How to Act During a Psychotic Episode, According to Experts – November 6, 2025 – Balance
Psychotic episodes can be frightening, but understanding how to respond canโค substantially improve safety and facilitateโ appropriate care. Experts emphasize a calm, supportive approach focused on de-escalation and professional help. While not all psychotic conditions involve โaggression, knowing how to โreact โคif it does โoccurโฃ is crucial.
Isโข Aggression Common During Psychotic Episodes?
According to doctors, agitation and aggression aren’t alwaysโค present in psychotic conditions. However, in the most severe cases – acute psychotic episodes – a โขpatient experiencing intense delusions may act on those beliefs.
Detecting theโ Onset of a Psychotic Episode
A โpsychotic break rarely happens suddenly, except in cases involving drug use.โฃ For โฃconditions like โbipolar disorder orโ schizophrenia,the onset typically unfolds over a few days. This โtimeframeโ allows for observation โฃof behavioral changes.
In individuals with bipolar โdisorder experiencing mania, signs can include accelerated speech and activity, and a reduction in sleep. “She feels more powerful, she starts to think she is more thanโฃ she really is,” explains a psychiatrist. Its also crucial to determine if a patient has stopped taking prescribed medication, as this can trigger an episode. In all cases, contacting the patient’s healthcare professional before the situation escalatesโ is recommended.
What to Do If You Witness a Psychotic โคEpisode
If a patient becomes aggressive, avoid beingโ aloneโ with them while they are agitated. if the individual has a known diagnosis, “you will quickly seek medical help,” advises aโฃ psychiatrist. If theโค patient’s โpsychiatrist is unavailable, or โคthe situation isโค urgent, call Samu (Brazil’s emergency โmedical service).
The patient should be taken to theโ emergency room for immediate care, where โฃthey can be medicated to calm them and manage agitation or aggression.
Maria Fernandaโ Caliani, a specialist in Cognitive-Behavioral Therapy from USP, stresses prioritizing the safety of everyone โinvolved. “The ideal is to remain calm, avoid โarguments or attemptsโ to convince as at this point no logical argument will make sense, the critically important thing here is to seekโ professional โฃhelp promptly,” she explains.
she cautions against attempting physical โrestraint without proper training or support,โค as this could worsen the situation.Instead, a receptive attitude, a โฃcalm tone of voice, and โthe presence ofโ a โขtrustedโค person can be helpful while waiting for professional assistance. “Reception,โ a calm tone of voice and the presence of โsomeone you trust make a difference until the specialized team arrives,” she adds.
Is Hospitalization Appropriate?
Brazil’s Psychiatric Reform Law (Law 10,216/2001) prioritizes treatment in freedom, close to family and community, minimizing โhospitalization. โขHospitalization should only be considered whenโข there is โa genuine risk โฃto the patient’s life or the lives of โothers, โand โฃwhen outpatient treatment options are insufficient.
Dr.Caliani emphasizes that hospitalization โis a phase of intensive care and should always be accompanied by a follow-up and reintegration plan. “the focus is to treat, protect and restore autonomy,” she says.
