Psychosis has been described as temporary insanity

My intention here is to share the experiences I had with my son, beginning with the first manifestation of his illness and our journey through the many subsequent episodes. As a parent and psychiatrist, I also provide commentary on the issues this experience raises, such as how the mental health diagnostic process works, how to work with treatment providers, and medicine problems. I hope this can be helpful to people with mental health issues, as well as their families and friends.

What is psychosis?

To understand how Bill’s illness developed, it is necessary to understand the psychosis that became a core feature of his illness. Psychosis can be either a temporary condition, usually described as “temporary insanity”, or part of a psychotic disorder, as described in Diagnostic and Statistical Manual Mental Disorders, acclaimed cookbook psychiatric profession. Cookbookbecause while it does a good job of classifying and distinguishing between different diseases, it only provides a list of ingredients that make up a specific diagnosis rather than a deeper understanding of the disease itself. To a person experiencing psychotic episodeLife takes on a different reality, and often they don’t realize how bizarre some of their ideas are. This is what mental health experts call failure. reality testing.

Psychiatry is structured around a taxonomy of more than 300 individual diagnoses, differentiated by criteria of timing, co-occurrence and severity of symptoms. A particular symptom may be part of several classes; for example, depressive symptoms may be part of several disorders, such as major depression, bipolar depression or post-traumatic stress disorder. Two patients with the same symptoms may receive different diagnoses—depending on the co-occurrence and timing of other symptoms—and a patient’s primary diagnosis may change over time, for example, when a person first diagnosed with depression may later be diagnosed with bipolar disorder.

Bill’s diagnoses at various times included schizophrenia, bipolar schizoaffective disorder, and bipolar I disorder with psychosis. These soft labels cannot convey what the patient experiences: the annihilating dissolution of the self, merging with delusions and hallucinations; havoc wreaked on the victim and those associated with him.

Feeling of deja vu

Here we go again, I thought. My sleep pattern has changed. The activity seemed much more focused on exercise and Buddhism, but also more scattered. He looked at me as if he was trying to read something from my face – could I look into it and read his thoughts? Again the eyes with that hard-to-describe difference. More tense, intense, fearful and intimidating. The first psychotic break had some of the same elements.

The next day he did not have dinner, but went out to the patio to practice. He had cigarettes with him and he was smoking firstly, something clearly prohibited. He shyly smoked a cigarette dangling from his mouth, James Dean style.

I ran into him and he said, “Yes, herbs cutting through the vessels and restoring blood flow.” He tensed his neck muscles and folded his arms in front of him, turning his shoulders forward. “I’m testing my grip. This is an ancient Eastern practice known to mystics.”

I asked what this meant, he replied: “By redirecting the flow of qi, I can direct the blood from the right side of my body to the left, which is weaker and needs to be redirected.” I told him I thought he was starting to get sick again.

He said, “You don’t understand. I’m a big T.

“What is this?”

“Big testosterone. Some men concentrate testosterone in their necks, they think too much and it suffocates them. Black men know how to control their belly grip. They don’t worry, they are in harmony with their muscles. I’m Black Chink. I’m in balance.” He told me that his new ability to “grow blood” made him a much faster runner.

“Mom, I can run Forest Park in 30 minutes. If you don’t believe me, I’ll show you. Let’s go.”

Emergency room or not

I briefly considered the prospect of taking him to the emergency room that night to deal with the whole emergency room scene, the long wait, the mandatory exam, then being seen by a resident, and then being told everything was fine. just like last time. Previously, when I took him to the emergency room, they told me he was sick. sociopath.

Should I have taken it? I think the answer would be yes if I hadn’t been able to assess the situation and make sure he was safe. In general, I would recommend referring a family member to the emergency department for evaluation if they are discussing suicide or any desire to harm oneself; they need to be assessed for possible hospitalization to ensure their safety. If you suspect they are hearing voices, becoming more agitated, or experiencing other symptoms of worsening psychosis, this should also be done. wise undergo testing to determine the underlying cause and ensure they receive appropriate treatment.

For me it was a fraught situation. It would be nice to have an independent, neutral assessment and not have to take on the psychiatric task of deciding for my son to wait. However, given my psychiatric knowledge and training, it was obvious that Bill was not in immediate danger, and I did not want to expose him and myself to unnecessary examination in the ER. I decided to wait until morning.