It was an April spring morning in Birmingham, England, and I had been suffering from severe symptoms of psychosis for two weeks. My only contact had been a nice roommate who made me dinner and left it outside my bedroom door.
At the time, I was convinced that I was Britain’s most wanted criminal and was being watched by the police. Holding this false belief, a symptom of a psychotic illness like paranoid schizophrenia, I felt overwhelmed and as if the only way out was to kill myself.
I was lucky that after my attempt the sun started to shine, and that gave me hope. I called the emergency services for help, because a psychotic crisis should be treated in a hospital, by doctors and professionals, not by the police, or in a prison.
I am far from alone. According to the National Alliance on Mental Illness, approximately 3 in 100 people will experience psychosis at some point in their lives, and when they do, they will experience a marked increase in suicide attempts, self-harm and dead. We often forget that psychosis and psychotic illnesses like schizophrenia can be treated effectively. What’s crucial is getting help early. This is where people like you are so important.
I want you to understand that you can help someone in a psychotic crisis – like the homeless people you might see on the streets of Los Angeles showing various symptoms of psychosis, or a friend of yours who is in pain. It may sound daunting, but it’s worth a try.
It has helped me during my crisis for other people to rely on small glimmers of hope that are always there – the sun, a cool breeze, good news on TV or a pet nearby are all comforting in times of crisis.
However, the management of psychosis attacks is not unique. Friends and acquaintances with psychosis have told me that it won’t work for them and would rather be listened to or guided by someone they trust who has access to their personal safety plan (a plan developed by the patient and a professional while the patient is stable to mitigate future seizures).
That said, there are always ways to help, regardless of someone’s preferred approach. On the one hand, consider taking a mental health first aid course, which teaches you how to manage a mental health or substance use crisis, whether or not you know the person, and includes steps you can take to help someone before a crisis occurs. It is taught across the United States, including some free offerings. You can find out more at mentalhealthfirstaid.org.
Sophie Eggleton, who teaches similar classes, told me that the key to helping and comforting someone in a psychotic crisis is not to focus on fighting them over what they believe to be true at the time. .
“Don’t stress them out further by prioritizing what’s true for you. Just make them feel supported, reassured and heard and focus on keeping them safe,” said Eggleton, mental health instructor and podcaster, told me on Twitter. “It’s fine to share that you are worried about them, but try not to be judgmental even if what they say is out of place or unusual. Try to stay calm and considerate and, if possible, ask them if they’ve been through this before If they have treatment in place, they might be able to tell you what helps, or they might have a crisis team in place that you can contact. an environment where you both feel comfortable.
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Pandemic stress, traumatic events and economic uncertainty have turned our world upside down. This series aims to make the cascade of threats to your sanity a little more manageable.
What most mental health professionals like Sophie and people with psychosis like me agree on is that staying present, even if it’s just texting optimistically, can be useful in a crisis. Reaching out to someone in crisis can not only prevent a death, but also mean that a person receives early support and experiences fewer relapses.
Feeling compassion and practicing empathy are also key to helping distressed people with psychosis.
If you can imagine for a moment what it feels like to think the world wants to get you, you might be able to develop some compassion for a poor soul who is in intense pain. Think of a time when your life was scary and out of control, and it will give you some insight.
“Probably the best thing you can do for someone in extreme distress is to understand the fear that is often associated with these experiences and obviously to seek medical support when you can,” psychologist Paul Gilbert told me, who founded compassion-focused therapy. “And you should contact a doctor urgently if the voices indicate harm to yourself or others.”
Psychologist Charlie Heriot-Maitland offers similar advice in his recent book “Relating To Voices Using Compassion Focused Therapy.” To help someone in psychosis, he says, it’s best to first be there and listen.
“If she is very distressed, her mind is likely to be organized in such a way that it will be difficult for her to process and use my suggestions,” Heriot-Maitland wrote. “So instead, I would be by her side, listening, allowing, holding, waiting, until she felt safe enough to start generating her own wisdom, ideas and plans… Warm and caring mental health workers will have the potential to help her feel calm, secure, validated and understood.
This was my experience in 2009 after my suicide attempt. In addition to my kind roommate helping me stay fed, I was greeted with kindness by the medical team who arrived at my house when I called them, including a nurse who encouraged me that I would be fine .
Suicide Prevention and Crisis Counseling Resources
If you or someone you know is struggling with suicidal thoughts, seek professional help and call 9-8-8. The first national three-digit mental health hotline in the United States, 988, will connect callers with trained mental health counselors. Text “HOME” to 741741 in the US and Canada to reach the Crisis Text Line.
I was hospitalized and diagnosed with paranoid schizophrenia, a disorder where psychosis is the predominant feature. I was in a mental hospital for only a week and responded well to antipsychotic medication. So much good has happened since.
I got my masters in creative writing, bought my own little whitewashed house in a small village, and rekindled love with my childhood sweetheart, Paul. If you had told me in 2009 that I would be sitting in my own office, with my own cat, my partner cooking breakfast, while I was writing for the Los Angeles Times, I wouldn’t have believed it. I thought my life was over after this diagnosis. But recovery is possible.
I have since been diagnosed with schizoaffective disorder, which is slightly less troublesome than schizophrenia. I learned to live with my paranoid thoughts, and as I did, they took over the real drivers of my life: love, family, and good food and drink. I even started driving my own yellow sedan on the country roads where I live.
As you drive through your own streets of Los Angeles, I implore you: please don’t abandon people with psychosis, especially if you find them in crisis. There is hope – and a cure – for them. And sometimes the first step is a caring soul noticing that they need help.