Surviving Psychosis

Psychotic man smiling and wearing gray polo shirt with tattoo on left arm

Living With Voices In Your Head

Some people are born into poverty, some are born with a mental disability, some become depressed and some develop psychosis. Some acquire the coronavirus and others remain healthy. Everyone goes through something; the world is always throwing something at you. But can you imagine living every single day with voices in your head telling you that the ambulance heading down the street is going to hit you? Surviving psychosis is a great challenge for many all over the world.

Many psychiatric patients who have been battling psychosis their entire lives, will tell you that their lives have been all about managing their symptoms and staying preoccupied as much as they can. Psychotic patients who were born into poverty have it even worse: they don’t achieve an education past a GED (if that), rely on an SSI/SSD check and unfortunately, may become involved with drugs.

But can you imagine a life where you don’t have an education, money and are suffering from auditory hallucinations on a consistent basis? Wouldn’t you be tempted to turn to drugs to get out of that reality? Some psychotic patients will tell you that marijuana, heroin and crack calms their internal voices. This is not an excuse to use, but we need to be empathetic of their struggles.

It’s scary enough to deal with sociopaths in society who kill for fun, but imagine having many sociopaths in your mind in the form of auditory hallucinations whispering 24/7, “I fucking hate you! I want you dead”; “Go push that person in front of the subway. She deserves it”; “You’re such a piece of shit! You should throw yourself off the bridge!

Even when psychotic patients take antipsychotics such as Zyprexa or Clozapine, the medications do not always work effectively. Another factor is that psychotic patients are not always compliant with their medications; they may become distracted from their symptoms, get involved with drugs or experience difficult life circumstances. In addition, with less education, patients are more prone to not comply with a psychiatrist’s recommendations.

Don’t be so quick to judge the next time that you see a psychotic patient in public. Think about how difficult it has been for them to survive psychosis. When you have psychosis, it’s like you’re trying to survive two lives: your regular one from birth and your second one which comprises of auditory hallucinations. Some people can’t even deal with their regular lives; imagine dealing with an intense mental illness on top of that!

Are you Ready? (This is Defeating Stigma Mindfully)


Thoughts Stolen By Psychosis

Red and white Do Not Enter street sign with drawing of demon between words

Outsiders Stay Away

In the realm of psychosis, logic, rules and regulations no longer stand ground; they dissipate as one’s sun falls off the end of the Earth and dark clouds slowly swarm in. When psychosis sets up a campground in your mind, believe the fact that it may remain there for a few days, months, years or even a lifetime. Thoughts stolen by psychosis is something that many people experience all around the world.

When people try to help those suffering from psychosis, their minds often respond with the message, “outsiders stay away!” This is the psychosis telling the patient, “keep these people away from you. They’re only here to disturb our plans.” The psychosis is attempting to form an alliance with the patient. Depending on the severity of the psychosis, this message can resonate with the patient to the point of inducing violence and murder.

When your thoughts are stolen by psychosis, many things can happen with your expression of language. One common thought process is called “thought blocking.” This is when a patient struggles to come up with words because the illness has interrupted the formation of their thoughts; they cannot put words together for self-expression.

When thought blocking is present, a patient can sit there for a few minutes or more before finally responding to your question. Thought blocking is an example of your thoughts being stolen by psychosis. Another example is the expression of bizarre beliefs based on auditory hallucinations.

Psychotic voices in one’s mind may inform the patient of anything under the sun. The patient can literally sit there, inappropriately smiling, while ignoring your questions. During these states, they are most likely actively hallucinating. The severity of their illness is very bad if a patient cannot even respond to you.

Depression while being stuck in a suicide forest is awful, but do not discount the severity of psychotic breaks. At least with depression, you can still maintain your sanity to a certain extent, unless you’re suffering from major depressive disorder with psychotic features. But with psychosis, sanity is often robbed from you. All you have left is your soul traveling in darkness, surrounded by evil clouds.

Are you Ready? (This is Defeating Stigma Mindfully)

Experiencing Command Hallucinations

Man with disturbed facial expression experiencing command hallucinations

Voices Inside Your Head

Imagine not only hearing voices inside your head, but scary ones that degrade you and your family and instruct you to harm others. Command hallucinations are the most dangerous types of auditory hallucinations experienced by people with psychotic episodes. They are not easy to control because they may be so demeaning, that patients eventually succumb to their instructions.

Command hallucinations may be experienced in schizophrenia, schizoaffective disorder, bipolar I disorder with psychotic features, major depressive disorder with psychotic features, substance-induced psychotic disorder and more. Patients usually complain of the voices being unpleasant and disturbing.

It’s important to keep in mind the differences between men and women with schizophrenia:

  • Men tend to develop it at an earlier age (early to middle 20s)
  • Men tend to have more negative symptoms (apathy, social withdrawal, blunting of affect, poverty of speech and thought, loss of motivation and anhedonia)
  • Men tend to have a poorer course
  • Women tend to develop it at a later age (late 20s and on)
  • Women tend to have more affective symptoms (depression, mood instability) and auditory hallucinations
  • Women tend to have a better course

Because women tend to have more auditory hallucinations, they should logically also experience more command hallucinations; however, it’s not clear if this is true. But what is true is the distressing nature of command hallucinations. For instance, when a patient hits a staff member, it’s not always due to the patient disliking the staff or being angry with them.

Sometimes patients hit staff or others in their surroundings because “the voices told me to do it.” A patient may complain that they were hearing voices inside their head degrading their family members and making them very upset. When this occurs, a patient may become very restless, attempting to neutralize the voices with violence.

During a psychotic episode, the voices tend to get worse. This may then be followed by the voices confusing the patient, by telling them that a certain person is out to get them. The patient refuses to believe but at the same time, can no longer take these menacing messages within their mind.

The voices then command the patient, “Hit him now! Kill him already! What the hell are you waiting for?” And that’s when the patient unfortunately reacts. Whenever a loved one or a friend tells you that they’ve been feeling different lately, take a compassionate stance and actively listen to what they are trying to tell you.

Can you imagine how hard it is to come out to your friends and family and tell them that you are hearing voices within your head? It’s almost as if you don’t want anyone to know. But if you are experiencing voices within your head, you have to let someone who you trust know about them.

Never keep these experiences to yourself, because you never know when they might become too overwhelming, causing you to commit a tragedy. Coming out and sharing your experiences is always the best step that you can take. Forget the existing stigma; allow the The DSM Ready Movement to take care of it by working hard every day to extinguish it.

You just do your part and share your experiences with the world. In return, we’ll give you the help, comfort and support that you deserve!

Are you Ready? (This is Defeating Stigma Mindfully)

Invisible Voices

Psychotic patient experiencing disturbing auditory hallucinations

Auditory Hallucinations In The Brain

The scientific belief is that when auditory hallucinations are experienced, there is too much dopamine in the mesolimbic tract of the brain. It is not clear why too much dopamine causes auditory hallucinations. But when a patient experiences invisible voices, it feels very real to them even if they have no basis in reality.

These invisible voices may be females, males or both. The voices may talk to each other or directly to the person. Some patients describe hearing voices of other patients on the unit talking directly to them in their head. You may notice when a patient is experiencing voices by the dysphoric appearance on their face; especially when they previously denied hearing voices and never had a dysphoric appearance.

Many psychotic patients, especially chronic ones, do not want to get rid of their auditory hallucinations. Initially, they may have a desire to experience improvement, but over time, many develop tolerance to the invisible voices and don’t mind their persistence.

This is because some psychiatric patients become so used to experiencing auditory hallucinations, that they would not know how it would feel without them. Like any person in life, once you become comfortable with a certain situation, making a change is not on your immediate agenda.

It is important for patients to tell their psychiatrists the truth regarding the content of their auditory hallucinations. Oftentimes, these invisible voices may make the patient feel uncomfortable and even command them to hurt themselves or others. When a patient is most vulnerable, such as being depressed or angry, is when these voices have the greatest chance of influencing the patient.

Antipsychotics do a very good job at alleviating the voices; for some, the voices go away altogether. But it is important to know that as with any medication, there comes the risk of side effects. In the case of antipsychotics, these may include:

  • EPS
  • Metabolic syndrome
  • Diabetes
  • Weight gain
  • Sedation

. . . and the list goes on. But the benefits often outweigh the risks. Who can actually live a normal life experiencing auditory hallucinations? The importance of taking the antipsychotics to help treat the voices trumps the concern of developing weight gain and sedation.

One can live a fairly normal life with weight gain and some sedation neutralized by caffeine. But can one live a normal life with a demonic-animalistic voice yelling at them in their head?

Make the right choice. Seek treatment.

Are you Ready? (This is Defeating Stigma Mindfully)

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