Information

Do people who experience a psychotic episode ever go back to normal?

Do people who experience a psychotic episode ever go back to normal?

Do people who experience a fully blown psychotic episode ever go back to their pre-psychosis self?


Short answer

Because some neuroses can involve psychotic episodes, it depends on the cause of the psychotic behaviour.

Longer Answer

When looking at the difference between neuroses and psychoses, although BPD, Bipolar Disorder and PTSD are generally neuroses, they can involve psychotic episodes in some cases.

For example, with Bipolar Disorder (Mind, 2018):

Psychotic symptoms can include:

  • delusions, such as paranoia
  • hallucinations, such as hearing voices

Not everyone with a diagnosis of bipolar disorder experiences psychosis, but some people do. It's more common during manic episodes, but can happen during depressive episodes too. These kinds of experiences can feel very real to you at the time, which may make it hard to understand other people's concerns about you.

Psychotic episodes in Post-Traumatic Stress Disorder (PTSD) can involve flashbacks (the sense of being back at the traumatic event) through hallucinations affecting touch, taste, smell, sound and sight either affecting one of the senses or a combination of them.

Once the PTSD or Bipolar Disorder has been resolved through the relevant treatment required, the psychotic effects will not return as the underlying cause has been sorted, and the person will "go back to their pre-psychosis self".

If the psychosis is a "pure" psychosis such as Schizophrenia, the problem cannot be cured, but the psychosis can be managed with medication and psychiatric help (Schizophrenia Society of Canada, n.d.). Schizophrenia requires lifelong treatment, even when symptoms have subsided (Mayo Clinic, 2018).

Minimizing the impact of the illness depends mainly on early diagnosis and, appropriate psychosocial treatment and medication. One problem with this is that people with schizophrenia sometimes lack insight into their illness, and therefore do not see the need for medication or other mental health help. Also, medication sometimes has unpleasant side effects and this may discourage individuals from continuing to follow their prescription.

References

Mayo Clinic (2018). Schizophrenia Diagnosis & Treatment[Online]
Retrieved from: https://www.mayoclinic.org/diseases-conditions/schizophrenia/diagnosis-treatment/drc-20354449

Mind (2018). Bipolar Mood Symptoms [Online]
Retrieved from: https://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/bipolar-moods-symptoms

Schizophrenia Society of Canada (n.d.). Frequently Asked Questions [Online]
Retrieved from: http://www.schizophrenia.ca/faq.php


A little response from my current courses in psychopathology (please don't hit me, I study in France and our courses are not as good as in anglo-saxon countries) :

Schizophrenic patients tend to have some cognitives consequences, consecutive of a previous psychotic episode, even between two psychotics crisis.

There is some case of isolated psychotics episodes when the subject doesn't suffer from any consequences after that.

In Bipolar disorder, in type I where the subject can experiment delusion and sometime hallucination during both maniac and depressive period, he can recover completly (?!) during the period called euthymia.

I omitted the fact that having a first psychotic experience improve the "chance" of having another one, which is a kind of consequence.

If someone has some cognitive test references in order to improve my poor intervention it would be welcome !


A lengthy and thorough definition of "psychotic episode" would be needed here, but by definition, if it isn't what is termed chronic or life-long, it is this, From WebMD:

[… ] brief psychotic disorder is a short-term illness with psychotic symptoms. The symptoms often come on suddenly, but last for less than one month, after which the person usually recovers completely. There are three basic forms of brief psychotic disorder:

  • Brief psychotic disorder with obvious stressor (also called brief > reactive psychosis): This type occurs shortly after and often in
    response to a trauma or major stress, such as the death of a loved
    one, an accident, assault, or a natural disaster. Most cases of brief psychotic disorder occur as a reaction to a very disturbing event.

  • Brief psychotic disorder without obvious stressor: With this type, there is no apparent trauma or stress that triggers the illness.

  • Brief psychotic disorder with postpartum onset: This type occurs in women, usually within 4 weeks of having a baby.


What Treatment Is Available for Psychotic Symptoms in Dementia?

Antipsychotic medications are the first-line treatments for function-impairing delusions and hallucinations. Typical antipsychotics such as haloperidol and chlorpromazine are effective in treating these symptoms, but they have significant side effects including extrapyramidal symptoms (e.g., parkinsonism, tardive dyskinesia) and anti-cholinergic effects (e.g., sedation, worsening cognitive deficits). 12�

Although less studied, there is an emerging literature on the role of atypical antipsychotics in demented individuals with psychosis. 12, 14 Due to the lower incidence of side effects than with typical antipsychotics, atypical agents have emerged as the first-line treatments for these symptoms. Placebo-controlled trials of risperidone and olanzapine have shown a decrease in psychosis (with 1 and 2 mg/day of risperidone and 5 and 10 mg/day of olanzapine). 12 In a nonblinded trial, quetiapine at a mean dosage of 100 mg per day decreased psychotic symptoms at 12 months. 12

Although atypical antipsychotics have fewer side effects than traditional agents, attention must still be given to adverse effects, including orthostatic hypotension, anticholinergic symptoms, sedation, weight gain, and prolongation of the QT interval. Clozapine is the most anticholinergic of the atypical antipsychotics (followed in descending order by quetiapine, risperidone, and olanzapine) and the most prone to causing orthostatic hypotension. All agents may cause sedation and QT prolongation. Clozapine and olanzapine are most strongly associated with weight gain in nondemented patients, but there has been little study regarding their effects on weight in patients with dementia.


Psychosis & Psychotic Disorders

Psychotic disorders are severe mental health conditions. This group of neurological disorders changes the way a person thinks, feels and behaves. Psychosis, a shared symptom among psychotic disorders, is characterized by the presence of hallucinations and delusions.

Contrary to widespread beliefs, psychotic disorders are neither permanent nor impossible to manage on an outpatient basis. They are treatable psychiatric condition that can be controlled with medication and therapy.


Linked conditions

What mental health conditions are linked with psychosis?

  • a one-off experience,
  • part of a long-term mental health condition. You may only experience psychotic symptoms as part of your condition. Or you may experience other symptoms too, such as depressive symptoms.
  • part of a neurological condition such dementia, Alzheimer’s or Parkinson’s,
  • caused by a brain injury,
  • a side effect of medication,
  • an effect of drug abuse, or
  • an effect of drug or alcohol withdrawal.

Hallucinations can also happen if you are very tired. Or if someone close to you has recently died.

On this page we use the term ‘symptom’ instead of ‘experience.’ This is because symptom is a medical term. And here we are describing mental health conditions from a medical view.

If you want more information about psychosis linked to neurological conditions or brain injuries look at the Useful Contacts section at the end of this section.

Schizophrenia

You may get a diagnosis of schizophrenia if you experience a mixture of what medical professionals call ‘positive’ symptoms and ‘negative’ symptoms.

You can have a combination of negative and positive symptoms.

Positive symptoms
Positive symptoms are something you experience in addition’ to your normal experience. Such as psychosis. They include the following.

  • Hallucinations. Such as hearing voices.
  • Delusions. Such as believing something that isn’t factually correct.
  • Disorganised thinking. Such as switching from one topic to another with no clear link between the two.

Negative symptoms
Negative symptoms are things which are taken away from your normal experience. They include:

  • lack of motivation,
  • slow movement,
  • change in sleep patterns,
  • poor grooming or hygiene,
  • difficulty in planning and setting goals,
  • not saying much,
  • changes in body language,
  • lack of eye contact,
  • reduced range of emotions,
  • less interest in socialising or hobbies and activities, and
  • low sex drive.

Bipolar Disorder

Bipolar disorder can be a life-long mental health problem that mainly affects your mood. Your mood can change massively. You can experience episodes of mania and depression.

If you experience manic symptoms you may also experience psychosis. Your delusions will usually be grandiose. This means that you may believe that you are a very important person. Or you believe that you are able to achieve something which can’t be achieved. For example, you may believe you have special powers or are on a special mission.

Not everyone with bipolar disorder will experience psychosis. And you may feel well between episodes of mania and depression. When your mood changes, you might see changes in your energy levels or how you act.

Schizoaffective disorder

Schizoaffective disorder is a mental illness that can affect your thoughts, mood and behaviour. You may have symptoms of bipolar disorder and psychosis.

Drug induced psychosis

People who use or withdraw from alcohol and drugs can experience psychosis.

In rare situations side effects of medication can cause psychosis. Also taking too much medication can cause psychosis.

Depression with psychotic symptoms

You may experience psychosis if you have severe depression. Severe depression means that your symptoms are more severe than someone who has mild or moderate depression.

If you have a diagnosis of depression you may:

  • feel low,
  • lack motivation,
  • lack energy,
  • feel guilty,
  • lose your appetite, and
  • sleep poorly.

Postpartum psychosis

If you have psychotic experiences after giving birth, this is known as postpartum psychosis. This is a rare condition. This is most likely to happen suddenly within 2 weeks of giving birth.

If you experience postpartum psychosis you may:

  • experience psychosis,
  • feel confused,
  • be suspicious,
  • talk too quickly,
  • think too quickly, and
  • show signs of depression.

This is a serious mental health condition and should be treated as an emergency. If you don’t get treated quickly there is a risk that you could become worse very quickly.

You are likely to make a full recovery as long as you get the right treatment. You may be admitted to a mother and baby unit for support.

Delusional disorder

You may have a delusional disorder if you have a single firmly held belief that is not true. Or a set of related beliefs that are not true. These are likely to be constant and lifelong beliefs. You are very unlikely to hear voices with this disorder.

Brief psychotic episode

You will experience psychosis for a short period of time. The psychosis may or may not be linked to extreme stress.

The psychosis will usually develop gradually over a period of 2 weeks or less. You are likely to fully recover within a few months, weeks or even days.

You can find more information about:

  • Schizophrenia by clicking here.
  • Bipolar disorder by clicking here.
  • Schizoaffective disorder by clicking here.
  • Depression by clicking here.
  • Personality disorders by clicking here.
  • Hearing voices by clicking here.
  • Post-traumatic stress disorder by clicking here.

What was your first psychotic episode like?

sorry my first psychotic episode was just heresay by a gp. if anything my parents were ill and behaved badly from worry. like my mum saying maybe I could hear what the blackbird was saying in english and I tried but could hear what it was saying[until many years later in period of 7years without antipsychotics I heard a blackbird faintly but he was in english saying all sorts of stuff on how bad life for a bird is how you wouldn't want to be a bird it was hilarious anyway] so my parednt did anything they could to help me. I can't even remembber what was going on just sleep deprivation and grief really and I got called psychotic for my interests and ideas about the universe, philosophies all $#%^ I lost and its likke everytime I would wake up to my potentials in life I have a family breakdown for them ever resorting to putting me in hospitals which happened years later, so I already been called psychotic. sometimes I would just be in love anrequited love and its dispair and transformational potentials, like truely creative periods of life. maybe I too far outside the norm and yeah funny enough the familiy crisis's and sleep deprivation had its way with me if not for mypartents perseistance in worry and what later turned to them expressing horrid love and using the "its because we love you" and polluting the concept when I held such great potential for love, with their worry and insane behaviour I would feel smothered and it is toxic environment.

perhaps coz I so inteerested in obtaining superpowers and knowledge of the universe that its easy for them to say I am deluded. abundant time ric h in self-tranformation.

If I remember it clearly it would blow the lid on my case in argueing insight to what my mental health is really all about relative to being called a shcizophrenic. I still kknow that I share these problems with other people maybe although nobody seems to make much sense of me anywhere, maybe I try to talk to far from the comfort zone in pragrammed awareness.

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Re: What was your first psychotic episode like?

by paranormalgirl » Thu Apr 09, 2015 2:34 am

Re: What was your first psychotic episode like?

by crazysurvival » Fri Apr 17, 2015 8:55 pm

My first was when I was 28, now I am 48 (and frankly not much better off).

Parts of it were really kind of cool. I would walk outside with my walkman and it seems like the DJ's were leading me on a treasure hunt and playing cool music for me. I walked all over town. Some of the signs seemed to speak to me. At work it seemed like my supervisors were harassing me, that wasn't so much fun. My family seemed to be saying a lot of weird things too. The battery on my walkman seemed to last a month straight, which I thought was strange. A lot of weird things were happening. Nobody was returning any of my calls, my mail seemed to stop for a month. It seemed like everybody drifted away and started lying to me. My life seemed like it was drifting away. I got frustrated, broke my walkman in my apartment yelling 'liars' and then got in a fight with a neighbor who knocked on the door to complain. I got curious if I was living in a virtual world so I asked one of my brothers if vodka and sleeping pills really kills people and that landed me on a psych hold. I spent the next 8 months homeless and in and out of mental institutions. It seems like my family just discarded me. Some of it was really cool. A lot of it was horrible. If I were to make a movie out of it, I would definitely integrate good music while walking around - things like Carnival by 10,000 maniacs, 'One of Us' by Joan Osborne, and even Bob Dylans 'Rolling Stone' for the homeless portion.

Re: What was your first psychotic episode like?

by tonighttonight » Sat Apr 18, 2015 7:09 pm

I've had psychotic experiences in the sense of hearing voices/seeing things since age 13 so it's hard for me to remember, instead I'll describe the most severe psychotic break i've had.

Prior to the episode I had been in a state of borderline psychosis, exacerbated by drug abuse, for 6 months or so. During this time I had been building up an intricate mental network of delusions centring around obsessive thoughts about certain numbers, words, and narratives. The complete psychotic break was triggered by not sleeping as a result of a manic episode (I have bipolar, not schizophrenia, but its very rapid cycling so it mimics schizophrenia in a lot of ways). After a couple of nights with no sleep I started to spot links to my network of delusions everywhere, I found myself in situations where i was faced with the numbers that I associated with 'the end' and the whole fabric of reality began to collapse. The voices in my head which had previously been somewhat in the background took over completely, I could hear them very loudly and clearly and they were telling me to run away from my friend who was trying to look after me. I called the person whose voice I could hear (the voices are always people I know) and talked nonsense on the phone to him which of course didnt seem like nonsense to me at the time. After a few days all my real-life memories left me and the only thing remaining was the voices and delusions. I also lost my ability to form new memories. I couldn't function in any kind of normal way, couldn't eat or drink, I could only blurt out psychotic gibberish. I couldn't help blurting out terrible things, all my worst thoughts and fears. It was as if every nightmare I'd had was suddenly real. I didn't sleep for over a week and only an hour a night for the subsequent week. I was admitted to hospital and stayed for 3 weeks. Once my sleeping returned to normal (thanks to a lot of benzos) my memory and self-control started to come back. I managed to regain self-control to the point I was able to lie my way out of hospital, continued to experience psychotic symptoms that I was able to hide for an additional month or so. They eventually subsided when I was put on antipsychotics.

Re: What was your first psychotic episode like?

by crazy_banana » Mon Aug 17, 2015 5:27 am

Re: What was your first psychotic episode like?

by FrozenSoul » Fri Aug 21, 2015 11:00 pm

2 years. It was about an old man who came into my room at night and dragged me down into my basement (he looked exactly like the picture of a person in a prayer book for children. I still have that book at home and even wrote the author an e-mail to ask about her motives for drawing that man, but I got no answer.) Sometimes I could narrowly escape and run into my parents bedroom, after that he wasn't there anymore. After all I was awake. However, every night I could hear those steps coming closer to my door and everytime I hoped it was just my parents. Well, apparently life hated me and my hope was destroyed every time by the sight of him opening my door. After some months I knew I couldn't change anything if I just stayed in bed doing nothing but crying, so I thought talking and being nice to him might change the situation. I was wrong either. After nothing changed and it only got worse (bad sleep, strong fear of darkness and our basement, delusion. That man was real to me like my parents were. I thought he lived in our basement, especially as a child you believe such things very easily.) there came that one night which terrified me the most and was the beginning of the real psychosis. Like every night I tried to escape and fortunately I made it into my parents bedroom. I turned around and like every other night I expected the old man to be away. But instead of that he still stood there, even though I was wide awake. He just stood there and looked at me and my parents. I told them that he can't enter their bedroom because they are my parents and he fears them. They of course were shocked and I think it's horrifying for a parent if your child is such a wreck in that young age. But it's not like I was extremely shocked that he still stood there, because like I said: To me he was as real as every other person I knew so to me there was nothing strange about seeing him outside of my dreams. After those 2 years of hell the physical therapist of my mom who believes in ghosts came to our house and told us that the old man I saw is an unhappy ghost who can't go to heaven. He "spoke" to the "ghost" and told me that he was told, that the old man was severely injured in war and afterwards died alone in a hospital, which stood at the place of my house. After his death he was filled with anger and wanted revenge, so he chose me as his prey. Afterwards he told us that he exorcised our house and the ghost is away and went in heaven. Since I was a child I believed everything he said instantly and to me that old man really went in heaven and was away. My childish believe was so strong that my first psychosis could disappear. I still was afraid of darkness and suffered of paranoia but for the next few years I was allowed to live relatively normal again - I could sleep at night like every other person. Until depression, my 2nd psychosis and other stuff came.

Re: What was your first psychotic episode like?

by Red.Raptor » Sat Aug 22, 2015 9:44 pm

It was about 7 years ago when I was about 17 or so. I'm 24 now.

I'm also schizoaffective - bipolar type and i don't hear voices or anything just see things ocasionally and delusional thoughts.

Anyhow! I was 17 and it started off rather well, not too many problems, who knew sleeping 4 hours a night IF i even bothered to was an issue? I thought I was just accomplishing a lot.

I withdrew a lot, never left my room really, only for class, bathroom, food, etc. But it was because I hated people, I didn't think they were real. i thought they were like robots with pre-determined scripts to my conversations with them. I started thinking of everyone that way, people i would see in the store or driving their cars, my parents. Eventually this turned into thinking that I was the only real one and they were all watching me on TV or something through cameras everywhere.

I probably spent a good 4-5 months in my room thinking this. I was self-harming so much and becoming so suicidal that i had to hospitalize myself because my parents didn't know or didn't care to. I'm not sure. I was also seeing things but that wasn't all that bothersome just floating letters to a language i couldn't figure out. I was pretty sure that the visual halucinations weren't real but couldn't shake the delusions.

In the hospital I told the doctor these things and they just prescribed me an antidepressant, so.. I lived like that for about 2 more years until I tried to kill myself again.

I ended up with a different doctor and he put me on antipsychotics and it helped a bit, I still think those delusional thoughts ocasionally but I don't believe them heart-and-soul anymore.

Little Angel, go away, come again some other day.
The Devil has my ear today, I'll never hear a word you say.

Schizoaffective - Bipolar type

Re: What was your first psychotic episode like?

by Sygwei » Thu Oct 15, 2015 1:43 am

Re: What was your first psychotic episode like?

by BenWilk87 » Thu Dec 31, 2015 5:29 pm

At the age of 25, I had my first and hopefully only psycotic episode. I was working for EA games as a tester. It was at the start of testing the next gen consoles on Madden 25. Every day I woke up refreshed and ready for work. While at work, I was manic. High energy levels, increased confidence and a feeling of real purpose were symptoms of my episode.

When I got home from work, it was a different story. Most days I crashed straight to bed. Some days I continued the manic behavior. One day, after telling a friend to move from the sofa to a bed so she wouldn't get a crick in her neck, I retreated to my room and got on facebook. While browsing I was overcome with a feeling of pure ecstasy. It was weird. The variations in my emotional state were not severe. The energy, confidence and sense of purpose seemed to me to be a normal, positive thing. One day I came home from work and couldn't rest.

The bills had come in and I was not able to pay them on my salary. I was working my butt off to end up in the hole. I paced the house, contmplating bills, work and life in general. I remember walking into my room and going "out". My mind raced at a million miles an hour asking myself questions. It slowed down near the end of the "hallucination" I was experiencing. The last question i asked myself was, "how will I support my kids in the future?" The "hallucination" I had was from my memory. It wasn't a halluucination although it was supernatural and it's hard to explain.

The memory played was all black with people made up of wisps of light. The memory was from work at a time when everyone was talking. I flew around the room, I guess you could say in spirit form, and stopped next to someone I knew. He said, "He has no idea we are just f'ing with him." They had been asking for my help, overworking me on purpose just to entertain themselves. When I came out of the hallucination, I was in my underwear, kneeling on one knee with my left fist on the ground in front of the double doors that lead to the back yard. I had just experienced a break.

I haven't found anything on the internet similar to my experience, an advanced form of memory and perception of reality as we know it. Anyway, I was soon diagnosed bipolar mimic and paranoid schizophrenic. I think it's bs. That's not the full story but I don't want to go on about my experience of hypersensitivity and conveniently running into the cops so I would confess my sins and be sent to a mental institution. Then jail. Yea, fun. 2 years of my life lost to mental institutions and jail. Recently out, I'm fine. No real issues of instability or anything I would consider to be mental illness. Just sharing.


Do they have memories of manic/psychotic episodes?

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Cannabis (Marijuana)

There is some evidence that using marijuana increases risk of schizophrenia, especially when used over a long-term. Those that are dependent on cannabis tend to have increased rates of psychotic symptoms, particularly in young people – regardless of other factors. It is known that some people experience a psychotic episode while intoxicated with cannabis and others may experience psychosis as a result of cumulative cannabis usage.

The age at which a person starts using cannabis as well as the person’s sex are thought to increase risk of cannabis-induced psychosis. The younger a person starts using cannabis, the greater their susceptibility to experiencing psychosis. Additionally males tend to experience cannabis-induced psychosis to a greater extent than females.

Cannabis-induced psychotic disorder (CIPD) isn’t always associated with those who develop schizophrenia. In fact, research demonstrates that PPI (pre-pulse inhibition) testing differs between those experiencing cannabis-induced psychotic disorder and schizophrenia. Particularly, those with schizophrenia tend to have significantly worse pre-pulse inhibition when attention is required by comparison.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/25175914
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/17662880
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/12537030
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/16319402

Psychopaths, sociopaths, and people who experience psychotic disorders how do you feel when media uses the terms "psycho" and "psychotic" in a negative context.

I have dealt with schizophrenia for a few years now which is already seen as a dangerous mental illness. As someone who experiences psychosis frequently it really hurts me to hear someone being called "psychotic" as an insult or to basically say that they're a bad person. It makes me feel like I am a bad person simply because of my illness. I am wondering if this is a shared feeling?

It also hurts me to see "psycho" used in such contexts. I wonder what the community has to say about it. It's also extremely infuriating seeing phrases like "cute but psycho" and that kind of thing on shirts and stuff. It's treated as a quirk when it is really a very serious and damaging illness. I don't think anyone who is a psychopath or sociopath would go around flaunting it publicly.


What Psychotic Episodes Really Look and Feel Like

When we hear someone is psychotic, we automatically think of psychopaths and cold-blooded criminals. We automatically think “Oh wow, they’re really crazy!” And we automatically think of plenty of other myths and misconceptions that only further the stigma surrounding psychosis.

In other words, the reality is that we get psychosis very wrong.

For starters, psychosis consists of hallucinations and/or delusions. “You can have one or both at the same time,” said Devon MacDermott, Ph.D, a psychologist who previously worked in psychiatric hospitals and outpatient centers, treating individuals experiencing psychosis in various forms.

“Hallucinations are sensory perceptions in the absence of external triggers,” MacDermott said. That is, “the trigger comes from inside [the person’s] own mind,” and involves one of their five senses. The most common is hearing voices, she said. People also can “see or feel things that aren’t there.”

“Delusions are persistent beliefs without sufficient evidence to back up those beliefs—and often with substantial evidence to refute the belief,” said MacDermott, who’s now in private practice where she specializes in trauma and OCD.

Psychologist Jessica Arenella, Ph.D, describes psychosis as a disruption in meaning-making: “The person may be finding meaning in otherwise random or inconsequential things (e.g., license plate numbers, TV ads), while minimizing or failing to grasp the importance of basic needs (e.g., showing up for work, changing one’s clothes).”

The signs of a psychotic episode differ depending on the person, because the symptoms are “an extension of each person’s unique thinking patterns,” MacDermott said.

Generally, people’s speech can be tough to follow or not make sense (because the person’s thoughts are disorganized) they might mutter or talk to themselves say extraordinary, often unlikely things (e.g., “An actor is in love with me”), she said.

During a psychotic episode, it’s common for individuals to act in ways that are strange or out of character for them, MacDermott said. “This can range from something small like wearing more layers of clothes than is appropriate for the temperature all the way to sudden bursts of emotion that seem to come out of nowhere.”

What Psychotic Episodes Feel Like

“[During a psychotic episode], I zone out. I’m gone. I leave reality,” said Michelle Hammer, who has schizophrenia. She’s the co-host of Psych Central’s A Bipolar, a Schizophrenic, and a Podcast and founder of Schizophrenic.NYC, a clothing line with the mission of reducing stigma by starting conversations about mental health. “I can be thinking of anything. A past conversation. A made-up conversation. A weird dreamlike situation. I lose reality of where I actually physically am.”

“I mainly just feel ‘off,’ Things just aren’t right,” said Rachel Star Withers, who has schizophrenia and is an entertainer, speaker and video producer. She creates videos documenting her schizophrenia and ways to manage it, and aims to let others like her know they are not alone and can still live an amazing life.

“The biggest tell for me is that I start talking to myself and thinking in third person,” Withers said. She’ll tell herself things like:”OK Rachel, just walk be normal.”

A patient once described psychosis in this way to MacDermott: “Imagine that you summon a picture in your mind like, say, a baseball. Imagine a baseball. Now imagine what it would be like to have the knowledge that you put that image in your mind taken away. Now, all you are left with is a thought having no idea how it got there. That’s what it’s like to be psychotic.”

MacDermott’s patients also have told her that they struggle with interpreting situations and see special meaning in everyday things. “That same patient once saw a family member put a knife down while they were cooking and had the thought that the family member was trying to send the patient a message that they were going to be killed because a knife represents death.”

In this piece on The Mighty individuals shared what it’s like to experience psychosis. One person wrote, “For me, it felt like I was watching a movie that was my life. I knew bad things were happening and I couldn’t stop it.” Another person described having an “out of body experience,” along with “excruciating sensations amplified by 1,000 at the tip of every sensor in my body.”

Someone else explained it in this way: “Every sense is heightened and colors are especially bright. The world is on a giant flat screen TV. Everything seems more crystal clear than you ever knew, but then it all becomes confused and muddled. You make your own realities, constantly decoding messages that seem extremely important, but are ultimately meaningless. They further the storyline in your head that seems so real.”

Arenella’s clients have described their psychotic episodes as “disorienting, overwhelming, frightening and isolating. They often describe heightened sensitivity, believing that there are no boundaries, that everything is related and transparent, and there is no privacy.”

Some might believe that they’re part of, or at the center of, a critical life-altering mission or plan, Arenella said. Which might lead to intense activity or the complete opposite: a feeling of paralysis.

Myths about Psychotic Episodes

One of the biggest and most harmful myths about psychosis is that people are dangerous and violent. Both MacDermott and Arenella emphasized that individuals in the throes of psychosis are much more likely to be victimized than to victimize.

Similarly, psychosis is not the same as psychopathy, MacDermott said. “Psychopaths are people who don’t feel empathy, are thrill seeking, and often are parasitic, aggressive, or manipulative to others. Psychosis is completely different and unrelated.”

Another misconception is that psychosis is always indicative of schizophrenia. Sometimes, psychotic episodes occur on their own, or as part of a different mental illness, such as depression, Arenella said. Most people only experience one or a handful of psychotic episodes in their lifetime, she said. (“Only approximately one third of people who experience psychotic episodes go on to have persistent psychotic states.”)

And if someone’s psychotic episodes are part of schizophrenia, it’s important to understand that people can and do recover from this illness, Arenella said.

Arenella, a founding member of Hearing Voices NYC, also noted that eliminating voice hearing isn’t an essential part of treatment. “How a person interprets and interacts with their voices is more important for recovery than hearing them or not hearing them.” (This TED talk from Eleanor Longden, who has schizophrenia, provides more insight.)

Moreover, even many mental health professionals believe the widespread myth that medication successfully treats psychosis, said Arenella, the president of the United States chapter of the International Society for Psychological and Social Approaches to Psychosis. While medication can decrease the intensity of symptoms, many people still hear voices and have difficulty in social relating, she said. Many also experience bothersome or serious side effects.

“Medication works for some people, some of the time, but it is not a cure all.” Psychosocial treatments, such as cognitive behavioral therapy for psychosis (CBT-p), have been shown to be effective in treating psychosis.

What Causes Psychotic Episodes

MacDermott noted that there’s a lot we still don’t know about psychosis, and that includes its causes. Genetics likely plays a role. “People with an immediate family member with schizophrenia are much more likely to have schizophrenia themselves than someone who doesn’t have an immediate family member with the disorder,” she said.

Adverse childhood events and trauma can contribute to psychosis, as well, even though the episode can occur years later, Arenella said. She also identified other common factors: loss, social rejection, insomnia, illegal and prescribed drugs and hormonal changes.

“A lot of antipsychotic medication reduces the amount of certain neurotransmitters, like dopamine, in the brain,” MacDermott said. This suggests that too much dopamine (and other neurotransmitters) might be involved in psychosis. But, as MacDermott noted, “People and brains are so complicated that we can’t know for sure exactly what triggers psychosis in each person.”

A big reason psychosis scares and confuses us is because it seems so out of the realm of “normal.” But in actuality, “psychosis is part of the normal range of human experience,” Arenella said. “While it is unusual, it is not fundamentally different from other human experience.”

That is, she said, “people who hear voices actually hear them and they sound just as real as all of the other voices of people. Imagine if someone were talking to you all day long while you’re trying to have a conversation with someone else you might be distracted, confused, irritable, and want to avoid conversations. This is a normal response, albeit to an unusual stimuli.”

Also, many people hear voices, and aren’t having a psychotic episode. Arenella noted that after a loved one dies, some people report hearing the person talking to them. “Musicians and poets often hear tunes and verses in their heads and may not feel as if they created them, but more like they received them somehow.” Many people also talk about hearing the voice of God or Jesus during pivotal moments in their lives.

We tend to be taught, both implicitly and explicitly, that psychosis is unlike any other mental health issue—such as anxiety or depression, and “is not amenable to regular therapeutic techniques,” Arenella said. “This fosters a profound othering and harmful stigma toward people who experience psychosis.”


Signs and Symptoms of Schizoaffective Disorder

Schizoaffective disorder affects each person differently. Some people experience cycles of severe symptoms followed by periods of improvement.

Symptoms may include the following: (1)

  • Hallucinations (seeing or hearing things that no one else can see or hear)
  • Delusions (false, sometimes paranoid beliefs)
  • Disorganized or illogical thinking (switching very quickly between unrelated topics speech may seem jumbled)
  • Depressed mood (feelings of sadness, emptiness, or worthlessness that won't go away)
  • Mania (feelings of euphoria, racing thoughts, or risky behavior)
  • Suicidal thoughts or behavior

What was your first psychotic episode like?

sorry my first psychotic episode was just heresay by a gp. if anything my parents were ill and behaved badly from worry. like my mum saying maybe I could hear what the blackbird was saying in english and I tried but could hear what it was saying[until many years later in period of 7years without antipsychotics I heard a blackbird faintly but he was in english saying all sorts of stuff on how bad life for a bird is how you wouldn't want to be a bird it was hilarious anyway] so my parednt did anything they could to help me. I can't even remembber what was going on just sleep deprivation and grief really and I got called psychotic for my interests and ideas about the universe, philosophies all $#%^ I lost and its likke everytime I would wake up to my potentials in life I have a family breakdown for them ever resorting to putting me in hospitals which happened years later, so I already been called psychotic. sometimes I would just be in love anrequited love and its dispair and transformational potentials, like truely creative periods of life. maybe I too far outside the norm and yeah funny enough the familiy crisis's and sleep deprivation had its way with me if not for mypartents perseistance in worry and what later turned to them expressing horrid love and using the "its because we love you" and polluting the concept when I held such great potential for love, with their worry and insane behaviour I would feel smothered and it is toxic environment.

perhaps coz I so inteerested in obtaining superpowers and knowledge of the universe that its easy for them to say I am deluded. abundant time ric h in self-tranformation.

If I remember it clearly it would blow the lid on my case in argueing insight to what my mental health is really all about relative to being called a shcizophrenic. I still kknow that I share these problems with other people maybe although nobody seems to make much sense of me anywhere, maybe I try to talk to far from the comfort zone in pragrammed awareness.

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Re: What was your first psychotic episode like?

by paranormalgirl » Thu Apr 09, 2015 2:34 am

Re: What was your first psychotic episode like?

by crazysurvival » Fri Apr 17, 2015 8:55 pm

My first was when I was 28, now I am 48 (and frankly not much better off).

Parts of it were really kind of cool. I would walk outside with my walkman and it seems like the DJ's were leading me on a treasure hunt and playing cool music for me. I walked all over town. Some of the signs seemed to speak to me. At work it seemed like my supervisors were harassing me, that wasn't so much fun. My family seemed to be saying a lot of weird things too. The battery on my walkman seemed to last a month straight, which I thought was strange. A lot of weird things were happening. Nobody was returning any of my calls, my mail seemed to stop for a month. It seemed like everybody drifted away and started lying to me. My life seemed like it was drifting away. I got frustrated, broke my walkman in my apartment yelling 'liars' and then got in a fight with a neighbor who knocked on the door to complain. I got curious if I was living in a virtual world so I asked one of my brothers if vodka and sleeping pills really kills people and that landed me on a psych hold. I spent the next 8 months homeless and in and out of mental institutions. It seems like my family just discarded me. Some of it was really cool. A lot of it was horrible. If I were to make a movie out of it, I would definitely integrate good music while walking around - things like Carnival by 10,000 maniacs, 'One of Us' by Joan Osborne, and even Bob Dylans 'Rolling Stone' for the homeless portion.

Re: What was your first psychotic episode like?

by tonighttonight » Sat Apr 18, 2015 7:09 pm

I've had psychotic experiences in the sense of hearing voices/seeing things since age 13 so it's hard for me to remember, instead I'll describe the most severe psychotic break i've had.

Prior to the episode I had been in a state of borderline psychosis, exacerbated by drug abuse, for 6 months or so. During this time I had been building up an intricate mental network of delusions centring around obsessive thoughts about certain numbers, words, and narratives. The complete psychotic break was triggered by not sleeping as a result of a manic episode (I have bipolar, not schizophrenia, but its very rapid cycling so it mimics schizophrenia in a lot of ways). After a couple of nights with no sleep I started to spot links to my network of delusions everywhere, I found myself in situations where i was faced with the numbers that I associated with 'the end' and the whole fabric of reality began to collapse. The voices in my head which had previously been somewhat in the background took over completely, I could hear them very loudly and clearly and they were telling me to run away from my friend who was trying to look after me. I called the person whose voice I could hear (the voices are always people I know) and talked nonsense on the phone to him which of course didnt seem like nonsense to me at the time. After a few days all my real-life memories left me and the only thing remaining was the voices and delusions. I also lost my ability to form new memories. I couldn't function in any kind of normal way, couldn't eat or drink, I could only blurt out psychotic gibberish. I couldn't help blurting out terrible things, all my worst thoughts and fears. It was as if every nightmare I'd had was suddenly real. I didn't sleep for over a week and only an hour a night for the subsequent week. I was admitted to hospital and stayed for 3 weeks. Once my sleeping returned to normal (thanks to a lot of benzos) my memory and self-control started to come back. I managed to regain self-control to the point I was able to lie my way out of hospital, continued to experience psychotic symptoms that I was able to hide for an additional month or so. They eventually subsided when I was put on antipsychotics.

Re: What was your first psychotic episode like?

by crazy_banana » Mon Aug 17, 2015 5:27 am

Re: What was your first psychotic episode like?

by FrozenSoul » Fri Aug 21, 2015 11:00 pm

2 years. It was about an old man who came into my room at night and dragged me down into my basement (he looked exactly like the picture of a person in a prayer book for children. I still have that book at home and even wrote the author an e-mail to ask about her motives for drawing that man, but I got no answer.) Sometimes I could narrowly escape and run into my parents bedroom, after that he wasn't there anymore. After all I was awake. However, every night I could hear those steps coming closer to my door and everytime I hoped it was just my parents. Well, apparently life hated me and my hope was destroyed every time by the sight of him opening my door. After some months I knew I couldn't change anything if I just stayed in bed doing nothing but crying, so I thought talking and being nice to him might change the situation. I was wrong either. After nothing changed and it only got worse (bad sleep, strong fear of darkness and our basement, delusion. That man was real to me like my parents were. I thought he lived in our basement, especially as a child you believe such things very easily.) there came that one night which terrified me the most and was the beginning of the real psychosis. Like every night I tried to escape and fortunately I made it into my parents bedroom. I turned around and like every other night I expected the old man to be away. But instead of that he still stood there, even though I was wide awake. He just stood there and looked at me and my parents. I told them that he can't enter their bedroom because they are my parents and he fears them. They of course were shocked and I think it's horrifying for a parent if your child is such a wreck in that young age. But it's not like I was extremely shocked that he still stood there, because like I said: To me he was as real as every other person I knew so to me there was nothing strange about seeing him outside of my dreams. After those 2 years of hell the physical therapist of my mom who believes in ghosts came to our house and told us that the old man I saw is an unhappy ghost who can't go to heaven. He "spoke" to the "ghost" and told me that he was told, that the old man was severely injured in war and afterwards died alone in a hospital, which stood at the place of my house. After his death he was filled with anger and wanted revenge, so he chose me as his prey. Afterwards he told us that he exorcised our house and the ghost is away and went in heaven. Since I was a child I believed everything he said instantly and to me that old man really went in heaven and was away. My childish believe was so strong that my first psychosis could disappear. I still was afraid of darkness and suffered of paranoia but for the next few years I was allowed to live relatively normal again - I could sleep at night like every other person. Until depression, my 2nd psychosis and other stuff came.

Re: What was your first psychotic episode like?

by Red.Raptor » Sat Aug 22, 2015 9:44 pm

It was about 7 years ago when I was about 17 or so. I'm 24 now.

I'm also schizoaffective - bipolar type and i don't hear voices or anything just see things ocasionally and delusional thoughts.

Anyhow! I was 17 and it started off rather well, not too many problems, who knew sleeping 4 hours a night IF i even bothered to was an issue? I thought I was just accomplishing a lot.

I withdrew a lot, never left my room really, only for class, bathroom, food, etc. But it was because I hated people, I didn't think they were real. i thought they were like robots with pre-determined scripts to my conversations with them. I started thinking of everyone that way, people i would see in the store or driving their cars, my parents. Eventually this turned into thinking that I was the only real one and they were all watching me on TV or something through cameras everywhere.

I probably spent a good 4-5 months in my room thinking this. I was self-harming so much and becoming so suicidal that i had to hospitalize myself because my parents didn't know or didn't care to. I'm not sure. I was also seeing things but that wasn't all that bothersome just floating letters to a language i couldn't figure out. I was pretty sure that the visual halucinations weren't real but couldn't shake the delusions.

In the hospital I told the doctor these things and they just prescribed me an antidepressant, so.. I lived like that for about 2 more years until I tried to kill myself again.

I ended up with a different doctor and he put me on antipsychotics and it helped a bit, I still think those delusional thoughts ocasionally but I don't believe them heart-and-soul anymore.

Little Angel, go away, come again some other day.
The Devil has my ear today, I'll never hear a word you say.

Schizoaffective - Bipolar type

Re: What was your first psychotic episode like?

by Sygwei » Thu Oct 15, 2015 1:43 am

Re: What was your first psychotic episode like?

by BenWilk87 » Thu Dec 31, 2015 5:29 pm

At the age of 25, I had my first and hopefully only psycotic episode. I was working for EA games as a tester. It was at the start of testing the next gen consoles on Madden 25. Every day I woke up refreshed and ready for work. While at work, I was manic. High energy levels, increased confidence and a feeling of real purpose were symptoms of my episode.

When I got home from work, it was a different story. Most days I crashed straight to bed. Some days I continued the manic behavior. One day, after telling a friend to move from the sofa to a bed so she wouldn't get a crick in her neck, I retreated to my room and got on facebook. While browsing I was overcome with a feeling of pure ecstasy. It was weird. The variations in my emotional state were not severe. The energy, confidence and sense of purpose seemed to me to be a normal, positive thing. One day I came home from work and couldn't rest.

The bills had come in and I was not able to pay them on my salary. I was working my butt off to end up in the hole. I paced the house, contmplating bills, work and life in general. I remember walking into my room and going "out". My mind raced at a million miles an hour asking myself questions. It slowed down near the end of the "hallucination" I was experiencing. The last question i asked myself was, "how will I support my kids in the future?" The "hallucination" I had was from my memory. It wasn't a halluucination although it was supernatural and it's hard to explain.

The memory played was all black with people made up of wisps of light. The memory was from work at a time when everyone was talking. I flew around the room, I guess you could say in spirit form, and stopped next to someone I knew. He said, "He has no idea we are just f'ing with him." They had been asking for my help, overworking me on purpose just to entertain themselves. When I came out of the hallucination, I was in my underwear, kneeling on one knee with my left fist on the ground in front of the double doors that lead to the back yard. I had just experienced a break.

I haven't found anything on the internet similar to my experience, an advanced form of memory and perception of reality as we know it. Anyway, I was soon diagnosed bipolar mimic and paranoid schizophrenic. I think it's bs. That's not the full story but I don't want to go on about my experience of hypersensitivity and conveniently running into the cops so I would confess my sins and be sent to a mental institution. Then jail. Yea, fun. 2 years of my life lost to mental institutions and jail. Recently out, I'm fine. No real issues of instability or anything I would consider to be mental illness. Just sharing.


What Treatment Is Available for Psychotic Symptoms in Dementia?

Antipsychotic medications are the first-line treatments for function-impairing delusions and hallucinations. Typical antipsychotics such as haloperidol and chlorpromazine are effective in treating these symptoms, but they have significant side effects including extrapyramidal symptoms (e.g., parkinsonism, tardive dyskinesia) and anti-cholinergic effects (e.g., sedation, worsening cognitive deficits). 12�

Although less studied, there is an emerging literature on the role of atypical antipsychotics in demented individuals with psychosis. 12, 14 Due to the lower incidence of side effects than with typical antipsychotics, atypical agents have emerged as the first-line treatments for these symptoms. Placebo-controlled trials of risperidone and olanzapine have shown a decrease in psychosis (with 1 and 2 mg/day of risperidone and 5 and 10 mg/day of olanzapine). 12 In a nonblinded trial, quetiapine at a mean dosage of 100 mg per day decreased psychotic symptoms at 12 months. 12

Although atypical antipsychotics have fewer side effects than traditional agents, attention must still be given to adverse effects, including orthostatic hypotension, anticholinergic symptoms, sedation, weight gain, and prolongation of the QT interval. Clozapine is the most anticholinergic of the atypical antipsychotics (followed in descending order by quetiapine, risperidone, and olanzapine) and the most prone to causing orthostatic hypotension. All agents may cause sedation and QT prolongation. Clozapine and olanzapine are most strongly associated with weight gain in nondemented patients, but there has been little study regarding their effects on weight in patients with dementia.


Linked conditions

What mental health conditions are linked with psychosis?

  • a one-off experience,
  • part of a long-term mental health condition. You may only experience psychotic symptoms as part of your condition. Or you may experience other symptoms too, such as depressive symptoms.
  • part of a neurological condition such dementia, Alzheimer’s or Parkinson’s,
  • caused by a brain injury,
  • a side effect of medication,
  • an effect of drug abuse, or
  • an effect of drug or alcohol withdrawal.

Hallucinations can also happen if you are very tired. Or if someone close to you has recently died.

On this page we use the term ‘symptom’ instead of ‘experience.’ This is because symptom is a medical term. And here we are describing mental health conditions from a medical view.

If you want more information about psychosis linked to neurological conditions or brain injuries look at the Useful Contacts section at the end of this section.

Schizophrenia

You may get a diagnosis of schizophrenia if you experience a mixture of what medical professionals call ‘positive’ symptoms and ‘negative’ symptoms.

You can have a combination of negative and positive symptoms.

Positive symptoms
Positive symptoms are something you experience in addition’ to your normal experience. Such as psychosis. They include the following.

  • Hallucinations. Such as hearing voices.
  • Delusions. Such as believing something that isn’t factually correct.
  • Disorganised thinking. Such as switching from one topic to another with no clear link between the two.

Negative symptoms
Negative symptoms are things which are taken away from your normal experience. They include:

  • lack of motivation,
  • slow movement,
  • change in sleep patterns,
  • poor grooming or hygiene,
  • difficulty in planning and setting goals,
  • not saying much,
  • changes in body language,
  • lack of eye contact,
  • reduced range of emotions,
  • less interest in socialising or hobbies and activities, and
  • low sex drive.

Bipolar Disorder

Bipolar disorder can be a life-long mental health problem that mainly affects your mood. Your mood can change massively. You can experience episodes of mania and depression.

If you experience manic symptoms you may also experience psychosis. Your delusions will usually be grandiose. This means that you may believe that you are a very important person. Or you believe that you are able to achieve something which can’t be achieved. For example, you may believe you have special powers or are on a special mission.

Not everyone with bipolar disorder will experience psychosis. And you may feel well between episodes of mania and depression. When your mood changes, you might see changes in your energy levels or how you act.

Schizoaffective disorder

Schizoaffective disorder is a mental illness that can affect your thoughts, mood and behaviour. You may have symptoms of bipolar disorder and psychosis.

Drug induced psychosis

People who use or withdraw from alcohol and drugs can experience psychosis.

In rare situations side effects of medication can cause psychosis. Also taking too much medication can cause psychosis.

Depression with psychotic symptoms

You may experience psychosis if you have severe depression. Severe depression means that your symptoms are more severe than someone who has mild or moderate depression.

If you have a diagnosis of depression you may:

  • feel low,
  • lack motivation,
  • lack energy,
  • feel guilty,
  • lose your appetite, and
  • sleep poorly.

Postpartum psychosis

If you have psychotic experiences after giving birth, this is known as postpartum psychosis. This is a rare condition. This is most likely to happen suddenly within 2 weeks of giving birth.

If you experience postpartum psychosis you may:

  • experience psychosis,
  • feel confused,
  • be suspicious,
  • talk too quickly,
  • think too quickly, and
  • show signs of depression.

This is a serious mental health condition and should be treated as an emergency. If you don’t get treated quickly there is a risk that you could become worse very quickly.

You are likely to make a full recovery as long as you get the right treatment. You may be admitted to a mother and baby unit for support.

Delusional disorder

You may have a delusional disorder if you have a single firmly held belief that is not true. Or a set of related beliefs that are not true. These are likely to be constant and lifelong beliefs. You are very unlikely to hear voices with this disorder.

Brief psychotic episode

You will experience psychosis for a short period of time. The psychosis may or may not be linked to extreme stress.

The psychosis will usually develop gradually over a period of 2 weeks or less. You are likely to fully recover within a few months, weeks or even days.

You can find more information about:

  • Schizophrenia by clicking here.
  • Bipolar disorder by clicking here.
  • Schizoaffective disorder by clicking here.
  • Depression by clicking here.
  • Personality disorders by clicking here.
  • Hearing voices by clicking here.
  • Post-traumatic stress disorder by clicking here.

Psychosis & Psychotic Disorders

Psychotic disorders are severe mental health conditions. This group of neurological disorders changes the way a person thinks, feels and behaves. Psychosis, a shared symptom among psychotic disorders, is characterized by the presence of hallucinations and delusions.

Contrary to widespread beliefs, psychotic disorders are neither permanent nor impossible to manage on an outpatient basis. They are treatable psychiatric condition that can be controlled with medication and therapy.


Do they have memories of manic/psychotic episodes?

Bipolar Disorder Vs Depression: What Are The Differences And Similarities?
Infocenter articles
  • Acute bipolar disorder
  • Symptoms of manic depression
  • Symptoms of bipolar disorder in adults
  • Best medication for hypomania
  • Symptoms and treatment for bipolar II disorder
  • Bipolar disorder or manic depression causes and treatment
  • Causes of bipolar disorder
  • Recognizing the symptoms of bipolar disorder
  • Full detailed information on Bipolar disorder
  • Schizoaffective disorder duration
  • Symptoms of bipolar disorder in children
  • Symptoms and cures for psychotic depression
  • Bipolar spectrum disorder
  • Therapy for bipolar disorder
  • Role of psychiatrist in recognizing and treating bipolar disorder
  • Bipolar Disorder (AKA 'Manic Depression'): What Is Typical and What Isn't?
  • The Key Differences Between Bipolar Disorder And Borderline Personality Disorder
  • Bipolar Disorder And Anxiety: Which Comes First And What If You Have Both?
  • 3 Healthy Habits for People with Bipolar Disorder
  • Inside Bipolar Mind
  • Being The Partner Of A Person With Bipolar Affective Disorder
  • Dealing With Abuse Memories
  • Cannabis Use Linked to Risk of Psychotic Disorders Later in Life
  • The Causes Behind Racing Thoughts
  • Psychotic Depression: Signs, Symptoms, Diagnosis, And Treatment
  • 6 Types Of Depression And Their Symptoms: Exploring Possible Diagnoses
  • Schizoaffective Disorder: More Than Just Schizophrenia
  • Childhood Memory: An Enigma Science Is Beginning To Solve
  • Smell You Later: Why Odors Evoke Potent, Emotional, Childhood Memories
  • Steer Clear of Pot, If You Have Psychosis
  • What Makes Elderly People Aggressive And Paranoid, And How Do You Deal?
  • How To Emotionally Cope With An Unexpected, Sudden Death: When Grief Comes As A Total Shock
  • Why Do You Keep Getting UTIs?

Cannabis (Marijuana)

There is some evidence that using marijuana increases risk of schizophrenia, especially when used over a long-term. Those that are dependent on cannabis tend to have increased rates of psychotic symptoms, particularly in young people – regardless of other factors. It is known that some people experience a psychotic episode while intoxicated with cannabis and others may experience psychosis as a result of cumulative cannabis usage.

The age at which a person starts using cannabis as well as the person’s sex are thought to increase risk of cannabis-induced psychosis. The younger a person starts using cannabis, the greater their susceptibility to experiencing psychosis. Additionally males tend to experience cannabis-induced psychosis to a greater extent than females.

Cannabis-induced psychotic disorder (CIPD) isn’t always associated with those who develop schizophrenia. In fact, research demonstrates that PPI (pre-pulse inhibition) testing differs between those experiencing cannabis-induced psychotic disorder and schizophrenia. Particularly, those with schizophrenia tend to have significantly worse pre-pulse inhibition when attention is required by comparison.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/25175914
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/17662880
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/12537030
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/16319402

Psychopaths, sociopaths, and people who experience psychotic disorders how do you feel when media uses the terms "psycho" and "psychotic" in a negative context.

I have dealt with schizophrenia for a few years now which is already seen as a dangerous mental illness. As someone who experiences psychosis frequently it really hurts me to hear someone being called "psychotic" as an insult or to basically say that they're a bad person. It makes me feel like I am a bad person simply because of my illness. I am wondering if this is a shared feeling?

It also hurts me to see "psycho" used in such contexts. I wonder what the community has to say about it. It's also extremely infuriating seeing phrases like "cute but psycho" and that kind of thing on shirts and stuff. It's treated as a quirk when it is really a very serious and damaging illness. I don't think anyone who is a psychopath or sociopath would go around flaunting it publicly.


What Psychotic Episodes Really Look and Feel Like

When we hear someone is psychotic, we automatically think of psychopaths and cold-blooded criminals. We automatically think “Oh wow, they’re really crazy!” And we automatically think of plenty of other myths and misconceptions that only further the stigma surrounding psychosis.

In other words, the reality is that we get psychosis very wrong.

For starters, psychosis consists of hallucinations and/or delusions. “You can have one or both at the same time,” said Devon MacDermott, Ph.D, a psychologist who previously worked in psychiatric hospitals and outpatient centers, treating individuals experiencing psychosis in various forms.

“Hallucinations are sensory perceptions in the absence of external triggers,” MacDermott said. That is, “the trigger comes from inside [the person’s] own mind,” and involves one of their five senses. The most common is hearing voices, she said. People also can “see or feel things that aren’t there.”

“Delusions are persistent beliefs without sufficient evidence to back up those beliefs—and often with substantial evidence to refute the belief,” said MacDermott, who’s now in private practice where she specializes in trauma and OCD.

Psychologist Jessica Arenella, Ph.D, describes psychosis as a disruption in meaning-making: “The person may be finding meaning in otherwise random or inconsequential things (e.g., license plate numbers, TV ads), while minimizing or failing to grasp the importance of basic needs (e.g., showing up for work, changing one’s clothes).”

The signs of a psychotic episode differ depending on the person, because the symptoms are “an extension of each person’s unique thinking patterns,” MacDermott said.

Generally, people’s speech can be tough to follow or not make sense (because the person’s thoughts are disorganized) they might mutter or talk to themselves say extraordinary, often unlikely things (e.g., “An actor is in love with me”), she said.

During a psychotic episode, it’s common for individuals to act in ways that are strange or out of character for them, MacDermott said. “This can range from something small like wearing more layers of clothes than is appropriate for the temperature all the way to sudden bursts of emotion that seem to come out of nowhere.”

What Psychotic Episodes Feel Like

“[During a psychotic episode], I zone out. I’m gone. I leave reality,” said Michelle Hammer, who has schizophrenia. She’s the co-host of Psych Central’s A Bipolar, a Schizophrenic, and a Podcast and founder of Schizophrenic.NYC, a clothing line with the mission of reducing stigma by starting conversations about mental health. “I can be thinking of anything. A past conversation. A made-up conversation. A weird dreamlike situation. I lose reality of where I actually physically am.”

“I mainly just feel ‘off,’ Things just aren’t right,” said Rachel Star Withers, who has schizophrenia and is an entertainer, speaker and video producer. She creates videos documenting her schizophrenia and ways to manage it, and aims to let others like her know they are not alone and can still live an amazing life.

“The biggest tell for me is that I start talking to myself and thinking in third person,” Withers said. She’ll tell herself things like:”OK Rachel, just walk be normal.”

A patient once described psychosis in this way to MacDermott: “Imagine that you summon a picture in your mind like, say, a baseball. Imagine a baseball. Now imagine what it would be like to have the knowledge that you put that image in your mind taken away. Now, all you are left with is a thought having no idea how it got there. That’s what it’s like to be psychotic.”

MacDermott’s patients also have told her that they struggle with interpreting situations and see special meaning in everyday things. “That same patient once saw a family member put a knife down while they were cooking and had the thought that the family member was trying to send the patient a message that they were going to be killed because a knife represents death.”

In this piece on The Mighty individuals shared what it’s like to experience psychosis. One person wrote, “For me, it felt like I was watching a movie that was my life. I knew bad things were happening and I couldn’t stop it.” Another person described having an “out of body experience,” along with “excruciating sensations amplified by 1,000 at the tip of every sensor in my body.”

Someone else explained it in this way: “Every sense is heightened and colors are especially bright. The world is on a giant flat screen TV. Everything seems more crystal clear than you ever knew, but then it all becomes confused and muddled. You make your own realities, constantly decoding messages that seem extremely important, but are ultimately meaningless. They further the storyline in your head that seems so real.”

Arenella’s clients have described their psychotic episodes as “disorienting, overwhelming, frightening and isolating. They often describe heightened sensitivity, believing that there are no boundaries, that everything is related and transparent, and there is no privacy.”

Some might believe that they’re part of, or at the center of, a critical life-altering mission or plan, Arenella said. Which might lead to intense activity or the complete opposite: a feeling of paralysis.

Myths about Psychotic Episodes

One of the biggest and most harmful myths about psychosis is that people are dangerous and violent. Both MacDermott and Arenella emphasized that individuals in the throes of psychosis are much more likely to be victimized than to victimize.

Similarly, psychosis is not the same as psychopathy, MacDermott said. “Psychopaths are people who don’t feel empathy, are thrill seeking, and often are parasitic, aggressive, or manipulative to others. Psychosis is completely different and unrelated.”

Another misconception is that psychosis is always indicative of schizophrenia. Sometimes, psychotic episodes occur on their own, or as part of a different mental illness, such as depression, Arenella said. Most people only experience one or a handful of psychotic episodes in their lifetime, she said. (“Only approximately one third of people who experience psychotic episodes go on to have persistent psychotic states.”)

And if someone’s psychotic episodes are part of schizophrenia, it’s important to understand that people can and do recover from this illness, Arenella said.

Arenella, a founding member of Hearing Voices NYC, also noted that eliminating voice hearing isn’t an essential part of treatment. “How a person interprets and interacts with their voices is more important for recovery than hearing them or not hearing them.” (This TED talk from Eleanor Longden, who has schizophrenia, provides more insight.)

Moreover, even many mental health professionals believe the widespread myth that medication successfully treats psychosis, said Arenella, the president of the United States chapter of the International Society for Psychological and Social Approaches to Psychosis. While medication can decrease the intensity of symptoms, many people still hear voices and have difficulty in social relating, she said. Many also experience bothersome or serious side effects.

“Medication works for some people, some of the time, but it is not a cure all.” Psychosocial treatments, such as cognitive behavioral therapy for psychosis (CBT-p), have been shown to be effective in treating psychosis.

What Causes Psychotic Episodes

MacDermott noted that there’s a lot we still don’t know about psychosis, and that includes its causes. Genetics likely plays a role. “People with an immediate family member with schizophrenia are much more likely to have schizophrenia themselves than someone who doesn’t have an immediate family member with the disorder,” she said.

Adverse childhood events and trauma can contribute to psychosis, as well, even though the episode can occur years later, Arenella said. She also identified other common factors: loss, social rejection, insomnia, illegal and prescribed drugs and hormonal changes.

“A lot of antipsychotic medication reduces the amount of certain neurotransmitters, like dopamine, in the brain,” MacDermott said. This suggests that too much dopamine (and other neurotransmitters) might be involved in psychosis. But, as MacDermott noted, “People and brains are so complicated that we can’t know for sure exactly what triggers psychosis in each person.”

A big reason psychosis scares and confuses us is because it seems so out of the realm of “normal.” But in actuality, “psychosis is part of the normal range of human experience,” Arenella said. “While it is unusual, it is not fundamentally different from other human experience.”

That is, she said, “people who hear voices actually hear them and they sound just as real as all of the other voices of people. Imagine if someone were talking to you all day long while you’re trying to have a conversation with someone else you might be distracted, confused, irritable, and want to avoid conversations. This is a normal response, albeit to an unusual stimuli.”

Also, many people hear voices, and aren’t having a psychotic episode. Arenella noted that after a loved one dies, some people report hearing the person talking to them. “Musicians and poets often hear tunes and verses in their heads and may not feel as if they created them, but more like they received them somehow.” Many people also talk about hearing the voice of God or Jesus during pivotal moments in their lives.

We tend to be taught, both implicitly and explicitly, that psychosis is unlike any other mental health issue—such as anxiety or depression, and “is not amenable to regular therapeutic techniques,” Arenella said. “This fosters a profound othering and harmful stigma toward people who experience psychosis.”


Signs and Symptoms of Schizoaffective Disorder

Schizoaffective disorder affects each person differently. Some people experience cycles of severe symptoms followed by periods of improvement.

Symptoms may include the following: (1)

  • Hallucinations (seeing or hearing things that no one else can see or hear)
  • Delusions (false, sometimes paranoid beliefs)
  • Disorganized or illogical thinking (switching very quickly between unrelated topics speech may seem jumbled)
  • Depressed mood (feelings of sadness, emptiness, or worthlessness that won't go away)
  • Mania (feelings of euphoria, racing thoughts, or risky behavior)
  • Suicidal thoughts or behavior