{"id":15106,"date":"2020-09-22T12:43:00","date_gmt":"2020-09-22T16:43:00","guid":{"rendered":"https:\/\/www.shortform.com\/blog\/?p=15106"},"modified":"2020-09-29T09:49:27","modified_gmt":"2020-09-29T13:49:27","slug":"pseudopsychosis-brain-on-fire","status":"publish","type":"post","link":"https:\/\/www.shortform.com\/blog\/pseudopsychosis-brain-on-fire\/","title":{"rendered":"Pseudopsychosis: Does It Differ From Real Psychosis?"},"content":{"rendered":"\n

What is pseudopsychosis? How does it differ from true psychosis?<\/p>\n\n\n\n

Pseudopsychosis is a symptom of an underlying condition. In Brain on Fire<\/em>, Susannah Cahalan appeared to be having a psychotic break but was suffering from an autoimmune disease<\/a>.<\/p>\n\n\n\n

Read more about pseudopsychosis and what caused it in Susannah’s case.<\/p>\n\n\n\n\n\n\n\n

Experiencing Pseudopsychosis<\/h2>\n\n\n\n

On Susannah\u2019s second day in the hospital, a team of doctors and nurses arrives to conduct another neurological exam. Susannah interrupts the exam to tell one of her neurologists, Dr. Russo, that the people on the TV are saying bad things about her. She throws herself off the bed and pushes her way past the team toward the door. Russo later diagnoses Susannah as manic and psychotic, with two possible diagnoses: bipolar disorder or postictal psychosis, psychotic behavior generated by seizures.<\/p>\n\n\n\n

Later that morning, Dr. Siegel arrives. He\u2019s a world-famous neurologist, and he assures Susannah\u2019s mom that everything will be fine.<\/strong> Susannah\u2019s mom clings to his words as if they\u2019re a lifeline. <\/strong> <\/p>\n\n\n\n

The next day, Susannah is visited by a psychiatrist, Dr. Khan, who describes Susannah as \u201cdisheveled\u201d and \u201cfidgety,\u201d noting that her pajamas are \u201crevealing.\u201d This visual description matches the psychological profile of mania. <\/p>\n\n\n\n

While Khan takes notes, Susannah announces that she has multiple personality disorder. She repeats her belief that it\u2019s not safe for her in the hospital and says that she can hear the nurses\u2019 thoughts. Khan asks what else Susannah can hear, and Susannah says, \u201cThe people on the TV.\u201d Khan concludes that the team should be looking for neurological causes for Susannah\u2019s pseudopsychosis. If they can\u2019t find a neurological cause of the pseudopsychosis, Khan suggests they consider a diagnosis of bipolar I, a mood disorder characterized by manic and depressive episodes. That means it wouldn’t be considered a pseudopsychosis. <\/p>\n\n\n\n

Susannah stares at the doctor as she writes her notes. As she\u2019s staring, she has a visual hallucination: The doctor ages right before her eyes. Susannah turns to Stephen, who\u2019s also in the room, and sees him age too. \u201cI can make people age with my mind,\u201d Susannah thinks to herself. \u201cI\u2019m more powerful than I\u2019ve ever been.\u201d<\/p>\n\n\n\n

Later that day, a fifth doctor joins Susannah\u2019s team. Dr. Arslan is a psychopharmacologist, who suggests that Susannah might be suffering from \u201cschizoaffective disorder,\u201d a condition in which mood disorders overlap with thought disorders. He does not tell Susannah\u2019s parents about his suggestion, believing the severity of the diagnosis would upset them.<\/p>\n\n\n\n

Recordings Capture Erratic Behaviors<\/h3>\n\n\n\n

The video recordings made by the cameras over Susannah\u2019s bed reveal that at 11:06 that evening, Susannah is trying to conduct a phone call using the TV remote control. \u201cOh my God,\u201d she suddenly cries out and hits the call button for the nurse. \u201cI\u2019m on the news. PUT THE TV BACK ON!\u201d  <\/p>\n\n\n\n

\u201cWe\u2019re investigating Susannah Cahalan. Her father recently murdered his wife,\u201d Susannah hears the news reporter say. <\/em>On the video recording, Susannah grabs the remote and speaks into it again. \u201cPlease get me a doctor,\u201d she moans. \u201cPlease.\u201d She hears the woman in the next bed talking on her cell phone: \u201cThere\u2019s a Post<\/em> reporter in the bed next to me. I\u2019m going to record her and we can sell it to the Post<\/em>.\u201d Then the woman whispers to Susannah, \u201cI don\u2019t trust the nurses here. They\u2019re bad news.\u201d <\/p>\n\n\n\n

Susannah grabs the wires on her head and pulls them out along with chunks of hair. She leaps out of bed, sprinting past the security guard, racing into the arms of a nurse. The purple lady holds her down on the cold floor. \u201cLet me go,\u201d Susannah spits out, her teeth clenched. \u201cPlease.\u201d<\/p>\n\n\n\n

Susannah\u2019s behavior prompts<\/a> Dr. Russo to change her diagnosis from \u201cseizures\u201d to \u201cpsychosis.\u201d Without telling Susannah\u2019s parents, she recommends transferring Susannah to a psych ward if warranted.<\/p>\n\n\n\n

As Susannah continues to deteriorate physically, her pseudopsychosis seems to recede. She begins to spend most of her time staring off into space. On her fifth day in the hospital, the doctors seize on Susannah\u2019s passivity to give her a spinal tap. <\/p>\n\n\n\n


Many adults diagnosed with the disease were originally diagnosed with schizophrenia or autism.<\/strong> A small number of doctors, including Dr. Najjar<\/a>, are currently researching the link between schizophrenia, autism, and autoimmune disease. (Shortform note: In 2018, Dr. Najjar suggested the term \u201cautoimmune psychosis\u201d to designate a subset of diseases in which autoimmune disorders masquerade as psychosis. See Najjar\u2019s recent research<\/a> published in the Journal of Neuroinflammation<\/em>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

What is pseudopsychosis? How does it differ from true psychosis? Pseudopsychosis is a symptom of an underlying condition. In Brain on Fire, Susannah Cahalan appeared to be having a psychotic break but was suffering from an autoimmune disease. Read more about pseudopsychosis and what caused it in Susannah’s case.<\/p>\n","protected":false},"author":6,"featured_media":15303,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[40,16,9],"tags":[130],"class_list":["post-15106","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-books","category-health","category-psychology","tag-brain-on-fire","","tg-column-two"],"yoast_head":"\nPseudopsychosis: Does It Differ From Real Psychosis? - Shortform Books<\/title>\n<meta name=\"description\" content=\"Pseudopsychosis looks like someone is having a psychotic break. 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