I believe, and my family members also believe, that I was suffering from serious paranoid delusions for years. I also had repetitive physical movements that I couldn’t control, and some hallucinations. I came out of it spontaneously, without medication two and a half years ago.

After coming out of it, I went to a psychologist. He said I was describing psychotic symptoms. He said he could refer me to a psychiatrist to get a diagnosis, but we agreed that this didn’t really make sense, since I had no way to pay for treatment, and the diagnosis could only hurt me, by making it more difficult to get insurance later.

Over the last two years, I have continued to get better, and to be able to think more clearly. And I have begun working part time. (I was living out of savings prior to that. And I still am partially. But my savings are limited.)

From what I’ve read online, it seems like people routinely come out of psychotic states with medication. How common is it for people to come out of a psychotic state without medication? And what do you think is the best course of action for me now?

A. It is possible to come out of a psychotic state without medication. Usually medication is required but not in every case. Specifically, antipsychotic medications are typically used to decrease or eliminate a psychotic state. It is interesting that you were able to do this without medication.

I disagree with your psychologist who advised you against seeing a psychiatrist. You may have had other delusions and not been aware of the fact that they were delusions. That is cause for major concern. Psychosis does not occur in a vacuum. There is a reason for the psychosis.

Something else to consider is the possibility of an undiagnosed neurological condition. It is unusual for psychosis to occur, but it is even more unusual for it to last for years and then to disappear without intervention. For that reason a thorough exam is necessary. You can be examined by a psychiatrist, a neurologist, or both. I believe that it is imperative that you be examined. You may never be able to definitively determine if you were psychotic but a thorough examination may be able to rule out a medical problem.

Your psychologist believes that you may have been psychotic for a number of years. If he or she is correct it is a serious issue that needs to be investigated. The danger of course, is that the psychosis or the neurological condition will return. This is an outcome you would like to avoid. I wish you the best. Please take care.