People tend to fear the unknown. Psychosis is arguably the group of symptoms that the average person finds the most frightening when it comes to mental health problems. There is stigma associated with many/most/all mental health conditions, but psychosis kicks it up a notch.
What psychosis is
As a quick explanation, psychosis refers to a cluster of symptoms involving hallucinations, delusions, and/or profound disorganization (formal thought disorder).
It can occur in primary psychotic disorders like schizophrenia or schizoaffective disorder, and also in other conditions like bipolar disorder or major depressive disorder.
To the uneducated person, though, there’s likely to be a lumping together of psychosis = crazy = schizophrenic = frightening = dangerous. The reality of psychosis is simply not a part of the social dialogue.; Since it is not understood, stereotypes are clung to more tightly when evaluating or contextualizing someone who appears to have psychosis.
Stereotypes
There are quite a few stereotypes about psychosis, and while some of them may have a germ of truth for some people some of the time, overall, they’re most certainly not accurate.
Talking to themselves
One classic stereotype of psychosis is someone talking to themselves. This is a bit of a misnomer in that people aren’t actually talking to themselves, they’re responding to their hallucinations. This can be observed sometimes, particularly when people are highly unwell, but as a broad generalization, it’s just not accurate. It’s most likely to be observable in someone who is very ill or someone whose illness is treatment-resistant.
Tinfoil hat
Another stereotype is the tinfoil hat. While it’s true that severe paranoia may lead some people to take steps to protect themselves from perceived outside energies, radiation, or mind-reading attempts, this is not a run-of-the-mill occurrence seen in most people experiencing psychosis. When this kind of paranoia manifests, it’s most likely to trigger perceived protective measures around the home; in 15 years of nursing, I’ve never seen an actual tinfoil hat, although I’ve witnessed some elaborate strategies in people’s homes.
Poorly groomed
There is the stereotype of the dishevelled, malodorous person living on the street. This is the person whom the rest of society views as somehow less human and a lost cause. It likely stems at least in part from an underlying fear that the onlooker could someday end up in that position.
When people with psychosis do end up resembling this stereotype, it’s because the system has failed them on multiple levels over and over again. It is not the unkempt homeless person that’s to be feared, it’s the system that’s so broken that it can’t catch people when they first start to fall.
Violent
Then you have the violence stereotype. There’s yet another mass shooting? All of a sudden everyone’s clamouring to say the shooter must have been crazy. Forget about better gun control laws, people want to lock up the crazy folks. Because after all, how could someone do something like that and not be psychotic? Easy answer – a psychopath.
Psychotic ≠ Psychopath
That brings us to another issue, the idea that psychotic, psychopathic, and psycho all refer to the same thing. Psychotic is an adjective for someone experiencing psychosis. Psychopaths are kind of an extreme version of sociopaths. They lack empathy, but psychopathy is not considered an illness. Psycho is a slang term that derives from the Latin word psyche, meaning mind or soul, but gets tossed around loosely to label anyone who’s seen as being crazy.
The Cambridge Dictionary defines psycho as “someone who is crazy and frightening”, along with an American English definition of “a psychopath”. The Merriam-Webster thesaurus lists several synonyms of psycho; many of these are derogatory, and psychotic is on the list. As unhelpful a word as it is, though, psycho probably isn’t leaving the popular lexicon any time soon.
And really, the word psycho is a minor issue compared to the fear around psychosis. Fear flourishes in silence, which means we need to talk about what psychosis actually looks like.
Experiencing psychosis
With my depressive illness, I’ve experienced some psychotic symptoms, both hallucinations and delusions. They haven’t been a big part of the overall illness picture, and tend to appear mostly when I’m really sick. Sometimes it hasn’t been entirely clear if what I was experiencing was psychosis or not. During one of my hospitalizations, I kept hearing whispering, and it was plausible that I was overhearing conversations from a distance, but then the whispering stopped not too long after I was put on the antipsychotic olanzapine.
Have you experienced psychosis as part of your illness? Have people reacted with fear because of it?
The post Let’s Talk About Psychosis is the hub for all psychosis-related content on Mental Health @ Home.
My latest book, A Brief History of Stigma, looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.
You can find it on Amazon and Google Play.
There’s more on stigma on Mental Health @ Home’s Stop the Stigma page.
I’ve had a couple of borderline-psychotic episodes, but they only lasted for a couple of seconds at a time, so it’s hard to get a firm diagnosis of what happened during them. I have worried at times about becoming psychotic, though. The fact that the depression books/sites I was reading acknowledged that people with depression can become psychotic without really going into detail about what psychosis entailed, which probably added to the fear (this was a number of years ago; I hope things have changed).
Re: psychotic people being blamed for mass shootings, I think that’s as much about our understanding of mass murder as it is about our understanding of mental illness (that and the NRA looking for a scapegoat). That we assume that someone who could kill dozens of people for no obvious reason must be not ‘normal’ in some way.
Interesting that “not normal” is automatically equated with mentally ill. Easy target, I guess.
I think the assumption is that the psyche is, on some level, what makes us moral, so a killer must have a damaged psyche rather than e.g. diabetes.
I haven’t experienced a psychosis where people feared me, (thank goodness).
This was an excellent post, Ashley. I couldn’t agree with you more when you stated the gun laws need to be examined more closely. That, they do need!
Yes, absolutely
The first time I was hospitalized was because, as the doctor said, of psychotic depression. This was in 1995 so I don’t think people were as aware as they are now, of mental illness. I can only imagine what people were thinking/thought when I sat down on the floor of a crowded train car.
Even now I’m not sure how aware people are.
I agree.
I can honestly answer yes to both of your questions. I sometimes scare myself even. I am on anti-psychotic meds and they help some, but I’ve learned what can trigger these things in me and try to avoid them. Not always easy considering it’s usually rudeness or stupidity that will set me off, I stay home mostly. LOL
That’s so tough when it’s external triggers you have no control over that trigger reactions.
Thank you. At least I know what they are. I feel for those that are at the whim of something they can’t identify, how do you protect yourself from that?
Yeah good point
Have you experienced psychosis as part of your illness? I suppose I have. Three ..no scratch that… FOUR times. Three during major surgeries and once because someone triggered an anger episode that I’ve never experienced since and hope to heaven I never do. I was out of control. In the surgery situations, I didn’t realize, initially, that I’m allergic or highly sensitive to general anesthesia, or components of it. It’s probably the pain meds they mix in to that stuff that causes my psychosis (if that’s what it was). I become highly paranoid (during one of them I called a good friend in the middle of the night and claimed ‘they’ were trying to kill me and she needed to come break me out). I’m combative, angry and act out during these episodes. Fortunately as the effects of the anesthesia wear off, so do my symptoms. The first time it happened, it scared me to death. The last time (after my knee surgery), it was so severe that I lost an entire week of time. I have no idea how I acted, although a family member said they came to visit me and I kept ranting about what a horrible mistake it was having my knee ‘fixed’ and how I was so stupid to put myself in the situation again.
Have people reacted with fear because of it? Sometimes yes. But it had its upside in a weird way. After the knee surgery I was in a rehab facility for about three and a half weeks roughly. Initially the facility overbooked and I was given a cubbyhole in a wall behind a curtain. I shared a bathroom with four other women, two of whom were apparently highly incontinent. I know I scared the staff into giving me the first private room they had come available because I said I didn’t know what I would do to those women who soiled the bathroom so badly and that I was going to sue the facility for putting me in a ‘room’ that had no handicapped modifications (not even a bed rail for me to hold onto to get out of bed at all), and that wasn’t even a room.
I am, under the surface, a highly angry individual at all times. Maybe anger is the most dangerous part of a psychotic episode.
Yikes, that’s an awful reaction to anaesthesia, and not exactly the kind of thing you can necessarily avoid.
Very interesting read and one I can identify with completely. Anything that is deemed as not acting ‘normally’ or ‘not coping’ is automatically seen as being crazy or unstable.
I hate that. I hate both those labels.
Thank you for sharing.
– Nyxie
Yup, labels like that suck.
I’ve never had a true psychosis, but the thought of it does scare me. I think what would be scariest to me is the loss of control over yourself, your decisions, reality itself…
Yeah for sure
Ended up in jail after a psychotic manic episode a few years ago. Started my ongoing recovery soon after I’ve been on since.
It’s sad that all to often people end up hitting that kind of rock bottom before things start to turn around.
Better than never turning things around, ya know
For sure
olanzapine is what my mum is on.
“It is not the unkempt homeless person that’s to be feared, it’s the system that’s so broken that it can’t catch people when they first start to fall.” 👏👏👏
Great post! 🙂 I have always been frustrated by the misunderstanding that psychotic symptoms =psychopath
Yes! It shouldn’t be that hard a concept to grasp.
I always admire your informative posts and courageous honesty. Great read. 😊
Thank you!
I’ve had delusions and visual & auditory hallucinations but most of mine were being unmedicated plus being on meth. And you don’t sleep when you’re on meth, which of course, also creates hallucinations. Outside of drug use, I’ve only had minor delusions. I still hear whispers when I’m alone. I can’t make out the words but it’s like someone is whispering in my ear but idk if it’s my bipolar or something else. It happens a few times a week & it’s not bad. Just weird.
Meth is so awful for psychosis.
It really is. I’ve seen way worse off than I was, it’s scary.
I suffer with psychosis/psychotic episodes due to being diagnosed with schizophrenia, anxiety, eupd.
It’s truly terrifying. Most times I can’t remember what has happened in these episodes but my meditation seems to be working right now. Best wishes to all of you. Xx
I’m glad the meditation is helping 🙂
It’s really unfortunate that there’s not more understanding about this.