Hi, guys. Can I get opinions (or facts, if they’re out there) about where the line is between experiencing psychotic symptoms and having a psychotic episode or break?
Some people have described first episode psychosis as like an explosion on their head, their brain on fire, etc. Is it always like this, or can there be a slow aggregation of symptoms that eventually overwhelm you? And if the latter, where’s the line? It seems subjective.
And a second related question: Is it possible to have an undetected psychotic episode from which you return to relatively pre-episode functioning without intervention?
Any thoughts on any part of this would be very much appreciated.
I almost walked naked down the freeway with nothing but my guitar. Thankfully my wife stopped me. I was headed out the door with nothing on but a crazy smile.
I think an episode is when the symptoms are interfering with day to day life that you can’t function. At this point you may have to be hospitalized or get extra help to cope/manage at home. I think you can be symptomatic and still function and it’s not an episode-you’re able to cope on your own. Everyone presents differently-sometimes with a rapid onset of symptoms or slow insidious progression over weeks or months.
I think the main difference is that psychotic symptoms just linger there for a while, we are able to manage them and deal and have an everyday life.
In a psychotic break you lose touch of that reality and things just become different, unreal and you’re no longer able to manage those symptoms so well.
Thanks, that’s helpful, and more or less my understanding. I had a period in my life that lines up exactly with average onset for first episode psychosis in women, where I was definitely experiencing symptoms, was definitely preceeded by a typical prodromal period, and definitely followed by things people describe as a post-break experience - cognitive decline, depression.
But it didn’t constitute what I would consider a break with reality, and I was able to function throughout, and friends, family and my employer didn’t seem to notice anything. I’ve just been a little concerned that it might have been an episode and I didn’t recognize it.
Your story is similar to mine I guess. Looking back it’s hard to decide if it was an episodic or just symptoms rearing up. I went undiagnosed for about 10-11years and managed the ups and downs of the illness by myself and no one knew, maybe suspected.
Now that I’ve got the SZA dx I’ve really spent a lot of time, esp lately trying to figure out what was going on all those years. I always chalked it all up to depression it wasn’t until the past 3 years that I’ve acknowledged hallucinating, it was always there, but I managed. I could tell reality from the hallucination so no one knew and it was normal for me, so I didn’t know something wasn’t right.
That’s the same exactly with me. I don’t remember ever not having hallucinations, or ever thinking they were real beyond a second or two. I’ve just always thought, Eyes are weird! Oh, hearing things again! Must be tired!
The time I’m referring to involved a lot of anxiety and paranoia on top of that, so definitely new and troubling symptoms, but I was able to navigate it.
Anyway, I’m not diagnosed yet. My doc and I are working through it. It just seems like there’re a lot of grey areas.
It takes time, be patient with yourself and pdoc. My 1st hospitalization was 3.5 years ago, then it took about 1.5 years to settle on a dx. Mostly it took so long because I was in denial that something serious was wrong and I hid my symptoms very well. I never told the docs what was really experiencing, because of intense distrust of therapists. It wasn’t until my 4th hospization that I finally admitted to hearing command hallucinations that I could no longer ignore.
I came because I was experiencing psychotic symptoms, and this was the first place I found where those symptoms were described and discussed in a way I recognized. I found this place while looking up new visual disturbances I’d been experiencing.
I think you’re a terrrific presence in this forum. And, as I told you before, I really hope you don’t have sz and still stick around. But you’re going to be able to handle whatever diagnosis you have. I’m sure of it. We’re strong!
I think for me, I didn’t recognize that these things were anything to report. I spent a lot of time in therapy and under a doctor’s care, but if they had asked “do you ever see things other people don’t and you can’t explain,” I would say no - everyone sees things like this and it’s because your eyes are sometimes glitchy and also your brain sometimes misinterprets input into other expected forms. I’m understanding slowly that while the second part may be true, the first part is not, at least to this degree.
Thanks, guys. I know there’s a lot of angst in this place about who belongs and who does not, and it can make it difficult to phrase and interpret what should be a straightforward question. We’re all good, but it’s really nice to be appreciated
