Recovery from Psychosis in Schizophrenia Spectrum Disorder Is Possible

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This is the story of some of the delusions I experienced for a period of ten years starting in 2013, my spontaneous recovery after a substantial period of time, and some reflections on the psychosis and the recovery. The journey was a personal one and the reflections are also personal.

It all began in 2013 when my role in the company where I was employed was becoming questionable as our investors were holding back on continued funding of our projects. Under the pressure of being rendered jobless, I began imagining that my colleagues at work were prodding me to take up additional work, given that I was not fully occupied in my current job. I became convinced that they were continually hinting that I should continue in my current job AND do my previous job at the same time.

Around the same time, I became convinced that, in order to prepare me for a higher position, the senior directors of the parent organisation had hired two international consultants: (1) a life coach and (2) an ex-CIA operative (to undertake a surveillance programme using the latest technology to investigate me). I believed that the surveillance program was undertaken by tapping my telephone calls, text messages, email and social media accounts, and this info was to be passed on to the life coach so that he could use the information for my personal improvement.

As the CIA consultant began a stricter surveillance, I became wary of almost everyone and began to suspect that they were all out to get me. In my perception, the escalating environment of surveillance also extended to TV channels which were set up to convey messages specially directed at me. Radio programmes were playing music with lyrics that were intended for me.

This period of distrust, fear, and the constant feeling of being watched lasted for almost four years. I would talk about it with my wife and daughters and one friend/colleague in the office but held back with others. They remained tolerant throughout and would usually listen and gently distract me by changing the subject. Then, starting in 2017, another even more debilitating symptom of my condition began: significant cognitive impairment. During the next ten months, I had difficulty reading. I would stare at the words and not understand them. It was difficult to find ways to spend time during the day because I was unable to concentrate on any activity. I remember trying to follow four steps in a simple recipe but being unable to do so.

My psychiatrist, in addition to prescribing antipsychotics and antidepressants, advised that I write out a daily schedule including basic activities such as brushing my teeth and washing the dishes to ensure that I kept busy and actively engaged, and also to reflect back on ‘achievements’ at the end of each day to give my brain some positive signals. But here, too, I was erratic. Most days, I had neither the discipline to make a schedule nor the energy to do any task. Miraculously, this phase also passed. I became better and began to read again.

Unfortunately, I grew overconfident. Since the doctor couldn’t give any reason for my reading ability to return, I concluded that the doctor didn’t know how the medications were affecting my brain and abruptly decided to stop the medication. The psychoses returned in 2019 but in a new form: now, I was convinced I had a chip implanted in my brain — a chip controlled by a battery of neuroscientists sitting in various state-of-the-art labs in the US, and these scientists controlled my thoughts, actions, speech, physical ailments, etc.

In this euphoric, couldn’t-do-anything-wrong phase, I decided to invest a fairly large sum of money building a website, under the impression that the CIA consultant with all his cutting-edge technology was now on my side and would make sure I wouldn’t fail.

After a year of having the website built, I realised I was totally unclear about how to take the project forward. Meanwhile, my wife kept insisting I go back to the psychiatrist and I finally relented. He explained that I had most likely gone through a manic phase. As the website project began to sink, it made me doubt that the consultant would make sure that my project would succeed; nobody was going to transform my project into a grand success. The consultants were not guiding my website developer as I had imagined!

The failure of the website project ended up being a trigger that forced me to begin questioning the very existence of the consultants. Once on that road, I deduced that if there wasn’t any consultant, then there probably wasn’t any surveillance programme either. My delusionary world began to evaporate. In psychiatrist’s language, I was told that my psychotic symptoms were in remission.

Stressed by the failure of my business, my cognitive impairment symptoms returned and, once again, I began to find it impossible to read. A few months later, while at home, I had a seizure. Soon after that, my mind became clearer. I found I was able to read, and cognitively I began to improve, slowly but surely.

My doctor advised me to join the psychiatric rehabilitation programme of the hospital where he was practicing. The routine activities (gardening, vegetable cutting, bakery packaging, and yoga) would help activate my brain, he said. Engaging in the activities in the psychiatric rehabilitation programme forced me to get out of the house three days a week, and to interact with other people, even if it was in a limited way. And that made me more confident to step out further into the real world: I began to volunteer with an organisation focused on mental health advocacy. After a few months, a friend contacted me with an interesting business idea and I became a co-founder of a startup in real estate and hospitality. I am becoming re-integrated with the real world.

I’m not sure if my brain will ever fully recover from the episodes of psychosis. There are still mild cognitive issues and a feeling that my brain has definitely slowed down. There are also several physical side effects of the medications — muscle stiffness, dystonia, even lung fibrosis — that remain.

I sometimes conjecture that my delusions emerged from a deep psychological root since they were inextricably linked to real (vs imaginary) people: my work colleagues, my close friends and family. The delusions were in the realm of possibility — surveillance technology does exist — but personalising it was my psychosis. Most people who heard about my delusions would admit that what I was imagining was not impossible, but would question why anybody would be interested in launching such hi-tech surveillance on me.

Unfortunately, psychiatrists aren’t willing to spend time discussing delusions since they don’t attach much significance to them. In my case, I had become totally uncommunicative with the couple of talk therapists I met, who always recommended that in the condition I was in, I should have medication to enable me to come to a more communicative position. In my opinion, talk therapists in India don’t want to take up complicated cases of severe mental disorder and prefer to focus on common mental disorders; for severe mental disorders, they recommend that psychiatric treatment be the first course of action.

On a separate note, I believe that analysis and interpretation of delusions have been tried in Finland and patients have been cured with hardly any incidence of relapse, so maybe there is a possibility that one day this might be tried as an alternative treatment approach in other countries.

Without any doubt, what has got me through up to this point has been the continuous and unstinted support of my wife and daughters, my sister, my extended family, my doctors who were available to my wife and me at short notice, and a few select friends. I absolutely agree with theories that mental health recoveries are more likely in a supportive environment, and would even hazard a guess that the contribution of a positive environment (where no one ever treated me as a crazy person or dismissed me as a mere patient) and financial security (not having to worry about money) may have an equally important role to play as medications, in my recovery.

I’ve read about experiments that suggest managing patients under the Soteria paradigm (minimal medication, a caring/nurturing environment, communal duties) have yielded equal or better results in the treatment of people diagnosed with schizophrenia spectrum disorders when compared with conventional, medication-based approaches. I wonder why this approach is not pursued more widely. Is it because, unlike the use of medication which is seen as a magic bullet where one doesn’t have to do much other than consume it, following an approach of lifestyle modification and care and nurturing requires more rigorous attention and perseverance to be successful? Are the delusions of psychosis merely a matter of excess dopamine in the brain pathways as some believe (and others dispute), or is there a psychological component involved in the genesis of this illness?

For rehabilitation and easing me into daily life, I am grateful to the founder of the NGO where I’m volunteering. She didn’t hesitate to give me some responsibility in spite of knowing my mental health condition. The trust of my fellow co-founders in my startup, despite being made aware of my condition, has enabled rapid progress in my recovery. It might have been easier to stay at home and read books and remain socially disengaged. But taking on these roles has improved my engagement and helped me make good progress toward recovery.

Ultimately, after three episodes of severe mental disorder, I’ll attribute my current state of recovery to (a) the supportive and non-discriminatory environments I’ve been in, both at work and at home, (b) other people’s acceptance of me, (c) the lack of any overt stigmatisation from anyone, and (d) the opportunities for rehabilitation. Often patients diagnosed with schizophrenia spectrum disorder are condemned to a lifetime of being burdened by severe illness, but my own experience tells me that it is possible to recover and the biggest injustice done to a person with such a diagnosis is to give up on them for the rest of their life.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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51 COMMENTS

  1. Thank you for sharing your story, Sumit. I am in the United States and work and have worked inside the mental health system here for short periods of time and have done therapy for years, in hindsight finding it mostly damaging and a waste of time that made it harder, not easier to find reality.

    I think what I see most frequently here is that healthcare professions lack the ability to be willing to differentiate within the context of what someone is doing and saying what is, and what is not, delusion.

    I have watched in an inpatient setting someone suggest something as bizarre as the CIA watching them, and the clinician with a doctorate is asking, “Why do you feel that way?” rather than the most human thing to do, which is delineate what is real and not real. This is “why do you think that? Why do you feel that?” stuff is bullshit, mostly when dealing with cases of psychosis to the point I think it’s inhumane.

    I feel like clinicians who are treating psychotic cases should just say, “The CIA is not watching you.” Sure, they could be, I guess. But working within statistical likelihoods is far safer.

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    • I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.

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        • That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!

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      • I think, maybe, a good response would be, “That must be very painful for you, to feel that you are being watched all the time.” Challenging delusional beliefs doesn’t work in my experience (with a husband who has had several psychotic phases) and can make the person feel very angry, frustrated, and invalidated. They really are convinced and no amount of statistical probability will help. But one also must guard against encouraging the beliefs by saying anything such as, “who’s watching you?” Because they will feel bound to back themselves up and then the story they provide is incorporated into the delusion and it just feeds on itself.

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        • In my case, I didn’t feel it was painful to be watched, more annoying, to not have the freedom to do anything without being watched. And, yes, like Steve pointed out, if one could come to one’s own conclusion about reality, that would work the best.

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          • That’s a very curious statement – everyone should come to their own conclusion about reality?
            On the one hand, that’s what we all do anyway. Regardless of what anyone else says – we weigh the evidence we have, and conclude whatever it is.
            However, evidence includes our feelings, past traumas, the reactions of those around us to the sometimes odd ways in which we behave, etc. A person who grew up being bullied, just to take a simple example, will often live the rest of their life suspicious of people’s intentions, interpreting a smile as a smirk, a compliment as a snide comment, etc. Do you really think that living life with this possibly skewed perception is “best”? Should one just leave people to their own sometimes tortured thoughts because “it’s their thoughts and they’re entitled to them”? Or should we engage with compassion and try to penetrate the layers of defenses?

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    • In my case, my psychiatrist did, on occasion, try to argue with me, to convince me that my thinking could be my imagination, but I remained firm in my false belief until I came to that conclusion myself. Most people did not contradict me, probably, more out of politeness.

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      • What I do is to ask about the thoughts and always give the benefit of the doubt that what the person believes is true until proven otherwise. Ernest Hemingway was plagued by paranoid delusions that the Feds were tapping his phone and spying on him at his bar. His friends tried, with no avail, to convince him that he was imagining it. Lo and behold, decades later, documents became public that proved he was right all along. When patients mention beliefs that they are being surveilled I also throw out the fact that yes, “they” are surveilling ALL of us through our phones and etc. to one degree or another, as has been revealed in document leaks over the past decade or more. I will ask the person if they think there is any chance that part of it might be just their imagination. Based on the response and their degree of receptiveness, I might tell the person the following: Yes, they might be correct, and I cannot tell them 100% that they are mistaken, but that I personally believe that their brain is probably playing tricks on them. Other people I will simply ask them how much people have been following, harassing, spying on them, etc. But always with respect. I believe that most or all “delusions” are based in actual things that have happened, usually traumatic or humiliating things, that made the brain especially sensitive to certain topics, and which then exaggerates the threat signal to degrees beyond what we typically discuss among polite company.

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      • I’m not sure that, in psychosis, (fixed beliefs), it’s easy to penetrate defenses and amend those belièfs. At least, in my case, I couldn’t find anyone to help alter my beliefs till circumstances caused me to doubt those beliefs and conclude the beliefs may have been incorrect.

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  2. Honestly, I recommend a psychosis. It showed me that thought is just a cat sitter in my head. It looked after the cats that we were, or that the human animal is. Obviously it went wrong and like a darlek but that’s another matter. But we, or the human animal, are just like cats or monkeys, only a bit more clever, because we had a cat sitter in our heads – and we thought we were the cat sitter. But my cat sitter went off seeking alternative employment, so now I’m just the cat. Miow!

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  3. Expressions and impressions. That is all we know. Outgoing and incoming. Outgoing and incoming. But it wasn’t not meant to be a war. I am at war with this office furniture and a room full of white polystyrene cups. Of course I will go mad in an objective life that is already madness. When did we consented for trees, birds, waterfalls, insects, animals and the summer breeze to be replaced by air conditioned office furniture in a room plastic, metal and glass that is really indistinguishable from my expensive high spec refrigerator. Chilled our hearts in that. It happened. And so I say: shake this plastic low, shake this plastic high, shake this plastic right up into the sky. Don’t ask me how when where or why. I want to see this plastic rise up to the sky. And you call this madness. It’s just a song. And like all songs it’s a mimetic exposition in audio of the physical and psychological texture of an insane social reality that is as mad as a box of frogs, only less natural. Asphyxiated a world with that: it happened.

    Vacuum packed, I put me now back on the production line.

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  5. I think all politicians are receiving secret behind the scenes electric convulsive therapy, or at least the leading democrats and republicans, because they all look like they are receiving regular electric shocks. Exceptions to this are the fire brands like AOC and some of the other radicals who have their moments, but AOC is always on fire and without that fire in American cultural life – that one little fire – the whole country would seem about 30% less healthy, which is a very serious matter because surely American culture is one of the most diseased cultures there ever was in human history. America, Russia, and North Korea I would argue have among the most deluded socially conditioned minds in the whole Earth, and you may argue that other countries are similar, but you don’t understand how perverting and distorting and absurd so much of your social conditioning is, for example your intense and barbaric attempt to morally regulate and judge and coerce rather then understand other people, your toxic perversions within Christianity which has merged with the money lusts inflamed by all the capitalist, neoliberal and consumerist ideologies, your deranged sense that some how having a mechanical weapon that can blow the brains out of anyone is some kind of birth right (why not make sex toys a birth right instead? They are far less harmful, and please don’t tell me it’s because the Christians would prefer to be able to blow people’s brains out with a bullet rather then an orgasm): and your national myth and your pratiotism which, as an illusion, got a a unique and exceptional boon in the case of American patriotism because of the fact that America is and for a century has been the biggest ECONOMY on the Earth. This gave the delusional appearance of some kind of basis or truth in the idea that America is be ‘best or ‘greatest’ country on Earth, even though GDP is an index of plundering greed past and present. And this ECONOMY is not your life – it is a parasitic disease process feasting on your life, so it is quite absurd that we take it as a measure of worth in our society.

    I would far rather live among the Tibetans personally who, even though the country is being destroyed by China, is perhaps one of the most benevolent, healthy, beautiful traditional cultures on Earth. But even there I would wish we could dismantle all the traditions and religious practices and go for observing and understanding and transforming our beautiful lives in freedom, for such good and healthy people should obviously be absolutely and perfectly free. This would be a boon for the whole of humanity, and it is true of all sincerely compassionate or religious or ‘good’ people. If they were radically free at the same time that goodness would be empowered and flower into radical action, but being conditioned by religious ideas, they live in the little enclosure of their constraining beliefs and practices and dare not wonder beyond their limitations. This is a tragedy for the whole Earth if you ask me.

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  6. We cannot, in the same breath, claim that therapy is a process of “meaning-making” while simultaneously denying the opportunity to understand why some people consistently believe the CIA is watching them. It would have been much more effective if the therapist allowed the clients to make sense of their experiences by providing space to flush it out. The writer had a job and worked in organizations facing structural or other issues, and anyone who has worked in large corporations knows that rumors or gossip mills about loss of jobs and reputations. In such situations, it is understandable that someone with certain sensitivities might feel they are at risk and start imagining real situations in their mind and express their feelings in hyperbola or delusions – it is extreme risk assessment without concrete risk yet. This is similar to how violent movies are thought to influence teenagers or promote a violent culture—because what we see is what we imagine, especially when there is a lack of concrete evidence.
    What failed the writer, unfortunately, is not that they were extremely stressed and triggered (or at least what seemed triggering), but that the system, as the writer noted, did not care enough to genuinely understand and make sense of the client’s narrative not to challenge but look for ways to associate enough to make “sense”.
    Anyhow, thank you so much for sharing your story both how it felt inside and how it was perceived outside. It is not easy to have these feelings that are often out of context and hard to understand but to somatize them and use of medications is the bigger problem.

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    • I agree. There probably was a degree of extreme stress and triggering which brought on this episode of delusional thinking. Whether this could be resolved by analysing the thoughts and understanding what brought them on, I don’t know as this approach was never considered. I was put on to antipsychotic medication to suppress the thoughts and I could communicate with no therapist either.

      As I mentioned in the article, I read that this approach was successfuly tried by a group of researchers in Finland.

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      • Awareness of the movements within awareness is the only sane and healing action. All creatures of nature know only this. And the highest reaches of human understanding rediscover this in what we call meditation, but we should not call awareness of what is meditation, because it is all there ever is. The brain just has to understand the IMPORTANCE of this awareness of what is as opposed to it’s own socially conditioned security and pleasure seeking operations including the analysis of phenomena which is a security operation because it puts the phenomena at a safe distance, behind a screen of socially conditioned words through which it cannot be understood at all. Only seeing heals, and actually, you must know this.

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  7. I found, while working in a psychiatric hospital, the best way to handle delusions was to first listen to the patient, then express what my opinion of what they were saying, prefixed with the statement “that I could be totally wrong” and ending with the fact that we could both be wrong and there could be some other explanation. This approach has the advantage of unfixing his/her attention from his own concept of reality while not alienating the patient by telling him that he is wrong or that as I was staff and therefore, I knew better. Fixated attention is a common human problem.

    I also discovered that giving the patient a more rational rationalization was no benefit to the patient as it was still a rationalization. Better a non-committal acknowledgement like “you could be right”. Even, after experiencing a psychotic episode, I realised that I didn’t know better than the patient what he/she is experiencing. It’s not only the patient but also the staff that lack insight. Humility over hubris.

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          • Actually, that’s NOT the question, with all due respect. It makes the assumption that A. these drugs are “medicines” for “diseases,” and B. that it’s always better to do something than nothing. If doing something wastes money and has no positive benefit, we are better off doing nothing than pretending we are “treating” a “disease” that we clearly do not understand!

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          • Replying to Steve McCrea:

            Doing nothing when someone is psychotic and potentially dangerous to themselves if not to others is only an option if you have somewhere like Soteria where the person can be kept safe.
            Without that, the “antipsychotics” are useful in that they get the person to sleep, a lot, and slow them down, until the psychotic stage passes (when you get them off the drugs). Of course it’s not ideal. Like so many things in life.

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          • It is true that antipsychotics can be useful in the short run to help people get under control. I’m just saying that calling it a “treatment” is a lot like saying morphine is a “treatment” for a broken bone. Might make you feel better and be helpful, but it’s not going to help to simply prescribe morphine without finding out what’s really going on.

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          • Anti-Psychotics were originally approved to facilitate treatment. As such they were very successful and resulted in many escaping the psychiatric system however the movement to use them as a treatment has been meet with an increase in the number of people reported as suffering from mental illness. Wither this increase is due to the change in approach or to the greed of the pharmaceutical companies wanting to sell more pills does not change the fact this is F**K Up.

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  8. Mr. Guha – thanks so much for sharing your story! It takes great humility to open up such vulnerable parts of yourself in a public setting as this. As I was reading through your article, I kept wondering how much of your “symptoms” were actually medication-induced side effects that would have never happened if you never took a psych drug. The mental dulling, the possible “manic” episode. The rough numbers, as I understand them, suggest that “bipolar condition” has increased in the range of 1000-fold since we started using our fancy new medications, as I describe them to my patients. At least according to what I learned from Robert Whitaker’s books, manic depression used to be found in about 1 in every 50,000 people. Now, after so many people have taken antidepressants and stimulants (and cannabis), something like 1 in 50 people end up with a diagnosis of bipolar. Best wishes for all future journeys!

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  9. This is one of the most difficult questions to answer. How much of mental slowing, day time drowsiness, physical lethargy, psychomotor retardation etc are because of the illness and how much because of the medicine.

    As I began to improve, I stopped trying to make this distinction and focussed on battling known side effects of the medicines, such as orthostatic hypotension, dystonia, muscle stiffness, gait and balance issues, slurring of speech, hoarseness and softnesd of voice, lung fibrosis etc

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    • What do you mean by ‘the illness’ when you say “how much of mental slowing, day time drowsiness, physical lethargy, psychomotor retardation are because of the illness”? This implies a division between this thing you call the illness and this thing you call the symptoms, but is there any such division, or are the symptoms (the dysfunction) not the illness? So the question is are these symptoms the psychological, emotional and neurological injuries of social life that you call ‘mental illness’ (sic), or are they caused by the drugs which are still psychological and social existence, because they are the socially conditioned mental and life activity of the psychiatrists who prescribe you drugs, and the psychology of the socially conditioned mind who accepts these drugs, both of which are conditioned by the society that constitute the living environment and conditioning medium of every human being in the Western world? Whatever way you look at it, and the evidence supports only this, what you call mental illness is manifestly, obviously, objectively the natural injuries of a barberous, blind, stupid and unnatural society, which has impacts on psychology and neurology and the body. Otherwise we are saying that Mother Nature goes mad or gets obese or develops type 2 diabetes in nature, which is just not so. She only does when domesticated in society, either as humans or pets. And how can we imagine Mother Nature goes mad when HER world is only sanity and beauty, and ours only ugliness and madness? Please do look around you people. The whole human world is mad, and psychiatry is one of the more toxic and mad things in that society, although there is the whole political and cultural insanity of America which at times even makes the ravings of a psychiatrist sound sane.

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  10. It’s an insane society that created psychiatry and the diagnosis of psychosis without any fundamental understanding. I say psychiatry and society are mad even though they diagnosed me as psychotic. So am I right, or is psychiatry and society right? We can’t both be right. Wouldn’t it be rather shocking if this psychotic is right and the whole of psychiatry is delusional, dangerously violent and destructive, and totally insane? It wouldn’t shocking to me at all because I absolutely know it to be true. Even though I have lost my ordinary mind I’m the most sane person I know, except for the animal and plant life and Mother Earth around me, but admittedly, everyone else does set an extremely low bar.

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