The Reality of Psychosis – Beyond the TV Drama

TRIGGER WARNING: Psychosis, schizophrenia and hallucinations explained.

How do you know what’s real and what is a cleverly designed trick played on your senses by your own psyche?  

A well mind can make the distinction between a vivid dream, an imagined scenario and waking reality. But a psychotic mind cannot separate what is real and what is not. I guess that’s what makes psychosis so frightening, and contributes to the fear onlookers feel when dealing with a person labelled ‘psychotic’.

I want to take this opportunity to explain, from a person who has experienced hallucinations, what the reality of such experiences is actually like. I also want to give hope to others who have been through this.

I have had a number of acute psychotic episodes over the years, each intense, powerful, frightening and vividly ‘real’. It has taken me many years to trust my senses after becoming ill and even now, a decade on from when I was so unwell I was sectioned, I have to check my reality with others to make sure what I’m seeing, sensing and feeling is real. And not my imagination distorting the signals received by my senses.  

It was unknown back then, and not diagnosed, that I actually have Schizophrenia. When I went through my acute psychotic episodes the feeling was that these would pass, and the symptoms wouldn’t last. Well, they did last. And I spent over ten years often thinking that strangers were staring at me, shouting abuse at me, and threatening to kill me. Worse than that, was the feeling that the strangers looking at me would actually be incensed to kill themselves, just from the evil that emanated from my presence.

I was obsessed with the existential, with Jesus and the Devil, and the intermingling sensation that the two were one being; me. In the height of my psychosis I was all powerful, I could control others telepathically and I could manipulate situations. I was sure I was controlling everything around me. This in itself was terrifying. With the deep belief that I was evil, I truly thought I had the power to cause others to take their own lives. I had a strong feeling that I didn’t want to be evil, but I struggled with feelings that the devil doesn’t choose to be the devil and must come to terms with his/her intrinsic reality. As, in a way, I thought we all have to accept ourselves. Yes, we can develop, choose our actions and behaviours, but who we are deep down? Do we choose that?

During one episode, I was at a Police station having been arrested after an attempted suicide and I saw every man in the building weeping uncontrollably. That was my reality. Clear as crystal and clearly embedded in my memory, as real as the memory of writing this article will be, I physically saw tears and sensed a collective despair brought on by my presence, by my evil. Every turn of my head saw another man in turmoil, reduced to hopelessness.

Psychosis is real. It’s physical, your physical senses are involved, and you simply don’t know the difference between what you’re seeing and what others are experiencing. Your reality is simply your reality, whether its recognised and experienced by another person or not. Real.

That’s the message I want to get across by writing this. Psychosis is not, as often portrayed, simply hallucinating the odd dark, sketchy creature in the corner of the room that disappears as fast as it appears. It is an entire distortion of reality. Conversations can happen with real people in the mind of someone with psychosis that they will remember clearly but that never actually happened. Feelings get mixed up and confused and the entire psychotic experience is a lonely one. Humans enjoy sharing experiences and the psychotic mind can be totally separate from the reality others are experiencing. Leaving the sufferer totally alone, utterly confused and panicked.

Hallucinations can indeed be ‘hearing voices’ and yes, in some cases those voices can tell you to do things; I never experienced that. But these experiences can also be the creation of entire people, fabricated in the mind of the psychotic. They can be messages through televisions directed at the person; I did experience this.

Personally I find that often the more disconcerting hallucinations are the subtle ones. And it really annoys me when psychosis and schizophrenia are depicted in the media as the experience of extreme full-blown monsters. If I saw a monster, I could probably reason with myself that it isn’t real. That makes the thought of seeing monsters less frightening. What I can’t distinguish is whether, when I hear the click of a window latch when I’m in bed, that sounds like an intruder breaking in, is real or not. That click could be anything. It could be the wind, the radiators or indeed an intruder, but how do I know? It’s a slight hallucination, a subtle trick on the senses that is so small and insignificant that distinguishing it from reality is hard.

This kind of hallucination is more difficult to recognise but the media don’t want to talk subtle. They want to frighten; to incite terror and separate the psychotic from the well-minded. Making the public think we are on a different scale. But I don’t believe we are. Any brain can be pushed to a level of stress that might incite the experience of a hallucination. After all, what are dreams?

A well mind can also be played tricks on, through a heightened state of anxiety a person may feel threatened, does that make them psychotic? I don’t think so. We all have powerful minds that are still little understood. Psychology is in its infancy and we must use our experiences to understand it further. We must share stories of our realities and reduce the fear and stigma still attached to schizophrenia and psychosis.

For me, the subtle leftovers of my illness are unsettling. But it’s about managing these symptoms effectively. I simply ask my partner, ‘did you hear that’, when I hear a strange noise. And luckily, most of the time, the answer is ‘yes, it’s next door. Or the wind’. I am still frightened by my illness, but it no longer rules my life. I find laughing about it a fine tonic for reducing anxiety around the fears of slipping reality again. If I do hear something, I’ll often make a joke out of it and my friends and family, although perhaps a little shocked at my dark humour, tend to receive it well.

Reasoning with mental health issues, in my opinion, can help the individual put defence mechanisms in place that can ease symptoms. You have to be on it. Analysing my experience has become a constant for me but lessens the further away from regular symptoms I get.

I understand that this subject is scary and reading this might make you worry that I’m dangerous, ‘off my head’ or ‘mad’. But I’d like to suggest that people with severe mental health conditions are more likely a danger to themselves, they don’t want to hurt you. If they hear voices they are probably telling them negative messages about themselves, it’s really got nothing to do you with you.

So don’t be afraid. Reach out. Ask a psychosis sufferer what it’s like to have hallucinations, to move within a distorted reality. In my experience, those that have suffered are incredibly articulate, and talking about these experiences can really alleviate the traumatic after effects of suffering such events. I suppose that’s why I’ve written this piece. It’s been a cathartic hour.