Psychosis and insight - do you know when it happens again?

I came across this thread on crazymeds forums. It didn´t get a lot of answers, only 2. So i decided to steal the thread and post it here.

The question was do you know when it happens again, when you have a relapse can you tell you are relapsing or do you again as the first time it happened believe everything that is real?

Pdoc told this person that once psychosis happens to you that the next time you will know.
What do you think? What are your experiences?

I only had one episode so i cant tell, but i hope this is true. I mean if i get some symptoms occasionally i can tell they are symptoms, but i am unsure if i could do this for a full blown psychosis. Maybe i could because i have experience with it?

This is just me… it depends on what is happening.

If hallucinations are coming up… I can usually tell it’s the head circus acting up and it’s time to decompress… get away from the over stimuli… or get some help.

If it’s paranoia… I know where that leads… anxiety spike and panic attack… that will trigger an episode. I can work on that too…

If it’s delusions… I usually need some help talking those through… but there are some times were what I believe doesn’t interfere with getting through my day.

If I’m manic… I don’t always catch it until I’m in need of help. But if I’m feeling empty… flat… and drained of all motivation… I can feel that and work to get out of the negative swing.

I do believe that we learn to recognize and catch ourselves…

I’m on meds… and in therapy… and I have some trusted people on my side.

If someone wasn’t medicated… no support system… no therapy… no help… they might not be good at recognizing when things are slipping.


Yeah but those can be just symptoms. At least they are for me. Light symptoms. I understand and dont let it bother me and i try to overcome that.
When it first happened to me i had those symptoms combined and much more intense. At the same time i dont know how i believed those things i should have recognized something was wrong :confused:
I think that maybe i could now, but im not sure. Full blown psychosis is a b***h.

I can tell for a while, like a period of days, then I’m in trouble as I lose touch with what’s going on.

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Yeah I can tell. I had a full blown relapse last fall. I notice my thought patterns and slipping in and out of reality, as well as the hallucinations. What do I do when I think I am showing the telltale signs? Cut back caffeine to only in the morning and keep my mind busy- “use it or lose it.” Use my mind or else watch it disintegrate.

It’s also a matter of consistency; when I keep having the same horrible day over and over again, that’s no good. When I can identify what is making one day horrible and it checks out as a legitimate reason for a horrible day, it’s just a bad day.

Now when I have really annoying intrusive thoughts and keep hallucinating for no good reason other than “well that’s schizophrenia” I shouldn’t be resigned to “that’s schizophrenia” because I am heavily medicated to keep that state of mind away.

I can tell if I am stable or relapsing by having gone through a full blown relapse. The telltale signs are not exactly the same for everyone, but there are some workbooks on relapse prevention which were obviously written by experts (pdocs and clinical shrinks) which list lots of common relapse symptoms.

I know I am not okay when I am having trouble paying attention and sitting still, particularly I know I am in the shits when I feel a constant impulse to scream.

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I can tell when I start slipping. I used to try to fix it on my own, but now I tell everyone in my support system, because I know from experience I need outside help to get through it. I just had a mild episode last night. I told my fiancé what was happening, and if it lasts for three days to check me into the hospital. Luckily, he kept reminding me of my coping strategies, and we were able to put me back in reality after like seven hours. Having someone I can trust who can view things objectively is essential for me.

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I’ve only had full blown psychosis twice. When that happens, I have no insight. The rest of the time I have insight. I sometimes doubt I have schizoaffective disorder.

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I’m not worried about psychosis because when I was in it I was pretty happy. There is a negative psychosis I sometimes have to endure, but it is mild and easily tamed by nostalgic music from my gaming days.

I think I don’t realize I’m in an episode until the episode is ending. I know all my warning signs but it’s like it doesn’t click that I’m in one until it’s almost run its course.

Mainly I just try to avoid things that set off episodes for me. (Which isn’t always possible…sigh…)

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My psychosis isn’t pleasant. I would say it’s an entertaining yet unpleasant experience.

I kind of envy that.