Step into Psychosis-A Break With Reality

Psychosis or a Very Bad Trip - Drug Induced or Otherwise! 

You may have a history of substance abuse or be self-medicating to deal with adverse symptoms from the onset of a psychotic disorder. You could belong to a family that has a pre-disposition to schizophrenia. Are you aware of the vicious cycle of abuse-illness-abuse? A person can experience a psychotic break without being necessarily classified a schizophrenic, or other psychiatric diagnosis. However continued substance abuse can place one at greater risk of further and ongoing psychiatric intervention/s.  

Envisage this, you are as a 17 y.o.in the later years of secondary school with above average marks especially in maths/science. You had decided long ago to emulate your father and follow him into chemical engineering. Melbourne University is first choice, just like your dad. But you are lamenting the fact your dad would not bear witness to your choices and guide you through. Dad is no longer in your life. He was severely injured in a car wreck 5 years ago. Then due to ensuing legal battles and ongoing debilitating effects from that accident, he, your dad, took his life 2 years ago this July!   

You spent much of your time with him before and after the accident and miss him desperately. Your desire to have him in your midst in this moment is immense. The company of a good circle of friends was a factor that had kept you grounded and busy and they were fully in your life. Your relationship with your mother has never matched the connection you had with your father, but you know she cares and is supportive as much as you allow.  

During the preceding year subtle changes were noted as you gradually withdrew and have exhibited less interest in activities with friends or family. You have difficulty thinking clearly and concentrating and your energy levels have declined. Unusual and distorted thoughts are becoming prominent, and you have difficulty organizing those thoughts to express them clearly or even understand them. 

These early signs are referred to as the prodromal phase and can be indicative of not just the onset of schizophrenia but also depression, anxiety and substance use and abuse. Whatever the potential mental health issue early intervention and assessment by mental health professional/s is crucial and early intervention may significantly improve your long- term outcomes.  

Life continues fragmenting and as you diminish your need for intervention you spiral into a complete break from reality. You become increasingly bombarded with dark imaginings, relating to your father’s death, and you withdraw into a fantasy world in which you can save your father from his demise. You ruminate about being a hero to his cause. Otherwise, no part of your life makes any sense anymore. Where you are, is becoming frightening because your mind is taking you into uncharted territory. You cannot explain the journey you are on; nothing is familiar.  

The use of weed continues unabated to manage the symptoms, but what you do not realize is that self-medicating is only heightening your illness. You are increasingly disinterested in interacting with your mates despite them imploring you on the regular. Your only desire is to remain at home in your increasingly unkempt room surrounded with ‘dark’ memorabilia and perpetual reminders of your lost parent. Lack of attendance to your hygiene has become a source of angst with your mother and ridicule from your older sister. Your attendance at school has diminished due to poor concentration, ridicule for your dishevelled appearance and particularly a fixed belief (delusion) you will be persecuted & humiliated you via messages over the school public address system.  

How do you envisage the behaviour of a hypervigilant person, a person being persecuted by something unseen or unheard? What odd behaviour might others bear witness too? Be mindful these issues are very is real to the sufferer and no amount of reassurance, redirection or reasoning will sway their belief. In fact, this may agitate them.How does society react when they observe someone acting out in a bizarre manner. You note the person to be hypervigilant, persecuted, avoidant, combative, nervous, frightened, distant, disconnected, bewildered, untrusting. You as the sufferer might constantly and persistently be looking over your shoulder, hiding around corners, avoidant of communal areas & school events. 

When attending classes you sit at the back of classroom, muttering to yourself & no longer take part in activities. Unsurprisingly you are unable to concentrate. You might be hearing evil persecutory voices or witnessing demons launching from the floors and footpaths, aiming to drag you down into the depths of hell. You check out of life as you knew it and lapse into absenteeism from the outside world. Over a period, you have descended into a world unfamiliar reaching a point whereby you never leave your room trying to avoid the demons that literally rise from the ground, ripping at your ankles to drag you into hell to reunite with evil. Eventually the torturous demons extend from the cracks in your bedroom floor.  

Sleep is fleeting, better if you smoke weed. Ultimately you need more weed for less effect and increased persecution, but given your mental state you are unable to recognise the connection. Your appearance is wretched, you avoid bathing because you believe the plug holes are a portal to hell, a place where those demons reside.  

Your mum is overwhelmed by your social capitulation and despite her imploring you to discuss your issues you cannot disclose anything to your mum out of an irrational fear the demons will invade her life too. You become too pre-occupied to eat properly, instead snacking on fast food and other food of poor nutritional quality. Copious cups of coffee and alcohol are the only fluid passed your lips. You smoke cigarettes incessantly in your room despite your mothers’ request not too for fear of incinerating the house and you and the family with it. You feel a small measure of control in the sanctity of your bedroom on your bed, but the demons are relentless outside. You have reduced yourself to using random receptacles to relieve yourself, rather than running the gauntlet over the floor demons, to get to the toilet. You have descended into a mental nightmare and are deemed by your loved ones to be unable to manage any aspect of your life and ultimately you present a clear and present danger to yourself and potentially others. 

The observer sees your reactions to these hellish experiences, but not the origin or cause, that is your own personal nightmare! So how does the observer react to your overt actions and behaviours? 

You are reliant on someone to speak up for you! Being a danger to your own wellbeing is enough to warrant intervention and offers a legal avenue for others to contact emergency services for urgent mental health crisis assessment or via mental health triage service 24/7. 

This deterioration may have traversed days, weeks or even months but eventually your life implodes and any control over your sanity has vacated your being. Life as you have experienced it will never quite return. You are enveloped by whirlwind of total insanity, nothing is real, but recovery begins from your first intervention.  

Provision of a safe environment is paramount and then over the short term comes consultation with the professional team for assessment & implementation of an individual treatment plan involving psychiatrists, doctors, nursing staff, allied health staff, your family and you. A medication regime would be instigated to manage the symptoms and facilitate sleep. Ongoing close observation and assessment of all facets of mental, emotional & physical state is monitored and documented.