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)


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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