What You Need to Know If You or A Loved One Develops Psychosis

A psychotic episode has the potential to be one of the hardest times in a person’s life, for both those afflicted and their loved ones. Someone in the midst of a psychotic episode may believe things that are strange and confusing for family and loved ones. Understanding common symptoms, etiology and ways to help, can ease anxiety for you and your loved one.

You or your loved one may be experiencing phenomena that is difficult and upsetting, be it hallucinations, delusions, or mood changes. Voice hearing, a more commonly recognized symptom, can be upsetting and disruptive on its own. But for many, delusions, in addition to or instead of, hallucinations are also common. A delusion is something that alters the fabric of reality for the person experiencing it, something more akin to a dream than a sight or sound.

Some people have euphoric delusions, such as feeling angelic forces, or believing one is connected to God. Delusions are not delusions purely because they are not realistic
(many people believe they are connected to God or feel angelic forces) but because of the way in which it disconnects people from others. People experiencing psychosis may be lost in their own world. One who feels connected to God may go to work, have dinner or host a party. But someone experiencing psychosis may find it difficult to concentrate on anything but the delusion. Should they be in the throes of a thrilling delusion, they may stop going to work or spending time with family, chasing the fast-paced highs of mania. Even with the dopamine rush, a life spent too long neglected is like a house that isn’t being maintained. The weeds overtake the back yard, the roof starts leaking, and eventually it may even threaten the foundation.

And though paranoia and fear-based delusions are easier to seek help for (no one wants to be tortured by demons, but who doesn’t want to feel connected to God?) they can be traumatic, as well as have consequences for one’s life. Delusions may be so intense and all-encompassing that a regular experience like going out to dinner can turn into a cosmic nightmare. Sights and sounds may be louder, brighter. The clatter of the neighbor’s fork against her bowl may feel menacing, or the waiter may give you a look that makes you fear he’s going to team up with the hostess to kindap you in the parking lot as you leave. Even things you do to calm yourself can sometimes feel dangerous. Stepping outside for a cigarette, you notice a child pass you by and become concerned you’ve consumed part of her soul through the act of inhaling. While it may sound absurd, the possibility for any given perception in a psychotic state is next to endless. And again, it is not purely the irrationality of the belief that qualifies it as “psychosis,” but rather, the degree to which it pulls you out of the world. After such a frightful dinner, you may become scared of leaving the house, remembering what it was like in the restaurant, or on the sidewalk as you attempted to calm down.

While these experiences can elicit responses of profound fear, dizzying elation, or debilitating paranoia, they are only as life-altering as you allow them. Many people, upon realizing their condition, worry they will never be the same. And, though it is true that psychosis can be disruptive, sometimes scary, and even dangerous, it does not mean your life won’t go back to normal. Media rarely features the well adjusted, monetarily successful, doting parent with psychosis. There are people who suffer psychotic breaks and never seek treatment and recover. More will take medication for a short period following their break and recover without long-term effects. Still more will take medication or seek therapy and only experience mild psychotic effects that barely impact their life. Some may have periodic episodes that require treatment when they arise. The percentage of those with psychosis who experience world-altering effects such as serious drug addiction, homelessness or untimely death are far and away the minority, particularly with early intervention.

Evidence suggests that the best outcomes are associated with a combination of therapy and medication together. However, there are also treatments for psychosis that evade the medical model altogether. Though it has long been retired, in the 1970s a group of psychiatrists started a number of “sanctuaries” in which people were provided with a safe place to work through their psychosis with the support of staff who did not try to change or derail their course with either repressive techniques or medication. They believed that psychosis was a psychospiritual condition that should not be tamped down, but allowed to run its course. The sanctuary model had phenomenal results, but unfortunately little research was done to prove efficacy, believing, as the team did, that standard testing was dehumanizing and immoral. As a result, the sanctuaries of the seventies did not last, faced with grant funding and tax-based support that demanded numbers to justify payment.

The important takeaways, should you or a loved one experience this condition, is that psychosis is not a death sentence. The earlier it is treated the better. And it does not have to have the power to derail your life. If you or a loved one is experiencing psychosis, consult a therapist and/or psychiatrist immediately to discuss your concerns. Be an active participant in your care, be as open and honest with your care providers as you feel safe being, and do not let it impair your sense of worth. Psychosis can be scary, intimidating, even life-threatening. But it is also an explosion of creative and spiritual energy that can give you insight into the world around you, as well as help you understand the human condition—pain, fear, uncertainty, joy—better than most of the world. So, hey! Consider it a compliment from the universe.