to the person having them, but alarming to everybody else around them. A person having a psychotic episode may also behave unpredictably or violently, which can make you hesitant to approach them.

It is much easier to support a loved one with psychosis and stay connected if you understand their condition, what causes it and what you can do to help.

What Is Psychosis?

Psychosis is a leading characteristic of mental health conditions like schizophrenia, depression, bipolar, addiction and borderline personality disorder. Drug-induced psychosis may be a side effect of substances like hallucinogens, high-THC marijuana, antidepressants, muscle relaxers and blood pressure medications. Additionally, psychosis can be a response to a brain injury, trauma or extreme stress.

There is increasing evidence to support the hypothesis that using high-potency marijuana and other substances like hallucinogens can contribute to psychosis and mania in some people, especially if they have a family history of mental illness or other risk factors that make them more vulnerable. We also know that if someone has had one psychotic break, this makes them more likely to have another one, especially if they continue using substances and don’t receive mental health treatment.

Psychotic breaks rarely arise out of nowhere. Instead, a psychotic episode may begin with small, seemingly minor issues like paranoia, trouble concentrating, neglecting self-care or withdrawing from friends and family. Treatment professionals call these early warning signs first-episode psychosis. FEP often occurs in adolescence or young adulthood and can be a sign of a chronic mental illness such as schizophrenia that may be beginning to show symptoms.

Though you may feel unqualified to diagnose someone with psychosis, you can spot the unique warning signs that a loved one is starting to behave irrationally if you understand their risk factors and pay close attention to how psychosis symptoms manifest in them. Once a psychotic episode is over, you can also try asking your loved one to look back on what they were experiencing during that time and provide some insight into what it felt like.

What Not to Say When Someone Is Psychotic

During a psychotic episode, many people may be unaware that they are in a mental health crisis. The confusing, disorienting disruptions to their thoughts or feelings can make it difficult to determine what’s real and what isn’t. 

When talking to someone experiencing psychosis, do not belittle them or dismiss their concerns. Instead, listen without judgment and provide verbal affirmation. Avoid criticizing them for things they say or do during a psychotic episode or take their words and actions personally.

Here are some other don’ts for dealing with someone experiencing a psychotic episode.

• Do not challenge or confront them about their delusional beliefs. Telling them they are having a psychotic break will not cure psychosis or convince them to change.
• Do not encourage their psychosis by engaging with the conversation. Instead, you can say supportive things like “That sounds so scary” or “How are you handling the situation?”
• Don’t waste time trying to prove their beliefs aren’t real. Delusional people are unlikely to respond well to logic and reason.

Professional Treatment for Psychosis and Related Mental Health Issues

If you spot the early warning signs of psychosis in someone you care about, acting quickly to connect them with psychotherapy can make a significant difference in helping them keep their life on track. A psychiatric evaluation may also be necessary to help stabilize the person with medication. If someone is very erratic and possibly a danger to themselves or others, you may have to have them hospitalized to help them through the crisis and keep them safe. Treating psychosis in its earliest phases can prevent it from worsening into a more severe, ongoing condition, so it is essential to know the warning signs and intervene as soon as possible.

When mental health is a concern for you or someone you care about, R&A Therapeutic Partners is here for you. Our highly trained therapists and recovery specialists will address your specific concerns with a customized approach. To learn more about who we are and what we do, please reach out to us today.

At R&A Therapeutic Partners Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information please visit Therapeutic-Partners.com or on Facebook.