Friend with psychosis! - how to speak to them

[Darkt]

Massive apologies if I sound ignorant but need some advice. I have a good friend whom I've known for a few years. Over the last year or so she has been experiencing delusions. So thinking things have messages and things are sending messages to her etc amongst other things.

When she first mentioned these things I just sort of dismissed it and laughed it off with what on earth are you talking about etc. I didn't really understand that she actually did believe these things. The rest of the time she is "normal" for wont of a better word.

With the support of her family she has got help and is under psychiatric care. Her family told me this but she hasn't herself. However, her delusions are still there and have gone worse since the last time I saw her which was 6m ago so she will still talk about the messages etc.

My question is now that I know that what she's experiencing are delusions how do I talk to her about it. Do I ignore her, encourage her to think differently, reason with her. I don't know how to deal with it when she talks about it. I'm sorry if I sound awfully ignorant but genuine want to be supportive to my friend.

Also do these delusions go away eventually with the right meds or are they here to stay?

Sorry I have no idea why there's an exclamation mark in the title....

It depends, psychosis and delusions can resolve with the right treatment and medication, however unfortunately, psychosis can sometimes be caused by schizophrenia, personality disorders, bipolar etc, and the symptoms may not resolve completely/she may be on medication long term. Sometimes people can experience psychosis, get the correct treatment and never relapse, this may not be the case if the symptoms have been ongoing for 6 months plus.

I would acknowledge what she is saying and feeling, what is happening is completely real for her. I would say that it feels very real for her. If she is genuinely delusional (with 100% conviction) then there is no point trying to reason with her. I would just reiterate that she is safe.

OP, feel free to PM me if you have any specific questions, I do have knowledge in this field. 🙂

You might find the following info useful, OP.

As someone who has personally experienced delusions (bipolar), you're showing great sensitivity and thoughtfulness in what your intentions are.

https://www.rethink.org/advice-and-information/carers-hub/responding-to-unusual-behaviour-linked-to-mental-illness/

The advice I got in a similar situation is not to tell her that she’s wrong but also not to encourage her. So to say vague things like “it must be scary to think that” etc. I don’t know if this is necessarily correct but I found it easier to have some guidelines to follow!

I work for a mental health charity and would strongly echo what @CatOfTrees says. In a session with a client, I would meet them where they're at and I think as a friend you can do the same too. If your friend says things you know are not real, just treat the conversation as though it is, because for your friend, it's just as real as your reality.

In my job it's about compassion, non-judgement, and unconditional positive regard (which is basically 'love') and if you can apply those qualities to your friendship, you'll be a lovely friend for your friend.

You sound a really great friend OP.

Is she in psychotherapy? It can be really helpful for delusions. Sometimes they represent the brain's of displaying something which the brain doesn't feel conciously able to know, such as childhood abuse by a figure in a position of trust.

The link that ShantiNatasha posted above seems really sensible. I think my general approach would be "That doesn't match my experience of the situation but I hear and accept that that is what you are experiencing."

For her the delusions will be very real.so acknowledge that what's she's feelling, thinking maybe hearing "( if she's experiencing auditory hallucinations) although may feel.very real and sometimes frightening,they are part of her illness ,and in reality not real,but unprepared for her not to believe you or understand that ,she's unwell.

When my close family member has been sectioned for psychosis from bipolar I have found as PPs have said that all you can do is treat the delusions as if they are real because they are so real to the person experiencing them.

And on a bad day that might mean leaving immediately if the delusions are so strong the person thinks you are part of the problem and ‘in’ on the conspiracy against them, or similar.

And on a good day it can mean being able to say something like ‘I’m so sorry, that sounds so hard.’

But generally even safer is to just stick with making sympathetic noises of agreement and possibly hugs or reassuring arm squeezes, etc. Because I think mostly when people are suffering from delusions they mostly need your calm, sympathetic, loving presence and acknowledgment of their suffering. Much more than anything you actually SAY. It’s not rational, so any comfort you can bring is energetic / emotional rather than intellectual if that makes sense?

And then if for a moment or two they switch to something more positive / clear-minded, in my loved one’s case like saying some flowers in a vase are beautiful or they ate two puddings yesterday, if you can hop on that gently and fan the flames of the positive rational conversation for a moment or two, that can bring them some fleeting relief, especially if you can get in what a lovely person they are, and how right/wise they are, and that’s why you love them, etc.

But I think the key is just to follow their lead. And mostly just listen and show with body language that you love them.

You sound like a lovely friend and I hope your friend feels much better soon. 💐💐💐

Thank you all. It's really helped. Most if the time during conversations she's fine talking about normal things but then will talk about the delusion stuff too.

I don't know what type of treatment she is having. I know the psychiatrist has given some meds and that's all. I don't really know details of her treatment plan and family have only told what they want which is obviously fine. They did say that the docs have said the cause is probably schizophrenia. I do know that she does refuse taking her meds so don't know how consistent you need to be for meds to work.

So looks like from what you guys have said; be supportive, acknowledge her feelings and show positive regard. Thank you everyone. It's such a new thing to me and I'll be the first to admit that I really didn't know what to do about it at first.