Coping with Psychosis

[Depression = 72% of members]

Hello.  My wife w/BPD was recently hospitalized twice for symptoms of severe depression.  At times after these depressive episodes she can have symptoms of psychosis, such as having auditory hallucinations.

In the past she has responded well to antipsychotic medication.  However, this time she is still experiencing the auditory hallucinations, which can be debilitating for her at times.  She is learning to use more of her coping skills and to accept that her symptoms are occurring and may last for a while.  We also bought a workbook called Treating Psychosis to help her work with her therapist on accepting her current condition while applying her coping skills.  She has been attending therapy at least once per week to build her skills.

We have determined that she is not likely to act on the auditory command hallucinations.  She understands that it is a hallucination and her mood is currently stable.  She is unable to work for now either until hearing the vocal hallucination gets quieter or she is better able to apply her coping skills.

Do any of you have any additional tips for what to do while your partner has these form of psychotic symptoms?  Or any experience in supporting a partner with symptoms of psychosis?  She has had auditory hallucinations for over a month, which it usually does not last this long.  She did start a new antipsychotic 2 weeks ago.

My brother, who is a doctor, also brought up that perhaps she is just saying she is hearing the voices in an attempt to be hospitalized.  He also brought up that there could be a psychological reason for the voices (low self-esteem, poor self talk, negative and dysfunctional thoughts) as opposed to a brain chemistry cause.  I am also willing to accept that these voices may last for a long time or even be permanent.  By the way, my wife does not have a history of drug or alcohol abuse.

Thanks for your thoughts and support.

[Michael43]

Hello.  My wife w/BPD was recently hospitalized twice for symptoms of severe depression.  At times after these depressive episodes she can have symptoms of psychosis, such as having auditory hallucinations.

In the past she has responded well to antipsychotic medication.  However, this time she is still experiencing the auditory hallucinations, which can be debilitating for her at times.  She is learning to use more of her coping skills and to accept that her symptoms are occurring and may last for a while.  We also bought a workbook called Treating Psychosis to help her work with her therapist on accepting her current condition while applying her coping skills.  She has been attending therapy at least once per week to build her skills.

We have determined that she is not likely to act on the auditory command hallucinations.  She understands that it is a hallucination and her mood is currently stable.  She is unable to work for now either until hearing the vocal hallucination gets quieter or she is better able to apply her coping skills.

Do any of you have any additional tips for what to do while your partner has these form of psychotic symptoms?  Or any experience in supporting a partner with symptoms of psychosis?  She has had auditory hallucinations for over a month, which it usually does not last this long.  She did start a new antipsychotic 2 weeks ago.

My brother, who is a doctor, also brought up that perhaps she is just saying she is hearing the voices in an attempt to be hospitalized.  He also brought up that there could be a psychological reason for the voices (low self-esteem, poor self talk, negative and dysfunctional thoughts) as opposed to a brain chemistry cause.  I am also willing to accept that these voices may last for a long time or even be permanent.  By the way, my wife does not have a history of drug or alcohol abuse.

Thanks for your thoughts and support.

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[Purplex]

I think the best you can do to support your wife through psychotic episodes is to familiarize yourself with her symptoms and the skills that work for her. Going through the workbook together and talking to her about what she learned in therapy and how you can help her apply the skills is a great approach (provided she is comfortable with that of course). Maybe even join her for a therapy session to get a better understanding of how and when you can support her?

If she just recently started to learn to cope with her symptoms, this might be the reason why her episodes are lasting longer this time. Sometimes confronting a problem can cause it to manifest more severely in the short term, because we are actively working on changing our perceptions and reactions to it and it thereby is inherently more present. This isn't necessarily a bad thing and doesn't mean that there will be no improvement in the long term. It's often the first step to recovery. A change in medication can add to that as well.

perhaps she is just saying she is hearing the voices in an attempt to be hospitalized.

Is there a reason for you to think that? Does she want to be hospitalized again?

He also brought up that there could be a psychological reason for the voices (low self-esteem, poor self talk, negative and dysfunctional thoughts) as opposed to a brain chemistry cause.

Those things are interconnected anyway, thoughts, emotions and behavior can cause changes in brain chemistry and the other way around. She is already getting treatment on both fronts, therapy for psychological issues and coping strategies and medication for disbalances in brain chemistry. Not sure what else your brother is suggesting?