I have a complicated history of childhood abuse and mental illness. I take antipsychotic medication and am diagnosed with Borderline PD with some contention as to whether my psychosis(?) is more psychological or biological. I don’t hallucinate, my problem is mainly surrounding delusions(?) I often experience persecution via ‘government’ agencies via a very complicated system of mind control. I get very angry about being targeted. One example is that they are currently they are repeatedly putting feathers into my mouth to try and choke me, to wind me up, but they engage in a whole myriad of techniques to torment me and exert their power over me. They also affect the way I am able to articulate my experiences, so it’s difficult verbalising them to a psychiatrist in person (though, admittedly, I am partially reluctant because I know people don’t believe me about these things). This has been going on for nine or 134 years, or all in this second. I feel very confused, like there is no boundary to reality. I find that, in my waking/daytime life, some content of experiences has the rather random quality of dreamscape, and so it’s difficult to know whether I am awake or asleep. Added to this I have begun to experience what is possibly hypnagogia which has quite bizarre content – the confusion being that it works its way into my waking life and I believe what has happened throughout times to come. Apolgies for not being very succinct; my question is whether, in this sort of case, struggling to distinguish dreams, or indeed, delusions from reality is normal in psychosis or whether it’s likely to be something else?
A. There is no need to apologize. The thoughts and ideas presented in your letter seem indicative of psychosis. Please keep in mind that I cannot know that with certainty because I am basing my opinion on a short letter with limited details.
You asked whether or not your specific symptoms (i.e. difficulty distinguishing dreams from reality) is a “normal” aspect of psychosis. Yes, the very definition of psychosis is having a break with reality. Many people describe their psychotic experiences as their having difficulty knowing what is real and what is not. That, however, does not rule out the possibility of another problem. Alternative explanations for your symptoms may include an undiagnosed medical condition or a sleep disorder.
You did not mention whether or not you are taking psychiatric medication. If not, you may want to consider it as an option. Antipsychotic medications can reduce or eliminate psychotic symptoms. Understandably, some individuals are reluctant to take psychiatric drugs but a low dose might considerably improve your symptoms.
I would recommend being evaluated by your treating clinician and/or a medical doctor. You may also want to inquire about a sleep study. Your symptoms require treatment and they should not be ignored. An evaluation can uncover what might be wrong. Please take care.
Last reviewed: By John M. Grohol, Psy.D. on 17 Jan 2012
Randle, K. (2012). Frustrated — Does This Sound Like Psychosis?. Psych Central. Retrieved on September 17, 2014, from http://psychcentral.com/ask-the-therapist/2012/01/17/frustrated-does-this-sound-like-psychosis/