Understanding Psychotic Breaks

When you hear the phrase “psychotic break,” what comes to mind? Probably nothing good. In everyday conversation, the phrase carries a negative meaning for many because it’s perceived as a harsh and abrupt disconnect or “break” from reality—though it is more accurately described as an episode of psychosis.

Carlos Larrauri, for example, describes his experience with psychosis as more of a gradual decline, as opposed to a “break” occurring during a single event. His behavior deteriorated for a year, though he recalls warning signs as early as two to three years prior. He was in his first year of college when he noticed changes in his mental health: “I couldn’t do routine assignments,” Larrauri noted. “I stayed up all night talking to myself and had trouble concentrating.” His behavior worsened as he isolated himself, stopped showering, ate out of trashcans and picked cigarettes up off the floor.

Rather than seeing psychosis as something that out-of-the-blue one day “breaks” or “snaps,” it’s important to realize that possible warning signs can occur along a continuum of time. The problem is, people often don’t recognize psychosis until an individual reaches a point of crisis.

So, What Should I Look For?

“Psychosis can look different for many people,” says Chantel Garrett, founding director of Partners for StrongMinds (P4SM). “[But] early in the development of psychosis, a person tends to withdraw from their family and social networks.” Garrett notes other early signs can include:

• Difficulty sleeping
• Difficulty reading or comprehending what someone is saying
• Seeing shadows or flashes of light
• Hearing ringing or voices
• Smelling or tasting things that others can’t

There are additional early warning signs to look out for, especially among adolescents. In the U.S., 100,000 young people experience psychosis each year. Psychosis is a symptom and therefore temporary; however, if not treated early, it may develop into more intense experiences, including hallucinations and delusions. Psychosis can also be a sign of a mental health condition, such as schizophrenia or bipolar disorder.

What Causes Psychosis?

Many factors can lead to psychosis, including genetics, trauma, substance use, physical illness, injury or mental health conditions. However, we are still discovering why and how psychosis develops. “What we do know is that during an episode of psychosis, the brain is basically in a state of stress overload,” says Garrett.

Stress can be caused by anything, including poor physical health, loss, trauma or other major life changes. When stress becomes frequent, it can affect your body, both physically and mentally. “When a brain can no longer effectively process a certain level of stress, the processing of information and emotions is impacted, resulting in trouble perceiving reality,” explains Garrett.

Thus, it is very important to listen to our bodies so we can properly manage our stress. However, even with properly managing stress, some people will still experience psychosis.

How Can I Support Someone Who May Be Experiencing Psychosis?

Being supportive and persistent in helping a loved one find the right treatment can make a world of difference for someone experiencing psychosis.  Larrauri explains his journey to recovery was largely due to his friends, family and academic community. In college, a trusted friend notified his mother that something was “going on” with her son. Soon after, his mother arranged a meeting with him and his thesis advisor. After being reminded by his thesis adviser that he was not required to disclose anything private, Larrauri insisted on full disclosure while away at college.

“With all due respect, I have a Cuban mother. I’ve never had privacy,” Larrauri recalls telling his advisor. He knew his health was at risk. Over the next few years, his family played a key role in his recovery. Larrauri’s mother took him to several doctors until he finally received the correct diagnosis of schizophrenia. His father helped him enroll in classes part-time to encourage structure and develop coping skills. Today, Larrauri is in graduate school pursuing a career as a psychiatric nurse practitioner.

“People have maintained high aspirations for me,” adds Larrauri. “I’ve gone from someone who was seeking help to someone on the NAMI Miami Dade County board of directors. People recognize NAMI as a bridge builder in the community. We need to focus on early intervention,” he says. It’s a game changer for people experiencing early psychosis.

Want to learn more about how NAMI is getting involved with early intervention programs across the country? Register for the Schizophrenia Research Forum’s webinar on March 22 featuring Andrew Sperling, NAMI’s Director of Federal Legislative Advocacy. (Registration closed)