I was asked once whether I could tell when I was experiencing psychosis. The answer is “Most of the time”. I wanted to put together an answer full of some of my more colorful experiences.
I’ve had doctors who were surprised that I can distinguish most of my hallucinations from reality, so I’m led to believe it’s not common, but I am not a professional. Paranoia and delusions are harder for me to discern.
I know when I’m in a psychotic episode and I can use logic to detect most hallucinations. I call it “fact checking”.
If I’m in the car and I hear the driver (I don’t drive. I have a license, but it scares my family. It’s disheartening at times.) singing along with the radio, I look at the driver’s mouth to see if it’s moving. Sometimes it is, and I’m hearing them singing. Sometimes it isn’t, and then I realize I’m just hallucinating them singing.
Once, I saw a young, blonde haired boy in a blue and orange swimsuit floating motionlessly near me at the bottom of the pool. I panicked, yelled “Help!” and dove down to grab him and bring him to the surface. When I reached out to grab him, he disappeared. I returned to the surface with a pounding heart and told the lifeguard that I was mistaken, nothing was wrong, and thanked them for coming to help. My whole body was shaking for the next hour. Finding out you’ve had a hallucination is comforting in that the problem it presented is not really there, but your adrenal system will continue to flood you with panic chemicals long after you’ve found that out.
I frequently have visual disturbances, the most common of which is smoke or bent light in the air. Imagine billowing smoke, and then take the same curves and lines you would see and turn that into light. It’s a lot like the reflection of light at the bottom of a swimming pool. It doesn’t obscure my vision; it just passes over it. This is usually the first sign I’m having psychosis.
Following the billowing light, I usually become very frightened, with the cause being some vague danger, a threat to my loved ones’ or my safety. I frequently ask if we’re safe (anyone in my life knows to expect this, and fortunately the answer is always “yes”) and sometimes need my fiance to search the house for strangers on my behalf. This fear is paranoia. I actually consider myself lucky for not having more specific fears. The more specific the fear I’ve had in the past, the more intimidating it was. Sometimes, if I’m in public during a psychotic episode, I will believe that I can hear everyone’s thoughts, and that they can hear mine. I’m afraid I’ll think the wrong thing and everyone will hear me and get upset. That’s a great example of a paranoid delusion. In this state, I know I’m in an episode, which allows me to continue to move through the world looking a little bit normal (with the guidance of a loved one) even though I’m inside of an absolutely insane situation. I can experience it as real, the way I’m being forced to experience it, but pretend that nothing is happening and just do the things I’m told to do, like walk next to someone, get in the car, or stand in a line. This level of coping with psychosis is ninja-level. I cannot express how hard I have worked to get to the point where I can actively fear for my life and stand in line at the grocery store at the same time.
Being 12 years into my treatment for bipolar, nothing now is nearly as scary as it used to be. I used to be completely entranced by horrific hallucinations and believed completely that they were real. I once sat next to Satan on an American Airlines flight (I really was on an airplane). He had a little boy in his lap, and I was trying to figure out how to signal to the stewardess that the boy needed help, but I was crying, nearly paralyzed by fear. I looked down between my feet so he couldn’t see me crying, and the floor of the aircraft had disappeared. I was sitting 40,000 feet above the earth with nothing between me and the tiny lights below but air. That was real to me.
By 3 years ago, I’d come around to being aware of almost all my hallucinations. I once saw a flock of black angels/bird people flying over the car I was riding in. I knew it was a hallucination, but it still mattered to me. I wasn’t at all afraid. It was beautiful. I watched them swoop and dive around each other. They were fast and graceful. I watched until they disappeared. That memory is still special to me. That experience was only mine. No one else in the world could possibly have that memory, not even the people that were there.
Knowing I’m having hallucinations is much easier than knowing I’m having paranoia or delusions. Paranoia and delusions are less tangible. Seeing something is easy to disprove, especially if it disappears while I’m watching it, which is frequent with my visual hallucinations. If the person is singing in the car, I can watch their mouth. But if I believe I’m not “safe”, for whatever vague, paranoid reason, it is very hard, and sometimes impossible, not to trust my gut. Instead, I have to trust someone else’s gut. My fiance is my partner in life, and we have been through enough episodes together to have each other trained in what to do. If he’s the person I’m with, which is usually the case, I have to ask him questions, sometimes repeatedly, about the nature of actual reality as he is experiencing it. I use him to check what is real. I ask him about the validity of things I see, hear, and believe. I will ask him if we’re safe, and he’ll say yes. If I don’t calm down, he will describe why we are safe. If I’m far enough gone that I can’t calm down, it’s probably all terror-crying from that point on anyway, so he just takes me home, stays with me and reiterates that we are safe. I much prefer hallucinations, as you can imagine. They, at least, can sometimes be fun. Paranoia, so far, has never been fun for me.
I am self-aware enough now that I know when I’m in an episode most of the time. Sometimes someone else will point it out before I’ve figured out what’s happening, but as soon as I realize it, I am able to stay grounded in that knowledge. Knowing that I’m in an episode and that I can’t stop it sometimes feels like falling, only I never land. It just goes and goes, without my permission, and I can’t change it. The intensity of it can be ridiculous. Humans shouldn’t be able to manufacture that level of intensity, especially with no external source. It can be quite incredible, in the original meaning of the word. In fact, that incredibility is part of why fewer people understand or validate mental illness. It sounds made-up.
Knowing I’m experiencing psychosis keeps me grounded and safe during episodes. I know to alert my fiance or family, and I follow their lead, at least until I get out of public. At home, I am better able to cope with whatever counter-reality comes my way. Spiders on the ceiling, bugs on my skin, expanding bathmats, dripping ceiling fans, breathing walls, squealing marshmallows: all fine by me at this point in my journey. None of it is really that bad anymore. It used to hurt a lot. I’ve come a long way.