Psychosis: Disorganized Reality

I just wrote this research paper for my Psychology course.  It incorporates my personal experience.

When the human mind has lost contact with reality, it is said to be in a state of psychosis, a disorganization of thoughts that can manifest in the form of any number of changes of mood and behaviors such as grandiosity, paranoia,deadlyRestraints religious ideation or intense aggression and is treated in its acute stage with hospitalization and medications, followed by a combination of lighter medications and therapy (“Psychosis”).  I have experienced this loss of contact, the insanity ranging from giddy elation to a terrifying sense of persecution.  For 24 hours I was strapped in 5-point leather restraints to a gurney and for an additional 48 I was held in a tiny white room with nothing but a pillow, staring up at a skylight while the antipsychotic medication Haloperidol slowly worked to calm my madness to a mere mania.  I was certain that my mind would never return from the point it had been taken to; that I would be forever in this horrifying state of mental chaos.

Webster’s Dictionary defines psychosis as fundamental derangement of the mind characterized by defective or lost contact with reality especially as evidenced by delusions, hallucinations, and disorganized speech and behavior (“Psychosis” 1).  Delusions can cross a broad spectrum including negative, grandiose or religious.  Psychiatric research validated by the DSM-IV shows that negative psychotic delusions are closely linked to violence.  Patients experience “command hallucinations”, whereby they are convinced that they are being told to commit heinous acts or believe they are being threatened or persecuted (Taylor 651).  I suffered from delusions of grandeur, convinced that the ambulance taking me to the psychiatric facility was instead transporting me to a surprise party intended to celebrate the occasion of a “step promotion”, military terminology for an increase in rank without testing.  Delusions can often take the form of religious ideation, wherein the patient believes themselves to be touched by the hand of a deity or to be God or Jesus himself.  Hallucinations are often auditory, such as hearing the voice of God or the Devil, but in some cases patients experience visions and can also smell, touch or taste things that aren’t there.  Thoughts and speech are often disorganized, as they acutely were in my case.  The line between hallucination and disorganized thought will sometimes blur into what is known as ideas of reference or thought broadcasting.  This phenomenon is a frightening occurrence in which it would seem that the casual events of the outside world refer to oneself.  I was convinced that an episode of the Golden Girls and a particular radio advertisement were trying to send me a moral message.  Mr. K., a schizophrenic patient in a state hospital, thought that newscasters were controlling his thoughts and intended to kill his father (Noffsinger and Saleh).   Behavior can be quite bizarre, as in the case of Mr. C., kneeling on his mother’s front lawn, preaching loudly (Hurwitz and Lake).  Mr. C. was likely seen as a raving lunatic to anyone standing by that day, but he was a victim of the ravages of a mind that had lost control.  There was a treatment for his malady.

Acute care is critical, humane and widely available for the care of patients suffering from the severe effects of psychosis. Immediate hospitalization is imperative for those experiencing disabling psychotic symptoms (What is Psychosis?)  Physical restraints are often necessary to prevent the patient from injuring themselves or others, and chemical restraints in the form of antipsychotic medications are administered, preferably by mouth but frequently patients refuse help and must be given injections.  I was one of these belligerent patients.  Bound against my will by the wrists and ankles with thick leather cuffs and at my waist by a cloth tourniquet, I took the pills into my mouth but spit them violently across the room, forcing them to inject the medication into my body intramuscularly.  The fog started to clear but the meds were powerful and left me with a confused, still psychotic and hazy half understanding of what was happening to me.  After 24 hours I became less combative and was transported to a smaller room where I spent two additional days, then to a patient ward for 3 months while I weaned off the powerful antipsychotic and onto Lithium before discharge. During this time I attended groups intended to help orient my thinking back to reality and appropriate thinking, occupational therapy and various recreational activities.   The next step was to recover from the horrifying experience I had been through and timidly reintegrate into society.

According to SANE Australia, the best treatment for psychotic illness usually includes a combination of antipsychotic medication, psychological therapy and community support (Factsheet 10). Medications work to balance natural chemicals in the brain and can have debilitating side effects, creating the need for patients to sometimes try several different combinations before finding just the right mix for them.  Medications take time to work, sometimes up to six weeks, which can be a vulnerable time for patients who may quit their medications before they begin to make them feel better.  Therapy and support from family and friends are also vital to the mental health of schizophrenic and bipolar patients.  Medications are helpful in treating the chemical imbalance of the illness, but developing coping skills with the help of a capable therapist or counselor is a crucial step in the process of learning to live with mental illness.  Community and family support are also a crucial part of the support structure.  We have a tendency to start feeling better and ultimately decide that we don’t need our medications, starting the cycle in motion all over again.  When we have the dedicated support of our loved ones we are in less worry and danger of relapse into the swirling blackness of insanity.  It is also important that we educate ourselves about our medications and about our illnesses and we must take an active part in our treatment options.  These potentially life-threatening conditions are something we live a lifetime with; it is vital to learn to manage them and not be managed by them or by doctors and insurance companies.

To conclude, I would not wish the experience of psychosis on even the most loathsome of men, but I hope I have provided some small insight into what it is like for the sufferer.  The confusion, fear, rage and loss of control that accompany the insanity are disabling but are treatable with swift action and diligent follow-up care.  To be lost in the pit of despair that is psychosis is a lonely hell, and crawling out of it is akin to struggling out of a pit of quicksand.  Looking back upon my experience from 20 years this side of it is still painful but I am grateful to have persevered.  Some unfortunately have not and often end up institutionalized, homeless or dead.  The experience I have gained as a result of the nightmare of that summer in 1990 can help others and gives me compassion for the Andrea Yates’ of the world. Others may only look at her shocking actions and call her a child murderer, an animal with no conscience or remorse for her actions.  I have suffered too and understand why she did what she did in a way that only those of us who have been through the same experience can know.

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One thought on “Psychosis: Disorganized Reality

  1. A chilling post-script: the photo I found to accompany this post is an exact representation of the room I was held in for those 24 hours. As mad as I was, I will never forget.

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