After Psychosis: What To Expect (Perhaps) & What You Can Do (Definitely!)

“Healing may not be so much about getting better, as about letting go of everything that isn’t you – all of the expectations, all of the beliefs – and becoming who you are.”—Rachel Naomi Remen, heralded medical doctor and pioneer in holistic medicine

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  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. 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.

It is very useful to keep notes about as much as you can. How you’re feeling and what your eating and sleeping pattern is like. Keeping a mood diary is an powerful tool. 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.

13 thoughts on “After Psychosis: What To Expect (Perhaps) & What You Can Do (Definitely!)

  1. A recently had an acute psychotic break last April. Now I came out after that cocktail shot of Ativan , Haldol and Bendril. It’s a couple months later, I feel different. The long term memory loss is to a point where I remember facts. Simple facts, of my past childhood. Its where I am not emotional attached to the past. It’s just a statement of what happened in my life. I use to relive the past in my mind. Now I couldn’t recall one story. I live for today just because I don’t remember yesterday. Also no attachment to any emotions of my past events to my life. A blessing or a curse? Solitude has been my friend as of late. That memory is my major effect of my break. It’s very dissassociative stance in my life that wasn’t there before. Your thoughts?

    • My son has just had his 2nd break in 3 years. He is 22 years old. His last break was so psychotic that he made 5 out of 5 on the test at the hospital. The doctor said they usually only get 2. We witnessed it all. Every hour of 2 weeks, every minute, every second. We were and are still in hell. Our boy has been in two different hospital in the last 6 weeks and still is not close to being able to come home so we can help with his recovery. Where do we turn for support to try and understand what this awful thing keeps happening?

    • My daughter is a student, smart and beautiful, psychosis strike on her last Thursday, 6 days ago, fortunately her boyfriend and her brother were able to bring her to the hospital. She has hallucinations and completely lost her touch to reality. She is now in medications and we are completely in shock. What is the next? Will she get better? We love her so much and it is very painful to see a young girl suddenly not the same person anymore.

    • I felt the same way- my memory is shot. I don’t have short term memory and I feel very disassociated.

  2. I have experienced psychosis 2 months ago. I´m 17 years old and I feel terrible for this experience. In the early psychosis I cried a lot and I analyzed a lot of things. Later it went into such conditions that I thought I was Judas, who reproves God for treason, then I´m second Virgin Mary, I felt the same aroma that occurs in the church, then I´m Voldemort trapped in the body of 17 year old girl, then I thought about myself that I’m a vampire and I have to kill myself stab to the heart because it is the only way I can destroy myself. Normal or rather abnormal I pulled a knife and wanted to stab, but my mom stopped me. Later I wanted to hang myself, or drown, I just had suicidal thoughts, I’ve already had these thoughts before, but not too seriously. My family put me into facilities where I stabbed injection and and I then returned back to reality. After a month I embarked out and I´m not afraid of retuining to psychosis but that people find where I was and I will be considered me as fool.
    Sorry for English.

  3. Hi,

    I experienced psychosis this past december around the time the end of the world happening was suppose to be happening. Little did I know that it was the end of my world. I thought I was somehow the center of the universe and was the chosen one because I felt god was talking to me through music and TV. I also believed I could astral project in daily activity, feel peoples energy and such. I thought I had these special powers along with believing I could see the future. I thought I was Jesus, the anit-christ, and even Santa Clause. I spent days in my room isolated reading the bible and listening to music. I even did a ritual on my bath water to make it holy and able for me to bathe in. I even remember thinking that my roommate was the devil and was trying to stop me from doing what I thought was necessary mediation. I was psychotic from the 15th till probably the 15th of January. I was put on meds on Christmas day as my parents were able to convince me to go to St. Joseph’s hospital, as it made sense to me at the time. Everything was unfolding as it should of.

    The problem I’ve been facing since coming out of it, is that I am still really quiet. I have poor attention, concentration, memory, and I have lack of thoughts/ things to say with groups of people. As a result it is very difficult to try and have a normal conversation. It is hard to have confidence when all my confidence came from my ability to speak fairly well. Now that has been taken away. I can’t communicate on the level I need to return to my job as a radio broadcaster. I’ve been at home helping my dad with the family business in the mean time. I do however want to get back to my job as a broadcaster as I know I could have a lot to off as far as experience to people. This is killing me inside and I desperately want to have normal, fluent, consistent ability to talk to people and not be scared out of my mind about what I might say and what I don’t have to say. I want to know how many people do you know that had or are going through what I’m going through after psychosis? Does this get better with time? It’s been 8 months, still not on the right medicine for me. I see my doctor on Monday and going to bring up these problems again and see if she has an answer. I interested to see what you know from your experiences with people who’ve had psychosis.

    Thanks
    JW

  4. I am trying to be a support person to my dearest friend who has recently experienced a psychotic break. The chain of events landed her in jail. Twice. She is far from a jail bird and her story is somewhat of a novel. I want to learn as much as I can about mental illness and her condition so that I can support her. It all started with some bad decisions and a consequential divorce. Some of it, in the beginning, was garden variety depression. But then the voices in her head started followed by her belief that she had telepathy and those closest to her did too. She started accusing people of having relationships with people in her head. She also started believing close immediate family members (including her children) were dead. As you can imagine, this has been extremely traumatic for herself and her immediate family and friends. She is in her mid-forties and it is to the point that her sister has no choice but to obtain guardianship. The places she has been admitted to have released her after a short time and the legal/jail system is of no help at all. Most people think a good lawyer could solve all her problems but then she would be free to cause more pain to herself. I sincerely feel it is to the point that others must protect her from herself if that makes sense.

    A few questions:
    1. Is there hope for recovery?
    2. At what point does electro/shock therapy come into play and is it effective?
    3. Is it standard to rule out other brain disorders via cat scans and MRI’s? (i.e. tumors, etc)

    I am hopeful because as of late, hope is all I have.

    Scared and desperately concerned, a dear friend

  5. I suffered from multiple breaks of psychosis over a period of 4 months. I believed that I was specially singled out by some entity hiding in the walls, the sky, and in the form of other humans around me. I believed this entity could read my thoughts and was planning to kill me by the end of the year, and that I was being continuously thrown into alternate dimensions where nothing was real for punishment. I would spend a lot of time trying to decode messages from the TV, newspaper and even the crumbs on my desk to try to figure out the solution to ending the Entity.

    My last psychotic break was about a month ago now. I have a feeling the worst of my psychosis is over because I’m on medication and I’m feeling insight coming back to me, a sort of awareness which has been able to deal with the only fleeting moments of paranoia I get nowadays.

    However, I have descended into a deep depression after feeling that my cognition has since deteriorated. I can’t follow conversations properly, I’m not funny anymore, I can’t say anything interesting about myself and my self-esteem is at an all-time low. Even typing this message is a struggle for me.

    I’m only 17 years old and I feel like dying. This world has become more and more confusing and scary as time has passed on, and yes I’m aware that’s normal for the average human being, but for me it feels like I’m an alien on earth. The girl I used to be is gone. I don’t know what to do.

  6. This is the first time I have read something since my own break that I could relate too and feel comforted by. I thank you all for your stories and I want to believe that we will all make it through the trauma and depression. Especially you Gina, being 17 is hard is enough. My biggest problem is that I also had a religion related experience and spirituality was an important part of who I was before this happened and now I am not sure what to believe in. Any thoughts on that?
    I know I am 3 years late. But thank you. This is really important.

  7. This is extremely warm hearted and helpful. Psychosis is so scary. I’ve just started medication, and I’m able to ground myself in little ways throughout the day. Family has been a huge help, but I’ve lost Contact with a lot of friends, and at this point I am realizing that if I am to get out of this I have to take responsibility for my own health and wellness, and this includes being around loving people.
    I am going to start a healthy routine, and what you were saying about not wanting to (or really not being able to) be in stressful situations is true. I am working right now and it’s just a simple job but even getting to work is stressful in itself. I do believe that anyone can get through this. It’s hard as hell, but being able to heal would be incredibly badass.
    It’s okay to cry, to be angry, and confused. Life is still a journey, and hopefully everyone going through a hard time remembers this.

  8. My brother recently had an acute psychotic episode. He has always been the sane one in the family and then out of nowhere he just lost touch with reality. He started having hallucinations and was very delusional. Thought he was god at a point, cried a lot, talked about his childhood, had fears of everything. It was a very very very traumatic site to see and something I will never be able to forget. I just wanted my brother back. It was something traumatic that my whole family experienced. We took him to the mental ward at the hospital and the first few days, there wasn’t any improvement, until the third day. He was sounding more like himself. They kept on switching up his meds. Well, today my parents are finally taking him home so I am praying for the best and that he is going to be ok..

  9. Our 25 year old son just suffered his second psychotic break. He recovered from the first one pretty quickly-about 4 weeks. This time he was in the hospital twice and on a few different meds. He seems to be coming around-but very slowly. He has had to miss work for over a month. He was so smart and quick witted. Now he doesn’t want to talk or engage in anything social. We are keeping hope-but it’s just torturous to see him like this. He lives with us and I have been by his side nonstop. Any suggestions or comments?

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