Possible physical triggers

(1) Ensure adequate sleep. Sleep deprivation can produce delusions and hallucinations even in a perfectly healthy and balanced person. In this case, the most effective help is restoration of a normal sleeping routine. If they are afraid of falling asleep, ask them what would make them feel safe. Offer to stay with them in their room if needed. If they are overexcited and talking nonstop, suggest pausing for now and continuing the conversation tomorrow, after everyone has had a good rest. If they claim they do not need or want their usual amount of sleep, gently suggest that they just relax in bed without necessarily sleeping. If all else fails, suggest over-the-counter sleeping pills.

(2) Rule out intoxication/reaction to a chemical. Many legal and illegal substances can severely alter one’s mental state. It can be everything from cannabis (known to induce psychosis in some people) to black mold in a building where you live. Some medications taken as prescribed can produce hallucinations, suicidality, severe anxiety, or have other disturbing psychological side effects. If the person experiencing these problems abuses substances, has recently started a new medication, or has been exposed to other kinds of chemicals, try to remove their exposure (suggest that they come off recreational drugs and/or medication, move out of the contaminated building, etc.).

(3) Rule out withdrawal. Stopping a psychotropic substance cold-turkey can produce the same effects as starting it. Some people can use a mind-altering drug for a period of time, then stop it and move on. Others experience severe withdrawal symptoms that can include hallucinations, delusions, suicidality, severe anxiety, and all kinds of out-of-character behavior. If the person experiencing these problems has recently stopped a recreational drug or a prescribed psychiatric medication, suggest that they resume using the substance/taking medication, get stabilized, and then, if they want to stop, go slowly and carefully, reducing the dose gradually. See our directory for resources helping with safe tapering of psychiatric medications.