Psychosis (young people)
Reflecting on and managing hallucinations, paranoia and delusions
Remembering psychotic experiences
Many of the young people we spoke to had had continual psychotic experiences since their early or late teens, while some, like Andrew Z and Lucy, had started having psychotic experiences only relatively recently. Three of the people we spoke to, Sameeha, Becky and Joseph had had a single short period of psychosis in their early twenties.
Memories of psychotic experiences could be confusing or unclear. Andrew X said, “I struggle to remember things from my psychotic experiences… like my brain has blocked them out deliberately – which I’m cool with”. However, psychotic experiences could also feel so much like reality that some people had vivid memories of them. Joe’s first major hallucination comes back to him regularly as a recurring nightmare. Luke remembers “everything” about his delusions and at the time when he is experiencing them they don’t seem extraordinary. It is only afterwards that he wonders “Why did I think that”?
Memories of psychotic experiences can be upsetting and frightening (see hallucinations, paranoia and delusions). Sometimes people could act erratically and experience big mood swings. Becky described it as ‘like a demon comes out’ when she experienced psychosis. People also described feeling disinhibited; saying or doing things that they usually wouldn’t do or say. Afterwards it could be awkward remembering.
Sameeha felt as if she was sitting in her own chest watching herself. It was upsetting to hear afterwards how her actions had affected others.
Sameeha felt as if she was sitting in her own chest watching herself. It was upsetting to hear afterwards how her actions had affected others.
At its at its worst was awful. It's, you'd, you have no control of it at all. But your, your, how I would describe it 'cause there was a time period where I was in the hospital. It was the A&E and I just wanted to, I just wanted to go, I was surrounded by people. And I think it was a time period where I was acting—I might have been slamming this hinge thing on the wall. I was like slamming it and counting at the same time. And there was loads of people grabbing me and I was like, no, just let me go, just let me go. And it was very overwhelming. But I remember this like especially in that moment. Even I kept blacking out in and out. That I was like sitting, pretty much in the centre of my chest. Yeah, I was sitting in the centre of my chest kind of watching the whole thing go down kind of thing like I was just like this consciousness just, even I was like, oh my god, I'm screaming like from the top of my lungs, but I don't feel anything. I am just watching it go by. So there was definitely this separation from the ego of which I was Sameeha and it was just me watching this horrible thing go, go by, but there was no judgement of it. It, it was simply what it had to be. There was other periods where I couldn't even communicate, like say, if I wanted to say something, I couldn't even say what I wanted to say. There was a time where I've only speak, I was only speaking in numbers and colours. I was getting my, my, my moods were very irritable, like I could switch from being happy to go lucky depending on the person speaking to me. Yeah I remember during that period my friend as well right before I went. Completely kind of disconnected to reality. My friend had told me after that she had felt very scared, very frightened for her life. And I was just like, ah, that's very upsetting to hear, because obviously when you are in that kind of delusional period, you have no intent of anything at all. So, coming back and hearing what you did during those periods is very difficult, because you don't define yourself by that, but at the end of the day, you did it, so you can do nothing else but take responsibility for it. So, yeah, those are the things that are the most bad. Things like completely out of character, 'cause, for me, burdening people would, I would say it's one of the worst things I'd do. And I was constantly just in people's I, I was, I would talk and just mention nonsense and be so sure of the things I was saying and obviously, coming back to that, it's not pleasant 'cause obviously people can full on witness you not being completely there and it makes them uncomfortable and it makes them obviously they don't know what's going on and they don't understand completely what's going on in your head. So they, they're uncomfortable themselves. So that's difficult as well, working with, kinda thing. Dominic hears clearly identifiable voices. At one point he heard seven voices. The constant “chit chat” was “intense” and made him angry. The loudest voice would give him commands telling him to hurt others.
Dominic hears clearly identifiable voices. At one point he heard seven voices. The constant “chit chat” was “intense” and made him angry. The loudest voice would give him commands telling him to hurt others.
And they were sort of identifiable and separate.
Different, different tones of voice. I can't pinpoint, 'cause voices are supposed to represent a person you know or a voice you've heard. Sometimes it's your own voice in different tones. Like one of mine is, younger me. He's a very temperamental little twat. One of them is my dad's voice. One of them is my very good friend, [her] voice. And when it was seven, there wasn't any chance to identify them, because it was just constant flow of talking in my head. Do you know, I don't know if you've seen Bruce Almighty. You know he's in the restaurant and he's hearing all that. It's literally, it was like that, constantly over and over again. And I had no breaks. For once, because I wasn't smoking weed at the time. I wasn't doing anything. I wasn't drinking or I wasn't smoking weed. I was just living and it was just constant and it was exhausting to say the least. And it was so intense that it would get me angry, throughout the day while I was working, it would get me angrier and angrier and I'm trying to find a break and trying to have just a few seconds of peace and there was none of it, ever. And, that made me very angry. Made me a very angry person, in general. I didn't, I didn't need any more anger. I wasn't short on anger I had plenty of it. And I was getting increasingly angry. And, then the orders became the loudest voice, so I had all the chit chatter, and all the chit chat, every now and again, ‘Go and hurt that person. Go and put his head on that fucking pavement’ or whatever and it would be very oh, no, very loud and very [moves hands from head to demonstrate angst], you know. Barry experienced a “high” from drinking cold water because his senses were heightened.
Barry experienced a “high” from drinking cold water because his senses were heightened.
Right.
And it sounds a bit silly, because you get people who take drugs and this and that, to get their highs of whatever. But I, because they had a little water dispenser, and it was always really cold, all of a sudden I started drinking the water. And I thought I was getting high.
Okay.
Off of a cup of water [smiling].
Right.
I’d be drinking it, and I’d be drinking it in a way that the cold water was hitting the back of my throat.
Yeah, yeah.
And because I could, my senses were heightened, I could feel it trickling down the back of my throat.
Right.
I just, I’d just sit there with a cup of water doing it. And, I don’t know why, it was just weird. It was very weird.
People who had experienced psychosis for many years described “ups and downs” with their psychosis and said the psychotic experience itself usually didn’t change over time. However, they had often found ways to manage the psychotic experiences, which could make it easier to cope. Medication or talking therapies had helped reduce the number of psychotic experiences for some people, or made them less upsetting, while others had found self-management techniques that helped them.
Joe’s voices make him feel “blasts of emotion”. He uses mindfulness and meditation to make his brain “calm” so that the voices become calmer.
Joe’s voices make him feel “blasts of emotion”. He uses mindfulness and meditation to make his brain “calm” so that the voices become calmer.
So in terms of sort of managing it day to day now, and drawing on those things that you've learned –
I don't ever get them less frequently. Throughout the whole process, I've never got voices less frequently than I used to. But it depends what they do as to how much it affects my life. And nowadays it might just be - I got, I got - some of them - Well, all of them would sometimes communicate. Not even with words, just with sort of making me feel blasts of emotion. Like seeing, I don’t know, a person walk past the window, and I just got tremendously angry all of a sudden. Because that voice had access to that bit of my brain that could make me feel furious. But nowadays I might get a very brief flash of understanding and emotion but I don't really get that any more. I think because I am calmer about it in general, and they are parts of my brain which is calmer, they themselves are less stressed about - yeah. Well, you say - They, they perceive danger on a sort of heightened scale. So my voices, if they see something that is 2 out of 10 dangerous, would say 6 out of 10 dangerous. If they see something that's 4 out of 10 dangerous, they'd see a 10. But if I'm like a minus 2 anyway, they'd probably only see it as a 2 and it wouldn't be a problem.
So, how do you get your brain to minus 2? [Laugh].
Practice [laugh].
Yeah.
Honestly, just - I do a lot of mindfulness and meditation stuff. And actively try and make myself not worry. I think one of the things I've discovered is you, you can't change things. I - Because my job is quite stressful and awful sometimes, but the only way I'm going to ever cope in that job is at four o'clock when I leave, just leave it behind.
Because you can't – If you, if you hold all of the stress you could have at one point with you at any one time, it'll burn you up. You've got to sort of compartmentalise and get it to be - I can deal with it.
Green Lettuce says its best to try to ignore commanding voices, keep your mind as occupied as possible, and get a “proper routine” in the day and night. But Dominic found that if he ignored his voices, they would get louder and angrier and that what worked best was communicating with them on a daily basis.
Dominic says it’s important to find what works for you. When he purposefully “listens” and responds to what the voices say, the “power shifts” and they have less effect on him.
Dominic says it’s important to find what works for you. When he purposefully “listens” and responds to what the voices say, the “power shifts” and they have less effect on him.
And it's, the advice I'd give is it's finding what works for you. But don't be afraid to try. There's a lot of things your brain can do. A lot of ways it can trick, trick you and trip you up. But, you have to learn yourself that not everything that happens in your head is real. It's called, confirmation bias. When something happens, if you're powered by something and you're constantly looking for evidence that that backs up that paranoia, rather than looking at the broader picture. Joe has had multi-sensory hallucinations that involve him hurting others. Even though they only happened in his head he feels he needs to treat them as though they were real and tries to ‘forgive’ himself for what happened during the hallucination.
Joe has had multi-sensory hallucinations that involve him hurting others. Even though they only happened in his head he feels he needs to treat them as though they were real and tries to ‘forgive’ himself for what happened during the hallucination.
And then I walked back to the house. Because - Because at that point, I - That had actually happened for me.
Yeah.
I was basically going back to see if I could do anything to help. And then I got to the house, and they both opened the door, and it was completely fine. And my world just kind of melted together. Because it was two completely conflicting, but both completely real things happening in tandem. And, yeah. And, yeah. That was the first time I had a visual hallucination, or one that involved other senses. And that's what I mean about things being - whether you can if things are real. Because both those things, according to my sort of linear perspective on life - both of them happened around the same time. And both were exactly as real as each other. The only difference is, I'm living in a world with the results of one of those. But I could quite easily be living the other world, with the results of the other.
Yeah.
But that's something I sort of took quite a while to come to terms with. And I think it was somehow easier to – it, it was easier to accept that it happened, and try to forgive myself for it, than it was to try and say it didn't happen. Because -
It was easier to forget that happened? Than it was -
It was easier to forgive myself for it happening, even though I know I didn't do it. If that makes sense.
Okay.
Because the - If I denied that it happened, I have to deny every experience I've ever had, because it involved the same information.
If I play by these rules in this world - so like if I pick up that cup, it's going to be heavy, that's the same rules that world uses. So I have to - I don't know if any of this makes sense outside of my head.
Yeah. No, it does. You've kind of got to treat it as though it happened. So, this is real –
Yeah. Because otherwise you have - Otherwise you can't treat anything like anything happens. And then you're just sort of a nihilist, and. Yeah.
Others had not found anything that worked and could find themselves very quickly in a “crisis” situation.
Lucy, who had her first psychotic experience less than a year before she spoke to us, finds it hard to spot the signs when she is deteriorating. By the time she reaches out for help she is in ‘crisis’ and distraction doesn’t work.
Lucy, who had her first psychotic experience less than a year before she spoke to us, finds it hard to spot the signs when she is deteriorating. By the time she reaches out for help she is in ‘crisis’ and distraction doesn’t work.
And does it sort of take time to get to that stage? Are you sort of aware of it getting to that stage, or?
It does - it kind of builds up a bit. But then it kind of very suddenly will get really awful. And I don't - I'm not very good, I guess, at working out when I need to get help before then, because I feel like I shouldn't go and ask for help when things are quite mild and I'm just noticing a bit of, you know, not feeling great and, and thinking bad thoughts. But actually I probably should get help then, and then maybe it wouldn't escalate into the position where I don't think I'm in control and I'm looking at everything and thinking how could I take that to harm myself. And, but it does, it just slips. And then suddenly like nothing they kind of suggest really works. And it always, always ends up with like a crisis, and - or an overdose, or - or harming myself quite badly in some way.
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