What Not To Say To Someone With Psychosis

Psychosis happens amongst people with the mental illnesses schizophrenia, schizoaffective disorder, post partum psychosis, and sometimes those with bipolar disorder, borderline personality disorder and severe depression. Psychosis is experienced in two different ways; hallucinations and delusions.

Hallucinations are when a person hears, sees, smells, tastes or feels something that isn’t really there. It’s a sensory experience that happens without any outside stimuli. The world around them is perceived differently to everyone else, with others not being able to see, hear, or feel what they can. The whole experience feels very real to the person experiencing it. One of the most common hallucinations is hearing sounds and voices.

Those with psychosis often lose touch with reality and suffer delusions. Delusions are when you believe wild theories and beliefs that often have no evidence based in fact. People may have what’s called ‘delusions of grandeur’ where they may feel like the most important person in the world. They may believe they have powers or intelligence above and beyond anyone else.

Since being open about my experiences of psychosis, I’ve had many ‘helpful’ comments and sometimes some that are just downright insulting. So I’ve put together a list of the top comments that really shouldn’t be said to anyone with psychosis.

“Does that mean you’re violent?

This one comes up again and again. A very small minority of people with psychosis are dangerous. The vast majority are actually far more at risk of being a victim of violence and crime than committing one. Psychosis in fact makes you feel extremely vulnerable and scared of the world around you.

“Have you taken your meds?”

I find being asked this condescending and just rude. When I’m going through an episode of psychosis, being asked this question is not helpful. It actually makes me feel more paranoid than I already am.

“I’ve had hallucinations when I took…”

Ok, you may have taken an hallucinogen at some point, but it’s an entirely different experience when you suffer with psychosis. You have no idea when the next episode may happen, you can’t pick and choose how and when.

“You must be really mental, shouldn’t you be in hospital?”

I have lived with psychosis since I was a teenager and I’ve learnt how to cope with the voices I hear. When I have delusions I rely on my partner and family to keep an eye on me and my behaviour. It is possible to have an episode of psychosis and manage it without hospitalisation. Believing I should be locked away is deeply stigmatising and creates barriers to people discussing it. I might be having an experience that person finds uncomfortable and doesn’t fully understand, but that is on them to educate themselves, not for me to hide away.

“It’s just like having an imaginary friend isn’t it?”

I hear voices and no, it’s not like having an imaginary friend. That’s because children use their imaginations to create stories and scenarios. Psychosis feels like it’s coming from an outside source, from outside your own inner monologue or imagination. Imaginary friends are often a source of comfort to the person. Although voices can sometimes be a positive experience, they can also be deeply frightening and disturbing.

“That’s such a stupid thing to believe!”

Confronting and arguing with someone about a delusion they are experiencing is not helpful. It may sound ridiculous to you, but to them, in a midst of a psychotic episode it is very real. You can’t convince someone to start looking at something in a different way. They’re unwell and need understanding and support. Empathise with their situation and what they’re going through. Try and focus on what might be troubling them and what you might be able to do to alleviate the stress they’re feeling.

“Just stop thinking about it!”

This doesn’t work. It might be frustrating trying to understand, but you can’t just snap out of a psychotic episode. I literally can’t stop thinking about the delusion or the voices I’m hearing. Often the person just needs to ride out the experience if they’re having hallucinations. Instead focus on asking what you can do to help them. Be gentle in your questioning and stay calm.


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