There is nothing more confusing or more frightening than trying to make sense of behavioral changes that occur when our loved ones experience psychosis. In this video we will explain and help you make sense of psychosis and of the behaviors you may be encountering. For a deeper understanding of psychosis, please refer to Psychosis; Psychotic Illnesses: A Peer’s Perspective, by Darrel Herrman under resources on our BMSBDAC website. Mr. Herrman is a retired Captain of the US Army and former computer programmer who has lived successfully with schizophrenia for 40 years.
Behaviors suggesting possible signs of mental illness may include your loved one reporting he/she is being watched or is hearing or seeing things that aren’t there, personality changes or a sharp increase in anger and anxiety. Your loved one may have become slovenly in appearance and habits. His/her work habits may have deteriorated, and he/she may have withdrawn from social situations. The changes you’ve noticed may be complicated if your loved one is also using substances. It may be impossible to know if the substance use is causing the behavior or if your loved one is using substances to subdue thoughts and feelings he/she can’t control.
Today, in this video, we will help you explore what a psychotic episode entails. Though the word psychosis may sound scary and dangerous, the truth is that most people with psychosis are far more likely to be vulnerable to harm than to be at risk for harming others. With treatment, most people suffering from psychosis can learn to manage their symptoms and live productive lives.
When a person is experiencing a psychotic episode, he/she is experiencing hallucinations and delusions which they believe are real.
A person experiences hallucinations when they see, hear, smell, feel or taste things that aren’t there. Examples of hallucinations may include hearing doorbells, feeling bugs crawling, or seeing visions of God or the devil. They may also include hearing voices that are giving your loved one information or directions to do something they would never otherwise do.
A person experiencing delusions has false beliefs often based on hallucinations. He/she may believe he/she is someone else, such as the devil or God, or that he/she is working for someone else, or is on a mission. It’s not uncommon for a person to believe they are saving humanity or protecting him/herself from a terror other people cannot perceive. The delusion may also result in a person feeling they are being persecuted. This may include the belief that the government is after him/her, or that the electric or internet system is poisoning them, or that a demon has taken over a family member’s body. In this last instance, the family member who is beloved, under a delusion, can be perceived as the enemy.
When someone is psychotic, he/she believes these delusions regardless of how illogical they may appear. A person with psychosis may become dangerous if the hallucinations (often in voices speaking to him/her) or the delusions have convinced the person that he/she is being attacked. The person may perceive violence as the only means of self-protection.
In addition to hallucinations and delusions, another symptom many people with psychosis experience is anosognosia. Anosognosia is the inability of a person experiencing psychosis to believe they are ill or that they need help. Sometimes, this can be coupled with a delusion that they have been harmed in some way. For example, a person who was raised with love might have a false belief that he/she was abused. And then he/she may blame any problems on the perceived abuser. This should be differentiated from a person who is intentionally making false claims, as a person with psychosis fully believes the accusations.
Psychosis is a physical medical illness caused by both genetic and environmental factors. It is a feature of all people diagnosed with schizophrenia and schizoaffective disorder and in some people diagnosed with bipolar disorder. Although the extent of brain damage varies person to person, there is evidence that each episode of psychosis may cause further brain damage. This is one reason that it is important to seek treatment for psychosis as soon as possible.
When a person with psychosis does not have anosognosia, he/she may be educated about his/her mental illness. If he/she is receptive to receiving treatment, he/she can benefit from many options including therapy, medication, peer counseling, and warm lines (phone-line support). However, when a person has both psychosis and anosognosia, he/she will perceive problems and risks through the lens of his/her delusions. Therefore, in this case, those of us most willing and able to help may be perceived through his/her eyes as perpetrators or demons. The medications may be perceived as poison. A person with anosognosia would be unlikely to benefit from peer support because he/she does not see other people experiencing mental illness as peers. He/she believes it is others and not him/her who need to change.
Many of us with loved ones suffering from psychosis and anosognosia have watched helplessly as our loved ones suffer. We have reached out for help, but in many cases have been unable to find our loved ones adequate treatment. Family members, organizations including National Shattering Silence Coalition and Brett M. Staples Brain Disorder Awareness Coalition, health professionals, law enforcement agencies, and compassionate politicians have been increasingly advocating for more effective means of addressing the needs of people with severe mental illness and anosognosia.
Progressive Treatment Programs in the state of Maine, also referred to as Assisted Outpatient Treatment programs in other states, has been one means of addressing the gap between need and effective treatment.
