I sometimes have issues with temporary, stress related psychosis. This is very common in many conditions such as PTSD. In my case, I tend to hallucinate. My reality testing is usually intact (which means I’m aware that what’s happening isn’t real). I also become quite dissociative, have panic attacks, and may struggle with mild paranoia. All these things tend to feed into each other – eg the more anxious I am, the more psychotic experiences I have, and the psychotic experiences I have, the more anxious I get. I can struggle with this because of physiological stress such as bad reactions to meds, or due to psychological stresses.
Last night was a very bad one for me. Working out what the triggers are for these sudden degenerations can make a very big difference to my ability to predict and manage them. I’m frustrated but hopeful that this will be the case with this situation.
I think that interpersonal stress (eg conflicts in my important relationships) might be another really vulnerable area for me. There’s been a few lately, and yesterday just happened to involve another four conflicts to navigate in relationships important to me. By evening I was shattered and worn out. I went to bed to watch the other half of a movie I’d started last week; Solaris. Last week it was exactly what we needed, thoughtful and soothing. Last night different parts were watching and it fed straight into the high stress.
My peripheral vision filled up with shapes. There was a strong sense of being watched, or of something being behind me. I became profoundly afraid of the dark outside my room – which is unprecedented as a adult. I was afraid of the dark as a child but since PTSD feel safer hidden in the dark than I do trying to sleep in a light room. My anxiety went into overdrive, which is also unusual for me. I’m used to minor hallucinations, they don’t usually come with emotional distress. I did a massive skin flair and broke out in huge hives that antihistamines made no difference to. Insect bites from several days before suddenly swelled up to the size of golf balls. The sense of panic was intense, I was choking on a scream for hours. I struggled to calm myself down but none of my usual approaches worked. It felt like reality was dissembling around me. Knowing that it was me rather than the world that was falling apart had no comfort.
Things moved in my house in the dark beyond my room. If I looked at the dark, nightmares coalesced in front of my eyes. I found myself passing out for micro-sleeps and waking with a scream. My skin prickled and rippled with terror and all my hair stood on end. I felt nausea and I knew that sleep was critical, if I could ride the adrenaline it would start to ebb and I’d probably sleep deeply at that point. Lack of sleep amps psychosis. I just needed to stay this side of total terror, otherwise I’d have to get ACIS or someone else to intervene. I was close to that point. I was able to fall asleep in the end. I woke to my alarm for a planned meetup with friends today to sort out my paperwork. It turns out it had been cancelled due to illness, which is probably for the best. I wish I’d had the extra sleep.
Rose turned up this morning and I didn’t recognize her. I knew who she was but she had no familiarity to me at all. I explained what was going on and told her about all the relationship conflicts. She’s supported other people in this place and knows how to connect and be calming. When I close my eyes, I start dreaming immediately, seeing things in the dark. I can’t look at a dark room without seeing things in it. I’m dreaming while awake, which is still the best description I’ve ever heard of psychosis. I stay in bed all day, talking with Rose. She brings me small meals of things I can keep down. Food is also essential to reduce the impact of psychosis. We keep the room light, we talk about the future, about good things I’m looking forward to. She’s not afraid of me. The fear eases. I try to nap, but when I close my eyes the visions start instantly. I lose my sense of place, feel like I’m falling, like I’m fraying apart. When I check facebook, I see a friend struggling with psychosis. I message them with these suggestions, a few possible different ways of engaging a psychosis:
1. Grit your teeth, keep your head down, and get through it, because it is temporary and will pass.
2. Do major stress management; take time off work, go for longs walks, hot baths, go away for a few days (tell someone if you’re going to do that!) whatever would reduce stress for you
3. Get help to break the spiral of high stress > poor sleep > psychosis > high stress… Anti psychotics are actually major tranquillisers, they can be really helpful in the short term to get some rest and break the spiral. Any other things that help you to get decent sleep and keep decent amounts of food happening will also help you to not spiral and heal instead.
4. Emotionally connect with others to communicate emotional distress, which often drives this stuff, and to get safe reality checks.
I read some James Herriot to Rose – it’s gentle and has no supernatural themes. I have a horrible headache. I drink a lot of fluids and take mild pain relief. The fibro pain is bad. Rose rubs pain relief gel into my back very gently. When the anxiety gets low enough I find I can lie next to her and close my eyes. The visions don’t frighten me, they’re just dreams. I fall into them and sleep for a couple more hours. It helps.
My mind feels like it’s made of crystal, fragile, humming with it’s own energy, needing to be held gently. I feel calmer, fragile but calm. My peripheral vision is still full of shadows. I’ll sleep with the lights on tonight. I keep the tv running. It will pass.
Follow up – Where does my psychosis come from?