Talk Bipolar To Me – Part 3: A Series For Engaging Those With Mental Illness

Someone’s Cornbread Ain’t Done In The Middle

I get a chuckle out of this meme:

I guess there’s a difference between someone’s cornbread being half-baked and it being over-baked. Over-baked is what I’d equate to having psychosis.

If you’re having a tough time with someone in that state – whether bipolar with psychotic features or schizophrenic, here are some tips to engage with them.

Rare as the occasion might be, if you find you are around someone in psychosis, you will typically find them with a varying array of symptoms. The most common symptoms of psychosis manifest as delusional thinking (thoughts of grandeur), auditory or visual hallucinations (voices, shadows, or seeing things that aren’t there), and paranoia (someone or the government is out to get me). These are often accompanied by varying signs of lack of motivation, apathy, reduced communication, social withdrawal, and/or the inability to experience pleasure.

Depending on how well you know the person, you may be well aware of their struggle in this state of mind, or it may be something you’ve never understood. I want to help you better understand what they may be dealing with from the perspective of someone who has experienced bipolar with psychotic features.

When psychotic breaks happen, this can be damaging to the brain, and ultimately there should be professional medical intervention. The quicker you pick up on their symptoms and address them properly, the sooner they can be alleviated, and that will make a difference in their mental health and wellbeing.

The following tips are general guidelines to observe when interacting with someone in a psychotic state of mind.

Talking To A Person In Psychosis

Honestly, this was my last post in this 3-part series because it’s probably the hardest to address. I have been in manic psychosis and remember what it felt like, and why I believed what I believed. That said, these tips are based on my own personal experience, and what I would have liked someone to do had I been able to express it to them in psychosis.

• Listen. I’d like to point out that there is a pattern in these tips for talking to those dealing with mania, depression and now psychosis. When I was in their shoes, I wanted someone to listen to the ideas I was saying and give me legitimate affirmation and validation; I would have trusted that person more. It was incredibly obvious to the sane, normal person that I had lost it. What I wish those sane people would have known was that the way you dismiss my beliefs also has an effect on me. You lose my trust when you dismiss what I’m hearing, seeing or thinking as simply gibberish or non-sequitur. I can’t stress this enough: there is logic in psychosis, and compelling reasons why we believe the things we believe in our psychosis. The brain is misfiring, perhaps, but in our sick minds it all makes sense and is not random. Confused? Just trust me — I know what I’m seeing, thinking and hearing, even if you can’t.
• Validate. So you want to keep a person’s trust? Don’t give them lip service – they’ll see through that. Don’t judge them, they don’t need to be told “That’s not really there.” Instead, acknowledge what they’re saying.       And then…
• Ask. You cannot read their mind, and cannot possibly know what they’re experiencing unless you ask them. If they are close enough to you, see if they’d be comfortable and trust you enough to share more.
• Know. If they are experiencing voices, be aware that the voices heard in psychosis are usually negative, condemning and attacking (why that is, is for another post). Know that it’s hard enough to endure the voices, let alone tell you what they’re saying and communicate the feelings they have because of them. If you’re familiar with voices or hallucinations, they may be telling the person to hurt themselves or others as well, and this may be something the person recognizes and won’t follow through on because they disagree and have a strong internal sense of right and wrong, or they may try to follow through because they’re lacking self-control. If you know they are having these intense symptoms, it is probably a good time to…
• Involve a professional. Of course you’re likely not a trained or licensed professional prepared to deal with a person in psychosis on the level that’s required to de-escalate intense symptoms and reactions. So please, if they’re exhibiting a lack of control and cannot differentiate between reality and what’s in their mind, call a professional. Either their psychotherapist, psychiatrist, or a hotline listed below.

Crisis Text Line – crisistextline.org – text CONNECT to 741741
Text trained counselors anything that’s on your mind, 24/7, confidential, nationwide

National Hopeline Network (800) SUICIDE (784-2433)

National Suicide Prevention Lifeline (800) 273-TALK (8255) Veterans Crisis Line – Select Option 1

National Youth Crisis Hotline (800) 442-HOPE (4673)

National Alliance on Mental Illness (NAMI) Helpline (800) 950-6264