When confronted with a disturbed loved one, especially one who has been in the hospital with a psychiatric diagnosis, many people hear the word “psychotic” used to describe their behavior or thought patterns. What exactly does this term mean?

First of all, it is imperative to understand that those suffering from “psychosis” are often lost in their reality and thus are unaware they are “out of touch with reality” no matter how bizarre their behavior or ideas appear to other observers. 

“Psychotic” is a clinical judgment.

It is not a diagnosis but rather a symptom describing the status of a disturbance of a person’s mind. The difficulty with the word ‘psychotic’ is that there is no absolute state, or judge, of what constitutes “reality.” 

The word all too often is used to assess the condition of an apparently “sick” individual. Here is the issue– since all people live and operate in their perception– how can a court or clinician discern what a healthy reality is or is not unless their safety is a factor? 

A person with delusions of being God might well be perceived as psychotic (as was my case) and firmly believe their ideas. On the other hand, the constituents of a radical politician may applaud them for their “honesty” despite the negative emotions they might induce. After all, if people are not ‘harmed,’ what do feelings matter regarding health and perception.

Reality is always relative and never absolute, so that every diagnostic judgment is ultimately subjective to the clinician using it.

In society, “reality” is a cultural construct defined by the majority of that culture. In my case, I accept that it took me six years to return from my delusion enough to be able to have the mental and social focus to return to college after a schizophrenic “break” at my first university. It took a growing awareness and insight in a private “program” and nine hospitalizations before I was ready to re-integrate into an educational setting without regression to a state of illness.

But it was the transformation of my self-perceptions that finally freed me from the internal mental structures upon which my religious beliefs. All this work on myself and the steps to these changes has convinced me that my path forward hinges on bringing this awareness to the families of those diagnosed with schizophrenia. I want to help them navigate the challenges not only presented by their loved ones but more especially to themselves so they can believe “Recovery is Always an Option.”