Psychosis: The New Normal (Part II)

Last time, I presented on the topic of what psychosis is and how it seems (to me!) that it is becoming a more acceptable way of functioning amongst us who share this planet.  Well, whomever said that planet earth was the psychiatric unit of the Universe was not wrong!

Today's post addresses what it takes to come out of the fog of psychotic thinking, especially when it's been present for years and/or decades in a person's life.  Also, some resources and treatment strategies available to the client/patient to improve the quality of his/her/their reality-based life over the long haul.

The first thing to remember is that people suffering with psychosis and/or psychotic episodes are not living in the same reality that you and I typically experience.  They hear things (inside and/or outside of their own head), they may see things, smell things, taste things, and/or touch/feel things physically that others do not.  These experiences fall under the umbrella of "hallucinations".  Along with this, fixed false beliefs (delusions) also include specific attitudes and opinions based on false realities/beliefs that the psychotic individual is locked into as being "absolutely true" versus "absolutely not true".

There is a young lady on YouTube whose channel "SchizoKitzo" is very helpful in understanding someone's journey who has been diagnosed with both "schizo" (psychotic) symptoms and major mood disorder (affective) symptoms combined.  Her name is Kit Wallis and she is 30 years old.  I don't think I have before seen such a raw and yet brutally honest account of what it is like to be someone who struggles with psychosis---and yet who is able to communicate what it literally has been like for her experiencially speaking. (such as "feeling like something is pushing down on my shoulders and I can't stop it until I lie down on the floor and it goes away..")  She also talks about her treatment and why she is so committed to it...and what her treatment specifically involves, etc. etc.  She's worth watching for those who are interested in checking out her channel on YouTube....

Coming out of the fog of psychosis doesn't just happen because the psychotic person decides one sunny Spring day to make positive changes.  There is usually an event (or several taken together) which basically forces the psychotic individual to receive much-needed professional medical intervention as a first step.  

Examples would include an initial hospitalization for a self-inflicted or "accidential" injury which then leads to being transferred over to Psych (Behavioral Health Unit) once medically cleared.  Many times, patients will be discharged from the BHU with prescription medications that are designed to specifically treat their mental health diagnosis which involves active psychosis.  There may also be the recommendation attached to attend an IOP (Intensive Outpatient Program).  He/she/they may take these medications (or not!) until they run out...and/or attend IOP once or twice...and that's it.  No appointment made or kept with the referral psychiatrist attached to the psychotropic medications or IOP referral--because that's the way we roll in this country as it relates to keeping patients accountable for their own mental health.  We don't...until everyone is forced to via the court system....   

Or....a patient may be compliant for a time (a year or more), but then notices an unexpected uptick in their most distressing symptoms.  Rather than seeing their psychiatrist (or any one psychiatrist live and in person) to address the issue and find appropriate alternative solutions, they don't.  Whatever the circumstances are, individuals may suddenly decide to stop their meds for a myriad of reasons...  When this occurs, if the individual has also struggled with substance use and abuse, it is highly common to go back to their drug(s) of choice to self-medicate (alcohol, weed, cocaine, adderall, nitrous oxide, kratom, food, self-neglect, etc.).  Without working to break this vicious cycle, it will not be broken.

This represents an unfortunate pattern (of noncompliance) which causes psychotic individuals to stumble in and out of  the same revolving door of local area hospitals whenever their mental health issues lead to some form of significant injury or suicidal/homicidal threats requiring a trip to the ER or being brought to the hospital by ambulance.

For individuals I have worked with over the past 20+ years who do struggle with psychosis, I have come to appreciate how easy it is to believe oneself about their "inner" and/or "outer" voices serving as "friends" or "the truth panel" to them for many years running. "I got used to them living inside my head.  I don't want them to leave me too!  They never lie to me!" is the basic message I have heard far too many times to count.  When this is a prevailing logic underlying resistance to treatment, I hope you can see how challenging it can be to encourage actively psychotic individuals to accept treatment and remain medication compliant.  "If that medicine empties them out of my head, I don't want it!"  This is further complicated when the individual believes that the voice(s) he/she/they are hearing are from God Himself/Herself/Themselves. 

"God told me..."  should never lead anyone to justify the destruction or ruination of another human being or group through whatever means necessary.  Yet, we have way too many examples of how religious delusions can lead the psychotic individual to do things he/she/they thought they would never do---but did anyway.  If I had to name every individual in history who figuratively or literally destroyed one or more others (or themselves) due to their psychotic delusions about what God "told" them to do...I'd be stuck here typing for months!

Remembering now that psychosis involves both hallucinations and delusions (fixed false beliefs), imagine how invested an individual becomes when their own "truths" (voices) rarely let up, if at all.  Kind of like getting up in the morning, and "hearing" one or more voices judge you harshly for this while at the same time praising you for that...or yelling at you to "Hurry up!" or "Slow down!" or "Did you remember to....that you said you'd do last night and you didn't do last night?"

And yet this cacophony continues in whatever forms it takes unless you are dead asleep?  OMG!  No wonder psychotic individuals are so easily misunderstood by the rest of us!  They are so busy "managing" what they experience through their senses in any given moment---who has the time to focus on real life reality and what "other" real life people have to say!?  I can recall the person, many years ago, who insisted on examing every square inch of my office carpeting for "bugs".  I didn't know if the "bugs" being referenced were literal bugs like insects----or sound recording devices.  Turned out, for this individual, it was "bugs with drugs inside them".  Okay then.  Now I understood...and to the ER we went before that session ended.

Recent studies have indicated that 20 HZ high frequency magnetic pulses have helped schizophrenic individuals in reducing the frequency of their experience(s) with hearing voices (either inside or outside of their own physical bodies).  Sound bathing is not new;  if you go on YouTube, there are hundreds of "sound baths" that claim to help heal your brain, get you to sleep, reduce your cortisol levels, calm and soothe you, etc. etc.  My take on this is that if it works for you, then it works for you!  Great news.  However, no long-term "solution" for treating psychosis is limited to a single practice and/or form of medication.  

Getting better and reducing the frequency of psychotic episodes involves a team effort beginning with the patient himself.  Without genuinely wanting help to get and be better, it's not going to happen.  Period.  And in our country, we can't force anyone to do anything until and unless he/she/they are declared mentally incompetent in a court of law, appointed a Legal Guardian (or two), and then re-homed within a living environment where they will remain medication compliant and under appropriate supervision so as not to hurt themselves and/or others any longer.

The Center Will Not Hold is one book I have often recommended to clients who are schizo-something diagnosed.  Written by Elyn Saks, it gives hope to those who are dual-diagnosed with psychosis as part of their clinical profile...and who also struggle with addiction.

Hope is possible, but it is the patient's job to "want" real help and not just give lip service to the concept.  If you love or care about someone who you believe may be struggling with ongoing psychosis in the forms of hallucinations and/or fixed false beliefs, please do not hesitate to private message me for further recommendations.  I can be emailed at maryofnorthville@hotmail.com for this purpose.  

Until next post....

Psychosis: The New Normal?

I've noticed a trend lately. Psychosis is gaining ground as an acceptable and new form of neurodivergent thinking.  My apologies to all our neurodivergent thinkers out there, by the way.  It was the only term I could come up with to explain the acceptance of a "different" way of thinking and perceiving reality that deviates from the mainstream.  Neurodivergence, by the way, is associated with individuals who think outside the box (all things being grounded in rational reality that is!) when compared to their "neurotypical" counterparts.  Except with psychosis, it involves thinking, feeling, and behaving outside of reality and choosing to remain there for whatever reason(s) spoken and unspoken...

Psychosis, by definition, is abnormal.    The term comes from the Greek "psyche" which translanted means "mind, life, and soul"...and "osis" which translated means "abnormal condition".  As such, "psychosis" is an abnormal condition of the mind, life, and soul.  Now you know.

And what is "abnormal" in the first place you may wonder?  It is that which causes real harm to self or others without regard for the damage(s) being inflicted (to self or to others).  For example, "avolition" is a common behavioral pattern that often accompanies psychotic thinking/psychosis.  People who do not initiate, do not pursue, and are unmotivated to "do" their own life's personal responsibilities on a daily basis (you know, "get up, dress up, show up" for one's own life!) will often view this pattern of thinking and associated behavior(s) as a non issue.  "I can always get money;  money's not a problem for me."  (When it actually IS a huge problem...)  

Please do not confuse avolition with acute depression and/or grief.  Avolition which accompanies psychosis is an acceptable way of life.  Those who practice it don't mind being disconnected from reality.  Like someone who is addicted to all things virtual reality.  It's its own lifestyle "choice" based on an abnormal condition of one's mind, life, and soul.  You may be asking yourself, "Who cares as long as nobody's being hurt?"  Uh...how about the person with the psychosis hurting himself/herself/themselves?

We may not be able to stop you, but it is YOUR own functioning that is severely impaired when you choose to play guitar/video game/read/watch movies/"research" the net all day in your chosen place of refuge...and that's how you roll more days than not.  This damaging pattern of ongoing disconnection and protection from ??? (whatever you are believing) may prevent you from making and maintaining authentic friendships....graduating from high school/college/trade school....getting and/or keeping a job...perhaps driving a car...learning new skills....and/or otherwise "functioning" successfully enough as a person your age in this world you inhabit.

Of course, in today's world when a guy in a three-corner warrior headpiece in full costume starts swinging around a samurai sword in the middle of a downtown central business district (without an entertainment permit I might add!) and the community begins debating online his "freedom" to do that, I have to wonder who's lost their minds in what order.  In the situation, the same guy was spotted on the median of US-23 weeks later doing the same thing with sword in hand.  Listen, I'm in the business of supporting those who have chronic and persistent mental health issues, but I am NOT interested in mainstreaming psychotic episodes either in the name of personal choice and "freedom".  

Doesn't anyone remember the fairy tale "The Emperor Has No Clothes"?  I certainly do.  To be brief, the Emperor was being duped by a con man who charged him a King's ransom for creating clothes that were, in fact, non-existent.  Utilizing his skills of the con, this tailor sewed with invisible thread on invisible cloth to create a wardrobe for the Emperor beyond compare.  Everyone was too afraid to say they couldn't see the Emperor's "new" clothes...so they all agreed how beautiful and wonderful and amazing the tailor's finished work was.  Until a little kid showed up and pointed at the Emperor to proclaim aloud:  "The Emperor Has No Clothes!"  End of.  Finally!  It took a little kid to wake up the world around him about the aberrant reality of the present moment. 

When is that going to happen to us?  Who knows?  I do my bit for humanity in this regard;  how about you?  Living a life without reality-based truth attached is what allows us to do whatever we want, when we want, without a thought to how our growing acceptance of psychotic thinking genuinely affects ourselves...and the lives of those around us.  I know I am sick of being bullied into believing that "anything" is o.k. because a psychotic state of mind is something the culture decides to accept with open arms!  (If you have ever had a convo with someone talking about their acid trip(s) and how "sacred" and/or how "life altering" they were...you do understand what I am talking about here!)  Authentic spiritual awakenings and transformations comes from the inside out, not from the outside in.

Until you have seen psychotic thinking acted out in inappropriate ways, you may be tempted to believe that it's "not all that bad" a condition for those who have it.  I mean, aren't we all a little psychotic when we believe we still can do something we haven't done in years---let alone when that "something" involves physical agility, strength, balance, and core strength?  Reminds me of when I went back to the gym in early January and couldn't lift my foot and leg up off the ground for 30 seconds like everyone else did.  We are really good at deluding ourselves about our own present day reality more often than not.  I have done it.  You do it too.  However, my own "reality check" regarding my current physical condition inspired me to do my work to keep myself IN present day reality.

Psychosis as the new "normal" inspires us to keep ourselves out of present day reality and live inside the middle of our fixed false beliefs for as long as we like without challenging them.

You may be wondering what causes people to become psychotic.  There are all sorts of reasons involving pre-existing mental health diagnoses that the individual may not have been before made aware of.  "Major depression" as one example can very easily have psychosis as a diagnosable "feature" attached to it.  So can "Biplor disorder".  Then again, psychosis can occur from the use of certain drugs including those that are prescribed, alcohol, weed, and other recreational drugs.  Psychosis can also result from brain injury, damage, and other abnormalities that will remain unknown until appropriately identified and diagnosed.

If you know anybody with dementia, you may begin to understand what I am speaking of in today's post.  Sadly, I have too many friends and acquaintences who have been diagnosed with dementia.  It is a very unsettling reality when someone you "think" knows you doesn't recognize you at all when you go to visit him/her/them....or talks about things that make absolutely no logical sense.  "My sister came and saw me today.." (when sister has been dead for the past ten years).  Or "I went to Antartica yesterday and swam with the dolphins.."  Regardless of what brought us to a state of ongoing psychosis, when it's there it IS there.

The drug and alcohol use of our recent generations adds gasoline to the pre-existing fire of those who struggle with mental health issues...and then psychosis shows up as a drug-induced by-product of this groups' lifestyle choices.  Now that marijuana has been legalized, there are MANY users who have no clue how smoking or ingesting their edibles have served as a new gateway to psychotic thinking and behavioral responses they can't/won't/don't acknowledge.  For example, if you are bipolar or remain undiagnosed with a major mood disorder.....drug and/or alcohol use is NOT YOUR FRIEND!  You run a high risk of psychosis entering into your picture and staying there for longer than you anticipated.  I have often shared with clients the story of a patient who I saw back 25 years ago who "went psychotic" (which represented the venacular we used back then!) after taking a single hit of Ecstacy at a rave.  She didn't come back to baseline and ended up in an AFC home (group home for adults declared mentally incompetent).  She was in her early 20s.  It can be like that.  You want to believe you are "fine" when, in fact, you are not fine.  You are struggling with an ongoing state of psychosis and you don't even know it.

Next post, coming out of the fog of psychotic thinking/psychotic episodes with "proper" care and treatment...