5 Things Every Loved One Should Know About Psychosis
Ways to support a family member with psychosis.
Posted Sep 02, 2020
Shrouded in societal fear, psychosis is one of the most stigmatised aspects of mental illness. The main features of psychosis are hallucinations (seeing, hearing, or feeling things that are not actually there), delusions (believing things that are not true), and confused or disturbed thinking. Psychosis can be experienced in several mental health conditions including schizophrenia, bipolar disorder, and severe depression, as well as substance-induced psychotic disorders. Whatever the underlying cause, those who experience it may find themselves ostracised and deemed as "scary," while families may struggle to know how best to support them.
Despite the prejudices around it, those who experience psychosis can and do live fulfilling and complete lives, especially when both they and their loved ones receive proper support and respect. I recently came across a blog dedicated to the personal experience of psychosis, called "Little Big Thoughts," run by Bronwyn. I found her most recent post, on how relatives and friends can help a loved one, to be both informative and deeply emotional. She manages to offer such an uplifting while realistic approach to the experience that I wanted to share her insights here.
Thanks to Bronwyn for allowing me to reproduce her post:
1. It’s Still Us in There!
During an episode, we might do mad, awful, ugly things. Everything is confusing, everything is terrifying, and we will listen to anything that tells us it knows how to make it stop, even the voices. We may become convinced that you’re a part of it (whatever it may be) and stop trusting you.
But we are not different people. We don’t hate you. The worst thing about psychosis is how it can take everything you love and turn it on its head. The best things in your life become ways to torture you. Please try and understand that we only shut you out because we are convinced we have to.
Under the illness, we are still the person you love. You’ll have to fight for us as you’ve never fought before, and I’m sorry about that. We can learn to manage it. I promise you. We may be changed by it, but we can learn to cope. We can learn to be your wives, children, or friends again.
When we’re better, we will be utterly ashamed of every hurtful word and action. It will tear us in two. Please remember that we still love you, and it’s still us in there.
2. You Need as Much Support as Us.
Whether professionally, or from friends and family, you will need an outlet for what you have gone through with us. You may have been through the worst trauma when dealing with our illness. You will have needed to be our rock and our shelter.
At some point, you’ll need a break, or you’ll crack.
Please don’t suffer in silence. Speak to family, vent to your friends, or go to your GP. Find carers’ groups or online forums or something to help you deal with your share of the suffering. You are hurting just as much as we are, if in different ways, and you’ll need your own support network to cope.
My husband has had to seek some counseling to deal with the trauma of finding me after attempted suicides. It was horrific for him, and I will harbour guilt about that for the rest of my life. He tried to be too strong for too long, and it nearly broke him as well.
However you do it, get yourself support so you can help us.
3. We Won’t Get Better Overnight.
The pills aren’t a magical cure. They’re numbing, that’s it. We can use them as a crutch, but they won’t fix us.
The first step to recovering is finding meaning, and that takes time. We might need therapy to help us unravel the mystery of our heads; we may need to speak to peers who had similar experiences to find out what works for them; we might need a creative or expressive outlet.
If we’re out of work, we may need to find a job to feel more human again. We’ll need to re-learn our confidence, bolster our strengths, and re-prioritise our lives. We may need to experiment with diet, or exercise, or supplements, or relaxation. We have to adapt, over and over again, until we hit the sweet spot.
We may have the confidence to go back to work one week and be cowering under our sheets the next. It doesn’t mean we’ll never get through it, or that you have failed us. It just means we have more adjustments to make.
Please be patient with us and know we are trying to get back to you.
4. Don’t Be Afraid of Challenging the Doctors.
Yes, they are professionals. Yes, they’ve trained for years. But they don’t see us every day. They don’t know what our normal is. Tell them what you know.
The NHS is overwhelmed, so a one-size-fits-all approach is often all they can manage. But we are not one-size-fits-all people; no one is. Psychosis is unique from person to person in the same way that fingerprints are. Don’t be afraid of speaking up if you feel their treatment isn’t enough or isn’t working.
During my first episode, I ended up in hospital after an overdose. I was distrustful and uncommunicative. The doctors decided I was faking (as I later learned from my admission notes) and sent me home with bare minimum support—just sleeping pills and lorazepam—and a promise that the crisis team would be in touch.
My husband didn’t protest because he thought they were doing their best. The crisis team did come round, but what they said or did made no difference. I ended up in the hospital from another attempt two days later.
Don’t be aggressive, but question them if you feel they are not doing the right thing. They have so many patients that they need a kick sometimes to get things moving. Phone appointments get missed, prescriptions are put through late, and the sufferer is left to their own devices.
Don’t let us fall through the cracks.
5. Don’t Be Afraid of Challenging Us.
We are in a world of pain and confusion, but that doesn’t give us a free pass. That said, we may not know if we’re doing something hurtful to other people or care that we’ll regret it when we think of it later.
If the voices had told me that going to a nearby school and stripping naked was the way to make the hurt stop, I’d have done it in a heartbeat. I’d have also ended up on a list…
Please don’t let us do something stupid—or worse, don’t let us hurt you. Don’t be harsh, but do challenge us to get better. This is particularly important when we’re recovering. We are more lucid and more in touch with the real world, but can still be carried away by delusions or obsessions.
For instance, if we start to spend all our money on a new invention that we’re convinced is going to change the world, or stay up all night to research mind-control, or other conspiracies, you need to challenge us on that.
The Bottom Line
You—our loved ones—are a core part of our recovery and support network and are the best hope we have of getting well again.
Psychosis is scary and confusing; not just for the sufferer, but for their friends and family too. It’s hard—it’s bloody hard—and I’m not surprised that many people feel hopeless when their loved one is going through this torturous ailment.
But it’s not hopeless. We can get through it. With some help and patience and support, we can find normality again. You are crucial to helping us get there.
Read the original "Little Big Thoughts" post, and more, here.
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