Psychosis and Unusual Experiences

Many people have unusual experiences in perception and thinking, sometimes known as psychosis. Often signs of psychosis start in the late teens and early twenties when we are embarking on important life changes such as college or a first job. Variations of psychotic experiences, including hearing voices and having suspicious thoughts, are fairly common, occurring in approximately 7% of the general population (1) and some studies suggest an even higher number. Living with these experiences does not mean that you are “crazy.” It is important to keep in mind that people go through stress and mental health issues differently, be it panic attacks, depression, or hearing voices. Having psychotic symptoms can make people feel isolated and keep them from sharing their thoughts with others, though the research shows that seeking support and help are the most successful ways to manage (2).  And the earlier you get help, the better chance you have of your symptoms getting better (3).

References

  1. Linscott, R. J., & Van Os, J. (2013). An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: On the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine,43(6), 1133-1149.
  2. Dixon, L. B., Holoshitz, Y., & Nossel, I. (2016). Treatment engagement of individuals experiencing mental illness: Review and update. World Psychiatry,15, 13-20.
  3. Fusar-Poli, P., McGorry, P. D., & Kane, J. M. (2017). Improving outcomes of first‐episode psychosis: An overview. World Psychiatry,16(3), 251-265.
Most Common Signs and Symptoms of Psychosis

Please note that these symptoms are all within the spectrum of normal experiences or seen in other conditions such as anxiety, and do not automatically mean that a person has psychosis.

1) Disturbances or changes in your perceptions or senses:

  • Hearing your name being called, hearing low muffled voices, hearing people talking when you do not see anyone present or others don’t hear it
  • Having unusual sensations on your skin or in your body when you do not see anything
  • Regularly seeing flashes of light or things out of the corner of your eye (excluding ophthalmic issues)

2) Changes in thinking:

  • Suspicious thoughts that others are talking about you, following you, monitoring you, or conspiring against you in some way
  • Ideas that other people or machines are controlling your thoughts or behaviors
  • Thoughts that you are being referenced in the media like on TV or the internet
  • Ideas that you have supernatural or extremely accomplished powers or abilities, or special connections to celebrities or religious figures

3) Having difficulty organizing your thoughts and speech- others might comment that they don’t understand your ideas or that you are speaking differently

4) Changes in behavior:

  • Isolating socially or avoiding responsibilities because you don’t feel like engaging, are overwhelmed by thoughts or voices, or have suspicious thoughts about others
  • Not taking care of yourself or personal hygiene (i.e. bathing, eating)
  • What you’re saying and how your showing emotions are out of sync, like laughing when you’re describing something disturbing or sad
Causes of Unusual Experiences
  • Psychotic disorder, a mental health condition such as schizophrenia, brief psychotic disorder, or bipolar disorder with psychotic features
  • Drug use such as marijuana (read about cannabis and psychosis risk), stimulants (Adderall, Ritalin, methamphetamines, cocaine), LSD, psilocybin (mushrooms), PCP (angel dust), K2 (synthetic marijuana/spice)
  • Alcohol withdrawal
  • Reactions to traumatic events
  • Extreme mood dysregulation, sometimes in the context of another mental health condition such as Borderline Personality Disorder or Posttraumatic Stress Disorder
  • Sleep deprivation
  • A neurological condition (rarely)
  • Spiritual experiences: some cultures involve spiritual experiences like connecting with a higher power or hearing the voices of deceased relatives. It is important that we not be quick to assume that these experiences are related to a mental health condition.
What is the Treatment for Psychosis?

If you think that you might be experiencing psychotic symptoms, you are not alone. The first step is to tell someone. You can start with a mental health professional at CMHS any time by calling for an appointment, which can be the same day if you need it. If you need to talk with someone outside of business hours, call (617) 627-3030 and ask to speak with the counselor on call. In addition to meeting at CMHS, your clinician may help you make an appointment for a more detailed evaluation at a clinic such as CEDAR in Boston to get a clearer picture of what is going on and what steps to take. If you are worried about telling a clinician, it can be helpful to start by sharing with a family member or friend.

One of the most helpful treatments is psychotherapy. There is a huge body of research supporting the effectiveness of psychotherapy for psychosis, especially Cognitive Behavioral Therapy (CBT). If psychotic experiences are greatly interfering with your life, a clinician may also recommend medications called antipsychotics, which include Abilify, Risperdal, and Zyprexa among others. Social support and daily activities improve overall mental health with psychotic symptoms, though not formal treatments.

Resources

The resources below are to learn more about identifying and managing psychotic experiences. But don’t get stuck in a Google hole, call us!

  1. Strong 365, a comprehensive site about psychosis for young adults
  2. Article from NAMI: “A Diagnosis of Mental Illness Need Not End a College Career
  3. Infosheet from OnTrackNY: Phases of Psychosis
  4. PREP in Boston, Early Psychosis Program
  5. Hearing Voices Network, a positive and supportive online community for voice hearers