A diagnosis of psychosis may be made by a psychiatrist if a person is experiencing the following:
- Changes in perception – hearing, smelling, feeling, tasting or seeing things that other people do not. The most common one is hearing voices.
- Unusual, distressing beliefs – feeling that something is happening around you that is difficult to explain. It may be a feeling that people are going to hurt or control you in some way, making you feel very unsafe.
- Confused thinking – being confused by your thoughts and feeling that you cannot explain yourself very well.
- Other difficulties such as loss of interest in things, low motivation, low mood, difficulty expressing how you feel, distancing yourself from other people and struggling to care for yourself
Psychosis is a mental health problem, usually triggered by another mental health condition, for example bipolar disorder or schizophrenia or severe depression. It can also be triggered by drug misuse, traumatic events, or other physical conditions such as Parkinson’s.
My experience of psychosis was triggered by a manic episode, linked to bipolar disorder. I can talk about this freely now, and accept that I had been experiencing psychosis, however whilst I was symptomatic, there was very little anyone could have said to me to make me believe that what I saw and felt was not real life.
This lack of insight is not uncommon for people experiencing psychosis but can make sufferers extremely difficult to reason with. No matter how many times I was told that the things I saw were hallucinations, or that my thoughts and feelings were delusions, I simply could not believe it; from my point of view, it was my family, friends and professionals who did not believe me which made having psychosis so very lonely. I truly felt, for a long time, that it was me against the world and felt so rejected by my friends and family who appeared to no longer be on my side. I was terrified, calling out for help and it appeared that no one was listening.
Everyone who experiences psychosis will experience it differently and I do not believe that there can be a ‘one size fits all’ model for interacting with someone with psychosis, however what I would say is try to imagine what it is like to be inside that bubble of psychosis. Challenging my thoughts and stating that I was wrong, only increased my loneliness, served to make me more upset and often angry. What I found most useful was when people would ask openly about something, giving me a chance to explain my point of view. Sometimes these open, non-judgemental questions, could help me to question my own thoughts, and as my condition improved, helped me to come to terms with a realisation regarding what was happening. This was not always the case of course, but at the very least, it showed me that these people were still here for me, they did not have to confirm my beliefs, just show that they interested in them and not dismissing me outright.
Watching someone you love experience psychosis is extremely difficult and it is likely that something you say or do will upset them while they are unwell. Should this occur, please try to remember that they are unwell and have very limited control over what they say and do, don’t give up. The most important thing you can do for someone experiencing psychosis is to be there for them while they ride out the storm, not just during the episode, but also afterwards. Dealing with and processing your experiences of psychosis after the events can be just as difficult to come to terms with as the experiences in the moment and I cannot express how grateful I am to my family and friends for their ongoing support with this.