Understanding Psychosis

The word “psychotic” is perhaps one of the most misunderstood words in the mental health repertoire. To the public, who are used to hearing it in movies and other media to refer to a violent, remorseless, person, attribute it’s meaning to just that. Someone who is psychotic, by this definition, may be violent, violently “crazy”, or simply lacking empathy and remorse, capable of any wrong and evil doing. But, as so often is the case, Hollywood and the media have gotten it wrong, and in the case of psychosis, they’ve gotten it completely and dangerously wrong. This incorrect usage has led to irreparable stigma for those suffering from actual psychosis, the sufferers of which are far more likely to be victims than perpetrators of violent crime. In this article I will tell you, dear reader, about the real story of psychosis.

According to NAMI, psychosis occurs in about 3% of the population. Psychosis is a debilitating mental condition that affects the way we perceive reality. In a way, people undergoing a psychotic episode live in an “alternate reality”, different from what healthy people experience. They may believe, perceive, and understand things that are not actually in existence, to the sufferer however, this “alternate reality” is as real as the ground beneath our feet.

What is Psychosis?

Psychosis is often called a “break from reality” due to the reasons I described above. There are hallmark symptoms of psychosis that healthcare providers look for when diagnosing a person, such as…

Hallucinations: Seeing, feeling, tasting, and especially hearing things that are not actually there. The most common hallucination is auditory hallucinations, or “voices”. The voices may tell a person to harm themselves and say other negative things.

Delusions: Strong beliefs that do not change despite opposing evidence. For example, a person may believe that someone is stealing their thoughts, that they are being watched or followed, or that they are God.

Causes

Psychosis, like so many things having to do with the mind, is  hard to pin down to a single cause. There are several, intermingling factors that affect someone’s likelihood of developing psychosis.

Drugs: Psychedelic drugs, or even lighter drugs like marijuana, have been shown to trigger or worsen psychotic episodes.

Genetics: Many studies have been carried out that link psychosis and other mental illnesses to genetics. If your parents, family, or siblings have experienced psychosis, you are more likely to experience it.

Illness: Some illnesses and diseases, such as brain cancer, can cause psychosis, or what appears to be psychosis, in a person.

Stress: Stress and trauma can bring on or worsen psychosis.

Warning Signs

There are several early warning signs for psychosis which can be noticed by others, they include the following…

  • Difficulty in school or work
  • Isolation from others
  • Decline in personal hygiene
  • Lack of clear or coherent thoughts

Psychosis and Mental Illness

Psychosis itself is not a mental illness. It is, however, a component, or possible component, of many mental illnesses. It should then, be seen as a symptom rather than an illness. Many illnesses can include psychosis, including post traumatic stress disorder, depression, bipolar disorder, and schizophrenia, the last of which has psychosis as a hallmark symptom.

Treatments

Treatment is paramount for those suffering from an acute psychotic episode. There are a variety of treatments for psychosis, some of which I shall list  below.

Hospitalization: For someone undergoing an acute psychotic episode, the hospital may be the best option. The goal of any psychiatric hospital is to stabilize and rehabilitate enough so that a person may undergo further treatment after discharge.

Cognitive Behavioral Therapy (CBT): CBT is used in a variety of disorders to identify and change thought patterns. In psychosis, CBT can help a person identify triggers, manage symptoms, and identify strategies for getting through it all.

Medication: Medication for psychosis is referred to as antipsychotics, these drugs work by reducing dopamine (a neurotransmitter involved in psychosis) in the brain. While often effective, they can have detrimental side effects. Newer antipsychotics however, called atypical, have less side effects and are more tolerable to take than older drugs.

To Wrap it Up…

Psychosis is a serious mental condition that requires care as soon as possible. Unfortunately, it is also one of the most misunderstood mental conditions in our society today. This makes reaching out for help difficult for those who suffer, the stigma is real and is felt by sufferers every time they turn on the TV to a headline of “psychotic killer”. As someone who has experienced psychosis first-hand, I can tell you that getting help is possible, and it does help…it saved my life.

If you believe you or someone you know is undergoing a psychotic episode, please reach out for professional help, it will improve your life tenfold, and may just save it. Some crisis numbers can be found here.

Guest Post: Carousel Conversations

“Today I would like to present to you all a poem from a spoken word artist born and raised in Regina, Saskatchewan. The following poem sheds light on their experience with mental illness after having received a diagnosis and starting dialectic behavioral therapy – a form of cognitive behavioral therapy. This poem is a great representation of how difficult life can be for those combating mental illness.”

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Carousel Conversations

By: Cat Abenstein

(The following is inspired after achieving a diagnosis and starting Dialectic Behavioural Therapy.)

How can you hide from your thoughts?

The kind that probe and dig and break and demand and maim…

Thoughts like a leaky faucet,

drip, drip, drip,

steadily.

Some small and quick and mostly painless.

Gone before they’re even registered.

Others are big fat globs of water droplets that splash

down into the sink,

sending water flying up and around in

equally spaced,

equally wet,

runway lines of water.

“Remember your self soothing techniques we worked on.”

My therapist’s voice pops in my head.

She’s soft spoken,

and trained so well.

She nods and validates and leaves space for my words and doesn’t judge my actions,

but empathizes with how they make me feel.

She says things like,

“That must be hard.”

And,

“Do you think these rules you create are fair to you?”

And,

“You described your anger as feeling hot and tight. What else can make you feel hot and tight. Arousal? Exactly. Arousals not bad, is it?”

No, doc.

Arousal isn’t bad.

Turning my all too familiar rage into a watered down versions of itself,

is helpful when I realize my body reacts in just a few ways to so many different emotions.

My body feels the same when it’s angry

as it does when I’m horny,

as it does when I’m stressed,

as it does when I’m excited…

And knowledge is power.

Knowing is half the battle.

But now these answers:

Major depressive disorder

Borderline personality disorder

Leave me with so many questions.

Overwhelming

Grief inducing

Lip quivering

Shoulder heaving

Bargaining types of questions.

Like:

“Please. Not again. Why again?”

And,

“Make it stop. Will anything make this stop?”

And,

A splitting calm of dried tears tie these words to a bitter acceptance:

It won’t stop.

“It’s never going to end. I can literally never see a life without this pain. Even though I have more good days than bad, the bad far outweigh the good. This will keep happening. All the progress I’ve made will crumble under the weight of my expectation. I will constantly flip back and forth between enthusiasm for life and crawling on my living room floor, watering the floor boards with my pathetic tears. Begging like a stray for love scraps.”

Stop those thoughts.

Stop those thoughts.                            Stop those thoughts.

Stop those thoughts.

At what point do your suicidal and self harming thoughts become too much?

After the first thought? The first cut?

Even though you’re (pretty) sure you actually wouldn’t…

I used to hide from my thoughts

With cocaine

Speed

MDMA

…uppers that pulled me out of delusion into drug induced fantasies of superiority

Success

Friendships.

If not that,

Then sex

Shoplifting

Red line driving

Going bankrupt

Severing ties

Feeling alone.

So alone.

Now I embrace these thoughts.

Give faces to the impulses,

Call out the delusions…

But it doesn’t necessarily make it easier

every time I find myself back here.

I forget how hard the trip is.

How confusing this carousel ride is.

I hate how my seat stayed warm.

I hate my old shadow friends and how eager they are  to pick up where we left off, regardless if I can name them now, or not.

Spinning

Take me out

Spinning

Get me off

Spinning

Get me out

Spinning

And take me away.

Exploring the Science of Depression

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Too often the general public relegates mental illnesses like depression, bipolar disorder, and schizophrenia to just that, mental illness, diseases of the mind. However, with modern science, we are beginning to see more and more the folly of this simplistic viewpoint. We are now seeing the science behind these illnesses;  the changes in brain form, function, and chemical balance that alter how our brain functions and perceives the world around us. For the next  month or so, in my “Exploring the Science of…”  mini series, I will be talking about how what happens in our brain impacts what happens in our mind. For my first post, I would like to talk about how adjusting a few key elements in our brain can cause depression.


What Is Depression?

According to the National Institute of Mental Health (NIMH), signs of depression include long term feelings of sadness and emptiness, feelings of hopelessness, excessive tiredness, and more. Suicide is also a risk in those suffering from depression. Depression can be moderate to severe, and by NIMH’s count approximately 7% of the American population suffers from Major Depressive Disorder, a clinical term for depression. Depression is commonly treated with SSRIs (Selective Serotonin Reuptake Inhibitors) or MAOIs (Monoamine oxidase inhibitor), therapy is also helpful in changing thought patterns that can help make a person depressed.

Brain Changer

A brain is a brain right? Wrong. Turns out there are a lot of things that can go awry inside our brain, just as there is in our body. One of the things that gets wonky in depression is something called neurogenesisa fancy word for the generation of new nerve cells, particularly in the brain. It is believed that those suffering from depression cannot regenerate cells as fast as those without. This leads to loss of brain mass, particularly in the hippocampus, an area of the brain responsible for memory and recollection. Stress is believed to inhibit nerve growth, which may be one reason why the hippocampus is smaller in those that suffer from depression.

But the hippocampus isn’t the only area of the brain that changes due to depression. The amygdala, the part of the brain responsible for behavioral reactions and high level functioning, is also different in those that suffer from depression. According to Harvard Health, amygdala activity is much higher in those that have depression…even when they are not currently depressed!

The Juice

Brain function isn’t just about form, what goes inside that form matters too, specifically the juice of our brain; neurotransmitters. Neurotransmitters are a bit like messengers, to keep it simple (it gets a bit complicated). They tell your brain what to do, how to feel, and how to function. The neurotransmitter most looked at in depression is called serotonin. Serotonin is responsible for feelings of happiness, so it’s no surprise that it might be involved in depression.

Those with depression do indeed have lower levels of serotonin in the brain. We all saw that coming, but how do we fix it? Adding more serotonin of course! Well, yes, and that is the goal of many anti-depressants on the market today, but perhaps not for the reasons you might think. In depression, not only does serotonin make you happy, it also regenerates nerve cells…see the connection? Serotonin levels rise, neurogenesis increases, the hippocampus is happy, and you’re happy. This also explains why anti-depressants take a few weeks to kick into effect; neurogenesis takes time.

The Takeaway

Depression, like so many mental illnesses, is a complex disorder. It affects the brain as well as the mind, and requires treatment so that it’s sufferers can live a full, happy life. By understanding the science of why depression happens, scientists can create better treatment, tests, and therapies for it. If you feel you are suffering from depression, or have been diagnosed with depression, I hope you find comfort in knowing that this is a medical illness, with causes we can see, and not the fault of yourself. Thank you for reading and I hope enjoyed this, the first article in the “Exploring the Science of…” series.

Exploring my confrontation with mental illness

For today’s post, I would like to share with everyone insight into my own personal  and very humbling experience with mental illness – specifically what I felt during my engagement with mental illness and what I was able to take away from the ordeal.

Up until 3 years ago, I can safely say I had no idea what mental illness was. Whether it was my lack of education or personal ignorance towards the subject, I paraded around with the notion that “I have a strong mind, only those who are weak experience mental illness”. What I believed to be correct at the was not only incorrect, but shortsighted.

I can remember the event so vividly. I was sitting in a chair at a friend’s place and I remember starting to feel odd. It was a feeling I’d never felt before, which was quite alarming at the time. It started with a sense of dread, as though something catastrophic were about to happen, followed by a variety of unpleasant symptoms: severe chest pain, hyperventilation, I felt like I was choking on an invisible object, started shaking and sweating uncontrollably and, to top it off, was unable to concentrate on anything. When I looked at words on a page, I had difficulty understanding them. Sounds started to echo inside my head. When I heard a noise, I would hear it 4 or 5 times. This would happen for every noise. After what I believe was 5-10 minutes of this, I started to experience something else – the most terrifying event of the whole ordeal for me – derealisation.

Derealisation is an altered perception of subjective reality which may be brought upon by a traumatic event, such as the loss of a loved one, or, in my case, an anxiety attack. When derealisation set in, I had no idea what I believed in anymore. The only thought that I had at the time was “all that I perceive is a figment of my imagination”, which led me to start thinking that every person and object that I interacted with externally was an internal recreation that my brain perceived as reality. I couldn’t cope with all of this at the time. Life felt like it was spiraling out of control. I felt as though I was losing my mind. I called my girlfriend and had her take me home, thinking that rest would help the situation, but it did not. I continued to experience these symptoms for about a week until I consulted a doctor. At the time, I did not have a family doctor. If I was ill, I saw a doctor at a walk-in clinic.

When I first went to a doctor, I went while I was experiencing a full-blown panic attack. Again, I didn’t know it at the time, but reflecting upon it now, I am able to understand that. The doctor I saw asked about my symptoms, saw me for a few minutes and sent me off with a prescription for an antidepressant. Because the doctor’s diagnosis was so brief and I perceived my symptoms as being life-threatening, I went to another doctor for more answers. Thankfully, the second doctor I spoke with was more willing to explore my symptoms. I had various tests done – blood work, ECGs, x-rays, even a CT scan. All came back showing normal results, except for the ECG, which showed something that the doctor couldn’t quite put his finger on, so he consulted a colleague to figure it out, which turned out to be heart condition.

A year and one cardiac ablation later, the condition was no longer present, yet I was still plagued by anxiety. This forced me to start reflecting upon everything in my life. I couldn’t live like that anymore – I felt like I was going insane daily, having maybe 2-3 hours out of any given day where I wasn’t struggling with my thoughts. I wanted relief from my thoughts – an out, of any sort. At around this point, I had been having intense intrusive thoughts which weren’t comprehensible to me. The thoughts were relating to suicidal ideation, self-harm and harm to others. Having these constant thoughts made me a recluse. I wouldn’t leave the house in fear of harming myself, others, or because I didn’t want the possibility of something I perceived as “bad” to happen.

About 2-3 months after the ablation, the anxiety worsened until I eventually broke. For the first time in years, I cried like a baby. This didn’t just happen randomly. At the time, I was reflecting on my moral compass after reading something awful that just happened in the news about a large-scale manipulation of people. This resonated particularly well within me, and I started to realize that I had been manipulating people – taking them for granted. I had a purely subjective view of things, only seeing how things could benefit me, not the impact my actions would have in relation to the world and those around me. Having that thought opened up a whole new avenue of understanding for me, which allowed me to see my actions from an objective point of view. With this understanding, I started to see the error of my ways; certain things about myself that I disliked. The manner in which I was acting directly clashed with my morals and beliefs. This was the root cause of my anxiety.

After a year of reflection upon my actions, I was able to see the so-called error of my ways, which helped shape me into the person that I, in the long run, wanted to become. My anxiety stemmed from many factors, but largely, it came down to how I was interacting with the world around me. I wasn’t acting in a harmonious manner with the world. I was acting with selfishness as my motivator.

When we go about day-to-day life, our minds try to communicate with us in various ways. In my case, anxiety was my mind’s form of communicating. While the entire ordeal was very taxing, both mentally and physically, I learned a lot about myself and the world around me, which is something that I won’t ever forget. Although the experience was truly and utterly terrifying, I found that now, it was very humbling and helped shape who I wanted to become in life.

Mental illness may present itself in a variety of ways. My story above shows how important it is to see a medical professional when symptoms start to interfere with your day-to-day life. You may find an underlying condition that could be detrimental to your health. While it may not be a cure for your mental illness, cooperating with a medical health professional can help improve your quality of life, both physically and mentally.

Exploring emotional manipulation stemming from external stimuli

Having explored active and passive thoughts, intrusive thoughts, stress and a handful of mental maladies, we are ready to being to understand how external stimuli may manipulate an individual if they do not possess preexisting awareness.

As we know, external stimuli are enabled by emotional vulnerabilities – that is not to say emotional weakness at all. Certain external stimuli may affect one individual more than another depending on a number of factors, but largely comes down to how an individual feels toward a certain stimulus, or their connection to it. This could be something emotional, such as the death of a loved one, to something such as a political outcome that makes one party happy, another miserable, and the rest apathetic to the matter.

In the case of an emotional stimulus, such as a loved one passing, a person who has a strong emotional connection with the deceased individual will undoubtedly be affectedly more than a person who had little to no emotional connection to the individual at all. The same is the case with a political outcome – one party may express content in the situation if they have invested their time in it, where as a person who did not invest the time in the situation will be affected very little if at all by it. Everyday external stimuli are exploiting our emotional vulnerabilities in some way, shape or form, for some period of time. The duration may be instant, such as a reaction to a funny picture from one’s betrothed, perhaps of a cat, or it may be prolonged, such as if someone destroys another individual’s car, leaving the individual to feel furious. When an external stimulus exploits vulnerability in an individual, the individual becomes focused on the thought at hand, which can either be negative or positive. Anger, however, is quite different.

When an individual is angry, their heart rate rises, increasing their adrenaline, inducing a fight-or-flight type of response. When this type of intense emotion is triggered, all thoughts on the individual’s mind (not pertaining to the anger) are no longer important, which can lead to potentially detrimental behavior if prolonged. When angry, it is very easy to lose sight of why one was angry in the first place, which may induce even more anger. Being in this state of mind for extended periods of time can be very taxing to an individual’s mental well-being, which may lead to further mental health issues arising in the future.

Knowing how emotions and thoughts may be manipulated in this way provides awareness to help alleviate unwanted manipulation from external stimuli from occurring. Nobody has to be a slave to this form of manipulation. Being fully aware of how certain stimuli affect an individual is a key factor in maintaining and developing good mental health.

If anyone feels they are plagued by issues with anger, please see here for more information, or contact your local mental health association.