Psychosis refers to an abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a “loss of contact with reality”. People suffering from psychosis are described as psychotic.
A psychotic break with reality produces only one of the few base emotions - fear. You can argue high and low, but every subtle emotion that one feels during a psychosis flows forth from fear. A psychosis, however, is often not a loose condition. No psychiatrist worth his or her money will diagnose you simply with being psychotic - the psychotic state of mind is closely tied with the disorders of the schizophrenic spectrum;
- schizoaffective disorder
- schizophreniform disorder
- schizoid personality disorder
- schizotypal personality disorder
There are others, but they’re not schizophrenic spectrum disorders, they are simply psychotic disorders. We’re going to look at the schizophrenic spectrum today, because there are two types of symptoms all these disorders have; positive symptoms and negative symptoms.
- POSITIVE SYMPTOMS - Positive symptoms are symptoms that most individuals do not normally experience but are present in the disorder.
- NEGATIVE SYMPTOMS - Negative symptoms are symptoms that are not present or that are diminished in the affected persons but are normally found in healthy persons.
- hallucinations; a hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space. There are various forms of hallucinations - auditory (hearing), visual (seeing), olfactory (smelling), gustatory (taste), tactile (temperature, pain), propioceptive (feeling, as in body pressure) - and a few more, but the above are the most likely involved in the schizophrenic spectrum, the most common being auditory, visual and propioceptive. Following will be a personal experience portraying visual and auditory hallucinations exclusively.
I woke up in the middle of the night at my (then) boyfriend’s house - his bedroom was on the attic and the house was an old one, built somewhere around WW2. I had to be careful descending the stairs as not to wake up his family, whom slept on the first floor, because the stairs creaked. I did my thing and went back upstairs, up the first flight of stairs which inevitably creaked under my weight, and went up the second flight of stairs.
I suddenly felt a sense of fear, dread, and paranoia wash over me, because I heard the first flight of stairs creak again and I knew for a fact they weren’t supposed to unless it was in connection with weight being introduced to them. I quickly and quietly went up the second flight of stairs, which also creaked, but because it was new wood, in contradiction to the first flight. I was almost at the bed, when I heard the second stairs creak again, without any introduction of weight that I knew. Obviously, I panicked, and jumped in bed in absolute fear. Suddenly, the walls burst out in shadows of almost a million people like figures, and the next thing I knew, two tall, shadow-y figures were walking towards me, with exaggerated bodily proportions (tall, spiney arms and legs and really thin elongated torsos).
Needless to say, I woke up before I knew it, having passed out from absolute fear, with muscle aches and a stiff body - a realistic result of the term “frozen in fear”.
- delusions; a delusion is a belief held with strong conviction despite superior evidence to the contrary. Arguably, it’s my belief that delusions are a lot more devastating than hallucinations, because in some - most - circumstances, there’s an opportunity to remove yourself from a hallucination. With a delusion, this is not as easy. There’s also the opportunity of reasoning with yourself when it comes to a hallucination, whereas with delusions, it’s your logic that’s warped - the one thing you need for reasoning with yourself.
I woke up one night, for a reason I still have yet to find out, because taking my medicine, I usually don’t wake up until well into the morning. But there was something. For some reason, I didn’t feel safe, there wasn’t even a reason for me to feel like that. Slowly but surely, this idea, this belief, began to form and evolve in my head. There was someone - or rather something - in my house, looking for me.
Normally, these are reasonable ideas, but the problem was that it became more surreal with every passing minute. This thing, it didn’t walk. It hovered, or floated, from room to room. I could just see it in my mind, which its grin and its top hat, and the unreal way it could and would turn its head. I knew that this couldn’t be real, but I couldn’t talk myself out of this belief regardless. It was there, it was in my house, and if I stayed in bed, it would surely find me - it was just a matter of time, with its systematic searching of rooms - and I would meet a fate almost worse than death, I was sure of it.
But I was posed with a problem. Now that this belief was firmly rooted in my mind, and my fantasy just started adding details into the belief, making it even more realistic (for my now-warped logic), I knew that, while I had to leave my room and find a safe place to hide, if I left, there was a chance it would also find me and kill me.
It took so much courage to get out of bed and run downstairs where my mother was still sitting in the living room. For some reason, this thing didn’t like to be seen by other people, and it loathed daylight, so I simply fell asleep on the couch, and when it was light, I woke up and went back to my bed again, as the danger had passed.
NEGATIVE SYMPTOMS - When I see people play characters with a psychotic or schizophrenic spectrum disorder, they always forget to incorporate or fail to know that negative symptoms are also very present. They are the following;
- social withdrawal; many people suffering from any of the schizophrenic spectrum disorders will impose a social isolation of some form on themselves. This can be just from strangers, or it can mean that the person does not care for social contacts, and will therefore not have any, or at least not a lot. It can also go as far as to socially isolate oneself from absolutely anyone, including family. This can be for its own reason, due to social stigma from having hallucinations and delusions and not knowing how to handle them or how others will look at them because of it, or because of a delusion in the manner that others are a danger.
- anhedonia; this is a big one. Anhedonia means ‘the inability - or diminished capability - to feel or experience pleasure’. This isn’t just pleasure in the purest sense of it. It means satisfaction from activities you do or partake in, general happiness, et cetera.
- avolition; this is simply lack of drive, or motivation. You can see how it ties in with the other negative symptoms, and generally, a person with avolition doesn’t see the need to do anything, because the motivation lacks - this can be for differing reasons. They can want to do something, but they remain stagnant, and never do what they know they should, want, or say they’ll do.
- alogia; also known as poverty of speech, it doesn’t mean that a person has a small vocabulary, or that they talk absolute gibberish (while this can be part of schizophrenia, it’s not a necessity). It’s simply lack of additional speech, in which you only answer a question as it’s asked - “Do you have a brother or sister?” “Yes.”
There are more negative symptoms, such as attention control defect, formal speech disorder - from simply losing your train of thought mid-sentence, to the infamous “word salad” - but now that you know that negative symptoms are just as important a part of the schizophrenic spectrum disorders as the positive symptoms are, you can further your research on Google.