Psychosis: How Did I End Up There?

This week I’ll be interviewed by my friend Laura Howe on her Care Ministry Podcast. I am writing this blog post to review and refresh myself and you on psychosis, as it can unfold, and how it unfolded for me. I will be discussing this in detail with Laura and so check out her podcast to hear for yourself in May.

Psychosis Defined

The DSM-5 says that Schizophrenia Spectrum and Other Psychotic Disorders are “defined by abnormalities in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms”.

Some cases of those who have a bipolar disorder diagnosis can also have psychotic features. That was true in my case. In heightened states of mania, I jumped up into psychosis, and I recall these moments in my memoir in great depth.

For those living with bipolar disorder with psychotic features, or with a brain affected by schizophrenia or schizo-affective disorder, psychosis can be a scary thing. It not only led me to believe things that weren’t true, but it kept me in a constant terrorized fearfulness. Paranoia, a feature of psychosis, induced the feeling that my phone line was bugged, the sense that demons were watching my every move, and that the natural realm was being manipulated by the unseen/spiritual realm with great force.

As a Christian outside of this psychotic state now, I still believe demons can observe our humanity and study us, and that the unseen can influence the seen, but I don’t live in a state of perpetual fear anymore. As long as I remain on my psychotropic medications, I can live in the “real world” and not be paralyzed with these delusions.

Before Psychosis Begins

What I just discovered in recent advocacy work I’ve been involved in, is that there is a state before psychosis begins: the prodromal state.

According to an article in PsychiatryAdvisor journal, “In the majority of patients, onset of psychotic symptoms is preceded by a prodromal phase, in which subtle changes in belief, thought, and perceptions herald eventual full-blown delusions, formal thought disorder, and hallucinations.” This happens over a period of time, the mean average being 7.3 months and within two years.

For myself, I realize that before I bloomed into a full-blown psychotic state in my mania, I was beginning to strongly believe things that weren’t necessarily true or sound. Listening to a Faith-Word preacher during this time may have helped increase my desires and beliefs that I could be healed (off the medication) by the faith I held within. A wonderful misinterpretation of the statement of Jesus where he teaches that with faith the size of a mustard seed you can move mountains. However, to my dismay, I didn’t realize the mountain being moved must align with God’s will.

Going off my medications was not His will, by the way.

What Can Be Done?

So how could this risk of sliding into a psychotic state be avoided? It’s so subtle and sneaky, how can you detect the prodrome thinking in someone who may not have yet developed their First Episode of Psychosis (FEP)?

Listening to their thoughts or beliefs about the Bible, and about their world in general. It seems that the beliefs could be outliers, stranger, or skewed. This is where it would probably take a lot of discernment and wisdom. I don’t actually think you can predict a psychotic state. What you would want to do, if you were concerned, is make observations over time, if you love and know the person with the symptoms in question, or if you are the person with symptoms in question yourself.

Unfortunately, I have not come across ways to prevent a psychotic break aside from a good prescription of psychotropic medications.

Looking back on my own history, I don’t know that anyone would have spotted it unless they really dug into my deepest beliefs and thoughts and conjectured a presumption.

If someone has a history of psychosis and they’ve recovered or is relatively stable in their thinking, I’m not sure if they have as high a chance of it returning. In my own thinking, I’m now aware of my mental illness and retain insight to realize how I was in a psychotic state and alternate reality.

I hope and pray it wouldn’t return but as long as I’m taking my anti-psychotic medications as prescribed, I have a greater chance of it staying at bay, I’m sure of that.

Young people, typically in their teens and early twenties, are at higher risk to start seeing symptoms. While the brain doesn’t fully develop until the late twenties, the changes and growth of the organ prior to that, in addition to a large change/catalytic event, and a hereditary predisposition, may contribute to the onset of psychotic disorders.

My Prodromal Thought Process

A few examples of the chain of beliefs I had held during that prodromal state before psychosis are:

1. I’ve been prophesied over that I would throw up the medicines (and that was in fact spoken over me), so I must be healed.
2. I have enough faith within myself to claim healing in Jesus’s name, so I can be healed (off the medications).
3. My psych medications were switched “cold-turkey” at 16 (my first episode) and therefore maybe I had a drug-induced bout of a mental breakdown…maybe I don’t have bipolar after all.
4. The authority God has given Jesus to cast out demons and lay hands on the sick has been given to me too, and I can do this without psych meds – it’s as much spiritual as it is medical/mental.
5. There is so much overmedicating that many with mental illness may be possessed. The only way those who are possessed can function is by being doped up in the hospitals.
6. I am healed/cured. I don’t need my medications, as I’ve been doing well for the last 3 years. I will be fine if I decide to go off them. I do know to go off gradually, since quitting or switching cold turkey can cause more problems (learned this the first time). I’ll start weaning myself off, whether the doctor agrees or disagrees.
7. The doctor didn’t agree with me, but she didn’t see me at the last appointment either (she was two hours behind schedule.) I’ll see another doctor and convince them I discussed this with my primary psychiatrist (which I did), and can go off the medication gradually.

Entering Psychosis:

• The unseen realm around me – demons, angels, spirits—are watching me and, in their school of observations, are using me as an example of a specimen, and I can hear them talking about me (in my head).
• When I move the hangers on the rack in my closet, that sound is the sound of voices of demons speaking around me (in the unseen) and they’re watching me and commenting.

See how I ended up in such dire straits? There was a combination of truth, half-truths, and lies I was telling myself and believing. Whether the unseen could actually observe me and contact me through my skewed psychotic frame of mind or not, I fell into a state of psychosis before long.

It was probably a short thirty days before I was completely off my medications and functioning (albeit poorly) in a psychotic state. I was more out of touch with reality, than I was in touch with reality. Of course, the more it progressed and the longer I was off the medications, the harsher the symptoms and behaviors became. But this was how it came to be for me.

Further Actions to Take

If you or a loved one are experiencing a prodromal or psychotic state, I would see a psychiatrist immediately for further observation and medical treatment. This article and any other articles on this blog are not intended to diagnose or treat any mental health condition. KatieRDale.com and I are not responsible for any outcomes or actions you may have in response to reading these articles. Always consult a certified, licensed mental health provider.

To help you keep track of your medications, mental health history, providers, and have resources for them all in one spot, download your copy of Gameplan: A Mental Health Resource Guide for yourself today by signing up for my free monthly newsletter at KatieRDale.com/resources.

Stay bold, brave, and real.