How to recognise when someone is having a psychotic break

Kate Ng
·Trending Lifestyle Reporter
Updated ·6 min read
Katie Melua recently opened up about suffering an acute psychotic breakdown in her 20s. (Getty Images)
Katie Melua recently opened up about suffering an acute psychotic breakdown in her 20s. (Getty Images)

Being there for a loved one who is going through a hard time mentally is more important than ever, but it can become especially difficult to know what to do if they are going through more severe issues, such as psychosis.

Recently, Katie Melua opened up about suffering an acute psychotic breakdown that forced her to step away from her music career temporarily and led to her spending six weeks in hospital. Speaking on the Origins With Cush Jumbo podcast, Melua, 40, said that the psychotic episode was triggered by the pressures of being in the music industry and constant touring.

"I was hospitalised for six weeks. [I] had to go on medication. I had a really great doctor looking after me, and then my family were incredible because… from the age of 19 to 26, they kind of didn’t really see me a lot because I was just so busy with work," she explained. "And then suddenly at 26, their kid who they sort of allowed to leave the nest is now back with a broken mind. [It] was a bit of a shock to them."

The NHS describes psychosis as "when people lose some contact with reality". Experiencing symptoms of psychosis is often referred to as having a psychotic episode or breakdown.

Young man listening attentively to a friend while meeting in a house. Friendship and support concept.
You may see certain behaviours in a friend or family member who is experiencing psychosis. (Getty Images)

A person going through a psychotic episode may these three main symptoms:

They hear, see, and in some cases, feel, smell, or taste things that do not exist outside their mind. These hallucinations can feel very real to the person affected by them.

They have strong beliefs that are not shared by others, such as conspiracy theories.

Their thoughts and ideas come very quickly, making their speech confusing and difficult to keep up with or understand.

But how do you know if someone you love is going through a psychotic episode? They may exhibit the following behaviour:

  • Mention hearing voices or seeing things that you don’t hear or see, because they only exist in the affected person’s head

  • Mention experiencing tastes, smells or sensations that have no apparent cause and that only they are experiencing

  • Start spending a lot of money or taking on a lot of debt because their sense of reality has been affected

  • Start behaving as though they are being threatened or in danger, because they believe something or someone is trying to control, harm or kill them without reason

  • Speak very quickly and be difficult to understand because they are stumbling over their words or moving from one topic of conversation to another very quickly

Females couple with relationship difficulties.
A person going through psychosis may have certain mental health issues, or may have gone through certain experiences. (Getty Images)

Psychosis is often linked to specific mental health conditions, such as:

  • Schizophrenia

  • Bipolar disorder

  • Severe depression

It can also be triggered by:

  • A traumatic experience

  • Stress

  • Drug misuse

  • Alcohol misuse

  • Side effects of prescribed medicine

  • A physical condition, such as a brain tumour or dementia

  • Head injury

  • Childbirth

Treatment for psychosis can depend on the cause, but usually involve a combination of antipsychotic medicine, talking therapies and social support. Some people have to take antipsychotic medication on a long-term basis, sometimes for the rest of their lives, while others may be able to gradually reduce their dosage and stop taking them altogether if their symptoms improve significantly.

However, people affected by psychosis should never suddenly stop taking any prescribed medicines, as this could trigger a relapse of their symptoms.

According to mental health charity Mind, there are a few things you can do to try and help someone you care about who is experiencing psychosis - even though it can be hard to see.

Their tips include:

Staying supportive and calm can help your loved one feel able to talk about their feelings and experiences. Mind suggests listening to them and asking them what would help.

You may not know how to respond when someone sees, hears or believes something you don’t, which is understandable. However, avoid confirming or denying their experience, and instead, try: “I understand that you see things that way, but it’s not like that for me.” This can bring the focus on how the person is feeling about what they are experiencing.

Ask them if they would like any practical help, such as help with accessing a particular service or acting as an advocate for them.

Two women sitting in armchairs and talking. Woman psychologist talking to patient woman. Coach giving hands to smiling woman. Therapist's gestures. Female talking in coworking office
If you are worried a friend or family member is experiencing psychosis, there are some things you can do to help. (Getty Images)

Don’t try and make decisions without or for them, as this can make things worse for the affected person - even if you think you know what’s best.

This can help the whole family understand what the affected person is going through and identify what is helpful and unhelpful for them and for you. Mind recommends asking your GP if this is available in your area.

During periods when your loved one is feeling well, it can be a good idea to discuss a plan for how you can help them if a crisis arises. This can include planning practical things like treatment and hospital visits. You can also use this time to state clearly what you feel you can and can’t support them with during a crisis.

It can be distressing or frightening to see someone you love going through psychosis. You can get support for yourself reaching out to friends and family, or contacting mental health services.

If you are worried that your loved one is becoming very unwell or experiencing a mental health crisis, you can suggest that they use their crisis plan, if they have one.

The NHS also advises contacting a GP for them, or their mental health worker if they are receiving support from a mental health service.

If you think their symptoms are severe enough to require urgent treatment and could be placing them as possible risk, the NHS suggests:

  • Taking them to the nearest A&E, if they agree

  • Calling their GP or local out-of-hours GP

  • Calling 999 and asking for an ambulance

In severe cases, they may have to be admitted to a psychiatric hospital for treatment.

For support, you can contact Mind for information and support on 0300 123 3393 or email the charity at info@mind.org.uk.

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