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What is Acute Psychosis?

High fever can be a cause of acute psychosis.
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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 02 April 2014
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Acute psychosis is a condition that is usually differentiated from chronic psychosis. Chronic psychosis tends to refer to a long-lasting condition, where people may sometimes act normally, but at other times may suffer from periods of rage, hallucination, delusions and the like. People who have schizophrenia may have periods such as this, despite medication, and their condition is therefore chronic.

That doesn’t mean that a person who has a chronic psychotic condition never suffered from acute psychosis. Onset of their disease may have resulted in sudden symptoms of psychosis that are hard to mistake, and those phases when a person is not significantly in touch with reality may be thought of as acute phases. Yet, acute psychosis does not always indicate a mental illness. Some people suffer it as a result of illness, infection, high fevers, use of illegal and/or legal medications and drugs, or for other reasons. Trying to identify cause of acute psychosis is part of the work of physicians so that treatment is appropriate.

Treatment can be difficult because a person with acute psychosis may be violent, may be a danger to self or others, and usually is not aware enough to fully consent to treatment. In most cases, family members who usually notice symptoms right away bring those who suddenly develop psychotic symptoms into hospitals. Emphasis in treatment is protecting patients, protecting staff, and trying to resolve overt symptoms so that a diagnosis and course of treatment can be determined.

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In a hospital setting, a person with acute psychosis may need to be treated without their consent. This may mean administering medications that tranquilize the patient and placing the patient in restraints if necessary. If the psychosis has resulted in self-harming actions like attempts at suicide, treatment is given as needed to combat things like overdose or injury. Yet it can be very difficult to treat a person if they are in a combative or resistant state, so the first goal is usually to use medications that will promote calmer behavior.

An acute psychotic state can be very short lived, lasting only a few hours, or it may be longer lasting and persist for several weeks. Much depends upon cause, ability to diagnose, chance of the causal condition going into remission, and availability of effective treatment. Even a person with severe onset of things like hallucinations may have moments of lucidity and be able to participate in treatment decisions.

When the cause is clearly due to mental illness, patients may spend some time in a mental health facility, where staff is most trained to help patients with acute psychosis, and to make decisions about how to best treat those patients. Usually a person who becomes psychotic for other reasons, such as a one-time use of drugs or due to a severe infection, is treated in a standard hospital, where once treatment is undertaken, it is unlikely that acute psychosis will recur.

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Discuss this Article

anon932597
Post 13

Is acute psychosis curable?

anon314298
Post 11

After a period of considerable stress, I had not been sleeping much and then contracted a virus which gave me a high fever and vomiting. I was awake with this constantly for two days and nights, during which I stopped drinking and eating totally.

I started to taste and experience weird thoughts about my capabilities and then slipped deeper into a personal hell. I had feelings of overwhelming self loathing and hopelessness, crying and loneliness, coupled with continued insomnia and feelings of paranoia. I had beliefs that objects were affecting me. After a few more days, which, apart from the emotions I do not recall, I decided it would be best to commit suicide. It was the only 'logical' thing to do. I remember the relief it gave me to decide on it, plan the day time and method and having conversations where others agreed with me.

In this world I was in, I understood for the first time the true meaning of desolation and despair. I am fortunate I repeated the conversation out loud and my wife heard it. I saw the doctors, Urgent Response unit, got some food, drink and sleep, and within days it had receded. Within weeks I was over it, except for remembering the terror and the suicidal thoughts, neither of which I had ever experienced in over 50 years on this planet.

I am feeling stronger each day, except for the disconcerting lack of memory of my true words and actions and the lingering belief in some things which cannot have been true. I have now received talk therapy and decided to let it go. I am over it, I will never return to it, I know now, with certainty. I am not strong enough to survive it again.

anon287688
Post 10

I was diagnosed as bipolar 12 years ago after my first psychotic episode. I used to be a nurse and lived in denial of it for 12 years.

This year I stopped taking my anti-psychotic medication, and just two weeks ago, I had an acute psychotic episode. Fortunately I had enough insight to see the danger signs before I became fully psychotic. I was immediately hospitalised and a new regime of medication was ordered since I had stopped taking it five months ago. It took this episode for me to fully realise that I need medication to combat this disease/disorder.

For those who would question the benefits of anti-psychotic medication, think again. It could be the difference between sanity and delusion.

anon266151
Post 8

I am a survivor of brief psychotic episodes.

First of all, to be in a state like this is very very scary for the individual in it. It should be absolutely avoided to blame the individual for his behavior. In my case, the acute symptoms lasted about a week, I was hospitalized for 14 days and returned to normal functioning about six weeks after onset (started to work again).

The experience, though, hunted me for a long time, sometimes to this day, but I never returned to psychiatric treatment and live without any medication whatsoever.

anon257070
Post 7

My brother has recently had a psychotic episode. It was the worst thing we, as a family, have ever experienced. We want to give him the best treatment available.

It has been five days since his episode and the doctors first told us that in 72 hours, we would be able to see my brother, but it has been five days and we still haven't seen him.

My brother's a doctor himself. He's a very civilised, educated 25 year old man. I want to know how long does it take to come out of this state? I know it varies from patient to patient, but what is the average?

anon240133
Post 6

It can be caused by cough medicine, high fever, being extremely worried and many other reasons. I had this my freshman year.

I used to be really worried but now I am not worried about anything anymore. I used to not sleep well but after it, I slept great.

anon234736
Post 5

My husband has for 14 years been the calmest, smartest, and most stable person. An insignificant incident caused him to be angry at the city in which we live. In a matter of days, he has stopped eating, sleeping, and doing the normal things we do. He's already lost weight he didn't have to begin with. He talks with randomness, grandiosdity, and no logic. I'm afraid he'll need hospitalization. I don't know how to calm him and keep him alive. Meanwhile, our lives are on hold, as though we disappeared.

dill1971
Post 4

Acute psychosis is looked at as a type of “attack”. These attacks are sudden, incomprehensible, uncontrollable, and fortunately, reversible.

Many people, according to Freud, experience these attacks when they are longing for something they have lost. People are usually able to gradually detach themselves from the lost object and heal.

chrisinbama
Post 3

@momothree: There are actually several factors that can lead to acute psychosis. Many times, acute psychotic episodes happen because of inadequate coping skills after a traumatic event or an overwhelming stressful circumstance.

None of us know when or if it could happen to us. Everyone has a breaking point.

medicchristy
Post 2

I was a paramedic for many years and there has always been one call that stands out to me. The patient was a 44 year old female with no significant medical history. We arrived at the residence and she was screaming and cussing us out. She kept saying that the devil was after her.

Her family stated that she had never had anything like this happen. She was a devout Christian woman with a good job and nice home.

We ended up having to restrain her due to her combativeness. She spit, screamed, cussed, and hit all the way to the hospital. The doctors said that she was having an acute psychotic episode.

As it turned out, she had an intracranial bleed that led to the acute psychosis. I followed up with her a couple of weeks later and she was the nicest person you could ever meet.

momothree
Post 1

What causes acute psychosis?

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