When a subject experiences a psychotic attack, a break with reality occurs in his mind; experiences unusual perceptions, ideas or behaviors. Too, usually the individual also has a decreased awareness of the pathology.
Before the expression of the first symptoms of the psychotic attack, it is possible to observe certain different behaviors in the subject, such as an increase in social isolation, a decrease in self-hygiene or an increase in the suspicion of distrust. . If we perceive these signs that anticipate the presentation of the disease, 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 with a person who suffers from a psychotic attackpromoting their recovery and minimizing risks and dangerous situations.
What is a psychotic crisis?
We understand the psychotic epidemic as a psychiatric disorder characterized by a temporary break with reality; the subject ceases to perceive or interpret the environment or his inner 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 (eg related to psychotic disorders).
Although there may be an internal predisposition (i.e. the individual is more likely to develop a psychotic flare), environmental conditions that precipitate the flare are usually necessary, such as experiencing a stressful situation or a decrease or increase in stimulation.
Characteristic symptoms of a psychotic attack
The onset of the epidemic does not usually occur abruptly. It is common to observe behaviors before the onset of the main symptoms of the psychotic episode, and the patient himself notices changes in himself which serve as an indicator of the next flare.
Some of these prior behaviors, also called prodromal period, they are: strange ideas, which move away from the usual thought; suspicion (detects bad intentions in others); decreases hygiene and personal care; he isolates himself and separates himself from his environment; and disorganized behavior (tired of the predisposition to act in unusual ways).
When the outbreak is already present, actual psychotic symptoms, such as hallucinations, will be displayed, which consist of perception by the senses without real stimulus; delusions (false beliefs of the subject); psychomotor inhibition, disorganized thinking and language. This symptomatology can present different degrees of intensity, being able to require the hospitalization of the patient.
We must bear in mind that in most cases the subject shows little or no awareness of the symptoms of affectation, a situation that we know in psychology as anosognosia. The individual He truly believes that what he perceives or the thoughts and ideas he has are adjusted to reality and that there is indeed an external stimulation or a real cause which explains these sensations.
What to do with a person who suffers from a psychotic crisis?
Given the type of symptoms and the variety with which they can manifest, we need to support and help the person with psychotic symptoms as much as possible. It will be crucial that we take action to maintain control of the situation and prevent further damage or injury to others.
1. Behave calmly
At the onset of a psychotic attack, where the situation can be altered, It is crucial not to lose your temper and to be calm. In this way, it is easier to transmit this sensation to the subject who manifests the symptoms and we help to reduce his state of activation. Likewise, tranquility also allows us to act in a more organized way and being able to make more appropriate decisions, it will be easier for us to react.
2. Look for a quiet environment
As we have seen, stressful or overly stimulating situations can lead to psychotic symptoms. For this reason, in the event of an epidemic, we must take the subject to a calm environment, so that it is easier for him to calm down or at least the symptoms do not increase.
It will be better to avoid crowded places, trying to separate them from the crowd for more control. If possible, it is recommended that there are two people to be able to support it and have more capacity to act in front of the different circumstances that may arise.
3. Help the subject as much as you can
Another strategy that can be useful to help calm and promote the person’s state is to stay close to the subject, to act on what he does not say and to ask us until he can this is dangerous behavior. We’ll stay close so you can notice our presence, but we’ll avoid touching him or looking him directly in the eye, as these behaviors can further alter him. It’s best to sit next to him and try to come between the subject and the door, but don’t completely block the exit..
4. Be understanding
We must be aware of the situation in which the subject presents the epidemic, the behaviors shown do not execute them intentionally, that is, is in a situation of mental disorder in which he is not fully aware of his behavior, thus diminishing the responsibility it has for its 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 epidemic has diminished, it is also essential that we empathize and act by emotionally supporting the subject.
5. Communicate easily with the subject
Since the subject is already nervous, we must make sure that our reaction does not further increase his discomfort.
Disorganized behavior can range from yelling, speed-talking, or violent behavior. For this reason it is essential that we do not yell at him; we will talk to you calmly, with simple and short sentences that you can easily understand. We won’t try to talk too much, just enough to help you calm down and feel our support.
6. Call the emergency services
As we have already seen, the behavior of the subject who finds himself in an outbreak situation can become dangerous, both for the patient himself and for the individuals around him, which is why we must act with caution. Similarly, when the subject is out of control and has lost touch with reality, the best option is to contact the emergency room or mental health professionals so that they can intervene.
It will be necessary to guide the taking of drugs, in particular in the first days before the epidemic, to try to reduce and control the pathology. Thus, psychological treatment will also be useful, introducing it when the intensity of the symptoms has diminished and the subject can now 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 under observation and to carry out closer treatment and follow-up. Although this is the best option in situations where there is great affect and where there may be dangerous behavior towards oneself towards others, we cannot force the patient to be hospitalized, we won’t force him if we don’t get his consent.
7. Cooperate for improvement
One of the options we have considered for a psychotic flare is the possibility of hospitalizing the subject for a limited time. The stigma that hospitalization may have, especially if related to mental health, may cause the individual to be reluctant to accept the proposal. For this reason, we have to try not to see this option as unfavorable.
We will tell you that in the hospital it will be much easier to treat your symptoms, get a quick recovery, and the length of hospital stay is not permanent, when improvement occurs and you are ready, you can leave or you can do it anytime deal if he wants.
8. Accompaniment to follow treatment
Once the first intervention has been performed for the psychotic outbreak, it will be necessary to maintain treatment, both pharmacological (especially short-term) and psychological, which will persist longer. It is essential that we help you stick to the treatment and show you how to work with the professionals in whatever way we can to help you.
It will be very important to properly adhere to the treatment and follow the treatment prescribed by both the psychiatrist and the psychologist to reduce the risk of symptoms returning and another flare-up. We will therefore have to make sure that you respect the established doses and that you go to the visits with your therapist. This way, seeing that we support the intervention will make it easier for you to see it as a good thing.