It can be very distressing to see someone go through a psychotic episode. They may be saying, seeing, hearing and feeling things that you do not perceive or understand.
Psychosis may occur as a result of a psychiatric illness like schizophrenia. In other instances, it may be caused by a health condition, medications, or drug use.
It can be avery confusing situation. You do not understand whether to agree to their visions, disagree or just do nothing. More so, what can you do if they get violent?
Since most psychotic disorders are episodic, you would mostly not be facing it for the first time. Use this knowledge to make a note of what the episode contains:
What do they see or hear?
Whether they get violent or not?
How long does it take for them to calm down. When they are not having an active episode?
Are they lucid enough for you to talk to them about it, and if possible, make a mutual action plan.
One of the basic things to do is to get them the medical attention required. Proper medication and psychotherapy can reduce the intensity and even the frequency of such episodes. Knowing more about the disorder they have is also an immense help.
Secondly, make sure that the room they live in does not have any sharp objects that can be used for self-harm or to harm others. It should not have any windows or balconies one can jump off from.
During an actual episode, you should not agree with the delusion they have. This will reinforce it and make it stronger. At the same time, vehemently disagreeing with them makes them more violent and agitated.
The best thing to do then is to tell them with empathy, that you cannot see/hear what they do, and you do understand how distressing the experience is for them. Tell them that you are there for them and will help in any way you can.
Addressing distress with paranoid delusions (it is scary to think that people are following you/there’s a camera in this house) – that is, addressing the fear and other feelings behind it, works better than agreeing or disagreeing.
It is imperative to have a care worker if you can afford it, or look for a pro-bono worker if they are available in your area. Not only are they more trained and experienced, but caring for them alone with tire you and increase the risk of you hitting them or needlessly sedating them out of sheer stress and pressure.
Efforts should be made to talk to them about it when they are lucid. Research shows that when they are made aware of the episode when comparatively lucid, it can bring down the intensity of an episode and also increase insight into the fact that all of this may just be a product of their mind. This in turn makes them more willing and active in the treatment process.
You can also ask them how they would like to be handled when in an episode, and would they agree to being sedated if the need is high? Such an agreement helps clarity and avoidance of medico-legal issues.