How Long Does a Psychotic Episode Last?

What Is a Psychotics Episode?

A psychotic episode occurs when someone loses contact with reality, perceiving things that don’t exist.

What does a psychotic episode look like? Well-known symptoms include:

• Visual, audio, or olfactory hallucinations.
• Delusions: firmly believing something that’s contradicted by all objective evidence (e.g., “I’m being stalked by extraterrestrials,” “I’ve swallowed a horse,” “That movie contains coded messages for me,” “I can levitate off the ground anytime I want”).
• Incoherent speech.
• Talking to people who aren’t there.
• Behaving in wildly inappropriate ways (e.g., stripping off clothing in public, becoming violent without reason).

However, there are also milder symptoms that may not come to mind immediately when hearing the word “psychotic,” including:

• Inability to connect with others or concentrate on tasks.
• Difficulty maintaining one line of thought for more than a few minutes.
• Struggling to put thoughts into words or to comprehend others’ words.
• Mood swings or sudden distrust without apparent triggers.
• Depression or severe anxiety.
• Insomnia.

It’s also possible to experience “psychotic” symptoms outside of an episode, such as in cases of delusional (paranoid) disorder.

Drugs commonly linked to psychotic episodes include marijuana, amphetamines, cocaine, LSD, and other stimulants and hallucinogens. However, not all episodes are caused by drug use. Any brain-affecting factor, like Alzheimer’s disease, a traumatic brain injury, or a mental illness like bipolar disorder, can trigger them. Many people also have addiction and other cognitive or behavioral disorders, which can make it difficult to determine specific triggers.

According to the National Alliance on Mental Illness, approximately 3% of the U.S. population will experience at least one psychotic episode in their lives. While this may seem like a small number, it translates to over 100,000 cases annually.

Psychotic episodes present serious dangers. Individuals may:

• Wander into traffic.
• Step off a tall building.
• Attack others.
• Be shot by an emergency responder who misinterprets erratic behavior as a threat.

How Long Does a Psychotic Episode Last?

The danger of a psychotic episode is often tied to its duration. Most drug-induced psychotic episodes last anywhere from a few hours to a couple of days, though there are occasional cases that last weeks or even months.

A lot can change in a short amount of time, and what happens often depends on how long the psychotic episode lasts. The longer a person remains in a state of psychosis, the more likely they are to:

• Get into trouble.
• Get into dangerous situations.
• Experience a range of unpredictable symptoms.

An episode that seems minor at first may escalate without warning, or someone who appears out of control might suddenly calm down.

Since it’s near impossible to predict how long an individual episode will last or what will happen during its course, the more important question becomes: How quickly should someone experiencing a psychotic episode get medical help? The answer is simple—immediately. Even if the episode doesn’t seem too serious at first, waiting for it to “run its course” is playing a dangerous game due to its unpredictability. Professional medical treatment not only minimizes risks but also shortens the duration of an episode.

This is even more critical in cases of drug-induced psychotic episodes, which may indicate an overdose and are often linked to addiction disorders that require professional detox and a long-term treatment program.

Drug Withdrawal, Long-Term Recovery, and Psychotic Episodes

If someone is undergoing detox treatment, hallucinations, and other psychotic symptoms may also be signs of withdrawal. While stimulant misuse is commonly linked to psychotic episodes, the discontinuation of depressants (opposite of stimulants) can cause similar effects. For example, delirium tremens, which occurs in about 5% of alcohol withdrawal cases and can be fatal, often involves the following symptoms:

• Hallucinations.
• Panic attacks.
• Altered mental functions.
• Unusual sensitivity to stimuli.

In cases of alcohol withdrawal, psychotic symptoms usually last no longer than the 5–10 days it takes to complete acute withdrawal.

A longer-term danger is that susceptibility to psychotic episodes can persist for months or even years after the drug has left the body. You may have heard of “acid flashbacks,” where individuals experience spontaneous hallucinations years after using LSD. (This condition is called Hallucinogen Persisting Perception Disorder.) While the exact risk of future psychotic episodes for people who use LSD regularly remains unclear, it’s well-established that addiction is a chronic illness. As such, symptoms can resurface intermittently, even long after the body is physically “clean.”

Anyone in recovery from a brief psychotic episode and addiction should be aware of symptoms to watch for and know what to do if a new episode occurs.

What To Do if Someone Has a Psychotic Episode

If you notice someone displaying psychotic episode symptoms (whether or not you’ve seen them take any drugs), act promptly:

• Minor symptoms and cooperation
  If symptoms are minor, the person is cooperative, and you have a third party to help, you may be able to take them to an emergency room. However, be very careful with this option. It could have tragic consequences if the episode suddenly escalates while the person is in the car (especially if they are within reach of the driver, a door, or any dangerous objects).
• Doubts about safety
  Do you know who to call if someone is having a psychotic episode? If you have any doubts about safely getting the person to medical help, call 911 immediately. Be sure to ask the dispatcher to send someone trained in handling psychotic episodes and, if possible, request medical help rather than law enforcement.
• While waiting for help
  Do your best to reassure the person, keep them away from danger, and protect yourself. Be alert for sudden movements or potential aggression.
• Remove dangerous objects
  Clear the area of anything potentially harmful that is within reach.
• Provide critical information
  When help arrives, be prepared to provide details about any drugs the person may have taken, their medical history, and any other circumstances that may have triggered the episode.
• Post-crisis support
  After the crisis is over, encourage the person to seek medical evaluation. If they have an addiction disorder or another mental illness, offer your help and support for their ongoing treatment and recovery. Also, ask about the risk of recurrence and how to recognize or prevent future episodes.
• Dealing with past addictions
  If this is a friend or family member and addiction disorder has caused past problems in your relationship, avoid accusing them of relapsing if they experience another psychotic episode during recovery. Psychotic episodes can be caused by other factors, including lingering aftereffects of past drug use. Jumping to conclusions without listening could harm the relationships and increase the risk of an actual relapse.
• Responding to a relapse
  If the episode turns out to be due to a relapse, treat it with the same encouragement and understanding you’d show for a relapse with any other cause. A relapse is a little different from the recurrence of any other chronic illness symptom: they signal a treatable setback, not permanent failure.

If you’re ready or want more information on how to help a loved one, contact us today. Our admissions counselors are ready to help them take the first step toward recovery.

Can Psychotic Episodes Be Prevented?

While it’s not always possible to prevent a psychotic episode (since many aspects of psychosis remain uncertain), there are steps you can take to reduce the likelihood of experiencing one. Maintaining both physical and mental health, including staying sober, can significantly improve your odds. If you’ve had a psychotic episode or think you might be vulnerable to one, consider the following:

• Get professional treatment for addiction disorders and any other medical conditions you may have.
• Minimize stress in your life by avoiding over-scheduling or taking on unnecessary responsibilities.
• Practice mindfulness and relaxation techniques to reduce the pain of unexpected stress. Consider prayer, meditation, or mindfulness exercises.
• Pursue long-term goals and passions and believe in yourself.
• Eat a balanced, healthy diet, including plenty of protein and fiber. Avoid long gaps between meals, and don’t overeat. Be mindful of foods that trigger negative reactions.
• Exercise daily, even if it’s just by parking further away to get in some extra steps.
• Aim for at least eight hours of sleep per night, focusing on quality as well as quantity. Keep your bedroom dark and comfortable and establish a relaxing bedtime routine.

While understanding the duration of a psychotic episode can be helpful, what truly matters is increasing the number of healthy, fulfilling years in your life.

For more information on mind-altering drugs, see the following articles:

• Alcohol Withdrawal Hallucinations
• How Long Does a High Last?
• How to Tell If Someone Is High on Coke
• Long-Term Effects of LSD: Health Effects & Risks