Spiritual Awakening or Psychosis? How to Tell the Difference

A spiritual awakening can bring strong experiences. People describe visions, a feeling of oneness, sensing a presence, or the sense that everything has meaning. Some go days with little sleep because they feel so lit up.

Psychosis is a health condition where a person loses touch with what is real. It can include hearing or seeing things others do not, and holding beliefs that do not change even when the facts say otherwise. Psychosis can come from many causes, like lack of sleep, drugs, stress, bipolar disorder or schizophrenia.

You can see the overlap. Both can involve unusual experiences and a sudden sense of meaning. That is why people search for spiritual psychosis, and why the question can be so scary for the person living it and for their family.

In 1989, the psychiatrist Stanislav Grof and his wife Christina Grof published a book called Spiritual Emergency: When Personal Transformation Becomes a Crisis. They used the term spiritual emergency for a spiritual opening that becomes so strong it turns into a crisis.

Their idea was that some intense experiences may be part of growth, and that people going through them deserve to be treated with respect, not only as a list of symptoms. In 1994, the DSM-IV, a main handbook of mental health diagnoses in the US, added a category called "religious or spiritual problem". It gave doctors a way to note spiritual struggles without calling them a mental illness.

This matters because it shows that doctors and spiritual teachers do not have to be on opposite sides. It does not mean that every crisis is spiritual. Even people who believe in spiritual emergency agree that safety, sleep and medical care come first.

Whatever the cause, these signs mean a person needs help from a doctor now. One sign alone is enough to act.

• Not sleeping for days: Little or no sleep for two or more nights, often without feeling tired.
• Voices giving orders: Hearing voices others do not hear, especially ones that tell the person what to do.
• A special mission and no fear: Believing they have a chosen task and cannot be hurt, and acting in risky ways because of it.
• Paranoia: Feeling that people are watching, following or plotting against them.
• Not able to care for themselves: Not eating, drinking, washing or keeping safe, or not able to care for children.
• Confused speech: Talking very fast, jumping between ideas, or being hard to follow.
• Thoughts of harm: Any talk or thoughts of hurting themselves or someone else.

Many people feel stuck between two fears. If they see a doctor, they worry their experience will be called "just" an illness. If they do not, they worry something is really wrong.

You do not have to settle that question alone, or right away. You can see a doctor and still believe your experience has spiritual meaning. A good doctor will not ask you to give up your faith. They will check your body, your sleep and your mind, and help you feel safe again.

It also helps to know that care for psychosis often works best when it starts early. Getting checked soon is a kind thing to do for yourself.

Some signs that an experience may be moving in a gentler direction are sleeping and eating fairly normally, being able to talk about it calmly, still caring for daily life, and being open to other views. Even then, if you are unsure, get checked. You lose nothing by asking.

If someone you love is going through this, your calm presence can help a lot.

1. 1Stay calm and kindSpeak slowly and softly. Listen more than you talk.
2. 2Do not argue about beliefsYou do not need to agree or disagree. Try "That sounds really intense. How are you feeling?"
3. 3Focus on sleep and safetyAsk about sleep, food and whether they feel safe. These are easy places to start.
4. 4Offer to go with themSay you would like them to see a doctor, and offer to make the call or go along.
5. 5Act fast in dangerIf they talk about harming themselves or others, or cannot stay safe, call 988, 911 or your local emergency number.
6. 6Look after yourselfSupporting someone is hard. Lean on friends, family or a support group too.

Try not to push more meditation, fasting or intense practices during a crisis. Most teachers suggest stopping these until the person is steady again.