The Pure Terror of Psychosis
Seeing things that are not really there. Hearing voices that turn out to be fake. Believing that someone is watching you or plotting to harm you. It all sounds like some sort of horror film. It’s what people who experience psychosis have to live with.
I had my first experience of psychosis over a year ago, not too long after my discharge from a psychiatric unit. I remember it being late at night, and me suddenly hearing some sort of high pitched scream. Sadly, that wasn’t my only experience of it. Just a few weeks later, I ended up shocking some friends when I stormed out of a restaurant, convinced that something terrible was after me.
Then experiences came and went. At medical school, we had started to learn about pharmacology and the treatments for Parkinson’s Disease and schizophrenia. I found it rather interesting – a lack of dopamine could result in Parkinson’s and the complete opposite (i.e. too much dopamine in some brain pathways) could apparently lead to schizophrenia. This was the basis upon which neuroleptics (antipsychotics) worked.
None of the lectures, however, could do justice to just how frightening an episode of something like psychosis could be. It’s a common theme in medicine – we’re told about x, y and z symptom and how to treat it but we end up forgetting what happens in between.
Here’s what psychosis feels like to me.
The most recent experience
The reason for me writing this blog post now is because of what happened yesterday.
It had been a while since I had experienced psychosis. In fact, so much time had passed that I had almost forgotten about exactly how frightening it was. I knew it was frightening, but the full extent of it had left my memory somehow.
I was lying in my bed, about to go to sleep after a long day writing my lab report. It was then where I suddenly started hearing the floor creak. It was about 3am in the morning. Who was approaching my room, I thought? Then, suddenly, the window opened. Apparently of its own accord. I was suddenly frozen, too scared to go and close it. There was the sound of thunder, and then the sound of laughing. Cruel, merciless laughing.
I heard the door of my room open. It had to be my Mum, I thought. There was no one else in the house after all. She must be in my room, here to check something. I was still utterly terrified. So terrified, in fact, that I couldn’t speak. I instead groaned loudly, as a way to catch her attention and somehow let her know what was happening. No response. I tried again. Same result.
I looked wildly around my room and, to my horror, my Mum wasn’t there. What was going on? The window was still open, and rain was positively gushing itself in. Then I realised what was happening. None of this was real. There was no thunder, no one walking into my room, no invisible being pretending to be my Mum. It was all, I worked out, another psychotic experience.
How did it all stop?
Of course, simply realising that none of it was real didn’t make it suddenly stop. It’s not like my brain would suddenly go ‘April fools!’ and stop playing everything. Instead, I just decided to close my eyes and count to 10. I tried taking deep breaths in and out, but this was much easier said than done with my heart pounding. There was still cold sweat all over me, but I tried to ignore it.
Eventually – miraculously, to be honest – I fell asleep. In the morning, everything seemed normal.
What’s real and what’s not?
Luckily, in most of my episodes, I have been able to work out that my experiences were not real. One of my biggest fears is not being able to do this, either thinking that something which is real is not really there or thinking something which is not real is actually there. Let me explain the latter by giving an example.
I was just about to start my second year of medical school. At this time, I was hearing voices and sounds very often. I had believed it to be triggered by my stress and anxiety of going back, so I was trying my best to control that. The fire alarm went off. I was hearing so many voices at that time that I simply presumed that this too was a hallucination. You can probably see where this is going, but it turned out that the fire alarm was very much real.
Luckily, no harm was done in that case. However, it goes to show how these experiences are not only frightening but can also be dangerous.
“Stay away from that weirdo!”
Sadly, hallucinations and delusions such as these are very misunderstood. It’s not just the actual psychotic experience that upsets me. The aftermath of it hurts too.
Following my first psychotic breakdown, rumours had somehow started spreading in medical school as to what had happened. It was clear that people were talking about me behind my back, with details changing to reflect me negatively. I almost felt like an outcast, as though people thought I was odd or dangerous. Of course, time showed people that I was none of these things but it still hurt.
I am lucky that the people at my medical school are, in general, very understanding. They are future doctors after all. But the fact that rumours started spreading amongst even some of these, apparently well meaning people shows just how misunderstood all this is.
I can’t make this blog post too long as I have a lab report to write, but I think it captures my main thoughts. I will be seeing my psychiatrist and care coordinator (who is absolutely amazing, I should add) on Wednesday and we will discuss this then. In the meantime, I hope this was just a one off.