Beyond the Psychosis

One of the two main classes of mental illnesses is psychosis. In the field of mental health, psychotic illnesses are seen as major mental illnesses. This type of illness causes significant impairment in the functioning of the individual who suffers from the ailment. Psychotic persons are known by their loss of touch with reality which can be manifested in various forms.

It is quite common to encounter individuals whose reasoning or thoughts (as expressed by their speech) contain illogical themes. Logical thoughts tend to relate precedence, course, and conclusion with respect to issues at hand. Most of the time, the facts on the ground have no sufficient link with the conclusion arrived by the psychotic individual. For others, it might be quite difficult to follow their train of thoughts in a conversation.
Their speech may contain themes that are not linked together or include irrelevant and distracting themes.
Some other unusual experiences include hearing of sounds or voices not heard by other people around, or seeing strange things (objects or people) not visible to other people in the same place.
There are lots of other experiences they have and, the behaviors they exhibit that does not conform to what is expected or what is regarded by the generality of the entire populace where they find themselves. These could be their family, neighbors, or other people they come in contact with in their day-to-day activities. Above all, they lack an understanding of the nature of their experiences. They tend to reject the suggestions that their experiences might be a treatable or manageable illness. Individuals who accept their experiences as being abnormal might choose to associate such experiences to odd or esoteric causes.
            The psychotic episode is quite distressing to the person experiencing it and the significant others in their lives. In my own experience as a clinician in the field of mental health and from my research, the significant others in the life of a psychotic person tend to suffer significant distress. This distress might even be more intense than what is experienced by the person who has the primary illness. It is quite easy to get distracted by the overwhelming nature of the psychotic presentation, while we overlook some basic facts about the person who is ill and their caregivers. Our response towards the person who is ill and his/her psychotic experience can be erroneously influenced by our stereotypic understanding of what the causes, course and the consequences of the psychotic episode really are.

   Beyond the psychosis, there is a person whose personae has been distorted by an illness. What we tend to see is no longer the real personae but an adulterated one. That is why after the right treatment and resolution of the psychotic symptoms with a return to normalcy, the individual might even challenge the fact that they had previously behaved in the manner being reported, or deny the fact that they expressed what is being recounted about them. By that time, they have regained their touch with reality.

When you see anyone on the streets because of a psychotic illness, always understand that the person isn’t vagrant because of the illness, but, because of the failure of the support system that is supposed to help them get over their condition.

The support system might be the family, the government or other non-governmental organizations. There is a possibility that there are other individuals who have worse clinical conditions than the person on the streets, who are not on the streets because they have a reliable and responsive support system, that had rallied around them to provide the necessary medical attention that they need.

Beyond the psychosis, there might also be an ignorant family or community, a failed healthcare system, or a poorly responsive government.

We still have persons who have psychotic illnesses that are kept away from the hospital for longer than necessary because the family members don’t want to be “tagged”. When they eventually choose to visit the hospital for treatment (after visiting alternative non-health service providers for many years), the psychotic individual would have lost a lot in terms of livelihood, family, relationships, etc. Many have an erroneous belief that it is very expensive to treat mental illness in the government hospital. Others believe that the illness is spiritual, hence the symptoms will not respond to medications. When they eventually come in contact with the hospital and experience the contrary, they feel terrible for delaying their visit to the hospital!

The failure of the healthcare system to provide sufficient professionals, who are well trained to diagnose and treat mental illness at the right time, is probably one of the reasons why psychosis might not be diagnosed promptly. There have been cases of psychotic persons who present to “quack” health professionals who provide the wrong treatment and eventually ask the individual to seek alternative or spiritual intervention! Sadly, it is still happening.

 We need to look beyond the psychosis and explore some of these critical issues that allow psychotic illnesses to still be highly stigmatizing in this part of the world.

We need to begin to strengthen our health system by employing specialists and, building the capacity of our existing professionals towards being able to provide efficacious treatment and referral (when necessary);

We also need to educate the general populace to know more about psychotic illnesses, have a clearer understanding of the causes and the options available for care.

Beyond the psychosis,

Is a person who needs us all;

To hold his/her hands

And be the “eyes” through the darkness of the illness,

Into the light of reality.

Remain safe and sane; help others do the same!!

Ola Ibigbami


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