Personal involvement with someone possibly psychotic?
March 18, 2006 6:38 AM   Subscribe

I've recently found out a person I know could truly be psychotic. So my question is what are the general guidelines for psychosis and when does personal involvement with someone suspected of being psychotic become dangerous?

As more background, this person I know is a compulsive liar. But the lies are getting more hurtful and what I mean by this, is that the person actually will start yelling at me and screaming they can't talk because they're at work where cell phones are prohibited. I've found out later this person was not at work but sitting at a coffee shop at the time of the call. I know compulsive lying is unfortunately common, but when mixed with a short tempers and outbursts, is it verging onto dangerous psychosis where personal safety is called into question?
posted by anonymous to Health & Fitness (15 answers total)
Unless you're in a position to admit them; unless they've done something that needs to be reported to the police, the only thing you can do is warn people away, and get away yourself. Even when you're married to someone who's mentally ill and dangerously unstable, it's very, very, very difficult to get help for someone like that if they won't go along with it, let alone a friend or acquaintance.
posted by headspace at 7:11 AM on March 18, 2006

There is a huge gap between being an aggro jerk liar and being psychotic. Psychosis really means that person has some sort of break from what is commonly accepted to be reality. This is different from lying where the person knows and understands the truth but is choosing to misrepresent it. From your question, it's clear that much more information needs to be gathered. For example, if this person acts this way with you -- because you have some sort of history together -- and not with others, they are likely not psychotic. For more information you can go to this aptly named website for a list of what sorts of things you can expect to see in psychotic people. Note that lying is nowhere on that page. As far as interactions with a psychotic, they are much more in danger of harming themselves than doing harm to others. If they are at a point where they are actively delusional [I had a cousin who was/is a psychotic schizophrenic] you would be well advised to try to get them to seek psychological assistance. I am not a doctor but the person you are describing does not sound psychotic based only on what you have stated.
posted by jessamyn at 7:14 AM on March 18, 2006

What you describe does not even begin to approach the level of psychosis. It does however sound like depression.

I am not a shrink.
posted by mischief at 7:18 AM on March 18, 2006

If the lying turns into delusions, then you may have a problem. I had a friend that was always a bit "off". Not a liar, but certainly was out of step with the rest of the world. Over the course of the summer he began to have manic episodes, and I noticed started to notice delusional thinking on a grand scale. These were not lies... but true breaks with reality. Within a month, he "accidentally" set his apartment on fire and nearly died from the burns.
posted by kimdog at 7:30 AM on March 18, 2006

So my question is what are the general guidelines for psychosis and when does personal involvement with someone suspected of being psychotic become dangerous?

i think psychosis is a little too general a term to be of much help

also, i think personal involvement with a psychotic person is going to become unpleasant and unrewarding long before it becomes dangerous

even if it doesn't get to that point of psychosis or danger ... why deal with a person who's treating you like crap? ... do you have to put up with it? ... is that person that important to you?

you could suggest professional help i guess ... but more importantly, you could say that if the lies and abuse continue that you're not interested in being around them anymore

sometimes it's a good idea to worry about yourself and not the other person
posted by pyramid termite at 8:04 AM on March 18, 2006

jessamyn's comment is useful, but it sounds to me like you've given this person too much of your time already.

Am I the only person left in the world who thinks that if someone lies to me a second time they're not worth my time anymore?

but that's just me seeing what I want in the question.
posted by tiamat at 8:10 AM on March 18, 2006

If a person feels a strong lack of personal power to control the events in their life, then they will often resort to lying as a method for exerting some control in a situation. If the lie is challenged, then one strategy commonly used to defend the lie is a temper tantrum.

To put it another way, depression is the feeling associated with a belief in being powerless about controlling the circumstances in one's life. Anger is the first step in trying to regain that power. A natural progression back into empowerment would be; depression>anger>revenge>frustration>hope... . Unfortunately, expressing anger/revenge makes everyone but the depressed person acutely uncomfortable and so we teach anger management to get them to suppress those first steps out of the morass. The result is that they slide right back into depression. The pent up emotions make each successive outburst more energetic (and threatening), causing the rest of us to advocate "putting them away".

Unfortunately, chemical management of the depression/anger cycle doesn't address the underlying cause of the disempowerment, it only blunts the emotional response, making the patient more socially acceptable. If the chemical mediation is accompanied by therapy designed to rebuild the patient's belief in their own power, then it is often successful.
posted by RMALCOLM at 8:30 AM on March 18, 2006

Just another affirmation that (a) this person probably does not suffer from clinical psychosis, and that (b) you should distance yourself from him.

This guy clearly has a serious problem of some sort, but there's a difference between people who lie to manipulate (which it sounds like your friend is doing) and those who talk about things (often events or people) that don't exist.

I'm inclined toward mischief's armchair diagnosis, but it's very hard to say with such limited info. Compulsive lying is often associated with insecurity, which is often linked to depression.

Or, your friend may simply be an asshole.

Bottom line, it's not your place to try to figure out "his problem". And the answer to this:

when does personal involvement with someone suspected of being psychotic become dangerous?

is that if it gets to that point, you'll know. Trust me.
posted by mkultra at 8:33 AM on March 18, 2006

I know compulsive lying is unfortunately common, but when mixed with a short tempers and outbursts, is it verging onto dangerous psychosis where personal safety is called into question?

If you're asking the question you already know the answer.

(Although as others point out this does not sound like clinical psychosis it sounds bad. It sounds more like borderline personality disorder if you want to give it a name).
posted by unSane at 8:40 AM on March 18, 2006

unSane, there is not enough information to diagnose BPD in this post.
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
It would be safer to say that this person has issues to work out absent further information. Those issues may be traumatic, behavioral, or otherwise, but there are likely other things a professional would treat for first rather than jumping straight to a diagnosis of BPD. Furthermore, if the person discussed in the post is not a woman, the chances are significantly less likely to be diagnosed with BPD, at least from a statistical standpoint.

Personally, I'd advise staying out of the other person's mental health issues unless you have a personal, non-professional relationship with this person. Even then, there are a limited set of circumstances in which I'd advise intervention. As for how to handle such disruptive behavior, I'd recommend practicing ignoring it, deflecting it, or otherwise removing yourself from situations you react negatively to.
posted by sequential at 9:29 AM on March 18, 2006

I hvae to agree with the other posters -- this friend doesn't sound psychotic. If you ever encounter someone in a true psychotic episode, you will never forget the feeling of crisis, danger, and hopefully luck if you escape unharmed. Still, you should think twice about associating yourself with anyone who makes you fear for your safety, psychotic or not. You won't recognize the full stress and damage it does to your psyche for years to come.
posted by mrmojoflying at 9:46 AM on March 18, 2006

This person you're speaking of may just not like you and may just be trying to make you go away.
posted by pracowity at 9:49 AM on March 18, 2006

As usual, jessamyn's answer is very good. There's no basis for any kind of diagnosis presented in the question, depression, borderline or otherwise, but from the information the poster provided we can rule out psychosis. Nothing described by the poster indicates psychosis, unless the person in question believes the false things they're saying, in which case, they might be psychotic but would not be lying.
posted by OmieWise at 10:39 AM on March 18, 2006

You don't say in your question what reason you might have for not just ceasing contact with this person. Absent a very compelling reason that you must maintain contact with this person (wanting to help or caring about him/her is not a good enough reason), you should just cease contact, whether he/she is psychotic or not. He/she is still abusive and messed up, and it is better for you if you have nothing to do with him/her (don't know why you were deliberate vague about the sex of "this person").
posted by Dasein at 3:27 PM on March 18, 2006

"I've recently found out a person I know could truly be psychotic." Psychotic is one of the most misunderstood and misused words in the vernacular. Leave the labels to the pros and deal with the guy on a level you are familiar more familiar with.
posted by phewbertie at 8:03 AM on March 19, 2006

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