Coping With Psychosis

Author: Christina Chambers

Have you ever had a dream that was so vivid when you awoke it was hard to believe it didn’t actually happen? You had that surreal feeling of not being certain what was a dream and what happened in your waking life. What about a dream where you became aware you were dreaming and it wasn’t real, yet at the same time still believed it and reacted with joy, terror, despair or whatever emotions the dream instilled? I think these are common human experiences, however, most people’s brains easily find that grounded place of knowing the line between the dream world and realities of waking life. What if the line between dreams and waking life faded away? What if you experienced “dreams” as if they occurred in waking life? To me, this is most akin to what psychosis feels like.

According to WebMD, “psychosis is a condition that affects the way your brain processes information. It causes you to lose touch with reality. You might see, hear, or believe things that aren’t real. Psychosis is a symptom, not an illness. A mental or physical illness, substance [use], or extreme stress or trauma can cause it.” Psychosis can be a symptom of Bipolar Disorder. It is most commonly associated with mania, but can also arise in severe depressive or mixed episodes.

I first experienced psychosis with mania, at which point I was diagnosed with Bipolar I. In subsequent years, I experienced psychosis during episodes with mixed features. Throughout these excruciating divides between the two poles of high and low, I experienced loss of touch with reality. At some point, I began to experience psychosis when under high stress. Perhaps this is a latent bipolar symptom that blurred into the boundary of my norm between episodes. Maybe trauma is at the root of my stress-induced psychosis. Unfortunately, there is no definitive answer explaining why. What I do know is that I have experienced psychosis many times and I am prone to experiencing it again. It is scary and challenging, but it is also absolutely manageable. During these times I maintained work, strong relationships and that which is meaningful to me. I have learned a lot and continually grown, and it has gotten easier with experience.

Over the years, I have learned to manage psychosis in the following ways:

  1. Take prescribed medication everyday –I talk to my psychiatrist if it’s not working.
  2. Proper sleep and food – both are essential.
  3. Find a stimulation balance – not too much socialization, work etc.
  4. Grounding techniques – use the senses to stay grounded in present reality.
  5. List facts – to engage the thinking prefrontal cortex of the brain I list simple facts, such as where I live and loved one’s names.
  6. Ask myself “is this reasonable?” – given evidence and experience on a broad scale, does this belief or thought make sense?
  7. Check-in with trustworthy supports – I’ve educated my closest supports about my disorder, what to expect and how to help me. This is an ongoing process as we learn together.
  8. Act like I typically would – this skill has helped me to be out in public or work during psychosis. I behave in a way that I normally would, or in a way that fits with how others are acting in a situation, during those times when the bipolar part of my brain is feeding me skewed data.
  9. Recognize warnings signs –reflect after each episode to learn what early warning signs were present, such as: slowing or absence of thoughts, difficulty talking, inability to focus, confusion, extreme indecision, difficulties sleeping etc.
  10. Stress management –I need to do this daily for my bipolar disorder, but it is especially important when initial warning signs of an episode arise. I look at my perspectives around stress and work to reduce or eliminate any stressors that I can.
  11. Recovery time –Following psychosis, I am prone to re-experiencing it and swinging into another bipolar episode. Taking time to rest during this vulnerable time is necessary to getting well.

I will wrap up by sharing a journal entry I wrote after coming to terms with my most recent psychosis:

The greatest barrier anyone can face is their own fear. Fear is the seed of doubts that keep us rooted in our past, in who we think we should be and confined within our contrived limitations.

When we are trapped by fear, we are stunted – stuck in frozen ground. We do, however, want to remain grounded. Fearlessness would leave us uprooted and lost in a vast space, unable to touch down with earthly realities and that which makes us human.

Thus, one of the greatest challenges we face is to remain where we are and grow past frozen ground – to expand despite our fears.

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