If you know a person around you has a history of psychotic episodes, seek hints. Common behaviors in the days before a psychotic episode include: depression or irritability, alternating between inactivity and hyperactivity, and preoccupation with certain ideas, or social withdrawal. Pay attention to what the person’s triggers are—if they’re especially stressed, for instance, or if they aren’t eating well, it might increase their chances of having a psychotic episode. [2] X Expert Source Noel Hunter, Psy. DClinical Psychologist Expert Interview. 18 December 2020.
If you respond to the psychotic episode with fear and anxiety, it could further trigger the psychotic individual and worsen their experience. Ask if there’s something wrong, and if they respond, try to get them to describe what they’re experiencing. Say something like, “I’m not sure what you’re experiencing, can you try to describe it to me?”
Ask the individual going through this psychotic episode if they’ve had episodes like this before. Find out what helped previously, and repeat that treatment as much as possible. [5] X Research source You may also want to ask if the person has taken any non-prescription drugs. For example, if the person has taken a hallucinogen such as LSD, then this would help to explain their behavior.
Children may be scared, curious, or needy, and could upset the person who is having the episode. You can give them a job to do, like “call Dad and tell him to come help Mom” or “take your sister to the park, and wait for me to call or come get you. " If the person is severely distressed and could become aggressive, take special care to get vulnerable people (such as children, elderly people, and disabled people) away. If possible, try offering to take the person somewhere nearby where they feel calm. For example, if your aunt loves the outdoors, you could take her to the yard, or if your little brother feels safe in his room, you could ask if he’d like to go there with you. However if you are not positive that the person is able to maintain safety for others and themselves, it is not safe for either of you to be alone together and it is time to call for help.
If you don’t know the person having the episode or don’t know them well, then call for help right away. They may have a friend or family member nearby who is better equipped to assist them.
A history of drug and alcohol abuse increases the likelihood of the person becoming violent.
If you’re in a room with an aggressive person, leave the room immediately. If police arrive on the scene, try to explain the situation before they interact directly with the person experiencing the psychotic episode. Without interfering and endangering yourself or others, encourage officers to remain calm and resolve the situation without the use of force. [7] X Research source
If they ask why you are holding something dangerous (e. g. a knife), say “I’m putting it away. " If someone is prone to psychotic episodes, it may be appropriate to keep sharps/potentially dangerous items locked. Speak to the individual calmly, and try to de-escalate the situation. If the psychotic individual is asking for things or making demands, comply with those that are safe and reasonable. [8] X Research source
Your main priority should be keeping yourself and others safe. If you can do things to protect the psychotic individual (e. g. removing a knife from a nearby table top), make sure to keep yourself safe while doing so.
Ask them questions, and if their mind seem to be drifting, try to grab their attention. Make sure to reassure them and let them know that you are there for them.
Instead of, “I hear the same voices too,” try saying “I don’t hear those voices, but I can tell they are bothering you. ” It’s best not to directly contradict the person and tell them whatever they’re believing is untrue. That might make them feel angry and unsafe, which will cause them to retreat further into whatever they’re experiencing. [12] X Expert Source Noel Hunter, Psy. DClinical Psychologist Expert Interview. 18 December 2020.
“I can’t imagine what you are going through, but I’m happy to listen. ” “I don’t fully understand what you’re going through, but I understand it must be really difficult. ” “Is there someone you trust that I can call for you?"[14] X Expert Source Noel Hunter, Psy. DClinical Psychologist Expert Interview. 18 December 2020. “What can I do to help you feel safe right now?"[15] X Expert Source Noel Hunter, Psy. DClinical Psychologist Expert Interview. 18 December 2020.
Seeing a doctor is important. Psychosis may be a sign of temporary stress (such as grief or sleep deprivation), but it could also be a sign of a mental health disorder, or a physical health problem that causes psychosis. Mental-health professionals will be able to help the person take steps to decrease the frequency and severity of their episodes. Make sure that the person has somewhere to go to get help after the episode. If they do not, then help them to find help. Things like self-care, stress management, and counseling can make a large difference to the person’s mental health. [17] X Research source
If the person is a loved one, follow up with them as well. Make sure they’re safe and healthy. As long as you don’t downplay the importance of their own experience, you can tell them about your experience of their psychotic episode and why it was difficult for you as well. Make sure not to criticize them or pass judgment about their experience. It is important to avoid making them feel bad about their behavior or to make them worry that they might have scared you away. They need to know that you don’t blame them for their illness, and that you still care.
