At the beginning, you know you're mad. I remember the first hour or so, I was thinking "no fucking way this is real". But it feels so real that you quickly stop believing anyone who says otherwise and you mark them as the enemies. Your head keeps inventing reasons why is it real and the voices keep explaining it - in some cases it's religious experiences, in my case it's hyper-advanced technology enabling telepathic communication.

I didn't think it's the Star Trek from movies, I just thought we somehow made it work in secret and now I'm on it too. Paranoid people aren't paranoid just so, they are paranoid because there is a brutal mismatch between their perception of reality and what people tell them.

At one point, in a different situation, I knew I'm in the middle of psychosis - and my voices told me all about super-agent-psychiatrists who are trying to help me by doing James Bond-style interventions. So yeah, you can simultaneously know you're right in the middle of it, and discuss the situation with your delusions, while thinking the delusions are real.

How do you know it isn't true? Philip K Dick came to believe in his psychosis visions (he believed he truly was in Rome in 60AD or so but was being fed a created world by the Romans). But he had good personal evidence for it that he couldn't deny even in a non-psychotic state. Do you have anything like that?

I guess a better way to phrase it is, do you have compelling evidence that your beliefs are true that you have to force yourself to ignore, or does it just seem like nonsense when you aren't in a psychotic state?

Not OP, my manic episodes come with extreme paranoia, and I have had two psychotic breaks during really bad ones. This may be a completely different experience. Apologies if I sound a bit flippant.

For myself, my brain always knows what reality is because all of my senses work. Delusions are clearly internal. My self-awareness is firmly in reality but all I can do is watch myself react as if the delusions are reality.

Many people can’t grasp this. Awareness and control are always linked. “Blind rage” is just that. Awareness is gone.

I hope no one else ever has to experience being powerless in their own body and screaming uselessly in their head to make it stop.

As horrifying as this sounds, these experiences don’t haunt me. I thought they were just burnout from stress and carried on like nothing happened afterwards.

“Normalization of deviance” doesn’t even begin to describe my life experience. Eventually, I was convinced by my doctor to see a psychiatrist for ADHD. It wasn’t until my third visit she realized I had severe, high-functioning bipolar. Once I got over a month of denial, it was “Okay. That does explain a lot.” XD

You're not suddenly irrational in a psychosis, you still have your logic working, just with crooked inputs. So it took me months to sort through some details and make sense of what actually happened and what didn't. There are some things I'm probably never going to be able to explain and I just have to leave it like that. But I don't believe any of my delusions happened, I just would like to know what happened.

All the voices, and the sense of urgency and danger go away immediately when you wake up after a dose of antipsychotic medication. Your first thoughts are that you lived through some weird things which are not happening at all anymore, and now there's a psychiatrist untying you from a hospital bed and handing you a cigarette, which puts stuff into context. You also probably feel the best you felt in weeks/months because it's your first night of sleep since forever.

I can easily imagine someone thinking "well, I had a psychosis, but there was shit going on". Fortunately that's not me.

This is your personal experience, but I'll note there are others who do become irrational along with having altered perception. It's hard to give generalized descriptions.

So, rather than just having some false facts, they will make bizarre "inference" steps in thinking that can border on free-association. In the case of one of my relatives, this process would accompany something almost like amnesia. After a burst of this illogical reasoning that gets way out into the weeds for tens of minutes or hours, she would seem to lose track of it and "reset" in some way to start again.

Out of this recurrence, you could start to sense an overall theme that was evolving at a different time scale, beneath all the illogical tangents. Even through different phases of treatment and remission, those themes would resurface as a sort of barometer of her illness. There wasn't always as stark of a difference between normal days and psychotic break days.

I really appreciate your responses (and ones others have made elsewhere in this thread), they give much better insight into what someone is going through internally than the clinical definitions I see.

Just a general piece of advice: when a person is discussing their struggles with psychotic delusions, its kind of messed up to say "Yeah, but how do you know they aren't real?"

While incrediblybadly phrased, I feel it is an honest question on how psychosis works.

Then again, I treat my whole life is a fascinating science experiment and people have to beg me to stop talking about it.

Why is it "messed up"? It's a genuine question

The answer lies in this - can a question be both genuine and "messed up"?

Given the context in this conversation about how confirming a delusion can be dangerous, I think the concern is just that there may be situations where asking this genuine and interesting question could cause harm.

I think probably that on balance you've got away with it though because the people commenting seem to be safely outside the other side of their psychosis and are able to answer interestingly without being harmed by the question.

Yeah, it was odd because the first time I told a psychiatrist that I heard voices, it was because of a split-second incident out in the street where I swear I heard a distinct vocalization from the vicinity of a traffic light. No human was there, of course, and the illusion was over before it began.

That was enough to slap a prescription on me for years to come.

Eventually I began to question why they kept wanting to prescribe this stuff and why one of the standard questions was always "do you hear voices?" and I also began to question their terminology. "What do you mean, by hearing voices?" "Oh, well, hallucinations." and I drilled down into their definitions and epistemology for a while.

I told them that I am a Christian, and of course I hear voices. People of faith, who are quite sane, discuss this openly all the time. We are always encouraged to listen to the voice of Jesus, the voice of the Holy Spirit, to listen to the voices of those who wrote Sacred Scripture. I told the doc that I'd be crazy (and lost, and significantly more troubled) if I didn't hear anyone's voice.

Of course they're probing for stuff to medicate, they're probing for irrationality, and they're probing for evil voices who goad us to do harm to ourselves or to others. And of course I was troubled by those types too.

But they weren't unreal. They weren't hallucinations because the sources exist in reality. They don't come from human bodies, but spirits are real to Christians.

The solution is not to medicate the voices or deny that the voices exist or to ignore the voices, it's to form our consciences so that we can stand up to lies, stand up to temptation, and resist evil. It's as simple as that. Whether the voices come from Mom and Dad, or social media, or television, or they're 100% in our heads, we need to discern their spirits, and deal with them according to our conscience.

It was so jarring that the doctors would be goading me to deny my faith in this way and to claim that if I heard a voice encouraging me in a moral direction, that it was fake, a hallucination, a disease. I have been so profoundly insulted. This is one of the many reasons I lost trust in them.

A hallmark feature of psychosis and schizophrenia is lack of "insight", meaning that the patient can't recognize that they are having delusions, nor the fact that they are suffering from the illness. The belief that you are a Star Trek captain feels as real as knocking on wood.

The illnesses simultaneously cause hallucinations that enforce delusions, and twist your belief systems so you pick up on the most insignificant details to support your delusions. Almost all patients end up believing that they are god, Star Trek captains, or stalked by a government agency, because this best explains their (hallucinatory) experiences. For example, if you hear voices in your head, the patient can't usually understand it as an illness, but has to explain it in some other way, so you end up with CIA/god/whatever beaming voices into your head.

Seems like when you are dreaming, where the part of you that can assess if something is realistic or not is shut down.

For myself, my imagination and view of reality merged. My senses were fine but all of the processing and my imagination started writing to the same memory spaces.

I was aware that my senses didn’t match what I was processing. It didn’t matter.

That's what happens to kids. Up to eight years old, if I recall correctly, they're unable to tell apart imagination from reality. If they think of something, say a monster hiding at home, it exists in reality. Which is a big problem while watching movies that can have scary parts as they now think they're real.

This is way, way different.

A six year old can perceive normally. They really don’t see people who aren’t there. They consciously know the difference between seeing a monster and thinking it exists. They can mis-attribute information by categorizing something they see as a monster. They play and they get really invested in it. Children are not psychotic. They are using their imagination to explore reality.

I see the monsters in the room. I spent four months as a bipedal wolf feeling wind in my fur and the motions of my tail. I truly believed I wasn’t human and the humans would kill me as soon as they found that out. My childhood memories were replaced by imagined ones.

I still remember being a wolf. It was real to me.

Well, the part of believing they are something they aren't, I agree, it doesn't happen to them. But I have kids and they positively believe there are monsters in the house, and they positively believe toys are alive, because they saw toy story. Nothing I can say will move them from that belief.

I've had sleep walking episodes for most of my life since I was about 5, probably driven by sleep apnea. I've also had experiences that are as real as this waking life while meditating and especially back in my party days.

The real awakening for me was when it finally clicked that we are always hallucinating everything. The mind separates our conscious awareness from the 3D world, like in Plato's Allegory of the Cave. So what we see and hear isn't what's objectively real, but what our mind interprets it to be. Even though everything is real in our subjective reality, based on the contextual state that we've built up from the sum of our experiences.

Some examples of mass psychosis:

  * Many people don't know that their boss charges more than they're paid in wages.
  * Many people work administrative and loss-leader jobs and perceive their work as a cost on the organization (programmers, engineers, most people outside of sales).
  * Many people think that those around them are more knowledgeable and/or experienced than they are, and don't realize that their manager or boss is mostly winging it based on a probabilistic estimate of the best course of action.
  * Many people think that they are more knowledgeable and/or experienced than everyone around them (egocentric people working in IT/tech, doctors, lawyers, billionaires, etc).
  * Many people think that everyone else shares their spiritual worldview, everything from a man in the sky to we're all one in universal consciousness.
  * Many people think that others don't share their spiritual worldview (Christianity and Judaism may not see parents giving up their meals for their starving children in a bombed out Islamic community).

How can we have civilized society, including free and fair elections, under such mass hysteria? When people have so many delusions that politicians can pit half the population against the other merely be selecting sides from a short list of wedge issues?

My personal feeling is that western culture can't really endure spiritual awakening. And that we are seeing the breakdown of western society under late-stage capitalism with societal psychoses like much of the working class having to pay 50% of its income in rents. And corporate-greed-driven inflation rising unchecked without updated tax brackets for progressive taxation. And social safety nets being shredded to create a desperate working class dependent on service work while corporate profits are at an all-time high.

I just wish I knew how to wake up from The Matrix, whatever all this is. The points above have concrete solutions like a national tenant union, enforcing antitrust laws, taxing unrealized stock gains the same way as property taxes on homes, etc. But those obvious solutions assume a level of lucidity that will probably never exist while the powers that be lobby the government and engage in regulatory capture while handing out million dollar checks at random to voters who selected the candidate that promises to cut rich people's taxes. All to keep most people worried about the price of groceries and immigrants stealing their jobs.

But hey, I'm the delusional one.

Edit: the best answer I've come up with so far, after suffering for a lifetime under self-imposed limitations driven by many of the psychoses above, was to quiet my internal monologue entirely, acknowledging each thought but not indulging it, just being consciously aware of the process of living, without attachment or expectation on outcomes.