Some people with BPD may suffer from psychosis, or psychotic symptoms. Psychosis is what happens when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions).
Hallucinations and delusions are the two main symptoms of psychosis.
- hallucinations are where someone hears, sees, feels, smells or tastes things that do not exist outside their mind but can feel very real. A commonly reported hallucination is that of hearing voices that aren’t there.
- delusions are when someone has strong beliefs that are not shared by others; a commonly reported delusion is that of someone believing there’s a conspiracy against them, usually to harm them. Some people have delusions of being in power, or having super abilities.
The combination of both hallucinations and delusional thinking causes severe distress, and can lead to a dramatic change in behaviour.
Someone experiencing these symptoms of psychosis is often referred to as having a ‘psychotic episode’. It’s important to seek medical advice as soon as possible, so your GP can determine the best support for you, and refer you on to a mental health specialist.
Psychosis can be triggered by many different things. It can be caused by conditions such as borderline personality disorder, bipolar, depression or schizophrenia. It can also be caused by trauma, substance abuse, extreme stress, a side-effect of medication, or a medical condition such as a brain tumour, HIV or Alzheimers. The frequency and length of psychotic episodes vary according to its cause.
Treatment usually includes anti-psychotic medication, psychotherapy and support at home – a community mental health team or community psychiatric nurse, for example. Antipsychotic medicines are usually recommended as the first treatment for psychosis. They work by blocking the effect of dopamine, a chemical that transmits messages in the brain. Psychological treatment can help reduce the intensity and anxiety caused by psychosis. For some people, a short period of treatment is all that is needed, and for others it may be that longer-term treatment is needed.
While substance abuse or alcoholism could be the cause of a psychotic episode, the reverse is also true – some people turn to substance abuse or alcoholism to help them cope with the psychosis. It’s important to seek help from your GP or mental health professional if you are in this situation, as substance abuse can make the psychosis worse or more frequent.
People with psychosis have a higher than average risk of self-harm and suicide.Please see your GP if you’re self-harming. You can also call the Samaritans, free of charge, on 116 123 for support.
If someone has very severe psychosis, and are at risk of hurting themselves or others, they can be compulsorily detained at hospital for assessment and treatment under the Mental Health Act (1983).
It’s important to note that the stigma attached to psychosis is that the person suffering is dangerous. In truth, acts of violence and aggression are fairly uncommon in people with psychosis. They’re more likely to hurt themselves than others.