Distorted Reality: A Snapshot into Psychosis

by Vance Farrell

Throughout our lives, we constantly gather information from the myriad of experiences we have each day, week, month, and year. Some of these experiences are unique, while others are shared with countless others, and these experiences are what make up reality. For most, the reality we experience makes sense to us and others because our perceptions of these experiences are either similar or come from a perception we can comprehend. However, there are some who experience an altered state of perception which can cause them to experience a distorted reality. These perceptual differences can occur from illusions where a person’s senses are tricked into experiencing something false to trick the brain, but others are the result of an imbalance of certain chemicals or abnormalities in the structure of the person’s brain, causing them to perceive something that is not actually there, known as hallucinations.

            These hallucinations are false perceptions based on information the brain creates and makes the person believe it was taken in by our senses. While auditory (hearing) hallucinations are the most common type of hallucination experienced, visual (sight) and tactile (touch) hallucinations are also among the three most recognizable types of hallucinations because of their popularity in movies, television shows, video games, and other media/entertainment sources. The popularity of these three is partly due to the large impact these three senses have on our daily lives, with most of the information we take in coming from these three senses and the scenes that can be created and communicated across to the viewers. However, there are many other types of hallucinations experienced by those suffering from psychosis, such as: olfactory (smell), gustatory (taste), presence (feeling like somebody is in the room with you or right behind you), proprioceptive (feeling like your body is moving or flying when it is not), hypnopompic (occur while you are waking from sleep), and hypnagogic (occur while you are falling asleep). While some of these can be more impactful on a person’s day-to-day functioning, they all have the same impact of distorting a person’s reality and the potential to significantly impact their relationships.

            Individuals experiencing hallucinations because of psychosis are often assumed to be suffering from a psychiatric disorder, as numerous psychiatric disorders hallucinate as a common symptom associated with them. Some of these common diagnoses include Schizophrenia (or diagnoses on the Schizophrenia Spectrum), Schizotypal Personality Disorder, Bipolar Disorder (occurring during severe manic episodes), and Major Depressive Disorder with Psychotic features (also known as Psychotic Depression). While these are more common, there are medical conditions that are also known to cause hallucinations in those with the diagnosis and can have just as much of an impact. These conditions include Parkinson’s Disease, Alzheimer’s Disease, Lewy Body Dementia, Epilepsy, Narcolepsy, Charles Bonnet Syndrome (specifically visual hallucinations), and those suffering from a terminal illness. Additionally, hallucinations and psychosis can also be brought on by medications used to treat these and other psychiatric and medical diagnoses due to the cells they target, a person’s sensitivity to certain medications due to their age or based on the dose of the medication they are currently taking. Although it may still be hard to believe, hallucinations and psychosis are far more common than people tend to believe, with a range of 6-15% of the general population expected to experience hallucinations and 3% of people within the United States experiencing at least one psychotic episode within their lifetime.

That raises an important question: What do you do if you notice somebody experiencing hallucinations or suffering from a psychotic episode? It is common for people to want to challenge the thoughts and perceptions of the person experiencing something they are not, but that is not always necessary or the best route to take. Challenging these person’s perceptions could cause them to react in an emotionally elevated way, as they may start to suffer from anxiety, confusion, anger, or cause undue stress to them. Instead, stop and assess what they are saying they are perceiving and determine if this perceptual difference is so impactful that it requires immediate assistance or can be handled differently. Most of the time, it is best to reassure them with a calm tone and demeanor and avoid arguing with them, especially if it is not endangering you, them, or others. It is also best to follow up with a medical or psychiatric professional afterward to ensure everybody is safe.

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