A Story about Psychosis

I've worked as a mental therapist for many years and have had multiple encounters with people who are suffering from psychosis. Psychosis is a symptom of a mental health disorder and can include hallucinations, delusions, or paranoia and may appear as if the person is agitated or they may be incoherent. Psychosis occurs when an individual experiences impairments in processing  sensation, thoughts and emotions leading to a loss of contact with reality or is unable to engage in reality testing.

I'm going to share an experience with a *client I have worked with who shared their experience with psychosis:

*To maintain anonymity, descriptive and identifying information has been changed. In order to protect legal confidentiality, the following narrative is based on a combination of true events.

Jenna began therapy with me a few years ago. Her academic advisor suggested she talk to someone about changes in her behavior and appearance. Jenna’s academic performance had declined, she experienced significant relationship issues, and she showed increasing signs of depression. She came to session looking disheveled with paint on her fingers and she even admitted she had not brushed her teeth for a few days in the last week. At that time, Jenna did not display psychotic features.

Within the next year Jenna described to me what I believe to be an initial psychotic break, or first psychotic episode. 

Jenna said, “I have never told anyone this story because I didn’t want people to think I was crazy.” In this particular session, Jenna described her experience:

“It was late. Around one in the morning. I was pretty tired. My brother was still awake. We started talking, reminiscing about our childhood and sharing our take on similar experiences. And then something happen.

It was like a switched flipped and I thought,

 ‘He knows something I don’t know," and I started to become really suspicious of my brother, feeling worried that he was trying to get information out of me or set me up. I felt hot and panicked. Then this voice in my head, my own, said, ‘He’s in on it," and I had a strong sense that something terrible or bad was going to happen, that I was in some kind of trouble, and my life was in danger. 

I tried to act calm, I didn’t want him to know what was going on. A lot more thoughts came to my mind: poison was being released from the air conditioner, I was being video tapped, the police were using me as an informant... I stayed up the rest of the night worrying that someone was going to kidnap me and I was even planning an escape route."

During her episode she  reported experiencing somatic symptoms including trembling, pressure in her head, changes in body temperature, and a racing heart.

Jenna goes on to tell me that she realized her thinking was problematic, even labeling her experience as ‘paranoid’. She said she focused on remembering “There was a time in my life that I didn’t have these feelings,” “There was a time in my life that I didn’t think like this.” and asked herself, “Why would it be happening now?” 

Jenna displayed several precursors and symptoms of a psychotic episode. Typical symptoms include:

• Decline in functioning (at school or work, in self-care)
• Social isolation or withdrawal
• Going off track while speaking/tangential speech/word salad
• Depressed mood
• Increased anxiety
• Decreased motivation
• Reduced concentration
• Limited or over emotional expression
• Problems with handling everyday stress
• Impairment in personal hygiene
• Increased sensory sensitivity or tightened sensory awareness
• Suspiciousness or paranoia
  

 Psychosis is a severe mental health issue and it is imperative to receive treatment as symptoms may get worse.

Jenna was very fortunate, her previous counseling and mental health treatment prepared her with the coping skills she needed to work through her psychotic experience. Early intervention is key in treating psychosis. Establishing awareness and insight and can be the difference between adaptivity and insanity. If educated upon and treated early, psychosis can be alleviated, if not avoided entirely.

Further, Jenna’s willingness to share her story with me was a positive step in her recovery. 

If you believe that you have experienced a psychotic episode I suggest you seek immediate help from a  doctor or mental health professional. If you have experienced a single psychotic episode you are at greater risk of subsequent episodes. For more information on counseling and therapy services to treat excessive anxiety that leads to thoughts or feelings of psychosis, please visit www.TherapywithRaquel.com for more information.

---

Raquel Buchanan is a licensed marriage and family therapist (LMFT #118976) in Palm Springs, Ca. Raquel Buchanan provides counseling and psychotherapy services to children, teens, adults, and families. She specializes in treating self-esteem and self confidence issues related to childhood abuse and trauma.