What it’s like to have psychosis in the 21 st century
By Nora Spencer
TRIGGER WARNING: This article talks about psychosis, it’s symptoms, experiences, and hospitalization.
DISCLAIMER: EVERYONE’S EXPERIENCE WITH MENTAL HEALTH IS DIFFERENT
I guess I should consider myself lucky, that I had my condition when I did. I wasn’t thrown into a hospital and pushed to stay there for the rest of my life. It’s hard to consider myself lucky though.
Sitting at my friend’s birthday someone brought up ‘What if this world isn’t real?’
I stayed silent.
She continued and then I said ‘I can’t think like this.’
She persisted, not meaning any harm but trying to show me how everything is a matter of perception.
‘Why do you need things to be real?’
Because if nothing is real, people can think about that and be fine. I will not. I will obsess. Because if nothing is real, then the voice I hear is as real as anything. My sanity relies heavily on my recognition of what is real and what is not.
I have been asked many times why it matters if nothing is real. People may think of themselves as reflective, pensive, or even edgy for addressing the possibility that the world doesn’t exist. This mindset and forcing me to explain myself for needing the world to exist is triggering.
I say ‘I don’t know who I am’. They say ‘who does’. I say ‘I don’t know what I like or want’. They say ‘who does’. I say ‘I think my personality is a construct of other people’s expectations of me that I’ve internalized’. They say ‘isn’t everyone’s?’
I try to tell people about my symptoms and they shut me down. They think they’re helping by making it seem normal but really they’re trivializing everything that is debilitating me. I understand that people have a sense of finding themselves and often go through nihilism in ways that make them question reality but by comparing these thoughts to obsessions, fears, and delusions in this way, is potentially making someone think they don’t need help.
I was at a pancake restaurant with my friends when I started telling them how I didn’t believe they were real. They were confused and I laughed but I told them what I believed: everyone around me was fake and the world I was living in was a game designed to torture me. They asked how I ‘knew’ all this and I told them that the voice had told me everything. The voice knew everything because she was a person too once. In fact, she was me, and I was merely a poison that took over her body.
My psychotic and dissociative states have an entire lore to them. To expand further into this lore would not benefit anyone, but I feel the need to give a surface understanding to prove to you and to prove to myself that I was unwell. Why must I prove it? Because to this day, the UK doctors don’t necessarily believe I was ever psychotic, even though my home country’s doctors, who actually listened, knew I was.
After numerous attempts to get help in the UK, and being shut down, I chose to return home, leaving university life behind and taking a gap year. Within 6 hours of entering the country, I was in a hospital. I don’t remember much from that day but I remember speaking to people and them determining I should be in the hospital. Then when I went with my mother, I was repeating a sentence to the doctor for 5 minutes because I didn’t understand what he was saying. I rode an ambulance and got to the mental health facility. They put me on medication and since it was late and I was hyperactive, they gave me a sedative anxiolytic to sleep, with mine and my mother’s consent.
The hospital treated me well, which is something I would have not received in the UK. The meds started to kick in and over time with therapy, my psychotic depression became depression.
I improved drastically, and once I came back to feeling like I was alive again, I asked my mother what it was like to see me in that state. She told me that she didn’t recognize me or see life in my eyes.
Don’t get me wrong, I still struggle with my mental health and I still have dissociative episodes, but I feel joy again. I see the world as somewhere worth staying. However, people’s mentions of the possibility of an unreal world set me back because to them it’s a thought and to me, it’s memories of an intensely uncomfortable past.
They don’t understand that I spent a year on medication that would make me sleep 9-16 hours a day. They don’t understand that I have to remind myself that the world may seem coincidental in ways that can’t be explained but that doesn’t make it any less real. They don’t understand that I have to be careful in my life, with drugs such as weed or psychedelics, or with films that may be triggering, or with these thoughts and conversations so that I don’t get in too deep and forget what I spent months and months trying to recover: an ability to distinguish what’s real and fake. I still hear the voice, and forgetting to stay grounded makes me feel like I have to give in to what she tells me. I sit and I tell my family of the disturbing things I hear so that they understand why I may be quiet at the moment. They are used to it.
Destigmatisation comes in waves. Why is it that in a world where destigmatization is praised, a film like Split still comes out? A film that perpetuates this idea that people with dissociative or psychotic disorders are more prone to violence (1). In fact, many studies suggest otherwise (2). To think it is true is an outdated belief.
I am all for destigmatization but I think people are only comfortable to destigmatize what seems ‘acceptable’ to them. Depression and anxiety are things many people experience and even people who don’t experience, they understand, at least that. However, psychosis is still this thing that seems distant to people. These features such as viewing the world as unreal or having a lost sense of identity in the sense of delusions have become almost fashionable in a way that I find unacceptable. To say that people with psychosis are more prone to danger and to avoid it in talks of destigmatization but then allude to psychotic features in a casual way is self-contradictory and genuinely hurtful. I recognize my privilege and how I’m in a position where I can talk about my mental health, but still, every time I meet someone new, I recognize that telling them about my past means possibly losing them or possibly having to cut them out if they respond in a toxic way.
The contradiction of modern society’s approach to psychosis, through its fear of individuals suffering from it but acceptance of common delusions as angsty questions about existence, potentially leads to individuals being unable to get help, or even recognize they need it, followed by feelings of guilt and ostracisation for having the condition. I say this because this is what happened to me. Let psychosis be recognized as normal and okay without its symptoms being trivialized. So next time you’re questioning reality, be mindful of who you may be talking to.
References:
1. SPOILERS: Split is a film from 2016 where an individual played by James McAvoy has Dissociative Identity Disorder (DID), kidnaps and imprisons 3 young women, killing 2 of them.