Psychosis and Mania
Course and Guide
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Psychosis
Disorganization
“Do you have a messy desk?”
- Disorganization is a core feature of schizophrenia. Disorganization is felt by all people, but for people living with severe mental illness, their entire world can become disorganized and chaotic.
Do you sometimes have a hard time explaining yourself?
- All people from time to time have a hard time getting their point across. Miscommunication is commonplace, but for people living with mental illness this state of confusion and difficulty communicating can become the norm.
Disorganization can be in both thinking and behavior.
- Examples of how it feels to have disorganized thinking:
- Having trouble finding the right words to express your thoughts.
- Trying your best to explain yourself, but people simply can’t follow your logic, no matter how obvious it is to you.
Delusions
Delusions are fixed false beliefs. These are beliefs that are held, even after contrary information says that the belief is not true.
Do you ever feel like people are taking advantage of you? Like a car salesmen?
- Most people feel paranoid when dealing with salesmen. Are they telling me the truth? They don’t care about me; they just want something from me.
- People who are paranoid may feel as if the entire world is full of people concealing key information and trying to take advantage of them.
Grandiose Delusions are a common form of delusional thinking especially in people who are psychotic during mania.
- Do you ever overestimate your abilities? Maybe badly?
- Overestimating abilities doesn’t become psychotic until it’s very far from cultural norms.
- Whether it’s delusional or not, the feeling of overvaluing abilities is the same for people living with schizophrenia and those without.
- People who are psychotic sometimes have grandiose delusions and believe they have special powers, such as reading minds or predicting the future.
Are you superstitious? Do you believe in ghosts?
- The only difference between psychosis and the belief in ghosts is that believing in ghosts is culturally acceptable and doesn’t cause serious impairment.
- Do you feel like you know what’s best and other people should learn from you?
- When you have a discussion or an argument, and you’re sure your right about something, don’t you want other people to agree with you, and do as you suggest?
- When you’re feeling in the right, it’s the same feeling people with psychotic beliefs feel – they simply know they are right.
Lack of insight
Delusions, by definition require a lack of insight. If you know that what you’re believing isn’t true, it’s not a delusion.
Lack of insight is a human condition, it’s not even a little bit exclusive to people living with mental illnesses.
Have you ever said, “I’m fine, I don’t need to go to the doctor.”
Delusions, by definition require a lack of insight. If you know that what you’re believing isn’t true, it’s not a delusion.
Lack of insight is a human condition, it’s not even a little bit exclusive to people living with mental illnesses.
- Think about people who overestimate their abilities: singers on talent shows, people who believe they can make the PGA (when facts contradict this belief).
- A gym consultant surveyed their gym members and asked them how often they actually went to the gym. The typical answer was, “Five times a week.” But according to the scan cards that the gym used, the number was closer to 2 – 3 times a week.
Have you ever said, “I’m fine, I don’t need to go to the doctor.”
- It seems that most people have made a statement similar to this one. People can be very bad at estimating their health.
- This lack of insight is true for “normal” people, and it is true for people living with mental illnesses as well. But when people living with mental illness don’t attend to their illness, they are labeled as non-compliant or looked upon with anger, “Why don’t you just take your meds!”
- Do you refuse or procrastinate going to the doctor?
- Do you tell yourself your health is fine, even if there’s limited evidence that you’re fine: You have no lab results, you may not even know your blood pressure.
- Holding an incorrect belief despite evidence is a fixed false belief, which is a definition of a delusion. Believing “you’re fine” despite not having any objective evidence is the first step towards a delusion.
Hallucinations
Hallucinations happen when a person experiences a sensation without any actual stimulus from the environment, like hearing a voice when no one is talking.
•Ever been alone and hear your name called an no one is around?
•Have you ever heard from or believed you communicated with a loved one not around?
•Have you ever seen evidence of a ghost?
•Ever been alone and hear your name called an no one is around?
•Have you ever heard from or believed you communicated with a loved one not around?
•Have you ever seen evidence of a ghost?
Negative Symptoms
Negative symptoms are when normal functioning and behavior is “taken away,” or “subtracted.” So when a young man stops shaving and attending to his hygiene and isolates from his friends and family, he is experiencing negative symptoms.
- Do you ever feel like doing nothing?
- Seeing no one?
- Being left alone in your own filth?
Withdrawal is a common symptom of schizophrenia
In fact, schizophrenia doesn’t require hallucinations and delusions; one can be schizophrenic and be disorganized and withdrawn.
These symptoms are seen in stereotypical portraits of homeless people who are living with schizophrenia – long beard, unkempt, not bathing, not talking with other people. These are the homeless people who the other homeless people don’t want to hang out with.
Mania
Mania is an essential component for the diagnosis of Bipolar Affective Disorder. It is an elevated, expansive, with increased energy, and goal setting, that last at least of week, or less if treatment in a hospital is required.
Symptoms of mania can include
Symptoms of mania can include
- Feeling overly happy for an extended period of time.
- An abnormally increased level of irritability.
- Overconfidence or an extremely inflated self-esteem.
- Increased talkativeness.
- Decreased amount of sleep.
- Engaging in risky behavior, such as spending sprees and impulsive sex.
- Racing thoughts, jumping quickly from one idea to another.
- Feeling agitated or “jumpy.”
- Easily distractible.
Have you ever felt fantastic, ecstatic, like you were “on top of the world?”
Can you imagine what it would be like to win the lottery?
Can you imagine what it would be like to win the lottery?
References
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