Pathways to Calm: How is Agitation Managed?
The goals of treating an episode of agitation are threefold: ensure the safety of the individual and those around them, calm the person without causing excessive sedation, and, most importantly, identify and address the root cause.
- First-Line Approaches (Non-Pharmacological) Before medication is considered, the first step is to modify the environment and use communication techniques to help soothe the individual. Creating a safe, quiet space with minimal stimulation is key. Healthcare professionals use verbal de-escalation, speaking in a calm, respectful tone and validating the person’s feelings. Careful consideration of non-verbal cues is also critical; for example, intense and prolonged direct eye contact can be perceived as a threat by some agitated individuals and should be avoided. Physical restraint is an absolute last resort, used only when there is an immediate risk of harm, as it can often worsen the agitation.
- Medical Treatment (Pharmacological) When non-medical approaches are not sufficient or the agitation is severe, medication is used to help the person regain control quickly and safely. Depending on the cause, doctors may use medications like benzodiazepines (to reduce anxiety and tension) or antipsychotics (especially if psychosis is present). The goal is to provide rapid calming while still allowing the person to communicate and cooperate with their care.
Ultimately, managing the immediate crisis is only the first step. The long-term goal is always to treat the underlying psychiatric or medical condition that is causing the agitation in the first place.