How To Act In The Event Of A Psychotic Break? 8 Guidelines And Steps To Follow
When a subject experiences a psychotic break, a break with reality occurs in their mind; he experiences unusual perceptions, ideas, or behaviors. In addition, Normally the individual also presents decreased awareness of the pathology.
Before the expression of the first symptoms of the psychotic outbreak, it is already possible for us to observe some different behaviors in the subject, such as an increase in social isolation, a decrease in personal hygiene, or an increase in suspicion and mistrust. If we perceive these signs that anticipate the onset of the condition, we can act preventively and reduce the severity of the symptoms.
But… What to do when the symptoms of this pathology are already present? In this article we will see What to do if a person is suffering from a psychotic break promoting their recovery and minimizing risks and dangerous situations.
We understand the psychotic break as a psychiatric disorder characterized by a temporary break with reality ; The subject stops perceiving or interpreting the environment or his or her internal state as it really is, for a more or less long period of time. The causes can be multiple, both organic (such as substance use) and psychological (linked, for example, to psychotic disorders).
Although there may be an internal predisposition (that is, the individual is more likely to develop a psychotic outbreak), environmental conditions are normally necessary to precipitate the outbreak, such as experiencing a stressful situation or a decrease or increase in stimulation.
Characteristic symptoms of a psychotic break
The appearance of the outbreak usually does not occur abruptly. It is common that before the main symptoms of the psychotic episode appear, we observe behaviors and the patient himself notices changes in himself that serve as an indicator of the next appearance of the outbreak.
Some of these previous behaviors, also known as prodromal period, are: strange ideas, which are far from usual thinking; suspicion (senses a bad intention in others); decreases hygiene and personal care; is isolated and separated from its environment; and disorganized behavior (termed the predisposition to act in an unusual manner).
When the outbreak is already present, psychotic symptoms will appear, such as hallucinations, which consist of perception through the senses without there being a real stimulus; delusions (false beliefs held by the subject); psychomotor inhibition, and disorganized thinking and language. This symptomatology can present a different degree of intensity, and may require hospitalization of the patient.
We must keep in mind that in most cases the subject shows low or no awareness of the symptoms being affected, a situation that in Psychology we know as anosognosia. The individual You really believe that what you are perceiving or the thoughts and ideas you have are adjusted to reality and that there truly is an external stimulation or a real cause that explains these sensations.
What to do when faced with a person who is suffering a psychotic break?
Given the type of symptoms and the different variety with which they can be shown, it is necessary that we support and help the person who presents psychotic symptoms as much as possible. It will be essential that we act to try to maintain control of the situation and prevent harm or injury to another person.
1. Behave calmly
In the event of a psychotic outbreak, where the situation may be altered, It is crucial not to lose our cool and appear calm. In this way, it is easier to transmit this sensation to the subject who is manifesting the symptoms and we help reduce their state of activation. Likewise, tranquility also allows us to act in a more organized manner and be able to make more appropriate decisions; it will be easier for us to react.
2. Find a quiet environment
As we have seen, stressful or highly stimulating situations can lead to the appearance of psychotic symptoms. For this reason, in the event of an outbreak, we must take the subject to a calm environment, so that it is easier for them to calm down or at least so that the symptoms do not increase.
It will be preferable to avoid places with people, trying to separate them from the crowd to achieve greater control. If possible, it is recommended that there be two individuals to be able to support you and to have more capacity to act in the different circumstances that may occur.
Another strategy that can be useful to help calm and promote the person’s condition consists of staying close to the subject, acting according to what he does not say and asks of us as long as it cannot be dangerous behavior. We will stay close, so that he can notice our presence, but we will avoid touching him or looking directly into his eyes, since these behaviors can upset him more. It is better to sit next to him and try to put ourselves between the subject and the door, but without completely blocking the exit.
4. Be understanding
We must be aware of the situation in which the subject who presents the outbreak finds himself; the behaviors he shows are not carried out intentionally, that is, he is in a situation of mental alteration in which is not fully aware of his behavior, thus reducing the responsibility he has for his actions. We cannot blame him for his actions, since he is in a situation of breaking with reality and losing control.
Once the impact of the outbreak decreases, it is also essential that we show empathy and act emotionally supporting the subject.
5. Communicate with the subject in a simple way
Since the subject is already nervous, we must ensure that our reaction does not further increase his discomfort.
The disorganized behavior that may occur can range from screaming, rapid speech or violent behavior. For this reason It is essential that we do not yell at him ; We will speak to you calmly, with simple, short sentences that you can easily understand. We won’t try to talk much either, just enough to help you calm down and feel our support.
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6. Call emergency services
As we have already seen, the behavior of the subject who is in an outbreak situation can become dangerous, both for the patient himself and for the individuals around him, for this reason we must act with caution. Likewise, when the subject appears uncontrolled and has lost contact with reality, The best option is to contact the emergency room or mental health professionals so they can intervene.
It will be necessary to schedule the taking of drugs, especially the first days before the outbreak, to try to reduce and control the pathology. Thus, psychological treatment will also be useful, introducing it when the intensity of the symptoms has decreased and the subject can already interact with the professional.
In cases where the situation is overwhelming, it may be necessary to hospitalize the subject for a few days to keep him or her observed and to carry out closer treatment and monitoring. Despite being the best option in situations where great affectation appears and there may be dangerous behavior directed at oneself or others, we cannot force the patient to be hospitalized, we will not force him if we do not obtain his consent.
7. Cooperate so that improvement occurs
One of the options that we have proposed in the event of a psychotic outbreak is the possibility of hospitalizing the subject for a limited period of time. The stigma that hospitalization can have, especially if it is linked to mental health, can cause the individual to resist accepting the proposal. For this reason, We must ensure that he does not see this option as so unfavorable.
We will tell you that in the hospital it will be much easier to treat your symptoms, achieving a speedy recovery and that the length of the hospital stay is not permanent, when improvement occurs and you feel ready you can leave or you can also leave at any time during the day. process if he wishes.
8. Support to continue the treatment
Once the first intervention has been carried out in response to the psychotic outbreak, It will be necessary to maintain treatment, both pharmacological (especially short-term) and psychological, which will persist for a longer time. It is essential that we support you in compliance with treatment and that we collaborate with professionals in everything we can help.
It will be very important to adhere correctly to the treatment and follow the treatment prescribed by both the psychiatrist and the psychologist to reduce the risk of symptoms showing again and another outbreak appearing. So we will have to make sure that you comply with the established doses and that you attend visits with your therapist. In this way, seeing that we support the intervention, it will be easier for them to perceive it as something good.
