Psychotic disorders are serious mental illnesses in which the person loses contact with reality. One of the characteristic symptoms of this type of psychopathology is the appearance of psychotic breaks (hallucinations and delusions).

A psychotic break is a temporary rupture of reality , and during this period of time the person who suffers it does not distinguish whether what happens to him or her is real or fictitious. Images or thoughts appear in his or her mind as if everything were authentic. They may think that the whole world is against them and they want to kill themselves, or on the other hand, they may hear voices inside them telling them that they should kill themselves.

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

Psychotic break: who can suffer 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 break. In diseases such as schizophrenia or paranoid disorder it is possible that, if the patient is not medicated, several psychotic outbreaks may occur throughout his or her life.

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 following a very stressful emotional situation or the use of drugs such as marijuana or hallucinogens.

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Symptoms

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

However, there are certain signals that can indicate this type of behaviour :

  • Individual exhibits socially isolating behavior , and may stop going to work or school
  • Changes in dress and habits , as well as a neglect of appearance and hygiene.
  • The person shows a disorganized behavior , unusual, which seems meaningless, strange and extravagant.
  • Presents strange ideas that don’t seem to have any relation with reality. Even if you don’t share these kinds of thoughts with everyone, you may tell some people close to you about them.

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 usually manifest themselves in the delusional or paranoid disorder, while the latter are typical of schizophrenia.

But what exactly makes them different? Delusions are false beliefs. That is, mistaken 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, they may walk through a shopping mall and believe that people passing by are spying on them and then giving the information to the police.

On the other hand, hallucinations are false perceptions, like hearing, seeing or feeling something that doesn’t 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 him or her through the electrical outlets in his or her home.

Treatment

When a person suffers a psychotic break he/she needs immediate treatment . Since this is a serious disorder, the patient is usually admitted so that he or 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 the patients, but family members can also benefit from psychological help to cope with this situation. Psychotherapy is useful in providing information, tools and support in these cases.

In some cases (e.g., substance-induced psychotic disorder), the patient does not experience psychotic breaks in his or her life again . 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-term type of psychotic disorder, while a psychotic break is an acute manifestation that has a short duration. The psychotic break is considered a positive symptom of schizophrenia.

Do you want to know more about the different psychotic disorders that exist? In our article “The 8 types of Psychotic Disorders” you will find information about their characteristics.

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.