It's pretty easy to spot me (or most people, if you know them) being manic: excessively chatty, irritable, spending money I can't afford, excess energy, delusions of brilliance - pretty typical symptoms. It's only after I've been manic (fully-blown) for a few days that the paranoia creeps in.
I begin by reading significance into things that have no significance; a classic example being to hold the notion that the songs on the radio are 'telling' me something, or that the television is conveying a special message for me, usually sinister. I then start being convinced of conspiracy theories, especially that people close to me have evil intentions. Finally I get external auditory hallucinations (voices) which are terrifying, nasty and mocking. By the final stages I am well onto needing to be in hospital asap.
I cope with becoming unwell pretty effectively these days; because I live alone I don't infringe on other peoples wellbeing. I am aware that "it's happening" even though my grip on sanity is slipping.
When I start to feel like my mania is escalating out of control I ring my regional Psych triage; they have me on their files having rung them in the past. They instruct me to make an emergency appointment with my Psychiatrist, which I do at the earliest opportunity. If there is a wait to see my Psych I keep in frequent touch with the Psych triage number (which I'm sure drives them batty). If need be they fax my Psych about how I'm presenting over the phone, this can speed up seeing my Psych and if needed, getting a bed in hospital (private - as a voluntary patient).
If I didn't have private heath insurance I would have to solely rely on the Psych Triage service and seeing my Doctor until (a) I got better along with adjusted meds my doctor would prescribe me or (b) my condition worsened and I totally lost the plot and needed to go to Public Psych hospital as an involuntary patient, although not all people who go in the public system are involuntary.
One main difference that strikes me between public and private psych hospitals is that in the public system you get more violence; both verbal and physical. In the private one you have to sign a contract upon admission saying you won't physically or verbally assault anyone during your stay.
I guess what I'm trying to say is that for me psychosis is a gradual culmination of unwellness; I'm not nor would I ever be likely to just "snap" into being psychotic. There is a lead up to getting unwell, as described above. I wish people in the community would bother to learn a bit more about it, not just to assume things about psychosis from what they read/hear in the media (eg: man shot by police after wielding samuri swords and lunging at them; he was known to have schizophrenia).
The other thing I wish people understood is how terrifying it is to be in a psychosis; it's like a sinister nightmare, with distortions of reality lasting for days or even weeks until the antipsychotic medication has a chance to work. Then you tend to get really tired (heavy dose of meds) and put on weight (most antipsychotics really increase your appetite). Several weeks afterwards, there's post-psychotic depression, a really black place to go. Sucks, hey?
I wish someone with political clout had the experience of psychosis (not that I'd really want to wish it upon somebody), so that the politicians could do more than pay lip service to improving mental health care. So many people with serious psych illnesses are disenfranchised, or they slip through the cracks of the public system, never receiving adequate care and assistance.
I'm fortunate; when I got really sick in 2003 I did get appropriate care for a change; the rebuilding has be slow but steady. However I know I am in a minority.
Housing is a major issue; I couldn't have anywhere near my current peace of mind were I still in transitional housing. Other people aren't so lucky.
So.....psychosis.....yes I've strayed from the topic. If you're in the company of someone with schizoaffective disorder it's highly unlikely they would become verbally or physically agressive unless they were unwell, and that would, in my opinion be pretty obvious. I guess the point I'm making is that people don't just 'snap'; I never have. It's a build up of behaviours as described. I guess the perception that all people who have been psychotic/have the potential to be psychotic are dangerous is a sad reality. A perception based on misrepresentation and ignorance.
