It can be incredibly scary and debilitating if a loved one begins telling you that they are seeing or hearing things that are not there, or begins experiencing grandiose or intense delusions. It can feel like the situation is beyond your comprehension, or that they are a dangerous person to be around. In order to not abandon or neglect our loved ones, especially in moments of vulnerability and need, it is vital that we understand what psychosis is and can be, and how it can manifest itself.

Psychosis is defined as an episode or disorder wherein an individual feels a disconnect between their experiences and reality. It can manifest as false beliefs and delusions and/or hallucinations. Delusions are false beliefs that someone clings onto despite any evidence to the contrary. There are two types of delusions that can emerge: bizarre delusions (ideas and beliefs that are so extreme that there is no way they are true, like believing your co-worker is actually a robot) and non-bizarre delusions (beliefs that may be possible, but without any supporting evidence, like believing you’re being followed). These delusions can be intense in nature and can lead to extreme mood swings, feelings of paranoia and fear, changes in behaviour that can lead to harmful acts, and isolation and social rejection.

A person can also experience hallucinations, wherein they swear they are seeing or hearing things that are not there. Psychosis can result from a personality or mood disorder, substance abuse, trauma, unusually high levels of stress or anxiety, and other physical diagnoses. Dealing with psychosis can be extremely overwhelming and terrifying, and so having a strong support system of people around you who can help you navigate yourself into a safe, comfortable environment is key.

If you have a loved one who is experiencing symptoms of psychosis, here are some tips for how to communicate and cope:

• Try and focus on their feelings rather than experiences: If you insist that their hallucination isn’t real and don’t validate their true feelings in that moment, it can come off combative, judgmental, and like you are part of the problem.
• While you don’t want to encourage the hallucination or delusion, you should tread carefully in your speech and actions so your loved one does not push you out completely. Listen and try and understand, and work with them to de-escalate the situation. You can offer space (instead of trying to corner or impose your presence on them), and you can encourage them to breathe deeply, focus on a tangible physical object, and calm down, which can help reduce the intensity of what they are going through.
• Avoid using overly simplistic words so you do not patronize them, such as “you’re crazy!” This can contribute to the stigma or fear they may already be experiencing.
• It is important to avoid touching them without permission; also avoid nervous behaviours such as nail biting, pacing, or fidgeting, as it may add to their anxiety.
• Have a plan in place for a possible crisis ahead of time. While knowing what to do during a psychotic episode is important, having a plan for what the person would appreciate and want for future situations could help to establish a healthy strategy for managing psychosis.
• Tapping in mental health professionals, therapies and/or medicine for treatment and management is vital. This is not something you can or should deal with without the help of a trusted medical expert, so for the sake of your own mental and physical health and for your loved ones’, do not try to tackle this on your own!

For help, visit amiquebec.org/psychosis.

–Nazila Tolooei
From Share&Care Summer 2024

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