Family and Caregiver Schizophrenia Discussion Forum

What Does 'Episode' Mean?


I’m trying to understand what is meant by psychotic episode. In all the books and websites I’ve been reading, they are saying that part of what characterizes a psychotic episode is hallucinations and also a break from reality. The question I have is, can one be experiencing hallucinations but not be having an episode? And does one have to have a break from reality to be having an episode?

I don’t know why it really matters to me, but I’m trying to put a label on what my daughter is experiencing. She hears voices and sees and feels things that aren’t real, but has insight into the fact that they aren’t real. So, is she experiencing an episode? Or is she not because she knows they aren’t real?

Also, is the episode from the time she started hearing voices until it gets completely under control with the medication, or is it each time it happens? I’m just trying to get the terminology right in my mind, and I feel like I’m missing something from the things I’m reading.


Some can explain psychosis like a spectrum, which I agree with. There’s the hallucinations that we percieve as hallucinations and have insight into them, or there’s the hallucinations and delusions which we percieve as real and that’s a break from reality.

A psychotic episode refers to a break from reality, and without insight into what one experiences. Delusions are most common, and we percieve the hallucinations as real, or believe there’s some sort of entities or entity behind them for example.

Far from an episode, we still experience psychosis, like hearing voices or seeing things or still having unusual beliefs, but we manage those hallucinations and delusions and know they are not real.

In an episode we can become erratic and not know what we’re doing, that’s why we’re called crazy lol

Hope this helps.


everyone is different…

for me an episode meant a period of time that the head circus really acted up… delusions… hallucinations… huge spikes of panic and paranoia…

Because of the paranoia and the panic… triggered more delusions

A negative episode is when the negative symptoms would kick in and I could barely talk… move… react… reply… It felt like I was taken out of normal time and moving in slow motion as people got on with life.

Good luck and I hope things get better for your family


Reading your post or topic brings back a lot of memories for me. Back in my early 20s I first starting have my episodes or psychosis. I want you to know how lucky your love one is to have you in their corner and fighting for them. That support is so important. My mom was one of the few people that really was there for me through thick and thin. Please continue to learn all you can about sz and NAMI is a pretty good place for info too.Other good sources of info is a booklet called WRAP written by Mary Copeland. RI International is another good organization. You can check them out on the web. Thank goodness for good concerned moms!


I have hallucinations and delusions at any given time that I live with every day and am , mostly, aware of being seperate from reality. I would describe an episode as a period of time in which my functioning life is interrupted. When I’m being berated and told to kill myself and either I’m on the kitchen floor fighting to not grab the knife, or I’ve got the knife and I’m locked in the bathroom fighting to not use it, that’s, for me, an episode. I have a lot of symptoms that are integrated into a functioning life, but when I have to stop and fight and my regular life is put on hold for a time, that’s an episode. Even when I get caught up in paranoid thinking and there’s a distinct break from what is real and makes sense, that’s an episode. It’s when I’m sort of gone for a time and, thankfully, come back. So far I always come back.


This is a question I have been trying to sort out too.

During an episode, a person might be unable to care for self in basic ways i.e. stops eating, sleeping, bathing. Unsafe behaviors and accidents. Sometimes runs away. Maybe does numerous things that alienate friends or colleagues. Visibly or audibly responds to hallucinations and acts on/from delusions. Possible encounters with authorities due to strange behaviors. If this does not resolve and acute psychosis (break) occurs, hopefully the person can be somewhere safe and receive treatment. Even if that doesn’t happen, the episode will eventually wind down. But things can go horribly wrong. My mother who had bipolar one died during a psychotic episode by her own actions.

My family member with sz goes through frequent changes in the severity of symptoms of psychosis that I do not call episodes. As far as I know, my family member constantly experiences symptoms of psychosis. Increase of symptoms is a rough patch. Running around town screaming at cops is an episode.

I think it’s helpful as caregivers to be able to guess where we are each day and what we might need to do to respond if our family members become distressed or very symptomatic. Sorting out the episodes (relapses are episodes) from everyday psychosis means we can give professionals a kind of history if we have to. The most important part though is being able to respond to our family members’ symptoms in a way that is supportive. On a neutral or good day, there is no need to hover and interfere. On a bad day, sometimes a person should not be left alone for their own safety. It’s really important to try to figure out the difference.

I wish I could write this without sounding so distant, but I think of sz as an illness. I don’t want to lose another family member to serious mental illness. The illness is just an illness. My family member is a one-of-a-kind, irreplaceable person I could not live without.


Thanks for the input. I think I’m getting a better handle on it. This whole thing involves an entirely new vocabulary that I need to develop.


I don’t know if you found the website that is part of the forum…

but there is some great info on that on it - Sz Symptoms - Basic Over view - F.A.Q’s

Good luck