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 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 and she is in her late 20s. 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.
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. He/she/they may take these medications (or not!) until they run out...and then that's it. No appointment made or kept with the referral psychiatrist attached to the psychotropic medications which were dispensed while the patient was hospitalized in the BHU. 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 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, 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 a revolving door with 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" 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 killed 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....