June 13, 2019

By Meenal Khajuria


We’re making great progress as a society when it comes to talking more about mental health and even mental illness. However, there are still certain conditions and symptoms, such as psychosis, that we don’t talk about as often. And because we don’t talk about it, psychosis tends to be misunderstood. 
Far too often, those who experience psychosis are treated as violent or “crazy.” They may experience discrimination by being fired, shunned or jailed.
These stereotypes are often reinforced in TV shows or movies, where individuals who face delusions or hallucinations are depicted as dangerous and criminal. However, people with psychosis are much more likely to be the victim of a crime than to commit one.
Psychosis is already scary. Imagine not being able to tell what’s real and what isn’t—feeling paranoid and alone.  It’s already such a debilitating symptom, and adding the challenge of stigma and misunderstanding only makes things worse. This is why it’s so important to raise our shared understanding of what psychosis is, how to recognize it and how to help someone experiencing it.

What is Psychosis?

Psychosis itself is not a mental illness, but rather a symptom. It can affect individuals with schizophrenia, schizoaffective disorder, bipolar disorder, depression or substance use disorder. Psychosis can also occur when someone is experiencing dementia or trauma or after the birth of a child. 
When delusional, a person may experience paranoia. For example, they may believe the government is watching them or that a god has tasked them with saving the world. Additionally, individuals with psychosis may exhibit a number of symptomatic behaviors. Hallucinations may come in the form of internal voices that repeat highly negative things over and over, to the point that the person can’t focus or function. They may experience highly disorganized thinking and hop rapidly through topics in conversation, making it hard for others to understand them. They may also struggle with a lack of self-awareness and not be able to tell that their delusions and hallucinations aren’t real.
Sometimes, psychosis is situational and more short-term, occurring during or after trauma or postpartum. In other cases, it can affect an individual for a longer period of time. With proper treatment, including medication, talk and group therapy and support groups, a person can reduce these symptoms. 

How Can We Better Understand Psychosis? 

Programs such as Mental Health First Aid training classes provide people with the tools and insight to understand what someone facing a mental health emergency is experiencing and how to help. This kind of training can be beneficial for many members of our communities. This includes community organizations and leaders within public safety, public education and hospital teams such as emergency department staff. It can also benefit anyone in the community who has a family member, colleague or acquaintance with a mental health issue, or anyone who just wants to be prepared for the possibility of encountering someone who needs help. 
Psychosis simulation training is an especially useful tool. It encourages participants using smartphones or MP3 players with earbuds to play a recording that mimics auditory hallucination experiences (repetition, negative voices at a volume level that’s uncomfortably loud). Typically, training partipants do this exercise while trying to complete a number of tasks, which are tough to complete with that kind of disruptive, relentless noise. Just envision trying to sit through a job interview or walk down the street while these voices are repeating in your ears. By simulating the situation of someone experiencing a psychosis episode, we are able to understand what happens when a person faces these symptoms in real life. 
Training also teaches you what to do if you are near someone experiencing psychosis. For example, sometimes the right thing to do is to call 911 immediately if they are in crisis. In other cases, helping ensure the person is safe and encouraging them to get professional help may be the right approach. 
With ongoing efforts to educate others about psychosis and how to help people who may be in crisis, we can make a positive impact on our communities. Psychosis may be scary, but it doesn’t have to be lonely. 

Meenal Khajuria is a Community Engagement Specialist at Cardinal Innovations Healthcare, a managed care organization in North Carolina providing access to Medicaid and state-funded benefits to more than 850,000 people with complex health and wellness needs.

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