Having read a bit about it, I’ve been wondering what psychosis is like.
For those who have had psychotic episodes or have seen others in psychotic episodes or have theoretical/professional knowledge of it, I’d like to know more.
What are the salient features of psychosis?
What are its causes and effects?
To what extend can one deal with someone with a psychosis and how?
It feels like normal. You don’t know you’re misperceiving–you hear things, you know things, you process data in what you think is a reasonable way. When there’s conflict, it’s the other person who is behaving irrationally.
Given that, its effects can be devastating. Your friends will find they feel better when they’re not around you, the world becomes confusing because you’re the only sane person in it and heaven help you if you’re prone to paranoia because everyone can’t be irrational, so the reason nothing makes sense anymore is because everyone is messing with you. Watch Shutter Island (you have to watch it twice though) for a good first person example. Or get drunk.
Causes are many. Biochemical, drug-induced, brain damage, psychological trauma, disease, fever, abnormal brain structure, demonic possession, divine revelation…pick one or several.
What have you perceived during psychosis? Have you perceived things you had never perceived before? If so, how did that feel normal?
Does it suddently come on? If not, how does it gradually take hold?
I’m particularly curious about paranoid psychosis. I’d quite like to hear more about that, in PM if that’s better for you.
This is all just my experience–IANAD and all that. Also, this is likely to get tedious, self indulgent and hard to follow because, well, I sometimes am tedious and self-indulgent, and I have a lot of trouble focusing my thoughts anymore. That’s just part of the salad.
It’s hard to say how gradually or suddenly an episode comes on because everything feels normal before during and after. That’s part of why I went 40 years or so without treatment. I knew I was unpopular (despite having some close friends and other talents that were clearly appreciated by my peers), “moody,” and that walls and floors don’t really ripple & roll like the surface of a lake as they sometimes appeared. But it had always been that way. My internal WTF! alarm never went off because no matter how oddly things and people behaved, nothing was unusual enough. Walls don’t ripple because they can’t, and yet I see it happen–so who am I going to believe? It is beyond reason that the whole school can keep a newsletter or rumor mill entirely secret from me for years on end, and there is no reason for them to do so, and yet I am certain this is going on–so what am I going to believe? It seems like there is a part of my mind that intentionally overlooks some things in order to make all the sensory pieces fit together in the most satisfactory way. It wasn’t until I learned to start “pulling at threads” and unravelling my worldview that I started to understand what was going on.
Delusions are weird creatures because they prey on stuff that is difficult to prove, and they seem to grow out of misperceptions–mistakes in your data processing that aren’t readily obvious except in retrospect. At home you say something to the wife and she doesn’t respond. She must have heard you and you didn’t say it in Latin, yet she didn’t even flinch or look up at you. (Reality: maybe she didn’t hear you, thought it was the TV, or maybe you only thought you said something because you were thinking it really loud). This happens again the next day. Why is she ignoring you? And doesn’t it seem like she’s coming home from work a little later each day? Maybe she’s getting a bit behind and feeling the grind–I’ll do something nice for her. She likes flowers, I’ll get her some flowers. Good, she liked them. Only now she’s angry because the cat knocked over the vase, spilled water everywhere and eaten a bunch of the flowers and vomited them throughout the house. I’ve made things worse. I suck (cue: depression monster). No wonder she’s staying late at work–she has to come home to me. I wouldn’t blame her if she’s just staying late to chat with frinds. Likely some better-looking dude who isn’t such a mess to be around. Her battery died at work for the third time this week and she had to get a jump from her pal Mark. Car maintenance is my job, I’m failing. Figures. I wonder if her car battery really has been dying. Who is this Mark guy anyway? Funny how it’s always him who is there to save the day…After a few weeks of spinning life’s events in this direction you’ve got a cheating wife, a guy who is sabotaging her car in order to fix it, and it’s all totally justifiable because you’re just a basket case whom nobody would really want to have around anyway. And then you take some kind of action when things become intolerable. Maybe you make accusations and damage relationships, maybe you start drinking, maybe you start fitting a gun muzzle to your mouth just to see if any part of you cares what could come next. Maybe you do all of the above? At the root of all your problems, you realize, is you. At this point you’re out of the paranoia and deep into a depression that spawns another delusion: everyone hates you at least as badly as you hate yourself. There is really only one answer and that is to say “I’m sorry” as loudly and as sincerely as you can manage, and you reach for a gun, maybe a rope–yes, a rope because making a bloody mess of yourself will sort of take away from the apology.
While all this is going on, reason is bound and gagged and locked in a closet. Everything fits, and the answers all feel right. You know everything is just as you believe it. Slowly your life heals, sins are forgotten, stability is gained, and depression fades. You don’t want to dwell on the inky nastiness of the past–just look forward. But it was only when I DID look back that I was able to see the incongruities and say, “WTF?” I had a fortunate moment of clarity (real clarity) in which I was able to see that yes, I was given to delusions and paranoia, and that my wife was in fact preying on my confusion (she admitted to that when I confronted her). Just because you’re paranoid doesn’t mean nobody’s out to get you.
For the most part I’m good now. I left the soul-crushing witch, put together some “rules of reality” and refuse to feed mania, depression, or believe anything that does not make perfect sense no matter how “right” it feels. It’s exhausting and I’m pretty qwerky to be around, but I’m pretty happy and useful these days. But nothing really feels “right.” And the tug of depression, the urge to self-loathe, and at other times the yearning for recognition I truly deserve for my acts of inspired genius are a constant source of irritation. Like comfortable old friends who always get you into trouble.
Did ya get all that? 
It’s a tricky question because the basic answer is, for me anyway, psychosis simply feels normal–everyone else has a problem with me. Only, my normality can get really different from what others would expect. The irony is that in order to escape from paranoia, I had to realize people really ARE turned off by me when I act naturally. So I live in the reality everyone else expects, which feels like a lie, and I thrive.
I hear you. {{{{Hugs}}}}
I have PTSD with psychotic symptoms. I have flashbacks, auditory and visual, pretty much every day I have to leave the house… sometimes when I’m at home. When people think of hallucinations I’ve noticed they seem to think we all have conversations with people who aren’t there. What happens to me is brief flashes. I’ll be driving (which I can’t really do anymore) and see a plane falling out of the sky or a tornado coming at me. I see it long enough to have a terror response and it will sometimes lead to a full-on panic attack.
Dissociation or depersonalization sometimes leaves me feeling like I’m not in my body, but working controls from somewhere else. I feel like there’s two of me. I don’t have “multiple personalities” or anything like that. I just feel like there’s a physical “me” and a mental “myself” and they are always working against each other. Sometimes when I feel like this I will hurt myself because it’s a quick way to bring myself out of it, to make sure I’m real. Which probably sounds ridiculous, but it’s how my brain works. Since I’ve been taking Geodon I haven’t done it once, whereas before I was hurting myself, mostly with bruising with blunt objects, or cutting with whatever I can get my hands on. I don’t do it for attention and very few people have seen ANY of my scars. The dissociative episodes have only been happening for about a year or so, and increased wildly when my daughter was raped in March. I’ve been having a tough time of it, but this Geodon is like magic, at least for now.
Inigo Montoya thank you for this informative, interesting post. I have my own probs but my husband had a psychotic break sometime ago and was divorced from reality. He isn’t really communicative and it’s hard to get intside his head. This gives me some insight as to what he’s still dealing with.
Rushgeekgirl, I was on Geodon for a while along with a lot of other drugs. When I ran out over a long holiday I went through the worst withdrawals I’ve ever had. Apparently it’s really powerful so keep on top of renewals, okay? I’m so sorry about your daughter. I was raped. Don’t you two lose your power.
No experience with psychosis at all, but Inigo Montoya–that was a fascinating explanation. Thanks for taking the time.
Inigo,
Thanks for that account. It wasn’t tedious at all. I’d like more of it.
You mention rippling walls. What other hallucinations have you had? Anything otherworldly?
How do you pull at the threads to unravel the worldview and understand what’s going on?
What are your rules of reality?
For better or worse, OCD is not one of my problems so I don’t have a list of rules per se like how to survive in Zombieland. But the main one for dealing with paranoia is “Everyone behaves at all times in a way that makes sense to them right now.” Even risk takers and adrenaline junkies do some calculation before jumping out of an airplane, hopping into the marital bed with a complete stranger, or playing Russion roulette. Often folks will look back and say, “Man! That was a dumb thing to do!” but in the moment, any internal voice saying “we ought not do this” is overridden by all the other voices that assure an acceptable chance that catastrophe will be avoided–let’s live a little. Complementing that rule is this one.
As I see it, emotional disorders, hallucinations, and delusions are all the same wine in different bottles. They are all incorrect interpretations, or sometimes total fabrications, of consciously recognized information. They highlight a reality that most people never really have to face: the brain is an organ just like a heart, liver, and toenail. And it can malfunction. The brain’s job is to combine sensory input (collected and delivered by limited and imperfect organs), analyze it in relation to experience (which is a combination of older imperfect sensory input, emotional response, and memory of highly irregular quality), and then assign meaning to whatever is going on. It’s amazing humans can function at all when everything works right. For me, something happens to the visuals, and my emotional responses are very unpredictable. As a result, the meaning and feelings associated with events may not always be appropriate. So I’ve had to learn to distrust how I feel about things. The supportive and encouraging responses I’ve gotten in this thread process as sarcastic, snide, and generally mean-spirited. That’s just how my brain works. But it doesn’t make sense, logically, that people should resond to me so negatively. Knowing my past problems have stemmed from improper use of emotions (in this case fear & anger) I consciously remove emotion from my calculation, and take the comments at face value. It’s not a perfect answer because it makes me more vulnerable in some ways, but the payoff is that I’m no longer my own worst enemy. That’s what I mean by “pulling at threads.” I have to keep in mind that my brain is broken and that I am not allowed to respond to strong threats (or praise) without taking a second look at who said what and in what context.
Apart from ripply surfaces and the odd phantom knock on the door and occasional uninteligible whisper I don’t have any other hallucinations. No cool out of body stuff and, thankfully, no religious experiences.
I knew someone who had episodes of depersonalization after he weaned himself off of marijuana use.
He told me, “I looked at myself in the mirror this morning and
I don’t know who I am anymore.” Then he started to sob.
It was a startling thing to see. Very sad.
10,000 posts. That can’t be good.
What is psychosis like? I never had auditory hallucinations, nor visual hallucinations like Inigo. I would sometimes feel like I was looking at something and it would move forward and backwards, but that was minor and could’ve just been an optical illusion.
What I had were thought disorders. I had delusions of grandeur, religious delusions, delusions of reference (you thought songs and tv shows were giving you secret messages).
Looking back at it (I’ve had over a decade to try to make sense of it) it feels like living in a mind control cult. People in a mind control cult believe weird things, but they don’t think they are weird or duped. They just think they are privy to secret information and that they have an important role to play in the outcome of the world. The book ‘combatting cult mind control’ gave me info that I could really relate to about your old identity being suppressed and a new identity being formed. The identity I had when I was psychotic was a totally different one than the one I had before, or the one I have after (the one I have after has to integrate the trauma of my mental illness, so I’m not the person I was before this all started). I really related to Hassan’s book and the concept of cult mind control.
What are the causes? Biology, stress, birth order, being a certain age, vitamin deficiencies, environmental toxins, drugs, etc. etc. There are a lot of causes.
For me I had prodromal symptoms for about 6 months before I became full blown psychotic (social withdrawal, loss of interest in hygiene, failing in school, etc). I still don’t understand how nobody figured out what was happening. I have a lot of resentment for the adults in my life (I was a teenager when this started) because they all dropped the ball at the same time. There are only a handful of conditions that cause the behavior issues I had.
I never talked about what was happening because I didn’t think I was mentally ill. People lose insight when they are psychotic. In fact I would sometimes laugh to myself when I thought of telling someone what was happening because I figured they’d assume I was mentally ill. Again, this is something I can relate to cult survivors about. Steven Hassan (who wrote the book above) says cult members know that people in other cults are parts of cults (he said Moonies might realize Hare Krishnas are parts of cults, but not be aware of it about themselves). But they don’t have the insight to realize that applies to them also. I was aware enough to realize people would interpret my symptoms as due to a mental illness, but not self aware enough to realize it actually was a mental illness causing it.
As another example, it is like asking a diehard Zoroastrian what they think of Zeus and Mt Olympus. Of course that god is made up, but ours is real.
The main long term effects for me are a lot of shame. I am deeply ashamed of the stuff I did when I was psychotic, and extremely hurt by how isolated I was because my delusions made me think I was responsible for saving the world, which is very isolating. There is a lot of psychological trauma that comes from psychosis, at least for me. A lot of shame, isolation, feeling let down by people who I feel could’ve done more to help me, etc. I haven’t had symptoms of psychosis for 12-13 years, but the emotional trauma will haunt me for life. It may sound hyperbolic, but I feel like my soul was kidnapped and enslaved for 4 years.
How do you deal with a psychotic person? I don’t know. I wish I did but I have no idea. They aren’t going to realize they are sick. I get the impression a lot just remain sick until they break the law and a court forces them to be medicated.
Amazingly insightful posts in this thread. Thank you.
I’m sure you would have if you could, but you aren’t able to forgive yourself? It’s not the fault of people who have cancer, lupus, IBD, glaucoma, etc etc, that they have their disease and you’re no different. The disease did these things, not you.
I sincerely hope some day you find peace.
Forgot to mention this bit, it goes for me as well. Getting help requires overcoming the first obstacle of recognizing you have a problem: you’re nuts. Then you have to come to grips with what the cost of being nuts has been; not only to yourself, but to your friends, family…your children. I think it’s fairly well-known here my son is also nuts. I have to wonder how much of him is genetic, how much of him is because of how I was when he was a toddler, and how much better off he’d have been if I’d had my shit together.
Thank you. Self forgiveness is something I’ve tried working on with therapists but it generally eludes me. It is hard. I agree that a brain disease should be no different than a disease of any other organ. But I still can’t forgive myself for the stuff I did.
If I saw someone with cancer was unable to forgive themselves for being a shitty triathlete I’d feel bad for them and how hard they are on themselves for expecting their body to be perfect in the face of illness. But I do the same thing to myself for having terrible interpersonal and intrapersonal skills when I was mentally ill.
Psychosis doesn’t necessarily mean you think your perception is accurate. I had it for one day due to a medical condition (serotonin syndrome) and I knew the voices I was hearing weren’t real but it was still terrifying. That experience made me have so, so much sympathy for anyone who experiences that on a regular basis.
It’s your own brain coming up with it, so of course it knows EXACTLY what to say to most upset you. It’s awful, and there’s no way to escape it. And then to imagine someone thinking it IS real. What a nightmare. Pure torture. And now we have drugs that may help, but also have serious, often intolerable side effects. In the past we didn’t even have that. So many people have suffered so much. I went through it for ONE DAY and I’ll never forget it. It breaks my heart.
I’ve decided never to have kids of my own because my illness messed my mind up so bad I don’t think I could bring a child into the world so they would possibly face those same things, because I’m still too damaged to be as involved/responsible a parent as I would like to be, and because I worry about genetic carryover to the next generation.
But for me, schizophrenia (which is what I was diagnosed with after the fact) is not ‘that’ strongly genetic. The odds of having it are about 1-2%. If you have an identical twin the chances are about 30-60%. But if you have one parent who had it the chances are only about 9-13%. That sounds like a lot, but that is about an 87-91% chance the kid will not have it if one parent had it. If both parents have it the odds go up to about 40%, which is a lot but still a less than even chance. Even if someone has a kid, there still seems like an 8:1 chance the kid won’t get the same illness.
Plus there are various interventions you can do to negate it. Giving birth in winter (I believe) increases the odds because the kid will experience vitamin deficiencies in the womb.
Point being, I don’t think psychosis is ‘that’ genetic unless either you have an identical twin with it, or both parents (as opposed to just one) have it. If you have one immediate family member with it (sibling, parent) the odds are about 9-13%. But that is just schizophrenia, there are a lot of mental illnesses out there.
Can you provide more details?
How did it start?
What did the voices sound like? What did they say to you?
What thoughts, emotions and behaviors did it create?
I was asleep and then I woke up in the middle of the night and was hearing voices quietly and I thought it might be my neighbors (I live in an apartment). It was repeating “You have the power to ____” and the blank was filled in with a bunch of things, like “go to sleep” (I have insomnia) and “praise the Lord” (no idea where that came from; I’m not at all religious). I thought I had some weirdass neighbors listening to subliminal message tapes or something. Then I realized I could control what it said to an extent. Then it kept getting worse and louder. And physically I could barely walk. And I thought I was about to have a seizure so I was trying to look up symptoms of that online but physically it was really hard to even be coordinated enough for that because I was having muscle spasms.
Then I finally gave in and called 911 and tried to pack up stuff for the hospital (and to wake up my kid without alarming her too much). And it kept getting worse and worse and was eventually a very mean male voice and a very bitchy female voice. I forget exactly what they said though, something about some disturbing sexual experiences I’ve had that would probably qualify as rape. Then I started hearing banging noises and wasn’t sure if it was something going on in the hospital, or something in my head. Now I think it was in my head.
The hospital gave me Haldol. I felt like a crazy person. I thought it was the first stages of schizophrenia, and I was worried about that for a while. But now it’s been almost two years so I’m not worried about that anymore.