Psychosis Experience

Psychosis: How it feels and why it's misunderstood

Everyone who experiences psychosis shares general similarities, but they also have significant individual differences.

When I was a psychology student, I learned that psychosis includes delusions (strong beliefs that are not grounded in reality, including but not limited to: grandeur, persecution, infatuation, and religiosity ) and hallucinations (sensations with no physical root, such as hearing voices, the touch of bugs, a sudden, familiar taste or smell, or seeing colors or distorted figures before your eyes).

We were taught that symptoms of schizophrenia result from an imbalance of dopamine in various dopamine pathways of the brain: The mesocortical pathway (involved in rational thought, cognitive control, and judgment) produces too little dopamine, while the mesolimbic pathway (associated with reward, motivation, and fear) is overactive. Delusions and hallucinations are thought to be a biproduct of the overactive mesolimbic system.

Diagram illustrating the overproduction or underproduction of dopamine system in different areas of the brain, contributing to psychosis (positive symptoms).

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It wasn't until I was inflicted with bipolar disorder that I learned that these definitions are not that simple. For me, my delusions stemmed from fantasies and private experiences that I held secret from the world and only I can fully understand. I learned that while my disorganized thinking was unusual, there was a logical pathway to my final thought. For example, I often told people that I was a "human dolphin", not because I literally believed I was a dolphin, but because I connected my lack of sleep to dolphins' need to sleep each brain hemisphere at a time to come up for air. Since I was pretty functional on little sleep (especially before my diagnosis), my rationale was that I slept half of my brain at a time, too.

Since doctors do not typically dive deep into these thought patterns, perceived delusions may not be true delusions. But it likely depends on the individual case.

Science of sleep in dolphins.

The kernel of truth of delusions of persecution

When I was in mania, many of my loved ones were extremely worried about me. I was still articulate but the things I said were out of the norm. I focused heavily on spirituality and drawing larger connections between science, mathematics, and the universe, without a complete understanding of these connections at all.

My family spent many years trying to get me help, but I felt like they were against me because they did not seem to see that my state was a part of me; it was just unstable and unknown to anyone but me. Because I did not feel heard by my loved ones, I ended up convincing myself that the closest people to me were trying to take away my sense of freedom, autonomy, and confidence that accompanied my psychotic state. I would ask doctors not to call them, which made it harder for doctors to really understand who I am at baseline and what was wrong (since I was fairly articulate despite the bizarre thinking and social behavior).

For some people, delusions of deliberate persecution have roots of truth in them, even though, overall, the people closest to you just want to get one of their favorite people back to a healthy, familiar, and functional state. When I finally regained my sense of self, I learned that none of my family and friends wanted to harm me at all, but they did want to have control, to some extent, because I was partially a danger to myself due my impulsivity and unpredictable choices.

For those trying to help their loved one overcome the hardships of psychosis, I strongly suggest asking questions instead of trying to assert what you see as truth. Asking questions allows the person to reflect on why they believe what they do, and it will help them work towards disproving their delusions themselves and will also make them feel heard, seen, and validated rather than discredited and rejected by those they love who don't seem to understand what they're going through.

Artwork and poetry depicting psychotic breaks

Art, music, poetry, and other forms of creative expression also shed light on what it's like to go through psychosis first-hand and how it feels when you return to basic reality.

A powerful, written account of psychosis by Sandy Jeffs.

"The Scream", by Edvard Munch in 1893, was based on his sister after she was sent to an asylum. On his walk, the sky was red and a scream reminded him of her. He illustrated this period of psychosis in his well-renown painting.

A realization that those with psychotic features are not completely alone. There are many others like us, too.

This artwork, with the original sketch being sold on Etsy.com, is up to interpretation, but the colorfulness of the figure's thought patterns stands out among the shades of darkness.

As the woman in the picture stares at the perceived patterns on the wall, it is as if her shadow (possibly her true self) is reflecting in front of her (trapped within the webs she sees).