Patient information from BMJ

Brief psychotic disorder

Last published:Sep 13, 2024

Brief psychotic disorder is a short-term mental health condition. It can be very distressing, but there are treatments available to help.

You can use our information to talk to your doctor and decide which treatments are best for you.

What is brief psychotic disorder?

Brief psychotic disorder is a short-term mental health condition. It’s called BPD for short, but this shouldn’t be confused with borderline personality disorder (a different condition).

If you have BPD, you have psychotic symptoms that come on suddenly and last for between 1 day and 1 month. The symptoms then stop, and usually they don’t come back.

There are three types of BPD:

• BPD that’s caused by an extremely stressful event. This could be anything, including the death of a loved one, the end of a relationship, or being in an accident. Some military personnel have BPD after a traumatic experience.

• BPD that happens to a woman while pregnant, or shortly after giving birth. This is called BPD with postpartum onset. It happens to 1 or 2 in every 1000 women within 4 weeks of having a baby.[1]

• BPD that has no known cause.

 There is still a lot that we don’t know about BPD. But we do know that it is more common in:

• people in developing countries

• people with a personality disorder. (For more information, see our patient information titled: Personality disorders: what are they?)

• women who are exposed to stress while pregnant or shortly after giving birth

• people with a history of mental-health symptoms, and

• people with family members who have had BPD. 

What are the symptoms of BPD?

The main sign of BPD is psychosis. Psychosis is caused by problems in the front part of the brain. When this part of your brain stops working as it should, the way you see and think about the world changes, sometimes in extreme ways.

Psychosis can include:

• Hallucinations: Seeing, hearing, and thinking you can touch things that aren’t real.

• Delusions: Believing things that aren’t true.

• Confusing speech or behaviour: Speaking or behaving in a very confused and random way.

• 'Catatonic' behaviour: Hardly speaking, moving, or reacting at all to the world around you.

Psychosis can be frightening for you and the people around you. If you have psychosis, it’s important to see a doctor straight away. You can bring someone with you for support if you need it.

Your doctor will try to find out what’s causing your psychosis by examining you or checking your medical history. They might also ask you (or the person you brought with you) some questions.

Your doctor will want to know about things like:

• any medical conditions you have, including conditions that might affect your nervous system

• whether you have a history of mental-health problems

• what medicines you take

• whether you have taken any recreational drugs, either recently or over the long term

• any recent head injuries, and

• whether you have had contact with any toxic chemicals.

You might have blood and urine tests, to check for drugs, medicines, and other toxic substances.

This is because other causes of psychosis need to be ruled out before a doctor can tell if you have BPD.

Another way doctors can tell that you have BPD is the short duration. BPD lasts for between 1 day and 1 month. Afterwards, you return to your usual self. 

This means that doctors can only say someone has BPD after they’ve recovered.

This doesn’t mean that you won’t get any help if you currently have psychosis. It just means that your doctor will not be able to tell right away if your psychosis is caused by BPD.

If you have psychosis, your doctor’s first concern will be to keep you safe and look after your health. This might mean that you need to be kept in hospital for a while, even if you don’t want to. Your doctor can make this decision against your wishes if they think you might be a danger to yourself or others. 

This might be for several reasons. For example, you might be:

• unable to look after yourself

• behaving aggressively

• having severe delusions or hallucinations: for example, you might be hearing voices telling you to do dangerous things

• behaving in a way that suggests that you might try to harm yourself or someone else.

If you are hospitalised in this way for a while, you might need to be given medicine to keep you calm and safe. You might not want this medicine. But your doctor can go against your wishes to keep you and others safe until you are feeling better.

What treatments work?

Antipsychotic medicines

The first treatment for most people with symptoms of psychosis is medicines called antipsychotics. As the name suggests, these medicines help to ease the symptoms of psychosis. 

If you have BPD, your psychosis symptoms will last less than 1 month. This means you shouldn’t need to take the medicines for long. If you need to take them for several weeks, your doctor might suggest reducing the dose gradually when the time comes to stop taking them. 

Some antipsychotic medicines can cause side effects such as weight gain, high blood sugar, and high cholesterol.

This could be dangerous if you already have conditions such as diabetes or heart disease. Your doctor will decide whether these medicines are safe for you to take. As people with BPD usually only need the antipsychotics for a short time, it normally isn’t a problem.

Talking treatments and other support

As well as medicine to help with your symptoms, your doctor might also arrange for you to talk to someone about your mental health. This might mean talking with someone who is specially trained to help with mental health issues, like a psychotherapist or psychiatrist. Or it might be enough just to talk with your doctor. 

Whoever you talk to, they will want to discuss things like: 

• helping you cope with the stress that led to the BPD

• helping you prevent BPD from happening again

• what help and support you have from friends or family, and

• whether you need to have talking therapy regularly for a while.

BPD in new mothers

Many new mothers struggle with the physical, emotional, and mental changes that happen after having a baby. For example, most people know about postnatal depression. But BPD with postpartum onset is not as widely understood. You might have heard it called postnatal psychosis.

Treatment for BPD with postpartum onset is generally the same as other types of BPD, but your doctor will also think about how any medicines might affect your baby. You might also be offered talking treatment with a team specially trained to help with BPD in new mothers.

There are also support groups for new mothers with BPD. Your doctor might be able to help you find one in your area, or you could easily search online.

What will happen?

Antipsychotic medicines can work well for BPD. It’s important to take them as prescribed, and not to miss doses. 

This can be hard when you are struggling with symptoms of psychosis. So it might help if you have a family member or friend who can help you with taking your medicine on on time.

Once your symptoms have stopped and you don’t need the medicine anymore, your doctor will probably want to see you at least once a month. This will continue for a few months so they can check how you are doing.

BPD can happen again in some people, but it shouldn’t keep happening. If you do keep having episodes of psychosis, your doctor will want to look at whether your symptoms are being caused by something else.

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