Break with reality


What is a break with reality?

It often happens that a small percentage of society experiences a "split" or rupture with reality, causing them to hear and see things that do not exist for most other people. It can occur if:


General information on the treatment of mood disorders

Psychosis A person with psychosis experiences another reality and hallucinates (hearing and seeing things that do not exist).
Schizophrenia Schizophrenia is a mental state characterized by a lack of meaningful and logical thought processes.


General information on the treatment of mood disorders

  1. Why is treatment needed for psychosis and schizophrenia?
    Schizophrenia is a degenerative condition, which means that the symptoms gradually get worse and worse without the right treatment. Reality disorders can be related to other diseases in this regard, e.g. diabetes, be compared. Both require continuous pharmacological treatment (medication) and monitoring by a professional, and the results are generally also much better if the person is regularly receiving psychotherapy from a psychologist. Because there is a strong chemical underpinning of the symptoms, so the symptoms can escalate and it is difficult to keep the symptoms under control, professional treatment is extremely important for anyone diagnosed with schizophrenia or even just a once-off psychotic period. has.
  2. Who can diagnose me or a loved one?
    Mood disorders are complex; therefore, we recommend that you be tested and diagnosed only by a clinical psychologist or psychiatrist. They are trained to distinguish between different psychological disorders that may have very similar symptoms.
  3. What role does psychologist play in my treatment?
    A clinical psychologist can diagnose any mental disorder and treat psychotherapeutically. This means he or she can help you understand what your diagnosis is, how to live with it, and how to apply a strategy that can lead to behavioral change. A psychologist in South Africa may not prescribe medication and usually works with a psychiatrist in a team.
  4. What is the difference between a GP, clinical psychologist and psychiatrist?
    1. Family doctor:A GP has been studying medically for seven years. Because they do not specialize in the field of psychiatry like a psychiatrist, they have only limited exposure to the training necessary to diagnose and treat people with psychological / psychiatric conditions. Your family doctor may prescribe medication, but is also ethically required to refer a patient to a specialist if needed.
    2. Clinical psychologist:A clinical psychologist is studying human behavior and psychotherapy, and must have at least a master's degree (six years +) in South Africa, with an internship and research that must be completed in order to register. It is the person who will help you understand and live with your psychological diagnosis (such as schizophrenia).
    3. Psychiatrist:A psychiatrist also studied medically for seven years, but specializes in psychiatry, namely the chemical treatment of disorders related to human behavior. So a psychiatrist is the doctor who can diagnose you and prescribe the right medication for your psychological condition (eg schizophrenia). The reference to "psychological states" or "psychiatric states" is exactly the same.
  5. Is there a specific type of psychologist I need to see?
    In South Africa, there are currently five different categories or specialist areas within which all psychologists must register:
    1. Clinical psychologist
    2. Counseling Psychology
    3. Educational Psychology
    4. Industrial Psychology
    5. Research Psychology

    The different categories indicate the specialist areas within which psychologists must adhere to strict regulations and comply with ethical and legal requirements. Only one clinical psychologist can according to the HPCSA make a clinical diagnosis.


Advice for loved ones and family members living or working with someone diagnosed with psychosis or schizophrenia

If a loved one or friend is diagnosed with psychosis or schizophrenia, your support and motivation can play a very important role in accepting and managing the diagnosis. The following are guidelines for supporting an individual:

  1. Be patient. People who struggle with a concept of reality do not always have the ability to say how they feel or what they experience. Give them a chance to get used to the diagnosis first, and then gradually start taking concrete steps that the person can take to manage his or her daily life.
  2. Be informed by building up knowledge of psychosis and schizophrenia. The more you and your loved one, family member or colleague know about the disease, the more you can work together on ways to support the person in his or her management of the disease.
  3. Ask what your loved one needs from you. One can easily assume that you know what is best for another person, but the easiest is to ask how he or she wants you to act.
  4. Listen to the person. Do not give advice or try to reason with him or her logically. It is important for the person to take responsibility for the illness and the effect it will have on his or her life. When someone makes choices on behalf of someone else, it may cause the person to become dependent on the helper and then not want to fight the disease himself. It is not your illness, but your loved one's. Listening is a wonderful way to support someone with this condition.
  5. Get to know the signs and symptoms so you can act early. Everyone's symptoms do not manifest in the same way; therefore, it is important to know and understand in advance how this particular person's symptoms will manifest. For example, when your loved one experiences a sudden break with reality, you can take time to deal with it.
  6. Do physical activities with the individual. It is not a cliché that regular exercise helps people with psychological diagnoses. It relieves tension and anxiety, and aids in the production of low-mood nutrients. Regular exercise is therefore a successful anti-depressant.
  7. Encourage a healthy eating and sleeping pattern. An established routine not only helps the person manage their illness, but also helps to see signs / symptoms early.
  8. Take a good look at yourself! Remember, a person with diagnosed psychosis or schizophrenia in your life can also negatively impact you by involving you in their disorder. Living with a person who has been diagnosed with psychosis or schizophrenia can feel frustrating, exhausting and sometimes chaotic. Make time for yourself too.


If you or a loved one is struggling with mental health issues, we suggest the following options:
  1. call your GP (if available);
  2. go to your nearest hospital emergency room;
  3. call one of the following emergency numbers: SADAG (the South African Depression and Anxiety Group) 24-hour helpline: 0800 456 789 or suicide crisis line: 0800 567 567; or
  4. contact Wie is ek?