5 Things All Mental Health Professionals Should Know About Psychosis

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Part 1 of the “15 Things You Need To Know About Psychosis” Series

A little while ago, I was asked on Twitter to write about what I think people need to know about psychosis. It was a question that got me thinking about my experience and the effect it had on those around me.

Throughout my episodes, I felt completely lost, confused, and overloaded by what was happening. The actions of doctors, my employers and – to a lesser extent – family and friends, often made matters worse.

It’s hard enough to battle serious mental illness; it’s even worse when your environment is unsupportive or even hostile.

In the next three posts, I will be re-hashing the main points of my original Twitter thread and detailing the issues which affected me when trying to get better.

This first post is aimed at mental health professionals. I’m talking to the doctors, nurses, GP’s, paramedics, and psychiatrists – NHS or Private – whose job it is to help us relieve the immense pain and confusion.

When we come to you, we are often at rock-bottom. We are distrustful, agitated and terrified. We are looking to you to help us be people again. Your warmth, diligence and empathy could be the difference between life and death for us.

Sound melodramatic? Maybe… but it is really THAT serious.

Here are the things you need to know to help us get better:

Sections in this post:

Anti-Psychotic Meds Are Not a Cure

The symptoms we experience are not just due to brain chemistry. There, I said it. It’s natural to look for the simplest answers to complex problems – but the brain isn’t simple.

Back when I was a 14-year-old, I also subscribed to the “I can be fixed with a pill” idea. What a lovely thing… just POP a pill, and the demons leave you alone.

More than a decade later, I’ve learned the hard way that that isn’t the case. Our brains are a tangle of neurons and neurotransmitters, sure. More than this, they are the sum of experiences, the coagulation of memories and the crystallisation of our upbringings. These core experiences – our narrative, if you will – interacts with our body and biology to form a thing of beauty that is both wondrous and malevolent.

You cannot fix the trauma I faced as a child with a little peach-coloured pill. Let alone one that comes with such rabid side-effects.

They make me so hungry I could faint. After taking them, I’m sooo sluggish and dull. I feel – and look – like a zombie. My legs jerk, my hands tremble, and my heart flutters. They’re just awful.

Don’t get me wrong, I’m not a member of the “Anti-Med Brigade”. Medications can be helpful. They can numb someone off, or perk someone up, just enough for them to begin healing.

And as much as I hate the way they make me feel, I still take them – even at a low dose – because I know that they’re necessary for me at the moment. They allow me to feel just far away enough from my stressors to keep them in perspective and not get overwhelmed most of the time.

Despite this, I know they’re not good for my body (hello weight gain!) and I don’t plan to be on them for the rest of my life.

Don’t just stick us on them and leave us with no other support. Give us therapy, or even just a consistent level of care. Show us how to manage the symptoms and create a good support network. Show us how to have meaning despite our illness.

Those are so much more effective than drugs.

Our Family Needs Support Too

We are your patients. I get it. But our loved ones are suffering as much as we are, if not more in some ways.

They see us do bizarre and terrible things that they have no idea how to stop. They comfort us when we are shouting at the voices to shut up; they hug us to stop us trying to beat the voices out of our heads.

They do the housework when our meds make us too tired to do anything other than nap. They work overtime when we have to take time off sick. They drive us to appointments, and hold our hands in A&E, and explain our issues to you when we’re too out-of-our-minds with terror to say a goddamn word.

They see the scars and the tears. They hear our screams. We shrink from them with fear, and it all scares them beyond belief.

Point them to support networks. Teach them how we need to manage our symptoms so they can help us stay on track. Involve them in our treatment – and don’t shut them down when they raise concerns. Then help them recover from the experience.

My husband is still feeling the effects of my last suicide attempt (three years ago), and that kills me inside. He’s experienced his own low moods and went to the GP. Only to be given anti-depressants and vitamin D supplements, with no word on how he can get help to process everything that we went through.

Because we went through it. Help our families too.

We Are Still Bloody Human

Don’t assume that because we look calm that our heads aren’t screaming at us. Our illness is, like depression, subtle and sometimes invisible.

Last year, I ordered my medical notes from the times I’d been in hospital during my episodes. The things written in there hurt me to my core. The doctor who treated me – after an overdose – wrote that because I was not “expressing” emotions, I was making it up.

Why was that the first conclusion they came to? Why is that the thought process? If someone with depression shows little emotion, you aren’t going to turn around and tell them they aren’t depressed… are you?

In my case, I was numb. I’ve learned since then that one of the ways my brain avoids pain is by numbing off – dissociating – and hiding from the real world. My mind clouds over, I can’t think straight, and my body physically loses feeling.

Ask me anything when I’m in this state, and I’ll sound like I’m barely alive. I’d been through a crisis. I’d scarcely come round after taking a bunch of my medication. Why do I feel like I have to explain this? Why can’t I expect my pain to be believed?

We already feel like burdens, and we’re terrified and confused. Sometimes we know something is wrong with us. Sometimes we don’t. Please don’t be cynical and assume we’re out for attention. Certainly, don’t write it in our notes!

And don’t treat us like we’re a waste of your time.

You’re stressed and struggling to treat too many people with too few resources, we know.

That is not a reason for cynicism. We didn’t choose to get sick. Please show us some compassion and act like we matter to you – even just a little bit.

Treat us like we’re human.

Don’t Expect Us to Trust You

My episodes have been the most confusing and scary periods of my life. And that’s saying something.

Voices told me lies, which steadily turned into delusions and took over my thought processes. Visual hallucinations sought to unsettle me, and everything – no matter how mundane – took on a sinister meaning.

Over time, I became utterly certain that I was not human. I was an experiment, a weapon, a monster. I was sure that the voices could control me; I was afraid they’d make me hurt James if I went to sleep. I was terrified.

Even worse, I couldn’t trust anyone.

If I told James, then “they” – the experimenters… the government… the CIA… I’m still not sure who I thought “they” were – would come and find me, and take me away, and I’d never be seen again.

Hell, at one point, I even thought James (who had treated me with nothing but kindness and love) was a part of it. He was my “Handler”, and was reporting back on my mental state… I knew it.

The doctors were part of the conspiracy against me. I was an experiment, and you were just there to monitor me and report back. Whatever had been done to me – I thought – you were there to make sure the results were measured and the experiment was a success.

I desperately wanted it to end, but I couldn’t trust you. How could I in this state? Everything I experienced supported this conclusion. Belief is a powerful thing, and I believed this message with all of my heart. That sort of faith is hard to overturn.

Don’t take it personally or assume we’re just “difficult”. Don’t give up on us. Don’t threaten to leave us alone when “we won’t work with you”. It’s a “can’t”, not a “won’t”. It’s a symptom; we aren’t wicked or lazy people.

We can get better. We can find our trust again – but don’t expect that to be easy.

Don’t expect us to trust you.

We Can Still Be Logical, Even When We’re Not Rational

I can’t tout this fact enough. Everything we’re doing makes sense to us, even if it doesn’t to you.

Yes, we’re mental, but there is a cold logic behind it. We don’t engage with the world in the same way; everything we know has become morphed and twisted. It makes sense then that the ways we try to adapt to it would seem warped to the outside eye.

While our actions are irrational, they make complete and overwhelming sense to us, and are designed to wage war against the “nightmare world” we find ourselves in.

If we hurt ourselves, it’s to try to appease or get rid of the voices. If we stop talking, it’s because we believe that talking will make it worse. Don’t assume – again – that these behaviours are because we’re difficult or unstable patients. We can be, but this is a side-effect of our behaviour, not the motivation behind it.

For instance, during my 2nd episode, I became obsessed with the number nine. The meaning of nine formed a core part of my delusions and my relative stability from day-to-day.

In my head, nine was terrific. Nine was mystical, magical. Nine could fix me. The voices encouraged me. If only I could work out the meaning of the number nine, everything would be better.

What was it that made it special? Well, no matter how far you go, the digits every multiple of nine will add up to a multiple of nine. To me, it was the perfect number. I started to write out the multiples of nine.

Then I decided to decode them. I changed them into Binary, then other codes. I tried looking for patterns. I googled snippets and pored over every digit of the nonsense letters. Why? My dad had been a programmer, and the answer was in the code. I just knew it.

You’ll always find something in nonsense if you look hard enough.

Ugh… I hate writing about that part of the episode. It makes me feel nuts, embarrassed, and stupid. I’ve always prided myself on being logical and scientific.

The fact that my brain can take logic to such an insane end is disturbing. The problem is that we can’t filter things which hold meaning from things which don’t. Our logic becomes perverted by whatever it is we’re taking meaning from.

We are not rational, but we can be meticulously logical.

Why Does This Matter?

The experiences of people who battle psychosis day-in-day-out are vital to changing attitudes about this debilitating and often misunderstood illness. If we want more supportive systems in place for people like us, we must be willing to speak out about the things we’ve had to endure while seeking treatment.

Some of the most upsetting responses I’ve had from people when talking about psychosis has come from mental health professionals. If you can’t already see how wrong that is, I don’t know how to convince you.

If some of the professionals I’d dealt with had known (or remembered) the above facts, I wouldn’t have had such a hard time accessing support.

Come back next week when I’ll be detailing the five things that every friend and family member should know about experiencing psychosis.

As always, until the next post!

Bronwyn @ LBT x

What did you think of this list? What do you wish people knew about psychosis? Leave us a comment below, or head to the contact page and drop me a line!