Tag: Psychosis

Epileptic Psychosis or Demonic Possession?

Epileptic psychosis—often termed psychotic epileptic disorder—is a condition where epilepsy intersects with psychotic symptoms. This essay explores its classification, clinical features, real-life examples, and correlations to historical cases misinterpreted as demonic possession requiring exorcism. Through rigorous review, I aim to highlight medical realities over stigma, advocating for integrated care in mental health and neurology.

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Psychotic epileptic disorder, or epileptic psychosis, refers to psychotic episodes occurring in individuals with epilepsy, where symptoms like hallucinations and delusions arise in temporal relation to seizures (Mental Health, 2025). It affects 3-7% of epilepsy patients, significantly higher than the 1% schizophrenia prevalence in the general population, with elevated risk in temporal lobe epilepsy (TLE) and uncontrolled seizures (Mental Health, 2025; Epilepsy Action, 2025a).

Classification includes pre-ictal psychosis (PrP), occurring hours to days before seizures with anxiety and derealisation; ictal psychosis (IP), during seizures featuring fear and automatisms; interictal psychosis (IIP), between seizures resembling schizophrenia but with better prognosis; postictal psychosis (PIP), following seizures after a lucid interval with emotionally charged delusions; and forced normalisation (FN), paradoxically triggered by seizure control (Wang et al., 2024; Epilepsy Action, 2025a).

Clinical features encompass delusions, hallucinations, paranoia, social withdrawal, disorganised thinking, and mood swings (Mental Health, 2025; Epilepsy Foundation, n.d.). For instance, in PIP—the most common type—symptoms like violent behaviour or self-harm emerge 12-72 hours post-seizure, lasting up to two months (Epilepsy Action, 2025a). Causes involve neurobiological mechanisms: structural changes like hippocampal volume loss, neurotransmitter imbalances (e.g., reduced glutamate and GABA), neuroinflammation via cytokines (IL-1β, IL-6, TNF-α), and genetic factors such as mutations in GRM1 or CNTNAP2 (Wang et al., 2024). Anti-seizure medications (ASMs) like topiramate or levetiracetam can precipitate psychosis, especially in those with family history (Epilepsy Action, 2025a). Diagnosis requires specialist assessment, including EEG to link symptoms to seizure activity, distinguishing it from primary psychoses (Mental Health, 2025).

Treatment emphasises coordinated neurology-psychiatry care, balancing seizure control with antipsychotics. For IP and PrP, seizure management suffices; PIP often resolves spontaneously but may need benzodiazepines; IIP and FN require antipsychotics like olanzapine or risperidone, with ASM adjustments (Mental Health, 2025; Wang et al., 2024). Early intervention teams and psychosocial support—case management, vocational rehab—aid functioning, as untreated episodes worsen cognition and independence (Mental Health, 2025).

Historically, epileptic psychosis has been misinterpreted as demonic possession, leading to exorcisms instead of medical intervention. In ancient times, epilepsy—termed the “sacred disease”—was attributed to supernatural forces, with seizures and psychotic symptoms seen as divine or demonic invasions (Trimble and Reynolds, 1976). This persisted into modernity, correlating with cases where TLE-induced hallucinations were deemed possession. The most infamous is Anneliese Michel (1952-1976), a German woman diagnosed with TLE and psychosis at 16, experiencing convulsions, hallucinations of “devil faces,” auditory commands of damnation, self-harm, and aversion to religious objects (Wikipedia, 2025). Despite treatments like Dilantin, Aolept, and Tegretol for five years, symptoms worsened, leading her devout Catholic family to interpret them as possession by demons like Lucifer and Hitler (Wikipedia, 2025; Goodman, 2005).

Real photos from Anneliese Michel.

Michel underwent 67 exorcism sessions from 1975-1976 by priests Ernst Alt and Arnold Renz, authorised by Bishop Josef Stangl, involving rituals where she growled, screamed curses, and refused food, dying of malnutrition at 30kg (Wikipedia, 2025; Duffey, 2011). Autopsy confirmed dehydration, pneumonia, and broken knees from genuflections, not supernatural causes (Wikipedia, 2025). Her 1978 trial convicted her parents and priests of negligent homicide, with probation, as experts attributed symptoms to untreated epilepsy and psychosis exacerbated by religious upbringing (Wikipedia, 2025; Getler, 1978). This case, inspiring films like The Exorcism of Emily Rose, exemplifies how TLE’s temporal lobe involvement—causing religious delusions and hallucinations—mimics possession, delaying care (Forcen, 2016).

Scene from The Exorcism of Emily Rose.

Modern examples show the impact of the disorder. In postictal psychosis, a patient experiences confusion, delusions, and hallucinations after partial seizures, resembling schizophrenia and causing social isolation if it happens often (Mental Health, 2025). Ictal psychosis occurs briefly during seizures, showing symptoms like auditory hallucinations and agitation in TLE cases, resolving after the seizure but can recur without treatment (Mental Health, 2025). Interictal psychosis, common in chronic uncontrolled TLE, leads to persistent threatening voices and cognitive decline, especially in patients with hippocampal sclerosis who show EEG abnormalities and need long-term antipsychotics (Wang et al., 2024). A Korean family with a specific genetic deletion showed epilepsy and schizophrenia-like psychosis, pointing to genetic factors (Wang et al., 2024). After temporal lobectomy, about 7% of patients over 30 experience temporary delusions that can be treated with medication adjustments (Mental Health, 2025).

Other historical examples include 17th-century European “possession” epidemics, where convulsive symptoms now recognised as epilepsy or conversion disorder led to exorcisms (Schwarz, 2014). In Christian contexts, epilepsy’s association with demons stemmed from biblical accounts, like Yeshua casting out spirits causing seizures (Mark 9:14-29, n.d.; KJV), influencing interpretations (Young, 2016). A 2013 thesis links such misdiagnoses to cultural fears, with “demonic” behaviours aligning with PIP’s aggression or IP’s automatisms (Snyman, 2025). In non-Western cultures, similar correlations persist, with epilepsy stigma leading to spiritual interventions over medical (Trimble and Reynolds, 1976).

Forensic profiling reveals these misinterpretations stem from limited medical knowledge, cultural-religious frameworks, and stigma, profiling “possession” as undiagnosed epileptic psychosis (Epilepsy Action, 2025b). Modern neuroimaging confirms brain-based origins, advocating evidence-based treatment over exorcism (Wang et al., 2024).

In conclusion, psychotic epileptic disorder underscores epilepsy-psychosis interplay, with real examples like post-surgical flares and historical cases like Michel’s highlighting risks of misdiagnosis. This should be profiled as a call for destigmatisation and integrated care, preventing tragedies through science over superstition.

References

Duffey, J.M. (2011) Lessons Learned: The Anneliese Michel Exorcism. Wipf and Stock Publishers. Available at: https://wipfandstock.com/9781608996643/lessons-learned/ (Accessed: 14 October 2025).

Epilepsy Action (2025a) Psychosis and epilepsy. Available at: https://www.epilepsy.org.uk/living/psychosis-and-epilepsy (Accessed: 14 October 2025).

Epilepsy Action (2025b) The history of epilepsy. Available at: https://www.epilepsy.org.uk/info/what-is-epilepsy/history (Accessed: 14 October 2025).

Epilepsy Foundation (n.d.) Psychosis. Available at: https://www.epilepsy.com/complications-risks/moods-behavior/psychosis (Accessed: 14 October 2025).

Forcen, F.E. (2016) Monsters, Demons and Psychopaths. Taylor & Francis. Available at: https://www.taylorfrancis.com/books/mono/10.4324/9781315382760/monsters-demons-psychopaths-fernando-espi-forcen (Accessed: 14 October 2025).

Getler, M. (1978) ‘Cries of a Woman Possessed’, The Washington Post. Available at: https://www.washingtonpost.com/archive/politics/1978/04/21/cries-of-a-woman-possessed/ (Accessed: 14 October 2025).

Goodman, F.D. (2005) The Exorcism of Anneliese Michel. Wipf and Stock Publishers. Available at: https://wipfandstock.com/9781597524322/the-exorcism-of-anneliese-michel/ (Accessed: 14 October 2025).

Mark (n.d.), Chapter 9, Verses 14-29, King James Version, Bible Gateway. Available at: https://www.biblegateway .com/passage/?search=Mark%209%3A14-29&version=KJV (Accessed 22 October, 2025)

Mental Health (2025) Epileptic Psychosis. Available at: https://www.mentalhealth.com/library/epilepsy-with-psychosis (Accessed: 14 October 2025).

Schwarz, H. (2014) Beware of the Other Side(s). transcript Verlag. Available at: https://www.transcript-verlag.de/978-3-8376-2488-5/beware-of-the-other-side-s/ (Accessed: 14 October 2025).

Snyman, M. (2025) ‘Hall of Horror: The Tragic Exorcism of Anneliese Michel’, Monique Snyman. Available at: https://moniquesnyman.com/hall-of-horror-the-exorcism-of-anneliese-michel/ (Accessed: 14 October 2025).

Trimble, M.R. and Reynolds, E.H. (1976) ‘Epilepsy, behaviour and cognitive function’, John Wiley & Sons. Available at: https://pubmed.ncbi.nlm.nih.gov/8051941/ (Accessed: 14 October 2025).

Wang, Y. et al. (2024) ‘Psychosis of Epilepsy: An Update on Clinical Classification and Mechanism’, PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11762389/ (Accessed: 14 October 2025).

Wikipedia (2025) Anneliese Michel. Available at: https://en.wikipedia.org/wiki/Anneliese_Michel (Accessed: 14 October 2025).

Young, F. (2016) A History of Exorcism in Catholic Christianity. Palgrave Macmillan. Available at: https://link.springer.com/book/9783319291116 (Accessed: 14 October 2025).

31 Oct 2025
Non-Pharmacological Approaches to Treating Psychosis

Psychosis is a serious mental health condition that can greatly impact an individual’s daily functioning and quality of life. While pharmacological treatments are often prescribed to help manage symptoms of psychosis, there are also non-pharmacological approaches that can be effective in treating this condition.

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One such approach is cognitive behavioral therapy (CBT), which aims to help individuals identify and change negative thought patterns that may contribute to their psychotic symptoms. Through CBT, individuals can learn coping strategies to help them better manage their symptoms and improve their overall mental well-being.

Another non-pharmacological approach to treating psychosis is social support and therapy. Having a strong support system of family, friends, and mental health professionals can be crucial in helping individuals with psychosis navigate their symptoms and find ways to cope. Group therapy can also be beneficial, as it allows individuals to connect with others who are experiencing similar struggles and can provide a source of understanding and encouragement.

Mindfulness-based interventions, such as mindfulness meditation and yoga, have also shown promise in helping individuals with psychosis manage their symptoms. These practices can help individuals become more aware of their thoughts and emotions and learn to respond to them in a more adaptive way. By incorporating mindfulness into their daily routine, individuals can reduce stress and anxiety, which may in turn help to alleviate symptoms of psychosis.

Additionally, lifestyle factors such as exercise, healthy eating, and adequate sleep can play a significant role in managing psychosis symptoms. Regular physical activity has been shown to have positive effects on mental health, while a balanced diet and sufficient sleep can help regulate mood and energy levels.

Overall, non-pharmacological approaches to treating psychosis can be effective in improving symptoms and quality of life for individuals with this condition. While medication may still be necessary for some individuals, incorporating these non-pharmacological interventions into a comprehensive treatment plan can help individuals better manage their symptoms and lead a fulfilling life. It is important for individuals with psychosis to work closely with mental health professionals to determine the best course of treatment for their specific needs.

6 Jun 2024
The Savior Syndrome: Unpacking The Christ Complex

Have you ever heard of the Savior Syndrome, also known as the Christ Complex? It is a psychological phenomenon where individuals feel the need to save or rescue others, often at the expense of their own well-being. This desire to play the role of a savoir can stem from a variety of factors, such as a need for validation, a desire for control, or a fear of being alone.

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Those who exhibit the Savior Syndrome may constantly seek out situations where they can be seen as the hero, whether it be in their personal relationships, at work, or in their communities. They may go above and beyond to help others, even when it is not asked for or needed. This can lead to feelings of burnout, resentment, and even harm to themselves and those they are trying to save.

It is important to recognise the signs of the Savior Syndrome in ourselves and in others. If you find yourself constantly putting others’ needs before your own, feeling responsible for everyone else’s happiness, or feeling guilty when you cannot fix someone else’s problems, you may be experiencing the Savior Syndrome.

One way to combat the Savior Syndrome is to practise self-care and set boundaries. It is important to remember that it is not your responsibility to save everyone, and that it is okay to prioritise your own well-being. Learning to say no and seeking help when needed can help prevent burnout and maintain healthy relationships.

If you suspect that someone you know may be struggling with the Savior Syndrome, it is important to approach the situation with compassion and understanding. Encourage them to seek help from a therapist or counsellor, and offer support in setting boundaries and practising self-care.

Overall, the Savior Syndrome can be a harmful pattern of behaviour that can negatively impact both the individual experiencing it and those around them. By recognising the signs and taking steps to address it, we can break free from the cycle of constant rescuing and learn to prioritise our own well-being. Remember, you are not responsible for saving everyone – sometimes the best way to help others is to take care of yourself first.

30 Apr 2024
Understanding the Psychotic, the Neurotic, and the Borderline: Navigating the Spectrum of Mental Health

The field of mental health is vast and complex, with numerous conditions and disorders that affect individuals in unique ways. In this blog post, we will delve into three specific disorders: the psychotic, the neurotic, and the borderline. By understanding these conditions, we hope to shed light on the challenges faced by those who live with them and dispel misconceptions surrounding their experiences.

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1. The Psychotic

Psychosis refers to a state of mind in which an individual experiences a loss of touch with reality. While it is crucial to remember that each case is unique, common symptoms may include hallucinations, delusions, disorganised thinking, and difficulty distinguishing between what is real and what is not. Conditions such as schizophrenia and schizoaffective disorder fall under this category.

People with psychosis often encounter significant social stigma and widespread misunderstanding, leading to feelings of isolation and fear. It is important to approach the psychotic experience with empathy and to support affected individuals through appropriate therapeutic measures and medications.

2. The Neurotic

The term “neurotic” has a long history and has been used differently over time. In the context of mental health, it refers to individuals experiencing anxiety, depression, and other related disorders, often influenced by personal experiences, genetics, or environmental factors. Unlike psychosis, those classified as neurotic can typically maintain contact with reality.

Generalised anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) are examples of neurotic conditions. Guided therapy, self-help techniques, and, if necessary, psychiatric medication can be valuable in helping individuals work through and manage neurotic symptoms.

3. The Borderline

Borderline personality disorder (BPD) is a complex mental health condition characterised by difficulties in regulating emotions, impulsivity, unstable relationships, and a distorted self-image. Individuals with BPD often experience intense emotional pain, a fear of abandonment, and drastic mood shifts.

Understanding BPD is crucial as it is often mischaracterised or dismissed due to stereotypes. A comprehensive treatment plan involving specialised therapy, dialectical behaviour therapy (DBT), or cognitive-behavioural therapy (CBT) can help individuals with BPD develop healthier coping mechanisms, build interpersonal skills, and improve their overall quality of life.

Conclusion

Exploring the world of mental health disorders naturally brings us face-to-face with the complexities and uniqueness of each individual’s experiences. While this blog post offered a glimpse into the psychotic, the neurotic, and the borderline, it is crucial to remember that mental health is a continuum, with many disorders and conditions fitting somewhere along the spectrum.

By seeking to understand and support individuals with mental health conditions, we can help reduce stigma and create a more compassionate society. Remember, mental health disorders do not define individuals, but rather add a layer to their multidimensional lives.

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15 Feb 2024
Hearing Voices: Understanding the Complexity of Auditory Hallucinations

In the realm of mental health, hearing voices has been a topic of intrigue and confusion for many. Popularised in popular culture through movies and TV shows, auditory hallucinations are often portrayed in a sensationalised manner, perpetuating stereotypes and misinformation. However, the reality of hearing voices is far from what is usually depicted. It is a subjective experience that affects individuals in varying ways and requires a nuanced understanding to truly comprehend its complexity.

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What are auditory hallucinations?

Auditory hallucinations, commonly referred to as “hearing voices,” occur when an individual perceives sound that isn’t present in the external environment. These voices can manifest as various sounds, including whispers, murmurs, or loud, commanding instructions. Contrary to common misconceptions, hearing voices is not exclusive to individuals with severe mental illnesses. In fact, studies have shown that approximately 5-15% of the general population experience auditory hallucinations at some point in their lives.

Exploring the causes

Understanding the causes of hallucinations is crucial in demystifying this phenomenon. While they are commonly associated with schizophrenia, hearing voices can result from a myriad of factors. Sensory deprivation, extreme stress, sleep deprivation, drug use, as well as certain medical conditions such as epilepsy or brain tumours, may trigger auditory hallucinations. Additionally, recent research has highlighted the role of social and cultural factors in shaping the auditory experiences of individuals, further emphasising the need for a holistic understanding.

The subjective nature of hearing voices

It is essential to recognise that hearing voices is a unique and highly subjective experience. The voices can vary greatly in terms of tone, content, and perceived intentions. Some individuals find comfort or guidance in their voices, perceiving them as benign or helpful sources of communication. Others, however, may find the experience distressing, with voices providing negative commentary or issuing distressing commands. It is crucial to remember that these experiences are highly personal and can significantly impact an individual’s emotional well-being and sense of reality.

Support and coping strategies

Offering support and understanding to individuals who hear voices is vital for their overall well-being. Encouraging open dialogue about auditory hallucinations, while respecting the individual’s experience, is crucial. Mental health professionals often employ techniques such as cognitive-behavioural therapy (CBT) to help individuals develop coping strategies to manage distressing voices. It is important to note that not all individuals who hear voices require treatment, as some manage their experiences without significant interference in their daily lives. Nonetheless, it is essential to provide resources and avenues where individuals can seek support if needed.

Challenging stigma and raising awareness

Addressing the stigma surrounding hearing voices is pivotal in ensuring that individuals are met with empathy and understanding. Media portrayals and societal misconceptions perpetuate negative stereotypes and hinder open conversations surrounding auditory hallucinations. By debunking myths and raising awareness about the subjective and multifaceted nature of hearing voices, we can foster an environment that promotes acceptance and encourages individuals to seek help without fear of judgement.

Conclusion

Hearing voices is a complex and multifaceted experience that affects individuals from diverse backgrounds. It is crucial to approach auditory hallucinations with empathy, recognising that experiences may differ vastly from person to person. By fostering understanding, challenging stigma, and promoting accurate information, we can create a supportive environment where individuals who hear voices can openly discuss their experiences and access the necessary resources and support.

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24 Jan 2024
Brief Psychotic Disorder: Understanding the Enigma of Temporary Psychosis

Psychosis is a complex mental health condition characterised by a temporary loss of contact with reality. Among its lesser-known variants is Brief Psychotic Disorder (BPD), a condition that often catches individuals and their loved ones off guard due to its temporary nature. In this blog post, we will delve into the enigmatic world of BPD, exploring its symptoms, causes, and available treatment options.

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Understanding Brief Psychotic Disorder

Brief Psychotic Disorder, also referred to as Acute and Transient Psychotic Disorder, is a relatively rare mental health condition affecting less than 1% of the general population. What sets BPD apart from other forms of psychosis is its short duration. The disorder typically lasts less than a month, with symptoms lasting for at least a day but no longer than a month.

Signs and Symptoms

Individuals experiencing BPD may exhibit a range of symptoms, including:

1. Delusions: The person may develop false beliefs that are not based on reality, such as being persecuted or having a special mission.

2. Hallucinations: Seeing or hearing things that aren’t actually there is a common symptom of BPD.

3. Disorganised behaviour: Erratic or unpredictable behaviour, including bizarre speech patterns or movement.

4. Catatonia: Immobility or a lack of responsiveness, where the person appears frozen or unresponsive to their surroundings.

Causes

While the exact cause of brief psychotic disorder remains unclear, it is thought to result from a combination of genetic and environmental factors, much like other mental health disorders. Some contributing factors that may increase the risk of developing BPD include:

1. Family history of mental disorders: Having a close relative with a psychotic disorder may increase the likelihood of developing brief psychotic disorder.

2. Substance abuse: Excessive use of drugs or alcohol can trigger brief episodes of psychosis.

3. High levels of stress or trauma: Traumatic events, such as the loss of a loved one or experiencing abuse, can contribute to the development of BPD.

Treatment

As brief psychotic disorder is a time-limited disorder, treatment often focuses on managing and alleviating symptoms during the episode. Psychotic episodes can be distressing for the affected individual and those around them, and prompt intervention is crucial. Treatment options may include:

1. Medication: Antipsychotic medications are often prescribed to reduce the severity of symptoms and help restore stability.

2. Psychotherapy: Individual or group therapy can provide support, improve coping mechanisms, and help individuals understand and manage their experiences.

3. Hospitalisation: In severe cases or when individuals are a danger to themselves or others, a brief hospital stay may be required to ensure safety and provide intensive care.

Support and Recovery

Once the episode subsides, individuals with BPD often experience a full recovery without any long-term residual psychosis. However, it is essential to develop a robust support system to aid in the recovery process. Regular follow-up appointments with mental health professionals and engaging in self-care activities can greatly contribute to overall well-being and reduce the risk of future episodes.

Conclusion

Brief Psychotic Disorder may be temporary, but the impact it can have on an individual’s life and their loved ones is substantial. By increasing awareness and understanding of brief psychotic disorder, we can provide early intervention and support those who experience this perplexing condition. Remember, recovery is possible, and with proper care, individuals can find their way back to stability, resilience, and restored mental health.

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7 Jan 2024
Neurosis, Psychosis, and Deluded Idealism

The human mind is a complex and mysterious entity, capable of astonishing brilliance as well as profound disturbances. Within the realm of mental health, three distinct phenomena stand out as significant challenges: neurosis, psychosis, and deluded idealism. In this blog post, we will delve into these intriguing psychological concepts, aiming to shed light on their nature, causes, and potential impacts on individuals and society.

1. Unpacking Neurosis

Neurosis refers to a broad spectrum of psychological disorders characterised by excessive anxiety, distress, and internal conflicts. It often manifests in symptoms such as obsessive-compulsive disorder (OCD), phobias, or generalised anxiety disorder (GAD). Neurotic behaviours stem from unresolved conflicts originating from childhood or traumatic experiences. They can shape an individual’s perception of reality and influence their daily interactions.

2. Investigating Psychosis

In stark contrast to neurosis, psychosis involves a severe impairment of thought processes and a loss of contact with reality. Individuals experiencing psychosis may exhibit symptoms such as hallucinations, delusions, disorganised thinking, and altered perceptions. Schizophrenia is one of the most well-known and complex psychotic disorders. While the exact causes remain unclear, psychosis has been linked to genetic predispositions, abnormal brain chemistry, trauma, or extreme stressors.

3. Unravelling Deluded Idealism

Deluded idealism, sometimes referred to as grandiose delusion, occurs when individuals maintain a deeply entrenched belief in their own unparalleled greatness or a mission of cosmic significance. This delusion often leads to destabilising consequences, as the individual may become disconnected from reality and exhibit erratic or even dangerous behaviour. Deluded idealism can arise as a symptom of mental illness, but it might also stem from strong narcissistic traits or an overzealous attachment to extreme ideologies.

Implications and Connections:

Though neurosis, psychosis, and deluded idealism each present distinct challenges, they share common threads that connect the spectrum of human behaviour. These conditions highlight the extent to which perceptions, understandings, and interpretations of reality can become distorted or veer off-course. However, it is crucial to approach individuals grappling with these conditions with empathy, compassion, and an appreciation for the complexity of their experiences.

The Role of Mental Health Support

The treatment of neurosis, psychosis, and deluded idealism requires professional expertise and tailored interventions. Psychotherapy, counselling, and medication are often employed to address the underlying causes and symptoms associated with these disorders. Timely and appropriate mental health support can help individuals navigate through their challenges, fostering resilience, improving functionality, and restoring a better quality of life.

Society’s Collective Responsibility

Beyond individual responsibilities, society has a vital role to play in promoting mental health in general. Educating the public about various mental health disorders, combating stigma, and ensuring access to affordable mental health services are all crucial in offering support to those struggling with neurosis, psychosis, or deluded idealism. By fostering a more inclusive and empathetic society, we can create an environment where everyone can find the help and understanding they need.

Conclusion

Neurosis, psychosis, and deluded idealism are challenging psychological concepts that demand our attention and understanding. By exploring these phenomena, we can develop a more compassionate approach to mental health, both individually and as a society. Remember, reaching out for support and nurturing an open dialogue about mental well-being can make a significant impact in the lives of those affected, fostering a path towards healing and a brighter future.

7 Dec 2023