What does psychosis feel like
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Understanding the Lived Experience of Psychosis
Introduction to Psychosis: A Complex Mental State
Psychosis is a profound mental state characterized by a disconnection from reality, manifesting through symptoms such as delusions, hallucinations, and thought disorders 6. It is often described as one of the most ineffable and enigmatic experiences of mental disorder, profoundly altering an individual's perception of the world and themselves 1.
Early Phases of Psychosis: Existential Disruption
In the early stages of psychosis, individuals often experience a loss of common sense and a feeling of perplexity, as if they are no longer fully immersed in the world around them. This phase is marked by a heightened sense of salience, where ordinary events seem unusually significant, and a perturbation of the sense of self, leading to a need to hide these tumultuous inner experiences 1. This period can be likened to a vulnerable brain under stress, where weakened neural circuits struggle to handle increased pressure, resulting in a kind of mental "electric discharge" 2.
First Episode: Tumultuous Internal Experiences
The onset of the first episode of psychosis can bring a mix of transitory relief and intense self-referentiality. Individuals may experience delusions, where they attempt to make sense of aberrantly salient experiences, and hallucinations, which are direct manifestations of these internal distortions 3. This stage is also characterized by a dissolution of the sense of self and social withdrawal, as the boundaries between self and world become permeated 1.
Later Stages: Grieving and Acceptance
As psychosis progresses into its later stages, individuals often grapple with grieving personal losses and struggling to accept the constant inner chaos. This period involves coming to terms with a new sense of self, the diagnosis, and an uncertain future. The journey towards recovery is seen as a process of reconstructing personhood and re-establishing lost bonds with others 1.
Sensory and Cognitive Distortions
Psychosis is also associated with significant distortions in sensory and cognitive experiences. For instance, individuals with psychosis-proneness may exhibit heightened susceptibility to the rubber hand illusion, where they perceive a rubber hand as their own due to visual-tactile integration distortions 4. This indicates a broader disruption in the integration of sensory information and stored knowledge, leading to misinterpretations of both internal and external cues 7.
Stress and Emotional Reactivity
Elevated emotional reactivity to stress is another hallmark of psychosis. Individuals vulnerable to psychosis often exhibit heightened sensitivity to daily stressors, which can predict more intense psychotic experiences. This stress-reactivity is considered an affective pathway to psychosis, potentially underlying more episodic and reactive forms of the disorder 8.
Conclusion
Psychosis is a deeply complex and multifaceted mental state that profoundly affects an individual's perception of reality and self. From the early existential disruptions to the tumultuous internal experiences and the ongoing struggle for acceptance and recovery, the lived experience of psychosis is marked by significant sensory, cognitive, and emotional distortions. Understanding these experiences is crucial for informing clinical practice, research, and education, ultimately aiding in the development of more effective treatments and support systems for those affected by this challenging condition.
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The lived experience of psychosis: a bottom‐up review co‐written by experts by experience and academics
Psychosis is a complex, painful, and ineffable experience, characterized by loss of common sense, perplexity, and a sense of self-dissolution, with varying degrees of relief and struggle for recovery.
Literature Review
Highly CitedPsychosis
Psychosis is like a weakened brain circuit causing electric discharge, similar to the process of electric discharge in old toasters when electric potential is higher than the circuit can handle.
Rigorous JournalHighly CitedPsychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia.
Psychosis in schizophrenia is linked to dysregulated dopamine levels in the brain, leading to aberrant experiences and symptom resolution through psychological resolution.
Highly CitedPsychosis-proneness and the rubber hand illusion of body ownership
Positive psychosis-like characteristics predict differences in susceptibility to experiencing the rubber hand illusion of body ownership, suggesting that visual-tactile integration may contribute to the development of psychosis and positive psychosis-like characteristics.
Observational StudyHighly CitedPsychosis in Children and Adolescents.
Psychosis in children and adolescents is often misdiagnosed due to symptom presentation and illness course, leading to inaccurate treatment guidelines and potentially harmful labeling.
Focus on psychosis
Psychosis is a clinical construct composed of various symptoms, with delusion, hallucination, and thought disorder being core clinical features, and reality distortion as a common denominator.
Highly CitedPerception of psychosis in patients
Patients with psychosis, such as schizophrenia, experience distorted perceptions of their own and others' states due to impaired mental appraisal mechanisms.
Stress-reactivity in psychosis: evidence for an affective pathway to psychosis.
Elevated emotional reactivity to stress is an indicator of genetic and environmental liability to psychosis, predicting more intense moment-to-moment variations of subtle positive psychotic experiences.
Literature ReviewHighly CitedA cognitive model of the positive symptoms of psychosis
This paper proposes a cognitive model for understanding positive symptoms of psychosis, integrating social factors and neurobiological research.
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