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21 Feb 2022, by Jessica

Let’s not sugarcoat mental health issues

Jessica believes that we should tell the more difficult truths around mental illness to battle stigma and help people suffering feel less alone in their experiences.

Trigger Warning: This article mentions self-harm, suicide, threat of death, threat of sexual assault, threat of injury and statistical outcomes that some might find upsetting.

Psychosis is like the kind of nightmare that jolts you awake, your skin smattered with beads of sweat and your mind afraid of whatever gnarly monster you conjured up in your imagination. Only you can’t wake up because you’re not asleep. For you, this is your reality.

Ever been afraid of something? Whether it’s being walked over by spiders or losing a loved one, imagine thinking it was happening and in my experience, that’s what it’s like to go through psychosis. For me, psychosis brought my fears alive.

Bringing fears alive

During psychosis I thought I would be blinded, raped, burnt alive, given a terminal disease,  poisoned, maimed, killed, abandoned by my friends and family, and made homeless. I thought people were following me. That I was being filmed for a TV show, a podcast or even a YouTube mini series. and that I’d been kidnapped by a cult. I thought I was the most dangerous female criminal in the world and that the police were after me. I thought that I was being tortured by sleep deprivation and that the tablets I was given contained poison.

I had various explanations for who was behind the conspiracy. From the Masons to people I used to work with, the plot kept thickening until it was a coagulated goop, like gravy leftover after a roast. For a while I thought Extinction Rebellion were behind the intricate web of deceit I felt had been crafted against me. I thought I was in a The Truman Showstyle dome, that I was a research experiment being tested on, even that I was on a Derren Brown TV special or the latest season of Black Mirror. I thought that I was in a version of The Matrix. That I’d been drugged and flown to a TV set in a different country.

I thought for a while that I was a psychopath being experimented on, and that I had dissociative identity disorder. I thought that I was being raped in the night while I was in hospital and that they were going to lock me in my room and set the whole place on fire. I thought there were trackers in my fillings. I thought I was a savant and was exceptional in some way. I thought I was in an escape-the-room video game, and that if I could just work out the clues I would be able to get out of hospital. I even escaped from the ward and ran down the road and knocked on someone’s door and told them I’d been kidnapped. They called the police and I was swiftly returned to hospital.

Psychosis isn’t a journey into wonderland

These are not pleasant things to type and they’re not particularly politically correct but they are what I thought during my psychotic episode. I don’t think I’m alone in these experiences and I’ve heard similar things from other people online, that they thought they would be the victim of an acid attack or that different colours were significant and people wearing certain colours were in ‘teams’ against them.

For me psychosis isn’t a journey into wonderland, it’s a trip through your worst fears. These might not be fears you think of consciously, for example, my greatest fear is not fulfilling my potential, but somewhere in my mind are these dark, complex fears which leaked out during psychosis. Many of these fears are part of the zeitgeist of our cultural psyche.

It’s not just outside forces that were a threat to me and I almost died by my own hand several times during my psychotic episodes. I thought I was meant to jump off a local bridge that’s notorious as a suicide spot and had to be taken home by the police. I thought I was meant to take several packets of paracetamol. I even went as far as taking an overdose and had to be taken to A&E and be put on a drip. I thought I was meant to put cigarettes out on my hand because I felt like the codes I could see in the world around me were telling me to. I thought I was really male and cut off all my hair. For a while I thought I was pregnant. I knew that there something something unusual happening and I tried to work out what it was, but failed to land on the truth: that i was losing my mind.

The weight of guilt

I felt a huge weight of guilt for every mistake I’ve ever made and kept writing lists of things I’d done that I regretted. Kind of like My Name is Earl. I felt like a was singularly responsible for global warming and every time I saw a coffee cup I assumed it was planted there to make me feel bad about all the times I had not used a reusable flask. I thought that litter was put there intentionally there to make me feel guilty about not recycling enough (even though I do recycle) and I picked up rubbish from the street and put it into my handbag. I kept calling the police to confess to real and imagined things I felt like made me a criminal. But this was just a result of one of the symptoms – excessive guilt. It was all in my head! These might seem like strange thoughts and actions, but when your realty is skewed, you act according to what it is telling you. I also thought music and television was sending me messages, kind of like the film Josie and the Pussycats.

Despite all this, I wasn’t violent because through psychosis I believed that I should show empathy at all costs, and show grace and humility to my captors. But if you thought you’d been kidnapped and that you were going to die, would you fight for your life? To a certain extent. faced with my own demise, I’m surprised I wasn’t more confrontational. Would you fight against your captors when they tried to inject you to calm you down? Would you confront the strangers following you? It might all be in your head, but if it feels real, then would you go quietly if you thought your life hung in the balance? Although people with psychosis are actually more likely to be victims than perpetrators, faced with your own demise, and no insight into your condition, I can see how things escalate. I did shout at strangers, and I kicked in the glass panelled door of the hospital and climbed out to escape. This was not an easy time in my life.

How can we help people relate to psychosis? People really ARE tracking you. They want to kill you and maim you. Music is sending you messages. Everyone’s an actor and you’re in a TV show about your life. THAT’S HOW PSYCHOSIS FEELS. not like you’re imagining it. Like it’s REAL!!

Creating a sugar-free mental health dialogue

Psychosis can be traumatic and we should be honest about just how traumatic it is because the most important audience for mental health content in my opinion, isn’t the general public, but the people with psychosis who want to be able to find context for their unusual experiences. When we romanticise or sugarcoat mental health issues we are just contributing threads to the fabric of stigma. There’s a tendency to either create inspiring stories which do not reflect the majority of experiences (but can help to break down stigma) or parade people with mental illness in front of the public like animals at the zoo. This voyeuristic view is not helpful either.

There’s no need to share all the gory details of psychosis, but a general watercolour is helpful. It contributes to the conversation we need to have: a sugar-free mental health dialogue! I don’t think my psychotic delusions say anything about me as a person, they’re so similar between people and they change with the times. Instead i think they are part of being human. They are an illness.

For many sufferers, psychosis is part of a lifelong and debilitating illness, such as schizophrenia and bipolar, and as many as 80% of people who have had one episode of psychosis go on to have a second. The life expectancy is lower for people with psychosis and sufferers typically die 15-20 years before the national average. It is a formidable illness but I strive to have hope for the future and what I can achieve with my life. I think it’s important to bear in mind the statistics because they paint a more realistic portrait of mental illness. And that’s what we need to aim for.

Similarly, when we champion the narrative of full recovery or career success in the face of psychosis, we might be battling stigma, but we are potentially failing the majority of people who do not fully recovery and struggle with the day-to-day. The majority of people who go through psychosis struggle with episodes throughout their lives and do not end up back in employment. It’s estimated in some studies that the number of people with psychosis who are in employment is as low as 5.8%. The suicide rate for people with psychotic illnesses is estimated at between 10-15%.

Optimism is all very well, but we need to be more open about the statistical outcomes and erratic behaviour that’s part of psychosis to give people a realistic understanding of their odds and curate a realistic narrative around mental illness. Rather than the rare horror stories of violence during psychosis, or the inspiring content of full recovery or success, we need to start posting helpful accounts which portrays the mundane reality of living alongside severe mental health issues like psychosis.

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