More than half of people living with PTSD experience psychosis. In this Insider article, Julian Lagoy, MD, discusses common symptoms and provides holistic approaches to manage delusions and hallucinations.

A mental health activist speaks out about their psychosis and how they manage delusions and hallucinations_julian lagoy,md_Mindpat health

A mental health activist speaks out about their psychosis and how they manage delusions and hallucinations 

Shortly after their father passed away in 2018, John Junior began seeing, hearing, and believing things that were not real.  

In 2019, a psychiatrist diagnosed them with complex post-traumatic stress disorder (C-PTSD) — a mental health condition that may sometimes trigger the confusing and often scary symptoms of psychosis. 

Psychosis involves a disconnect from reality where you have difficulty separating your perceptions from the actual events happening around you. It affects as many as 3 in 100 people at some point in their lives. In fact, more than half of people living with post-traumatic stress disorder (PTSD) also experience psychosis. 

How Junior’s symptoms began

Junior, now a mental health activist, was born with Klinefelter syndrome — meaning they have an extra copy of the X chromosome. This condition can cause both physical and mental symptoms, including low testosterone production and delays in speech and language development.  

More than two-thirds of people with Klinefelter Syndrome also experience depression at some point in life. Junior first began feeling depressed at age 11. Around the same time, they began experiencing gender dysphoria. After briefly considering gender affirmation surgery, Junior said they began identifying as non-binary. 

When their dad passed away suddenly in 2018, they began experiencing hallucinations and delusions — two of the most widely recognized symptoms of psychosis: 

  • Delusions are strongly held false beliefs, such as thinking you have special powers, that a celebrity is in love with you, that you have developed a medical condition you do not have, or that the government is trying to kill you. 
  • Hallucinations involve seeing, hearing, or otherwise sensing things that are not there — such as seeing shapes or distorted faces, or hearing voices whispering about you.  

Less well-known symptoms of psychosis include 

  • Disorganized or disrupted thoughts: While speaking, you may switch from one topic to another, frequently lose your train of thought, or say incoherent jumbles of words. 
  • Disorganized behavior: This might involve unpredictable or inappropriate emotional responses that don’t line up with the current situation. 
  • Catatonia: This condition can leave you temporarily unable to speak, move, or respond to your environment. 

During an episode of psychosis, you might also experience: 

  • Anxiety 
  • Depression 
  • Difficulty keeping up with basic self-care, work, relationships, and other everyday life activities 
  • Lack of energy and motivation 
  • Thoughts of suicide 

What hallucinations and delusions can feel like

Auditory hallucinations — those involving sounds — are the most common type of hallucination, according to Dr. Julian Lagoy, a psychiatrist with Mindpath Health. Many of his clients with psychosis report hearing random noises or people talking who are not there.  

Junior’s delusions have involved believing that: 

  • Someone hates them or is out to get them 
  • They are a superhero 
  • They are a secret agent  

Is psychosis a mental health condition?

Psychosis is not a mental health condition on its own, but a symptom of several mental health conditions, including: 

  • Schizophrenia 
  • Schizoaffective disorder 
  • Bipolar disorder 
  • Delusional disorder 
  • Major depression 
  • PTSD 
  • Postpartum psychosis 

Other possible causes include:  

  • Neurological disorders, like dementia, stroke, and multiple sclerosis 
  • Substance use 
  • Traumatic head injuries 
  • Vitamin B1 and B12 deficiency  
  • Genetics or a family history of psychosis 

Treatment and coping strategies

The first recommended treatment for psychosis usually involves antipsychotic drugs. These medications work by blocking the effect of dopamine, a chemical that carries messages to different parts of the brain.  

If antipsychotic medications do not help your symptoms, Borden recommends working with a therapist, who can help you recognize the signs of psychosis and learn effective coping strategies. 

In some cases, antipsychotics can cause serious side effects such as: 

  • Acute dystonias, or painful involuntary muscle contractions 
  • Tardive dyskinesia, a movement disorder that causes facial tics 
  • Myocarditis, or inflammation of the heart muscle 

Junior’s holistic approach to treatment includes: 

Exercising daily

Exercise may improve both your quality of life and mental health if you have psychosis, since it can help certain areas of the brain form new neurons and pathways. 

According to a 2020 review, structured weekly exercise can significantly reduce a wide range of symptoms of psychosis, including hallucinations, paranoia, aggression, lack of motivation, and social withdrawal. 

Taking supplements

Researchers are currently exploring how certain vitamins and minerals may help reduce psychiatric symptoms, including psychosis.  

Supplements that may have benefits include: 

  • Vitamin B12: Experts believe a vitamin B deficiency may cause or contribute to psychosis. Some research suggests that supplementing with B vitamins can reduce symptoms of schizophrenia 
  • Polyunsaturated fats (PUFA): A deficiency in these fatty acids can cause abnormalities in the brain that may lead to symptoms of psychosis, but supplementing with omega-3 fats, a type of PUFA, may help improve symptoms of psychosis. 
  • Vitamin D: Low levels of this vitamin may increase the risk of experiencing psychosis. But evidence suggests vitamin D supplements may help reduce symptoms of depression, which often occurs alongside psychosis. 

Doing cold water therapy

Emerging research suggests exposing yourself to cold water — such as with cold showers or ice baths — may help improve your mood and ease symptoms of depression. 

Other strategies

Lagoy says it is important for people with psychosis to avoid drugs — like cannabis and cocaine — and limit alcohol consumption since these substances can alter the chemistry of your brain and raise your risk of experiencing symptoms. 

Read the full Insider article with sources. 

Julian C Lagoy, M.D.

San Jose, CA

Julian Lagoy, M.D. is a board-certified psychiatrist. He received his bachelor’s degree in philosophy from the University of Notre Dame and his medical degree from St. George’s University. Dr. Lagoy completed his psychiatry residency at Virginia Tech Carilion School of Medicine. Dr. Lagoy has published in multiple medical journals and has presented his research at the American Psychiatric Association National ... Read Full Bio »

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