We must be careful not to let one case define psychosis in general, as each case of psychosis can be as unique and varied as fingerprints. Psychosis can draw from and play upon your deepest insecurities, memories, and relationships in a way that is deeply personal and customized. Alternate realities and false narratives are created by your brain through reshuffling what it has already experienced, and it seems 100 percent real.
Psychosis can present in infinite variations that are categorically different, so to learn of one publicized case and apply that understanding to all cases of psychosis is misguided and harmful for the vast majority of people who experience psychosis. One may assume that one case of psychosis is just like any other, but that is not correct. We should not define, judge, or epitomize an illness through one instance of psychosis and make decisions and judgments for everyone with that illness accordingly.
Every Case Is Different Based on Numerous Factors
Psychosis as a mental health condition is diverse and varied in many ways. There are psychotic-like elements (PLEs), one-time breaks, and chronic disorders. Cases range from mild to severe.
Some people black out, and others remember everything. Some have insight that they are experiencing psychotic symptoms, while others do not.
Some people hear voices, and others don’t. Some elements of psychosis, like hallucinations, can be friendly and helpful, but others can be mean and scary. Some people have psychosis for days, some for weeks, some for months, and some for years.
Some people can manage at home under careful supervision of family, and others need to commit themselves to a psych ward. Some people just need to be in an emergency psych ward to recover, while others need to be institutionalized in a state hospital.
Some people choose medicine, and others are determined to go without it. Some people experience debilitating side effects from antipsychotics and cannot get them resolved, while other people have milder side effects and can manage them. Antipsychotics offer a good prognosis to a third of patients, a moderate prognosis to the middle third, and then a poor prognosis to the last third.
Psychosis and psychotic symptoms can be caused by many other medical conditions besides SMI diagnoses, including, but not limited to: thyroid diseases, urinary tract infections, brain tumors, systemic infections like HIV, Alzheimer’s, Parkinson’s, multiple sclerosis, vitamin deficiencies, and lupus.
The Issue of Violence vs. Nonviolence
Perhaps the most debated and misunderstood difference among psychosis cases is the likelihood of violence. It is possible to break the law during a psychotic break, and in rare cases, violence like homicide occurs. However, the tendency to think that anyone psychotic is instantly dangerous is misguided and incorrect. In fact, 80 to 90 percent of people with a psychotic disorder are not violent at all, and I am an example of total nonviolence.
I was diagnosed with schizophrenia 15 years ago, and have been completely symptom-free, meaning literally zero mental health symptoms, for at least 13 years. I remember everything from each of my four psychotic breaks, and not once did I have a single violent word, thought, impulse, behavior, or desire. I do not have any violent inclinations in remission, either. I gave birth to a son during full recovery, and I can assure you I am no different than any other mother.
The Ultimate Tragedy: If We All Lost Support and Resources
More people fully recover from psychotic disorders than ever before, including schizophrenia, due to improved medication options, therapies, and resources in general. The World Health Organization states online that a third of all schizophrenia cases fully recover.[1] I am an example of someone who lives 100 percent mental illness-free while on antipsychotic medication for life.
Psychosis Essential Reads
It would be the greatest tragedy for any one case of the illness to influence support and resources for people with psychosis in a negative way. The existing support system and resources saved my life and made it possible for me to still achieve my life dreams and also give back to the mental health community. Furthermore, withdrawing support and resources for people with psychosis would just guarantee more tragedies like the ones that make national headlines.
Why You Don’t Hear Many Positive Success Stories
I know there are a lot more people like me who just aren’t public about their illness like I am. If you are fully recovered, there is no motivation or benefit whatsoever to sharing a stigmatized diagnosis and painful experiences if you don’t need to apply for work accommodations or explain any existing symptoms in social relationships.
Because of this, though, there are limited means to learn of a sufficient number of cases of psychosis and see how they vary, as well as see how the vast majority are nonviolent. Unfortunately for most of the public, their only exposure is what is presented in the media, where selective exposure on cases involving homicide is the norm. The media is less likely to cover a positive success story like mine, because a rare story covering homicide that feeds on fear and typical stereotypes gains higher readership.
To illustrate just how rare violence is associated with schizophrenia and related disorders, here are the latest facts, so we don’t generalize about psychosis based on one instance of the illness.
Essential Statistics on Psychosis and Nonviolence
- The chances of being murdered by someone with psychosis (who you don’t personally know) are 1 in 14.3 million.[2]
- A person with schizophrenia is 14 times more likely to be a victim of violence compared to being arrested as a perpetrator.[3]
- Schizophrenia is linked to 6.48 percent of worldwide homicides according to one study[4], while another study confirms that 95 percent of all homicides linked to schizophrenia co-occur with substance abuse.[5] If you take these two results together, what this means is that schizophrenia by itself (without substance abuse) is linked to only 0.324 percent of annual global murders.
- The likelihood for violence in someone with schizophrenia with co-occurring substance abuse is similar to that for substance abuse without psychosis.[6]
- Columbia University and the New York Psychiatric Institute partner to manage the world’s largest database on mass murder. In one study evaluating approximately 855 mass shootings (65 percent of 1315 mass murders analyzed were shootings), “active psychotic symptoms” were identified in only 5 percent of these mass shooters. This paper concludes “that policies aimed at preventing mass shootings by focusing on serious mental illness, characterized by psychotic symptoms, may have limited impact.”[7]
Following one publicized case is not an accurate means to learn what psychosis is like for everyone who has it. I hope these facts reassure you that we are categorically nonviolent, and truly learning more about psychosis requires a case-by-case evaluation.
