What should I do if my relative has an acute psychotic episode?

During an acute psychotic episode, accept the fact that the person is in an "altered reality state". In extreme situations the person with psychosis may "act out" hallucinations, e.g., shatter the window to destroy imaginary snakes. It is imperative that you remain calm. It is also imperative that your relative get medical treatment. While waiting for medical help to arrive (or before attempting to take your relative to the hospital) the following suggestions may prove helpful:
  • Remember that you cannot reason with acute psychosis.
  • Do not express irritation or anger.
  • Don't threaten. This may be interpreted as a power play and increase assaultive behavior by the person.
  • Don't shout. If the psychotic or depressed person seems not to be listening, it isn't because he or she cannot hear. They are probably experiencing traumatic internal feelings.
  • Don't criticize. It will only make matters worse; it cannot possibly make things better.
  • Don't squabble with other family members over "best strategies" or allocations of blame. This is no time to prove a point.
  • Don't bait the person into acting out wild threats; the consequences could be tragic.
  • Don't stand over the person if they are seated. Instead, seat yourself.
  • Avoid direct, continuous eye contact or touching the person.
  • Comply with requests that are neither endangering nor beyond reason. This provides the person with an opportunity to feel somewhat "in control".
  • Don't block the doorway. However do try to keep yourself between your relative and an exit.
  • Decrease other distractions immediately, turn off the TV, radio.
  • Express understanding for what your friend or relative is going through.
  • Speak quietly, firmly and simply.
  • Should the psychotic episode involve violence, there may be no time for all the above strategies. Do not hesitate to call the police. When you call, tell them that your relative is psychotic. Explain what you are experiencing and that you need the help of the police to obtain medical treatment and to control the violent behavior. Instruct the police not to brandish any weapon. If you are alone, be sure to contact someone to come and stay with you until the police arrive. The doctor who has been involved with the care of your relative should be advised of the situation as soon as possible.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.