Have you found yourself typing “Am I crazy?” into Google or asking Siri? You probably got back a patchwork of results, from online “sanity tests” to mental health forums.
Fortunately, most people who do such searches aren’t actually going “crazy,” as in developing delusions, paranoia, or hallucinations, says Gerald Goodman, PhD, an emeritus professor of psychology at UCLA.
“Believing that you are going crazy is a good clue that you are sane,” he says.
When someone is developing a serious mental illness with psychosis, such as schizophrenia, they usually don't know it. “Part of ‘crazy’ is getting away from reality,” Goodman says.
Marty Livingston, PhD, a New York psychologist and author, agrees. “They’re not aware of the difference between a feeling and a fact,” he says.
For instance, a healthy person might feel like someone is following them and know it's not true. “But somebody who’s really having an onset of psychosis believes that it’s true,” Livingston says.
Sure, you might ask “Am I crazy?” just to vent frustration, or to find an online mental health test. But Goodman and Livingston also offer these three possibilities:
"It doesn’t mean they’re psychotic, but it does mean that they’re anxious about something." -- Marty Livingston, PhD
1. Panic Attack
Panic attacks can feel like you're losing your mind. But you're not, Goodman says. “Lots of people have them,” Goodman says. “Don’t fight the attack. Accept it as temporary helplessness.” Panic attacks typically pass in a few minutes.
He believes they are a main reason that people worry about their mental state. Some people have one or two panic attacks in a lifetime. Others have them often enough to be diagnosed with panic disorder (a condition that involves repeated panic attacks and the worry that panic attacks will keep happening). Either way, therapy (and, in some cases, medication) can help handle them.
2. Feeling Disconnected
Livingston has counseled many people who feel alone and misunderstood enough to question their mental well-being.
“It’s a deep anxiety that ‘I don’t make sense; people don’t understand me,’” he says.
Such feelings go deeper than loneliness. “You can feel lonely and still feel good about yourself,” Livingston says. “You can miss a spouse that’s not there for the time being, or somebody who dies can leave you lonely. That’s different than the fear that ‘I’m lonely because nobody can understand me.’”
Some people can feel so disconnected that they fear becoming irrational, for example, by screaming and shouting and perhaps even striking out physically. “It’s a feeling of losing control,” Livingston says.
If that sounds familiar, look for mental health help.
“Sometimes, group therapy is really helpful with people who are afraid that they are different,” Livingston says. “They get to see that other people have similar feelings.”
3. The Start of Mental Illness
It's rare, but the feeling of “going crazy” could truly stem from a developing mental illness. “They are temporarily, at least, losing their ability to make sense of things. They’re feeling overwhelmed,” Livingston says.
He recalls one teen who at age 16 felt that “everything is fading away,” he says. In a short time, the boy began having more symptoms, including delusions, and was diagnosed with schizoaffective disorder, a combination of schizophrenia symptoms (including psychosis) and mood disorder symptoms, such as depression or mania.
If you're hearing things or seeing things that other people don't, see your primary care doctor. They can check on whether any physical illnesses might be causing the sensations you're noticing.
Another type of mental experience that might make someone wonder if they’re “going crazy” is the presence of obsessional thoughts that may make no sense but nevertheless become a focus of worry and preoccupation.
For example, obsessions might involve a constant worry that something bad might happen, or an unreasonable fear about germs or contamination, or the conviction that something is physically wrong with one’s health despite a doctor’s reassurances. Obsessions plus compulsions (rituals) could be a sign of obsessive-compulsive disorder, a condition in which the person on some level realizes that their fears and worries are excessive and unrealistic, yet cannot shake them without treatment. If that sounds like what you're going through, talk to your doctor or a therapist.
When It's Time to Get Help
If someone called him with concerns about being “crazy,” Livingston says he would spend a few minutes trying to understand whether the situation was urgent.
Even if it's not an emergency, “it means that they need some help,” he says. “It doesn’t mean they’re psychotic or going psychotic, but it does mean that they’re anxious about something and experiencing it in terms of losing control, being different, being crazy. And they certainly would benefit from talking to somebody.”
You can get a confidential referral from your doctor, your local mental health department, the national Treatment Referral Helpline (1-877-SAMHSA7 or 1-877-726-4727), or your job's Employee Assistance Program, if your company has one. The web site mentalhealth.gov also has a treatment locator widget to find mental health services in your area.