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What to Do for a Psychotic Episode: Understanding How You Can Help Your Loved Ones

what to do for a psychotic episode sun columbus

In 2021, 478,000 Ohioans had a severe mental health disorder. At SUN Behavioral Health Columbus, we know that having severe mental health conditions can result in a higher risk of terrifying and confusing symptoms for your loved one. We understand how seeing them dealing with symptoms of psychosis can leave you feeling helpless. 

We’ve helped many families through situations such as these, and one question we know many people have is what to do for a psychotic episode. Today, we are going to discuss what a psychotic episode is, how you can prepare for one to happen potentially, and how you can help your loved one during it.

Understanding What a Psychotic Episode Is

In the United States, approximately 100,000 people have at least 1 psychotic episode every year. Anything from sleep deprivation to trauma or substance use can trigger a psychotic episode, regardless of a person’s mental health history. 

Psychosis isn’t just a single symptom, but rather a collection of symptoms that involve a disconnect from reality. 

The most common symptoms of psychosis are delusions and hallucinations. Delusions are false beliefs that a person has. Hallucinations are things that the person sees or hears that other people do not. They might also seem to have incoherent speech, or their behaviors may appear inappropriate for what is going on around them. They may seem confused or have unpredictable behaviors that could lead to them harming themselves or other people. 

The Early Psychotic Symptoms: Spotting the Warning Signs of Psychosis

The changes to a person's behavior will begin before a psychotic episode occurs. They might have emotional concerns, a lack of motivation, and an inability to function. Other common warning signs for psychosis include:
  • Concerns with thinking logically or clearly
  • Unusually intense ideas
  • Strange feelings
  • Lack of emotions
  • Reduced sleep time
  • Decline in self-care
  • Unable to distinguish what is real
  • Feelings of suspiciousness or uneasiness with others
  • Having paranoid thoughts
  • Spending a lot of time alone
  • Difficult time communicating with others
  • Drop in school or work performance
understanding what a psychotic episode is

What Can You Do to Prepare for Psychiatric Emergencies?

The best thing you can do to avoid feelings of panic is to have a plan for a psychiatric emergency, much like one would have a plan for a fire in the house, or a tornado. If you or your loved one has recently been diagnosed with a condition that might lead to psychiatric episodes, these plans can be especially important. 

Keep in mind that not everyone who has been diagnosed with a condition that might come with psychiatric episodes will experience one. But knowing what to do in case one happens can keep you and your loved one safe. 

Wellness Recovery Action Plans

Sometimes called crisis plans, these are specific plans or lists that give you and your loved one the exact information to keep everyone safe if a psychotic episode happens. This plan can be created with your healthcare professional and your loved one. Keeping your loved one involved in this planning ensures they are comfortable and on board with the decisions. They can also provide insight into what they believe might be helpful for them during one of these episodes. You can also share it with family and friends so they know what should be done during a crisis. Plan to keep multiple copies of this plan in various locations such as the kitchen, phone, bedside table, safe, and glove compartment. This ensures that it remains safe and easy to access whenever needed. Some things that should be included in this plan include:
  • Names and phone numbers of healthcare providers
  • Names and numbers of family and friends who would be helpful in a crisis
  • Addresses of 24/7 crisis care facilities (900 E Dublin Granville Rd, Columbus, OH, 43229). These should be places you do not have to call ahead of time
  • Crisis line numbers
  • Your personal address and phone number
  • Record of previous psychosis episodes
  • Triggers
  • Things that have helped in the past
  • Your loved one's diagnosis and medications
  • If they have a history of substance use

Psychiatric Advance Directives (PAD)

In Ohio, this is known as a Declaration for Mental Health Treatment. This is a legal document that allows a person to appoint a trusted individual to make mental health decisions in the event they are unable to make those decisions themselves, such as in the event of a psychotic episode. It specifies who is allowed to make these decisions, when and how they can be made, what specific rights and actions the person making those decisions can have, and protects that person from liability. 

Any other power of attorney cannot override this legal document. The only thing that can override a mental health declaration is if the person has a living will, which is a document outlining treatment at the end of one's life. 

This document does not last forever, and the person is not bound to it for life. It expires every 3 years and requires renewal. However, the person can still revoke the document before then if they can mentally consent at the time they wish to revoke it. If you have any questions, contacting a legal professional is always a safe idea. 

4 Easy Steps to Help a Loved One With a Psychotic Episode

So, how should you respond during a psychotic episode? Amidst it, it feels frightening, overwhelming, and helpless. Other people may have provided suggestions already that lead you to wonder about the right option. Ultimately, each individual is different and requires different things to help. Discussing those needs in the plans mentioned above gives you a better understanding of what your loved one might need in these moments. 

But let's assume they are experiencing a psychotic episode, and no plans have been made. What should you do? 

Step 1: Remain Calm and Observe the Situation

The first thing you should do in this situation is to remain calm and avoid nervous behavior. This includes not shuffling your feet, making sudden movements, or fidgeting. You should also examine the situation and determine what risks are involved. 

One potential risk is suicide. If they are at risk of suicide, get them help as soon as possible, safely and calmly.

Step 2: De-Escalate the Situation

De-escalation involves not making threats towards the person, even if they are making threats toward you. Do not raise your voice or talk too fast, as this may be interpreted as a threat. They also might not be able to understand you amidst the delusions and hallucinations they are overwhelmed by. 

If they act aggressively toward you, do not respond with aggression or discipline. It will only worsen the situation. Do not try to restrain them. Pacing around the room may be helpful for them and restricting their movement can make them feel trapped. 

You can involve authorities in the instance where you feel unsafe or unable to provide adequate help  It is best, in most cases, to not utilize 911 as they are often not equipped to deal with a full psychotic crisis. Instead, here in Ohio there is a Crisis Lifeline for mental health and addiction – 988.

Step 3: Calmly Express Concern About Behaviors

Communicate with your loved one in clear, short, simple sentences. Keep your voice low and natural as you explain your concerns and how you want to keep them safe. If they ask questions, remain calm and answer honestly. 

Do not dismiss, argue, laugh, or minimize the person or any delusions and hallucinations they might have. These are real to the person experiencing them. Likewise, it is not advised to act horrified, embarrassed, or alarmed at the delusions or hallucinations they are experiencing.  

If they make a request, comply unless those requests are unreasonable or unsafe. This allows your loved one to feel like they are in control, which will prevent further agitation. The main point is to keep yourself and the other person safe. Help may be needed, but ensure everyone is on the same page as you discuss how to get them to help. 

Step 4: Offer Non-Threatening Options

Many available options are non-threatening. For example, if you have a space in your house where you can guarantee they will not harm themselves or another person if you leave them alone. In this case, it might be an option until you can get help or get them to a crisis care center. 

We understand that this is not always an option for many people experiencing a psychotic episode. Threats and warnings from the person you are trying to help may occur and should be taken seriously. Calling a crisis care center or 988 provides you with people who are experts in keeping loved ones safe every day. Remember that this can make things more stressful for the person with the episode and should only be done if you don't have another option.

Where to Go for Emergency Psychiatric Help for Psychotic Symptoms

While emergency rooms (ER) appear logical, they are not the best equipped for mental health emergencies. Studies show that people who go to the ER for mental health emergencies stay 42% longer than other patients. They also had a higher chance of being admitted into an inpatient setting or transferred to a different hospital if they didn't have the space or resources. If your loved one has any serious injuries as a result of their psychotic episode, then you should still go to the ER. 

24/7 crisis care centers are an excellent alternative for psychiatric emergency help. These centers relieve the pressure on ERs and have the proper staff, resources, and tools to ensure your loved one remains safe and receives help. Not every crisis care center is open 24/7, and a psychotic episode can happen at any time. This is why it is essential to put a 24/7 option on your plans, so you have a place to go no matter the day or time a psychiatric emergency occurs.

the early psychotic symptoms spotting the warning signs of psychosis

What Should You Do if Someone With Psychotic Symptoms Refuses Treatment?

Your loved one, while experiencing psychotic symptoms, may refuse treatment. Ultimately, you can't force your loved one to attend or even participate in receiving help unless they are at risk of harming themselves or other people. They are their own person who can make decisions for themselves. Many times, even if they see that they need help, they might refuse out of fear and confusion. 

Do not blame, shame, or threaten your loved one. This may result in resentment or an unwillingness to seek help. Instead, calmly explain to your loved one how mental health treatment will help find healing and clarity. These conversations may need to happen more than once, so be patient.   

Involuntary Commitment: Does My Loved One Meet the Criteria?

The exception to this is a law in Ohio known as involuntary treatment for mental illness. This is a law that requires someone to attend therapy for a mental health disorder under two possible legal processes. The first one is emergency hospitalization, which is only used by health professionals and law enforcement officers in the event of an emergency. The second is judicial hospitalization, which can be utilized at any time by the court, family, or friends. This requires court hearings and lawyers. To read more about this law, click the link above. To qualify for this type of legal process, the person must fit into at least 1 of the following 5 categories:
  • There is a risk of physical harm to self due to threats
  • There is a risk of physical harm to another person due to threats
  • There is a risk of physical harm to self because they are unable to provide for their basic physical needs due to their mental health disorder
  • There is evidence their mental health disorder might be a risk to the rights of others or themselves
  • There is evidence the person will not survive without supervision, is unlikely to participate in needed treatment voluntarily, or has a history of not complying with past treatment

Find Mental Health Help in Columbus, OH

Seeking mental health help can be terrifying and uncertain for both the individual and their loved ones. However, during the no-cost care assessment, you will meet with a specialist who can answer your questions and work with you and your loved one to determine the best treatment plan for them. They will consider your loved one's past and current symptoms and their doctor's recommendations to provide them with a clear path to a healthier life. 

SUN Behavioral Health Columbus solves unmet needs in Ohio. We stabilize mental health for the Columbus area's children, adolescents, and adults. Call us today at 614-706-2786 to learn more about our psychiatric services. 

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900 E Dublin Granville Rd
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