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What is a Psychotic Episode?

Mary McMahon
Updated Mar 03, 2024
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A psychotic episode is a period of psychosis that can last varying amounts of time. Some physicians distinguish between brief psychotic episodes lasting between one day and one month and longer periods of psychosis. This mental health condition can occur in conjunction with an existing condition like schizophrenia, or it may occur independently. A number of causes have been associated with psychosis, from extreme trauma to underlying variations in the chemical makeup of the brain that make some people more prone to psychosis.

People in an episode can experience one or more of the following: hallucinations, thought disorder, and delusions. Hallucinations are sensory experiences that are not grounded in reality, such as hearing, seeing, tasting, touching, or smelling things that are not present. Thought disorder involves disorganized thinking and speech and can express in the form of difficulty with spoken communication, confusion, memory loss, emotional volatility, and rapidly changing moods. Delusions are beliefs that people have difficulty differentiating from reality.

One of the key characteristics of the episode is that the patient experiences a break with reality. People have difficulty separating hallucinations and delusions, believing them to be real, and they may also reject aspects of the real world. This can be traumatic for the patient and can make it difficult for people to communicate with the patient or to provide assistance. Someone who genuinely believes that government agents are planning to attack, for example, may reject attempts at assistance, fearing enemy infiltration.

Psychotic episodes can be emotionally terrifying for the patient and expose people to the risk of suicide and self harm. Treatments include hospitalization to provide intensive inpatient treatment and monitoring, along with antipsychotic drugs and psychotherapy. If the psychotic episode occurs in connection with another psychiatric condition, treating that condition can assist with the management of the psychosis and help the patient make a recovery.

Once a patient recovers from a psychotic episode, the treatment regimen can be adjusted. In patients with a history of psychosis, the goal is to determine what triggered the event and to prevent it from happening again. This could include everything from taking medication for life to prevent chemical imbalances to receiving therapy for trauma to making adjustments to diet and exercise regimens. A psychiatrist usually needs to supervise care for the patient and the patient will need to check in periodically to confirm that the current course of treatment is still effective.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon967465 — On Aug 27, 2014

Am I psychotic because of the torture I endured as a child or am I something else?

By anon348213 — On Sep 14, 2013

@waterhopper: Last night I had a very little to drink and we were just sitting on the couch with a friend when all of a sudden, I started feeling anxious. I got up to use the restroom and according to my boyfriend and friend, I started running around the apartment panicking, with speech that made no sense. I remember feeling like I was in a dream where I could not wake up and was going in and out of reality.

I remember a lot of the feeling but I don't remember some of the things. It lasted about 10 minutes of running around and then I started to snap out of it. I have never had any episodes or psychiatric problems before so I'm a little freaked out. I'm a healthy 22 year old female and I haven't been depressed or anything. Do you know what might have caused this episode and will it happen again? It was very traumatizing.

By anon155012 — On Feb 22, 2011

My late grandmother-in-law (a/k/a Yia Yia) who was born in Greece & although she lived in the US almost 75 percent of her life, was only able to understand Greek. She was hospitalized after surgery to remove a large section of her intestines, and she was put into the Intensive Care Unit.

Her daughter, born in US, but quite adept at translating English to Greek and vice versa spent a great deal of time with her mother in the hospital to help avoid confusion for Yia Yia. Her daughter even made a table of terms that was posted above her mother's bed for speaking to her mother in Greek to let her know what they were doing or needed her to do, when her daughter was not present.

Unfortunately, many of the nurses and attendants did not take the time to tell the grandmother and obtain her understanding of what was going on. Yia Yia developed psychosis while she was hospitalized because so many had "snuck up on her and stuck her with needles unexpectedly". Yia Yia was always spooked, distrustful and got very agitated when anyone other than family members came into her hospital room. She'd launch into an all Greek tirade in direct confrontation with the staff and appeared to trust none of the staff.

After her recovery and return to her home, the problem resolved. Yia Yia was diagnosed as developing ICU psychosis during her hospital stay.

By anon148796 — On Feb 02, 2011

I'm just wondering, in an "episode" could it be possible if they do things and not remember? Like they act possessed? I know someone who carved in the numbers "333" in the wall and then went back into reality and didn't remember.

By WaterHopper — On Sep 27, 2010

@chrisinbama: That’s a good question. ICU psychosis can only be diagnosed in the absence of a known underlying medical condition that could mimic the symptoms of ICU psychosis. There has to be an extensive medical assessment done to search for any other causes for the behavior. Some of the things that are checked for are: stroke, low blood sugar, alcohol or drug withdrawal or any other medical condition that could cause the symptoms. Even sleep deprivation can be a cause of ICU psychosis.

After it is determined that ICU psychosis is the answer, treatment can begin. Familiar objects and the presence of family members sometimes help. Many of the patients are treated with haloperidol.

By chrisinbama — On Sep 27, 2010

@waterhopper: How do you diagnose ICU psychosis? I mean, how do you know it's not just a reaction to a medication or something?

By WaterHopper — On Sep 27, 2010

@medicchristy: I work as an ICU nurse and there is actually a condition called ICU psychosis. It is similar to a regular psychotic episode except that it happens while the patient is in ICU. Some of the symptoms of ICU psychosis include: anxiety, extreme excitement, hearing voices, clouding of consciousness, hallucinations, nightmares, paranoia, disorientation, agitation and delusions.

It is a temporary psychotic episode. The onset is rapid and can be very upsetting and frightening to the family members and the patient.

By medicchristy — On Sep 27, 2010

I have heard of something called ICU psychosis. To me, that doesn't sound real. Does anyone know if that actually exists?

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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