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a place to talk about psychotic experiences


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This forum will hopefully become a place to talk about psychotic experiences. I've called it "Schizophrenia and Psychosis" because the most well known varieties of psychosis are associated with that particular condition, which also happens to be particularly disabling and chronic in many cases. However, the experience of psychosis is not limited to Schizophrenia by any means, and I hope that people who deal with psychotic experiences caused by other conditions will feel free to post here.

Many people qualify for diagnoses of mental illness, but most of those diagnoses are half-way mild to moderate in severity. People experience significant problems but they remain able basically to function. Psychotic conditions aren't generally like that. Psychosis is all about the loss of shared social reality, and the hallucinations and delusions that cause that loss to occur. When you are psychotic much of the time, you can't function in society because you are responding to things that other people don't' experience and can't relate to. You stand out like a sore thumb. Experiencing psychotic symptoms on a regular basis make your life very hard to manage. Many become disorganized and can't make or keep commitments. When it gets bad enough, people cease to be able to care for themselves properly through no fault of their own. Even when the condition is well medicated and treated, there are often significant residual symptoms, and disability is frequent.

If you can get past the paranoia, however, I've found so frequently that the emotional, likable core of people dealing with psychosis remains intact and their good nature shines through. I've really enjoyed working with some of these people because they are, at core, such genuinely nice people. This is not an obvious thing, because on the face of it, psychotic behavior is so intimidating and frightening, but I do know it to be true from personal experience.

I'm thinking back on my various experiences caring for or just experiencing people who were experiencing psychosis. Sometimes I was able to get past the paranoia and sometimes I wasn't:

  • A woman living in my apartment building in New Haven, CT who had been attending Yale as a graduate student before she lost it. She developed a habit of wandering the halls, and when you'd see her she would glare at you with very wide aggressive and frightened eyes. She was largely alone in the world from what we could see and not under any sort of care. Ultimately, she yelled at tenants one too many times and police were summoned, only to find her apartment walls smeared with what I heard later was feces or blood (that's what I heard anyway). I recall that she was hospitalized, but moved out shortly thereafter and don't know what happened.
  • A man at a state psychiatric hospital in Albany, New York. I was volunteering as an aide on a ward through a university program. He was lonely and withdrawn and very paranoid. I tried to befriend him, but it was frightening to him for a long while. Finally, he showed me his notebook which was filled with pictures of penises and various symbols that didn't mean anything. He wanted me to understand something but he couldn't articulate it very well and I didn't understand it.
  • A man in a group therapy at the VA hospital in San Francisco. I was a co-therapist in a group for psychotic patients which was designed to try to help people stay oriented to reality. This fellow was very psychotic and actively hallucinating. He locked eyes with me and told me that he was in communication with the captain of a space ship that was orbiting the earth. I told him it was a hallucination. He didn't believe me at all.
  • A woman in another group at the Yale Psychiatric Institute. Her illness was very chronic but managed reasonably well with medication. She was oriented but continued to hear voices. She could talk about it as something she had to deal with, and understood that it was a hallucination she was hearing.
  • Walking in New York City one day near the Guggenheim museum, a man muttering to himself who was not on a cell phone. I must have glanced at him funny or something because he started yelling at me. I was embarrassed and walked away quickly.
  • At the VA hospital and watching the patients smoke their cigarettes. Some of them have tics and other symptoms of tardive dyskinesia. There is a compulsive quality to the smoking that I've always found fascinating. No one smokes as hard as a person being treated for schizophrenia.

Lots more impressions in my head but this many ought to do.

It would be most helpful if some brave soul would step up and share their experience of psychosis. This could be a personal account of having experienced psychosis, or it could be from the perspective of someone who cares about someone who deals with psychosis. As we share our experiences with one another, the opportunity for mutual support grows.

What have your experiences of psychosis been like?

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Guest ASchwartz

You ask a hugely important question, it seems to me, about how a person can tell if they are developing a psychotic illness. You report that you are 36 years old and that your father became ill at a later age. Actually, I do not know the answer because, in my experience, people developed schizophrenia by the time they reached 18 or sometime soon thereafter. I also worked with people who developed the illness during early childhood.

I would expect that, given your age, you would start to notice some classic symptoms of schizophrenia: wanting to isolate yourself from friends and family, starting to have hallucinations in the form of hearing or seeing things but it could happen with the other senses, thinking in paranoid ways, like people are out to harm you in some way or for some reason.

In other words, I am suggesting that you now have enough life experience to understand that something is happening to you. You would then go to your physician who could send you to a neurologist or psychiatrist. An evaluation would be done and, if it is some psychosis, medication treatment could be started along with psychotherapy.

What do others think about this?

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Guest ASchwartz

Dear Forgeting,

It would not hurt to have yourself evaluated by a psychiatrist to determine if you have any diagnosis such as Bipolar Disorder, etc. If you do carry such a diagnosis there are medications that help a lot, as you know.

I realize it can be pretty scary to think about such things when it your self that you are worried about. Yet, if you do not feel well help is available.

By the way, the psychiatrist would know the right questions to ask to help both of you understand what is going on.

Allan

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This link might help - the article talks about the general course of Schziophrenia and the "prodromal" or buildup period that occurs before a full psychotic episode occurs.

Schizophrenia and similar illnesses do tend to run in families. becuase you are a first-degree relative of someone with Schizophrenia, you are at an elevated risk statistically for developing the disorder yourself. The illness can come on at any time of life, but as Dr. Schwartz points out it is more frequent for it to occur when you are a young adult. Keep in mind that an elevated risk doesn't mean a certainty. There are many people who are children of someone with Schizophrenia and they do not experience any symptoms.

If you are thinking that something is off, it would be a reasonable idea to see a psychiatrist. What they will likely have to offer you is medication, and this is not something to go on lightly so think very carefully before you do that. Here's a question to ask and I don't know the answer off the top of my head. "Is there evidence to suggest that if you are taking antipsychotic medication prophalactically (as a precaution, not as remediation), that you can reduce the chances of having a psychotic break? I recall back many years ago, when I worked at Yale, some psychiatrists were doing research on this question, trying to help highly-at-risk children to avoid having psychotic breaks. If something like that could protect you from something that you and a doctor think is likely to happen, it might be worth it.

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