Never Coming Back

Never coming back - purple diagram of brain

It creeps in the background and you’re never coming back

The thoughts spike in

Your mind allows them within

You lose control

Paranoia like a swirl

Is my mind being attacked?

You lose confidence

You rewind laps . . .

Analyzing your sanity

But no this can’t be!

There’s a war on your mind

It fluctuates in severity

Sometimes it stings

Most of the time you’re okay within

Never coming back - entering another dimension

Never Coming Back – An Alternate Dimension?

Never coming back

Yeah, that’s how it feels

You lose touch with reality

As you fight to maintain presence in actuality

No it’s not the metaverse

We’re not there yet

But psychosis in meta? Oh forget it

Addiction runs rampant

Many lose touch with reality

They fight through the psychosis

To obtain that obsessional feeling

Their high surpasses any importance or meaning

The hijacked mind

Can it even function evenly?

If you find a way

Let us know

The community is waiting for answers

You best know.

Never coming back - orange van with surfboards on top

Surfing Your Way Back to Reality

You drink 10 bottles of water

Not only that

You splash your face ten times

Dang . . . still doesn’t work

Last call for alcohol?

Maybe . . .

But even that tastes bad

Can gum save the day?

At this point you’re desperate

Anxiety mixed with psychosis

A mental cyclone, like overdoses

Whatever you do

It starts to work

You start to remember logical thoughts

And patterns of your true self

Yes, this makes sense again

I’m not psychotic!

But mind games manifest at the wrong time

You start doubting yourself

At the wrong time . . .

This is getting tiring

My mind draining

I’m running slow like an old tire

Rolling bushes are faster to retire

Time becomes your friend

Or at least you think so

But the liver is on your side

Metabolizing to heal you

You still think so . . .

It’s starting to work

Your reality becomes thicker

You realize more and more

It was just psychosis

And now no more

How thankful you are for your mind

You become more appreciative

Life and time . . .

Complain less and appreciate more

Your mind is a treasure

Through Christ, life ever more

Smiley face


Psychosis: A Taste of Insanity

White woman laying on floor with face in trash bin

Inpatient Care

Psychosis, a taste of insanity minds you no time

It’s no longer the dominant factor

Your mind has discovered the matrix and does as it wishes

Hallucinations or reality, that no longer matters

Feeling good and partaking in the psychotic realm becomes the agenda

Psych patients often become violent when you’re interfering

Inpatient care isn’t easy when they’re freely swinging

You offer them medications but they’re freely swinging

Psychosis: A Taste of Insanity, Part II

Imagine a football team about to tackle them

Those sharp needles entering their body; they become spent

Sometimes four-point restraints don’t even provide a dent

Psychosis doesn’t give a damn; immovable hallucinations become the trend

To the patient this is nothing but part of the experience

You try to educate them but they continue their resistance

Psychosis is their best friend, but sometimes their best enemy

Satan enters their mind and tricks them into a deeper insanity

What can you do besides have potent drugs handy

Blank white psychotic face with hands on head

Do you see how Tricky Psychosis can be?

Many recover but many remain dormant

In the psychotic experience in which they keep roaming

Is there a cure to this madness?

Medications work but sometimes they flop

You keep pushing intramuscular injections

The patient becomes sedated and begging

“I want more, give me another shot”

You tell them they’ve had enough

They lose it even more banging against the wall

Their bleeding forehead leads them to their downfall

You order another injection to calm their nerves

By the time the nurse administers it

The patient is already on the floor hurt

After the chaos calms down you become relaxed

The staff becomes happy and you expect some claps

But who are you kidding

These patients are mentally ill

You didn’t do much besides feed them a pill

Psychosis, will you ever accept a cure?

Or will you keep torturing these human souls

Keeping their psyche in a stir

Are you Ready? (This is Defeating Stigma Mindfully)

Psychosis: a taste of insanity GIF face

The Unpredictability of Psychosis

Grayscale photo of psychotic woman holding belt around neck

0-60 In a Heartbeat

One thing to keep in mind with psychotic patients is that their behavior is very unpredictable. They can literally be having a pleasant conversation with you for 5-10 minutes, and 15 minutes later, they are yelling, cursing, agitated, banging on the walls and demanding medications! You scratch your head and wonder, “What in the world? I was just talking to them and everything seemed to be going well!” Psychosis could care less if everything was going well; when it wants its patient to terrorize, it will unleash all of hell’s dogs to get its fix. This does not mean that you should always expect psychotic patients to become dysregulated and violent; just be aware that the chances of that happening are higher than with other patients.

Are you Ready? (This is Defeating Stigma Mindfully)

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Psychosis Meaning

Abandoned psychiatric asylum

What is Psychosis?

One thing to keep in mind with psychotic patients is their very unpredictable behavior. The unpredictability of psychosis is very obvious; they can literally be having a pleasant conversation with you in one moment, and then yelling, cursing, and agitated in the next. You scratch your head and wonder, “What in the world? I was just talking to them and everything seemed to be going well!” Psychosis could care less if everything was going well. When it wants its patient to terrorize, it will unleash all hell’s dogs to get its fix. This doesn’t mean that you should always expect psychotic patients to become dysregulated and violent. Just be aware that the chances of that happening are higher than with other patients. What’s a psychosis meaning? Let’s expand below.

Psychosis Meaning – Unpredictable Patients

You should never assume that you’re on the good side of a psychotic patient. This is because their psychosis does not care if you’re nice, treat them well or say good morning every day. Their psychosis is unpredictable even when you think they’re doing well. They can snap at any moment and randomly assault you when you least expect it. The unpredictability of psychosis is not always due to their treatment. Many patients are on multiple antipsychotics and mood stabilizers and still become aggressive without anyone expecting it. A combination of factors is responsible for their aggressive behavior: receiving bad news, fluctuating hormones and neurotransmitters, not taking their medications or a psychotic break. You don’t want a taste of psychotic aggression.

Even with stable outpatients, you never know how they’re really doing. They can present to your office in one way, and a totally different way when out and about. Keep in mind that patients with psychosis often abuse tobacco and drugs, in particular cheap drugs such as K2 and synthetic smart drugs. My point is that you should never underestimate their mental status. Sometimes you don’t suspect them of using any drugs and that is when they can snap and become violent. Always keep your guard around a person with a history of psychosis. This applies to families, friends and healthcare workers who spend time with psychotic persons.

Psychosis meaning - disheveled girl holding knife

There is Hope

Now this doesn’t mean that psychosis can’t be treated. Many people suffered from psychosis at one point in their lives and successfully recovered. Some people experience drug-induced psychosis caused by the abusing of drugs. They may be psychotic for a few days to a week after stopping the drug and become normal again after the drug clears out of their system. Others suffer from psychotic depression, bipolar depression, brief psychotic disorder, schizophrenia, etc. All of them have the potential to become violent! But they also have the potential to become normal and lead successful lives again. The beauty of psychiatry is that medications work and we have a lot of great mental health professionals who demonstrate a lot of empathy and patience.

Have you experienced psychosis or do you know anyone who has?

Are you Ready? (This is Defeating Stigma Mindfully)

Unpredictability of psychosis GIF face

I Am Free Of Psychosis

Bald man in Adidas jumpsuit holding burning umbrella

Positive Affirmation: Psychosis

“I am free of psychosis because I listen to my psychiatrist and take my medications consistently, attend my outpatient appointments on time, make an effort to better myself by giving it my all in therapy, all while staying clear of alcohol and drugs and remaining physically healthy by exercising and maintaining a good diet!”

Psychotically Sheltered

Psychotic Indian man wearing glasses sticking tongue out

Three Blunts Later

Many psychotic patients have lost everything or never had much to begin with. Their home is the shelter or a psychiatric supportive house where they spend their days doing whatever they want. Many don’t have any requirements; they can sleep all day, create music, go to work . . . it’s up to them. Many continue to abuse drugs on the streets: popular ones in New York City are crack, cocaine and heroin; don’t count out marijuana.

But this is the problem with these shelters: they don’t drug test and even if they did, would they just kick out psychotic residents? They would all just turn homeless and nothing productive would be accomplished. So they continue to abuse drugs and take advantage of the free room and board. The problem with psychotic patients is that drugs impair their judgment and insight.

In the moment while they’re getting high, they’ll report to you that they feel better and that their symptoms have calmed down, depending on which drug they are using. If it’s crack or meth, their symptoms tend to get worse: they become paranoid, start hearing voices commanding them to commit violent acts and may even start experiencing visual hallucinations.

If it’s marijuana, many psychotic patients will report that the weed relaxes them and clears their mind. It may very well do that, but marijuana is prone to cause and worsen psychosis, especially the highly potent strains going around these days. Three blunts later and many of these patients start hallucinating, experiencing disorganized thoughts and behavior and freaking out.

Keep in mind that many psychotic patients are noncompliant with medications because they believe that they don’t have a mental illness. Add three blunts a day on top of poor insight and it turns into a recipe for a mental health disaster. It’s not usually the patient that brings himself into the hospital; it’s the residents or staff at the shelter that escalate the process due to their disruptive and dysregulated behavior.

There is no psychotic patient or mental health patient who I have met that benefited from drug use, including marijuana. They may tell me that they like weed and it calms them down, but then why are they in the hospital in the first place? What’s surprising is that many schizophrenic patients inform me that they’ll probably go back to using marijuana despite being hospitalized.

This is how powerful drugs are and we must continue to spread awareness for drug addiction and advocate for more resources devoted to the treatment and healing of drug addicts. But first we must continue to call on all the drug addicts to come out of the shadows and provide them with a safe and supportive environment and this platform is known as The DSM Ready Community.

Are you Ready? (This is Defeating Stigma Mindfully)

Chronically Disorganized

Psychotic black man sitting on sidewalk next to garbage on ground

When No Other World Exists Besides Psychosis

There are many psychiatric patients who are chronically psychotic. They have been through the system numerous times, whether that is through temporary inpatient psychiatric stays or state hospitalizations for years at a time. But just because a patient is chronically psychotic does not mean that they cannot function in society, especially when room and board are given to them; in other words, supportive psychiatric housing.

The worst part about these chronic psychotic patients is that many refuse to believe that they have a mental illness. Try asking them a question and they often irritably reply, “No psych stuff! I’m not crazy! Get the fuck outta here.” They are either in denial or have a poor insight; the latter is oftentimes the case. Schizophrenia can impair a patient’s insight to the point of them not realizing that they are psychotic.

So what happens when a chronic psychotic patient has a poor insight? They oftentimes refuse medications, allowing their psychosis to flourish. So how are they not hospitalized you may ask? Well, just because someone is psychotic does not mean that they cannot function; they become used to their psychosis and live under its presence. And when shelter is provided . . . well, even better.

Shelter and support help a lot because it allows the psychotic patient to be relieved of their stress and worry of going homeless. When food and shelter are provided, who needs medications is the thought process. And to add to the mix, many of these patients continue to abuse substances such as K2, marijuana, cocaine, crack (the hardened form of cocaine), heroin, etc. Unfortunately, this is how the system works for some: shelter, food, drugs, psychosis but no medications.

The problem is not access to medications. They are hospitalized countless times during their life with many opportunities to better themselves and follow up with outpatient psychiatric services; but they refuse. They refuse because it’s either too difficult for them to follow up, are not motivated or simply do not care enough to improve their mental health. And when they also have a poor insight because of their mental illness, attending their psychiatric appointments becomes more difficult than teaching a dog how to urinate and defecate in the backyard and not in the house.

This is what chronic mental illness does to many who are noncompliant with medications, abuse drugs and do not care about their health. But we must not give up as psychiatrists and humanity as a whole. The DSM Ready Community will always keep fighting on because we are based on love, unity, peace and openness.

Are you Ready? (This is Defeating Stigma Mindfully)

Thought Blocked By Psychosis

Psychotic person holding hands on head with mouth open

When Schizophrenia Chips Away At Your Sanity

Just because a patient was diagnosed with schizophrenia over ten years ago does not mean that symptoms will never return. There are many factors at play as to why symptoms may reoccur but one big factor is medication noncompliance. Many psychiatric patients have a strong desire to eventually stop medications. If you’ve ever been on psychiatric medications, then you most likely know what I’m talking about!

When I used to be on Prozac, I used to think to myself if there would ever be a day when I could stop the medication. After many months on Prozac, panic attacks eventually vanished; they weren’t part of my life any longer. So I thought to myself, “Thank God! I can live again. But now how much longer do I have to be on Prozac?” There is no right answer when it comes to continuing psychiatric medications.

For patients who have experienced more than one episode of psychosis, the answer likely is “lifetime.” That’s because each episode of psychosis increases the chances of experiencing a future episode. Even if you are experiencing a strong desire to stop your medications, never do so on your own; always talk with your doctor before making any changes to your medications.

Believe it or not, there are many schizophrenics who continue to take medications and still experience auditory hallucinations at random times, requiring an inpatient psychiatric admission. These patients may appear as thought blocked: in the middle of a sentence, they suddenly stop and can no longer find their words or they make take a little longer to form a sentence in the first place.

Can you imagine trying to have a normal conversation with someone and not be able to find the right words, as if someone or something is holding your tongue back in place? Can you imagine how depressing it must be to not be able to speak freely because of your psychosis? Do you understand why many people suffering from a mental illness also experience suicidal ideations?

There is no cure for schizophrenia or any mental illness; only remission. Remission is when a patient stops experiencing symptoms but this does not mean that the disease is no longer present. It just means that it’s controlled by therapy, medications or both. Psychiatric medications do not cure a mental illness in the same way that high blood pressure medications or insulin do not cure hypertension or diabetes.

We must continue to remind ourselves that there is nothing wrong with being on psychiatric medications. The end goal is to live a normal life without allowing a mental illness to control your sanity and wellbeing. If this means that you must continue medications until 97, then so be it. You’ll be much better off free of symptoms while on medications than stopping them and relapsing; some people don’t ever recover from a relapse.

Don’t take that chance. Maintain a strong alliance with your psychiatrist and always come up with a plan together.

Are you Ready? (This is Defeating Stigma Mindfully)

Substance-Induced Psychotic Disorder

Three same female faces with red glitter under eyes

Holding On To Drugs

Substance abuse, mental illness and medical complications go hand in hand; rarely do you have one without the other in the psychiatric world. In other words, a psychiatric illness without a medical comorbidity is possible, but oftentimes, there’s something at play behind the scenes, even if it’s something as common as high blood pressure. Don’t automatically assume that someone who abuses drugs does not have a medical illness; sometimes the drugs are there to mask the physical symptoms or even the psychiatric symptoms!

And don’t assume that someone who has a psychiatric condition does not abuse drugs; the psychiatric condition can be secondary to drugs. This is the case with substance-induced depressive or psychotic disorder. Substances are capable of inducing temporary psychiatric illnesses such as anxiety, panic disorder, depressive disorder or a psychotic episode.

The key word is “temporary” because once the patient has metabolized the substance, the psychiatric condition tends to dissipate. This is because it was the chemical component of the drug that was inducing the symptoms in the patient’s brain. Once the drug is out of the body, the symptoms tend to subside and the patient returns back to a normal state of mind. But there are many cases where the psychiatric symptoms persist and that is the big danger that comes with abusing substances.

The problem with chronic drug users is that their addiction can repeatedly bring back a psychotic state of mind throughout their episodes of binging. But even when they experience auditory hallucinations of voices commanding them to kill themselves, they continue to go back to using their drug of choice. In other words, they’ll enter a hospital for a few days to become mentally stable after metabolizing the substances in their system, and then be discharged with the same intent of continuing to use their drug of choice.

The hospital is a temporary lodging station for their psychosis to clear up. For instance, someone who is experiencing psychosis from cocaine most likely will not want to stay home and continue to experience frightening psychiatric symptoms; they have all the desire in the world to obtain professional care under the supervision of psychiatrists while in the hospital.

But that’s the disappointing theme with drug addicts: even after obtaining a successful medical and psychiatric treatment, they tend to go back to their old behavior of getting high. Drug addiction is often more deadly than depression with suicidal ideations because drugs impair the user’s judgment, impulse and even insight, increasing their chances of actually harming themselves. On the other hand, someone who is only depressed and does not abuse drugs can more easily recover because of the psychiatric medications taking effect.

Someone who uses drugs will often be noncompliant with medications; their compliance is tied to their drug of choice because it’s all about getting high and feeling good. At the end of the day, pleasure dominates the drug addict’s lifestyle at the expense of their sanity.

Are you Ready? (This is Defeating Stigma Mindfully)

Trapped By Schizophrenia

Schizophrenic woman with curly red hair holding small round mirror

When Mental Illness Robs Your Sanity

Mental illness affects everyone differently. While some people with schizophrenia remain functional in society, others end up in a state hospital for even years at a time. There are many factors at play when it comes to how a person handles their psychotic symptoms: it depends on their personality, the severity of their symptoms, the duration of their illness, their support system, their compliance with medications and whether they abuse any substances.

It’s no surprise that many patients who suffer from psychosis are trapped by schizophrenia. They are so affected by “negative symptoms” such as blunting of affect, poverty of speech and thought, apathy, anhedonia, reduced social drive, loss of motivation, lack of social interest and inattention to social or cognitive input, that they can be talking to you without any facial expressions despite suffering on the inside. They might even complain to you, “I don’t want to feel like this” and look like they are trying to cry, but cannot find the tears to do so, as if they are trapped within their own body.

It’s very sad to witness a patient suffering from psychosis. Keep in mind that not everyone who does is responding to internal stimuli, performing odd and extreme behaviors or are being physically aggressive. For some schizophrenics, if you were to see them on the street, you would never think twice of them having a mental illness. They can present as calm, cooperative and pleasant, but it’s not until you actually observe their behavior that you start to notice the differences in their speech and thought process.

They may even admit to experiencing auditory hallucinations of voices degrading them, “Shut the fuck up, you’re not good for anything! Go kill yourself, why are you still alive? Kill that bitch!” Can you imagine how difficult it must be to hear voices in your head on a daily basis? Schizophrenics are also prone to depression because of these experiences. Some even experience ideas of reference, such as believing that others can place thoughts into their mind or even be able to read their mind.

But medications do work and that’s the beauty of psychiatry; it just takes time, patience and compliance. The other beauty of psychiatry is forming an alliance with a patient and guiding them through their psychiatric experience; you can be there for them from the day they became psychotic to the day that they recognize that it was all a big delusion. It can be quite rewarding to see psychotic patients rebound on the bright side and recover from their illness.

This is a great time to be part of the mental health world and by coming together to share our experiences, we are contributing to the end of mental health stigma and the normalization of mental illness and the suffering that comes with it. Only through an open and honest worldwide community will we be able to achieve the three goals of The DSM Ready Community:

1) End mental health stigma and normalize mental health
2) Provide a safe and nonjudgmental place to share thoughts, feelings and advice about mental health
3) Maximize happiness and well-being 😎

Are you Ready? (This is Defeating Stigma Mindfully)

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