Psychosis and autism: My tenuous relationship with reality

Psychosis is a topic that (much like addiction) is rarely talked about in the autistic community. I suspect that it is more common than people care to admit; I also suspect that most in the community would not have any particular knowledge of what psychosis is besides Hollywood’s stigmatised take on the subject, and possibly what they have found on google.

The simplest answer I can give to the question “what is psychosis?” is this; psychosis is a total split from reality. When psychotic, the world is a vastly different place for the person. For me, it was a world of paranoia and persecution. I was no longer able to tell the difference between fact and fiction.

The first indication that something was wrong (for me) came when I was 18 years old. I had just moved out of home, and my three year long relationship came to an end. I started hearing disembodied voices calling my name. Very quickly they progressed to voices telling me that I couldn’t trust my friends, that they didn’t really like me and that they wanted to harm me.

For years I drowned out the voices and paranoia with a vast cocktail of illicit drugs and alcohol. The stigma attached to hearing voices was too great, I was scared to tell anyone what was going on, so I self-medicated. It started with cannabis and alcohol, and eventually I found myself heavily addicted to opioids, benzos, and spice.

The problem really came about when I achieved sobriety. I no longer had my buffer. Without the chemical crutches, the voice hearing became extremely intense. At the height of it, I was hearing multiple different voices including;

-A demonic voice that told me paranoia inducing lies about how dark forces in the world were working to harm me.

-A voice that i called “the sociopath” that would ask me to harm people.

-Two voices that never spoke directly to me, but would comment and bicker over everything I did. All day. Every day.

-There were other voices that I didn’t hear with any great regularity.

I also started to see a women in a black dress in my house. She never acted to harm me, and was not particularly threatening, but it was unsettling to say the least. Among other visual hallucinations, I would see spiders in my bed, and demons following people around. The visual hallucinations were as real as my best friend who is currently sat across the room from me.

The final nail in the coffin was the delusions. Delusions are difficult to explain. Imagine spending your entire life looking at a blue sky, but suddenly everyone is telling you it’s green. They present you with mountains of evidence that the sky is green, but all you can see is blue. The more you try to tell people the sky is blue, the more concerned they become about you.

I had many complex delusions, but the most notable ones were that I believed I was trapped in a computer simulation, that I had a microchip under my skin broadcasting my thoughts, and that my family had been replaced by imposters.

Of course this subsided with medication, but it threatens to return any time I experience stress. It taught me that my reality can change over time. For me, the boundary between what is real, and what is imaginary, is so very thin. My symptoms are largely controlled by the medication, but it is always there, under the surface.

This situation was made all the more complicated by being autistic. Professionals told me that I didn’t meet the criteria for a schizophrenia diagnosis because I wasn’t “typical” in presentation. My position on that has always been this; I am autistic, nothing about me is typical.

As an autistic, I pride myself on having a rigorously logical approach to everything, and yet, my brain can invent its own reality at a moments notice. I still have bad days where I hear voices and experience paranoia. I have learned that it is when I lose the ability to recognise that these things are not real, that i have a problem.

Psychosis was and still is a terrifying experience to me, but it has made me resilient. I have learned to survive in a multitude of different worlds.

If you or a loved one may be experiencing psychosis, please speak to a psychiatrist. Psychosis is an incredibly complex state that can not be willed away by lifestyle or all the good intentions in the world. No one deserves psychosis, and I mean that honestly. It has taken me years to trust my mind again, and I would not wish that on anyone.