Perhaps you’ve just come out of an acute psychotic break, or a loved one has, and you need to know, right now, just what you can expect after such a terrifying and traumatic episode; and how to work toward recovery, even with the intense fear and amnesia that often follows episodes psychosis.
Both your psychical body and mind have endured extreme shock. You’ve just spent a rather petrifying period of time—perhaps a week, maybe even a month—where you’ve not been able to identify what is real from false. You’ve existed, in part or sometimes in whole, in a type of reality which is only truly known by whose who have experienced it. Thus, in the way of empathy, things just don’t seem to be looking so hot.
Your folks and loved ones sympathize with your struggle, but they are afraid too. Just as victims of psychosis may develop PTSD, individuals in their support network may be traumatized as well, though clearly in a starkly different way. Nonetheless, it is still predicated on a similar sensation: tremendous fear. Try to remember that they saw you act in ways you may not be aware of. You might have been violent, screaming, rhyming, singing, dancing, or even without sound: catatonic and pallid. In time, you can and will make peace with the struggles entrenched in trying to uncover “lost” memories via therapy, solidarity, and self-love. As my psychiatrist advised me after me first and most extreme and horrifying psychotic break, try not to dig for those memories in ways that are ultimately injurious and prohibitive toward your recovery. Right now, your body may act as if it’s been exceedingly ill. And that’s only to be expected, for you have been. So be gentle with yourself. You deserve that, and so much more.
Respectively, it is highly probable you will experience physical symptoms that are similar to the flu. According to National Health Services (NHS) in the UK, post-psychotic patients may “sleep long hours every night (or even during the day); feel the need to be quiet and alone more often than other people; and be inactive and feel they cannot or do not want to do much; and may have unusual patterns of sleeping or eating (e.g., getting up for meals in the middle of the night).” As time goes on (remember, “withdrawal” can last up to six or even 12 months) it may become clear another medical issue is developing—a type of agoraphobia, really. It can be scary, but try to take comfort in the fact that this is largely your body and brain trying to recover. NHS stresses:
Putting too much pressure on the person to get up or go out and do things can make them worse during this time of recovery. This DOES NOT MEAN the person needs to lie down all day, have everything done for them, or never do any household chores, however. It is a good idea gently to encourage the individual to help with simple chores, chat with the family, or ask if they would like to go out on some outing they used to like. If the person says no at this stage, you should leave him or her alone, saying, ‘Okay, but you are welcome to come when you want to.’ [...] It is important for your recovering relative to have a quiet place to go. his is usually a deep need and is often helpful.
Please note that this is all for mutual benefit and recovery. The more your allies understand, the more they can help, always remembering the essentially that leadership must come from the person who experienced the psychotic break.
And then there’s the humiliation of it all. That word, psychotic, feels so extreme, and can be a deeply scary thing to admit to, especially because of years of societal stigmatization, and because of how afraid you are. Is this going to happen again? you may wonder. Is this how the rest of my life is going to be? Perhaps you’re frightened to sleep alone or in the dark. Maybe you fear the manner in which you’ll speak, so you opt for silence. You’re aware that you sometimes speak in strange or odd ways, in a manner that seems unfiltered, a flight of ideas. But here’s something else: this is not your fault, but due to a chemical imbalance in the brain which makes it exhausting for you to even try to have a “normal” conversation. This may be another reason why so may individuals who have suffered psychotic episodes are unusually quiet: because this illness can and has taken control of your very words. Because you know you may sometimes act in eccentric ways, misunderstanding basic social cues. Try to recall as often as you can that your true allies will always be there to support you, try understand, and most importantly, love you unconditionally.
You may also feel you need guidance that you do not have. Strangely, as those of us who have been in psychiatric institutions know, getting out of the hospital can be a much more harrowing than checking in. I am astounded by the number of people who just don’t know or care about this: doctors and nurses (and certainly hospital administration!) included. So while you are taking the time you require to recover, doing what you know you need to do to get well, you may want to engage in some healthy distraction tactics to fill that complex void (just be cautious they don’t turn into avoidance). A preliminary and critical step in your return to health is finding a safe place. This may be your home, or anywhere else. It’s your safe place, so it’s your choice! . Your home environment should be one that is relaxing and satisfying, but not overly stimulating. If you begin feeling trapped, frustrated, and/or agitated, try going for a walk or run (nothing that if you are feeling particularly disoriented that day, perhaps it’s better to stay at home. You can always take a soothing bath, listen to music, read a book, go on the Internet [there are so many support sites, such as depressionforums.org that have wonderful and supportive virtual communities). Additionally, try to resist watching or listening to anything excessively violent. And here’s another important one: resist complete self-isolation. The people who stood and are standing by you are true allies, and you have to trust them.
When I first came out of psychosis, I recall being critically confused very frequency (and naturally, frustrated with myself, which is why I suggest being gentle with ourselves). It is very useful to keep notes: about how you are feeling, what have are (or aren’t!) eating, and sleeping—and anything else you feel may help! Not only does this practice aid in ameliorating the confusion a bit, but it can be empowering and re-orienting too.
When you’re able, it will be very rewarding to get in touch with your loved ones again, and re-establish your connections, so remain as positive as you can, and attempt to gravitate toward happier and healthier environments and people.
I know you’re afraid. But just think about how brave you are as well. What you went through and made it out of. That you’re a survivor, and can do this. And, without question, will.