This Is What Psychosis Is Really Like
At the age of 48 – with no previous history of mental health symptoms – I was diagnosed with bipolar I with psychotic features. It was a life-altering moment.
Bipolar disorder is a mental illness that involves significant changes in mood, energy, and behavior. Bipolar I is characterized by manic episodes, which involve abnormally elevated mood, risky behaviors, and impulsive behavior. These "high" mood episodes often (but not always) alternate with depressive episodes, which are periods of low mood, lack of motivation, and difficulty concentrating.
Bipolar disorder may also involve psychosis. This is most common during manic episodes but can happen during depressive episodes, too. More than half of people diagnosed with bipolar disorder also experience psychosis at some point.
What is Psychosis?
Psychosis occurs when a person loses touch with reality. Common symptoms include delusions (unusual beliefs), hallucinations (seeing or hearing things that are not real), paranoia (believing others are out to get you), and disorganized thoughts or behaviors.
For me, psychosis showed up powerfully and suddenly. Here's what it was like.
Delusions: I Was Convinced I Was Comatose
Delusions are fixed, false beliefs that are not based on reality. Even when there is overwhelming evidence to the contrary, the delusion remains. One of my delusions was that I was in a coma. I went to the emergency room looking for answers. While in the ER, doctors conducted several neurological tests, including the Glasgow Coma Scale (GCS) and a CT scan. They wanted to rule out other brain issues for what I was experiencing, as psychiatric disorders usually appear earlier in life.
The doctors told me that I was not in a coma, but I would not accept this answer. I refused to believe them. They went over all of the neurological tests that they had conducted. Despite the results of these tests, I continued to believe that I was in a coma. Because I was so disconnected from reality, the doctors admitted me to inpatient psych.
Paranoia: I Thought They Were Spying on Me
Along with delusions, I frequently had paranoia during mood episodes. I believed that I was the subject of a secret research study and that my doctors were in on it. I thought that they were spying on me at my home. So I would call my doctors, accusing them of installing hidden cameras in my house.
Disorganized Thoughts and Behavior
During psychotic episodes, my thoughts were very disorganized and didn't make any sense. I also had disorganized behavior, and I would make decisions based on delusions. For example, when I thought my doctors were spying on me, I bought numerous cameras to catch them in the act. The cameras sit – unopened – in my garage to this day!
Anxiety
Though anxiety isn't listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a symptom of psychosis, it was a part of my experience. Delusions, in particular, can be extremely disorientating and frightening. You're terrified and confused, especially when reality does not match up with your internal beliefs and thoughts. For me, this resulted in panic.
People often portray psychosis as something that can't get better. That's not true. For me, the right treatment – medication and therapy – has made a huge difference.
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