Can a psychotic break happen suddenly?
A psychotic break can happen suddenly but with the potential to cause lifelong issues. Learn what a psychotic break is, as well as the symptoms, triggers and treatments, so you can seek help appropriately or recognize risk factors or psychotic episodes your loved ones may be experiencing.
Phases of psychosis
While it's most commonly a feature of a mental illness like schizophrenia, bipolar disorder, or major depression, psychosis can also be triggered by trauma, substance abuse, brain disease or injury, and even extreme sleep deprivation.
People who have psychotic episodes are often unaware that their delusions or hallucinations are not real, which may lead them to feel frightened or distressed.
An episode of psychosis is treatable, and it is possible to recover. It is widely accepted that the earlier people get help the better the outcome. 25% of people who develop psychosis will never have another episode, another 50% may have more than one episode but will be able to live normal lives.
A mental breakdown does not exclude the possibility of psychosis, but a psychotic break refers specifically to an episode of psychosis. Typically, a psychotic break indicates the first onset of psychotic symptoms for a person or the sudden onset of psychotic symptoms after a period of remission.
Often this is linked to extreme stress. But this is not the case all of the time. Your experience of psychosis will usually develop gradually over a period of 2 weeks or less. You are likely to fully recover within a few months, weeks or days.
Psychosis involves experiencing something that is not really happening and having a difficult time distinguishing what is real. The three stages of psychosis are prodome, acute and recovery. Psychotic disorders can last for a month or less and only occur once, or they can also last for six months or longer.
Signs of early or first-episode psychosis
Hearing, seeing, tasting or believing things that others don't. Persistent, unusual thoughts or beliefs that can't be set aside regardless of what others believe. Strong and inappropriate emotions or no emotions at all. Withdrawing from family or friends.
Almost always, a psychotic episode is preceded by gradual non-specific changes in the person's thoughts, perceptions, behaviours, and functioning. The first phase is referred to as the prodrome (or prodromal) phase.
Brief psychotic disorder (BPD) according to DSM-5 is the sudden onset of psychotic behavior that lasts less than 1 month followed by complete remission with possible future relapses. It is differentiated from schizophreniform disorder and schizophrenia by the duration of the psychosis.
Who is at risk for a psychotic break?
Some risk factors include: A brain injury, including a stroke or traumatic brain injury. A family history of schizophrenia, other psychotic disorders, or mood disorders. Dementia, such as Alzheimer's disease.
Antipsychotics can usually reduce feelings of anxiety within a few hours of use, but they may take several days or weeks to reduce psychotic symptoms, such as hallucinations or delusional thoughts. Antipsychotics can be taken by mouth (orally) or given as an injection.

Timely psychiatric treatment can improve not only immediate functioning, but also long-term prognosis. Because untreated psychosis can result in irreversible structural brain damage, clinicians must act swiftly to provide assertive treatment.
Brief psychotic disorder (BPD) according to DSM-5 is the sudden onset of psychotic behavior that lasts less than 1 month followed by complete remission with possible future relapses. It is differentiated from schizophreniform disorder and schizophrenia by the duration of the psychosis.
Psychogenic blackouts are blackouts or fainting spells that occur because of stress and anxiety, not because of a directly observable physical cause. However, just because these psychogenic blackouts have a psychological cause does not mean they are not genuine or faked.
Often this is linked to extreme stress. But this is not the case all of the time. Your experience of psychosis will usually develop gradually over a period of 2 weeks or less. You are likely to fully recover within a few months, weeks or days.
Acute changes in mental status are usually secondary to delirium, stupor, and coma, which are forms of acute brain dysfunction. These changes occur over a period of hours or days and are usually precipitated by an underlying medical illness that is potentially life threatening.
Stress—Intense stress can cause psychosis. In this particular cause, there may be no other conditions or diseases involved. This kind of psychosis lasts for less than one month. Stress can also bring on symptoms in people who are particularly at risk for psychotic disorders.
- talk clearly and use short sentences, in a calm and non-threatening voice.
- be empathetic with how the person feels about their beliefs and experiences.
- validate the person's own experience of frustration or distress, as well as the positives of their experience.
“What we do know is that during an episode of psychosis, the brain is basically in a state of stress overload,” says Garrett. Stress can be caused by anything, including poor physical health, loss, trauma or other major life changes. When stress becomes frequent, it can affect your body, both physically and mentally.
Will I ever be the same after psychosis?
In fact, many medical experts today believe there is potential for all individuals to recover from psychosis, to some extent. Experiencing psychosis may feel like a nightmare, but being told your life is over after having your first episode is just as scary.
- Excessive worrying or fear.
- Feeling excessively sad or low.
- Confused thinking or problems concentrating and learning.
- Extreme mood changes, including uncontrollable “highs” or feelings of euphoria.
Anxiety, panic, depression, post-traumatic stress disorder (PTSD), bipolar disorder, schizophrenia, and others can all fundamentally change how a person perceives and interacts with the world around them. Lastly, addiction can play a large role in these sudden personality changes.
Rapidly progressive cognitive decline is commonly seen in a wide spectrum of conditions varying from vascular, immune mediated, toxic, infective, metabolic, neoplastic, degenerative, drug related, as well as nutritional and degenerative conditions.
References
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