Common psychotic experiences
Symptoms
Just as other medical illnesses have signs or symptoms, so does psychosis. Symptoms are not identical for everyone. Some people may have only one episode of psychosis in their lifetime. Others may have recurring episodes, but lead relatively normal lives in between.
Others may have severe symptoms for a lifetime. Psychosis always involves a change in ability and personality. Family members and friends notice that the person is 'not the same'. Because they are experiencing perceptual dfifficulties, trouble knowing what is real from what is not real, the person who is ill often begins to withdraw as their symptoms become more pronounced. Deterioration is usually observed in:
- Work or academic activities
- Relationships with others
- Personal care and hygiene.
To understand the experience of psychosis, it is useful to group together some of the more characteristic symptoms:
Personality change
Personality change is often a key to recognising psychosis. At first, changes may be subtle, minor and go unnoticed. Eventually, such changes become obvious to family, friends, classmates or colleagues. There is a loss or lack of emotion, interest and motivation. A normally outgoing person may become withdrawn, quiet or moody.
Emotions may be inappropriate, the person may laugh in a sad situation, or cry over a joke, or may be unable to show any emotion at all.
Cognitive impairment
Cognitive impairment (thought disorder) is the most profound change, since it prevents clear thinking and rational response. Thoughts may be slow to form, come extra fast or not at all. The person may jump form topic to topic, seem confused or have difficulty making simple decisions.
Delusions
Delusions are false beliefs that have no logical basis and may colour thinking. Some people feel they are being persecuted, spied on or plotted against. They may be convinced the police are watching them. Or they may have grandiose delusions; believe they are all-powerful, capable of anything, even invulnerable to danger. They may also have a strong religious drive, believing they have a personal mission to right the wrongs of the world.
Perceptual changes
Perceptual changes turn the world of the ill person topsy-turvy. Sensory messages to the brain from the eyes, ears, nose, skin and taste buds may become confused. The person may actually hear, see, smell or feel sensations that are not real. These are hallucinations.
People with psychosis will often hear voices. Sometimes the voices are threatening or condeming; they may also give direct orders such as "kill yourself". There is always a danger that such commands will be obeyed.
People may also have visual hallucinations, a door in a wall where no door exists; a lion, a tiger, or a long dead relative may suddenly appear. Colours, shapes and faces may change before the persons eyes. There may also be hypersensitivity to sounds, tastes and smells. A ringing telephone might seem as loud as a fire alarm bell, or a loved one's voice as threatening as a barking dog. Sense of touch may also be distorted. Some may literally 'feel' their skin is crawling or conversely, they may feel nothing, not even pain from a real injury.
Sense of self
When one or all five senses are affected, the person may feel out of time, out of space, free floating and bodiless, and non-existent as a person. Someone who is experiencing such profound and frightening changes will often try to keep them secret. There is often a strong need to deny what is happening and to avoid other people and situations where the fact that one is 'different' might be discovered.
Intense misperceptions of reality trigger feelings of dread, panic, fear and anxiety, natural reactions to such terrifying experiences. Psychological distress is intense but the person will often try to keep it hidden due to a strong sense of either denial or fear.
People with psychosis need understanding, patience and reassurance that they will not be abandoned.
Time is of the essence . . . .
