The agony and ecstasy of psychosis

Content warning: some descriptions of psychotic delusions may distress

9th May 2022 sees the beginning of Mental Health Awareness Week in the UK and my contribution is following up on a previous post about my experience of psychosis because I think it is a topic, the detail of which is not widely written about, so people are not really aware of what it is and how it feels. Once I had experienced psychosis and was trying to make sense of what had happened and why, I couldn’t find very much to help me. The scientific literature is too technical for my GCSE Biology (Grade B, if you must know) and I didn’t find that many detailed personal accounts either.

Psychotic depression

I have lived through half a dozen bipolar episodes. Most were mania but the first was a psychotic depression which was quite earth shattering, I feared for my life in a delusion that lasted for a month, starting slowly with quite credible yet paranoid thoughts that my work computer had been hacked (by the head of IT no less) and ending with me convinced that I was a wicked and evil person, deserving to die and imploring friends then medical staff in hospital to put me out of my misery.

The peak of this psychosis came shortly after the Gulf War and Desert Storm, where pictures of the battles were televised. I became convinced I was the target of an execution order. This narrative then got entwined with the plot of plays I had studied at school a decade before, The Visit By Swiss playwright, Friedrich Duerrenmatt, where a millionairess returns to her home village to exact revenge on a childhood sweetheart, who had jilted her, by asking the inhabitants to murder him. My depression had come about following the end of a relationship and whilst my thoughts were not murderous towards my previous partner, I was not yet reconciled to our split. Also The Arsonists by Max Frisch, where two men (the arsonists of the title) infiltrate the home of a bourgeois and complacent citizen (Biedermann). The key quotation from this play that was obsessively going over in my head during that weekend, “Maenner wie Sie, Herr Biedermann, das ist’s was wir brauchen” (literally, “Men like you Herr Biedermann, that’s what we need”) i.e complacent and bourgeois. Yes, my bipolar aims high – not simple victories, but glorious battles of good versus evil.

I believed I was to have my limbs cut off (the millionairess in the play has several prosthetic limbs) and left to care for the six-month infant of my closest friends, who were also to be murdered. As you can see even from this distance, incoherent thoughts, some linked to memories, some to external events were shifting one to another like the crystals in a kaleidoscope – execution, revenge, disability and surrogate motherhood.

It was, however, truly terrifying over a number of days.

Mania and saving the world

By contrast, in my latest bout of psychosis I was in a state of ecstatic wonder. This because I was firm in the knowledge that I was about to reveal myself as the leader of a worldwide underground network and saviour of the world. A female Second Coming, living a quiet life until the time was right, until her true wisdom and powers were revealed to solve all the world’s problems at a stroke. All the signs were there and the moment for world peace was imminent. The practicalities of such a notion are swept away in the conviction that I was invincible, unstoppable and it was all coming together because of me.

Punning and word play as part of mania

When hypomanic or in full mania, coincidences and linkages become commonplace. On a tube journey one afternoon, weeks before a full-blown episode, a couple were talking to each other in Arabic, with the occasional English word. Every English one, however random in retrospect, linked back to me and I suspected that they were undercover agents, tracking me.

I arrived at one psychiatric unit telling the admissions nurse that I thought a spark plug was embedded inside me. She asked me why I thought that.

“Because I am a bright spark“.

During the case conference later that evening, attended by my GP, who I had met for the first time that morning when he came to my house to assess me then wrote the referral letter. I hardly knew him, but I did trust him. While waiting for the meeting to begin I held court, matching the names of attendees with characters from films. Thus when Ellie Thompson introduced herself, she became ET – “ET, phone home” I cheerfully told her.

I faltered with an African staff member until, inspiration came to me, a rhyme for his name, “Herge’s Adventures of Tintin” I announced, quite proud of the tangential connection.

The consultant gently told me that the meeting was now beginning and I should settle down and listen.

A week or so later, I had a visual hallucination, also linked to cinema, my obsession of the moment. One of the nurses was called Stephen White and he had a box file on a shelf in the nurses’ station which I saw as “ Snow White” and merrily chirped that I was being cared for by the same.

The 70s cinema advert for Martini ”Any time, any place, anywhere” became my signature tune whilst in hospital that time, even though I can’t stand the stuff. Its tagline “The right one” acted as a subliminal message to others of my special and messianic status.

When I am in the environment of a psychiatric ward these behaviours and utterances are somewhat tolerated as part of my condition and I can see that people not familiar with serious mental illnesses like bipolar might be alarmed or even frightened by them. I’m sure I was before I experienced them first hand.

Having done so though, it can be just as alarming to think back on what you said or did when unwell (if you can remember) and make some sense of it. After thirty years I am still trying to figure it out myself.