The content presented in the column (for this week), that follows below, consists of my opinions about a limited relapse into mental illness; I believe this to be knowledge and it arises from my personal experiences. Since I am not a doctor or mental health professional, if you need an expert opinion, you should go elsewhere.
A person with a psychotic disorder (whether it is Schizophrenia, Schizoaffective, or the psychosis that happens to bipolar people during their “up” phase) must deal with an illness that seems to have a mind of its own and that has the tendency to sneak up on a person. If I look back to the distant past at my previous full-blown psychotic episodes, usually a traumatic event took place about three to six months before I partially “deteriorated.” This deterioration led to me discontinuing medication against medical advice--with disastrous results. It seems that adverse circumstances which generate extreme levels of stress can be a trigger for a delayed reaction, a psychotic reaction in which judgment is the first thing to go.
One of the characteristics of being psychotic is the erroneous belief that one’s thoughts are accurate. Usually when a person is psychotic, they don’t know it. Once a person becomes aware that they have delusional thinking, usually the self-correction process begins. Being adequately medicated and getting sufficient food and sleep will pave the way for this self correction to take place.
A partial relapse into psychosis is always better than a total relapse. If a person with schizophrenia is lucky enough to have a lifetime companion, such a companion can help with alerting this person that they are approaching the danger zone.
If relying on a psychiatrist for that alerting service, keep in mind that the psychiatrist may not see a person often enough or over an adequate time span to become aware of the deterioration. A psychotic person may also be able to “con” or “snow” a doctor more readily than they could fool a spouse. A spouse of a person with mental illness knows more about their mate than does a doctor who may only see their patient a half hour every month.
It can be difficult to get along with a person who is experiencing even low-level psychosis. Being argumentative can be a symptom. Some afflicted persons may become assaultive when more psychotic, while others remain nonviolent and might become verbally abusive.
A partial relapse into psychosis is often characterized by increased anger, irritability, decreased appetite, and/or difficulty sleeping. In order to reverse course, in other words, back up from the low level psychosis, it is very helpful to have the insight that some of one’s thoughts were delusions, and to know which thoughts they were. At that point, the person with psychosis may or may not be able to correct their thinking without an adjustment in medication.
“Reality checking” is another valuable tool to deal with partial psychosis. “Reality checking” consists of obtaining the actual facts and comparing them to one’s belief. Sometimes this involves asking a person about it who is in a position to know the truth. When “asking” for the facts, it must be assumed that the person being questioned isn’t lying.
When mildly psychotic, a person can go in two differing directions: toward being increasingly psychotic; or toward correction of oneself and recovery.
You may notice in this article that I talk both about a biochemical-organic component of mental illness, and a psychological-cognitive component. The ability of the human psyche to make changes in itself should not be dismissed, even if one believes in the biological model of mental illness.
When a person suffering from psychosis experiences that “light bulb” coming on, the realization that oneself has been operating under delusions, it can make a huge difference. If the person is clinging to their delusions, and this can happen because of being emotionally attached to a belief, it is much harder for the person to “come back to reality.”
The realization that oneself has been living in a partly delusional world can be a big relief, especially if one was imagining being in danger.
When the conscious mind is engaged in cleaning up psychotic thinking, this can be a powerful augment to medication in battling psychosis. Neither medication by itself, nor self correction by itself is enough to deal with severe psychosis, which can be a sneaky, subtle and powerful adversary.
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