Onika L. Dainty

As I waited for the University of Toronto Master’s of Social Work (MSW) students to settle into the classroom, I could feel my nervousness rising. These young people are the future of social work, and I was a woman who had lived through psychosis, invited to offer something no textbook could provide. My role was simple in theory: share my lived experience of mental illness, offer insight into one of its most complex realities, and leave a lasting impact as they prepared to support clients experiencing psychosis firsthand. Simple, right?

Yet as I listened to the professor’s lecture on psychosis, stigma reduction, medication side effects, and intervention strategies, the full weight of my experience returned. How could I capture what it truly means to live through psychosis in such a short time? How could I help them understand that people navigating this form of mental illness are still whole, still human, and deserving of dignity, patience, and compassionate care?

Through my work with the University of Toronto’s Factor-Inwentash Faculty of Social Work, alongside social workers and lived experience advisors, I contributed to a Psychosis Simulation Project. Our goal was to bring lived experience into social work education. The initial result was an educational video that bridges clinical knowledge with human reality, highlighting both practitioner perspectives and the voices of those who have experienced psychosis and returned to wellness.

This blog explores why lived experience must be part of social work education. Psychosis cannot be understood solely through clinical language or diagnostic criteria. It must be understood through the lives of real people who live, work, love, and heal beyond their diagnosis.

Humanizing Psychosis Beyond the Label

One of the most important messages I share is this: I am not psychosis. I am not my illness. I live a full and meaningful life.

For many MSW students, their early exposure to mental health is rooted in clinical settings. Clients appear as case files, diagnoses, or mental status exams. In those environments, people can become reduced to symptoms. Their humanity is often overshadowed by hallucinations, delusions and disorganized speech. 

What is often missing is the fuller picture. The person behind the diagnosis may be a mother, a sister, a student, an employee, or a friend. They have identities, relationships, and aspirations that exist far beyond their mental illness.

Sharing my lived experience challenges this narrow lens. It reminds future social workers to see the person first and the diagnosis second. Hearing directly from someone who has experienced psychosis and built emotional stability, structure, and routine in recovery helps reduce stigma and deepen empathy. It brings forward dignity, identity, and the complexity that defines each individual life.

Stages of Psychosis: What to Expect Before, During, and After

Individuals experiencing psychosis often move through distinct stages, each with its own challenges and needs. Understanding these phases is essential for effective mental health support and long-term healing.

Before Psychosis

In the early stage, symptoms such as paranoia, delusions, and hallucinations may begin to surface. Many individuals are still living in the community, often without a strong support system or awareness of what is happening.

In these situations, crisis intervention may occur, sometimes involving police wellness checks. While intended for safety, these interventions can feel deeply distressing and, in some cases, harmful.

For social workers, this stage highlights the importance of early, compassionate intervention. Consistent check-ins, emotional support, and trust-building can make a meaningful difference. Care should not begin only after the crisis peaks. It must start as early as possible.

During Psychosis

During psychosis, individuals are not grounded in shared reality. Their thoughts, emotions, and behaviours may become intense, disorganized, or unrecognizable. Emotional responses can feel overwhelming, often described as a form of emotional hijacking, where the brain’s fear response overrides rational thinking.

It is important to understand that behaviours during this phase are symptoms of mental illness, not reflections of character.

Social workers must respond with steadiness, empathy, and a willingness to look beyond the moment. Supporting both the individual and their support system helps create a foundation of safety and understanding. This foundation becomes critical when the person begins to return to baseline.

After Psychosis

The period after psychosis is just as important as the crisis itself. Recovery does not end when symptoms fade. In many ways, this is where the deeper work of healing begins.

Supporting individuals in rebuilding structure, routine, and stability is essential. This may include sleep regulation, medication management, and reconnecting with daily life.

Social workers play a key role in this phase. They become a steady point of reference as individuals reintegrate into their lives. Care must remain continuous, grounded in patience, empathy, and non-judgment. True recovery is not a single moment but an ongoing process of rebuilding and growth.

Medication Management: Nuance and Non-Compliance

Discussing medication in mental health care is rarely straightforward. My own experience reflects this complexity. There have been times when I resisted medication and times when I recognized its value in supporting my stability and recovery.

For many individuals, hesitation around medication is rooted in real concerns. Side effects from antipsychotics and mood stabilizers can include emotional numbness, fatigue, and significant weight gain. These changes can impact identity, self-esteem, and overall well-being, especially for women navigating mental health and body image.

There is also the reality of forced treatment during acute episodes, when individuals may not have the capacity to advocate for themselves. This can create lasting distrust toward medical systems.

For social workers, advocacy is essential. This means asking thoughtful questions, listening without judgment, and helping bridge communication between clients and psychiatric teams. Medication management should be approached with empathy, collaboration, and respect for the client’s lived experience.

Lived Experience Reflection: The Social Worker Who Helped Me Trust

In 2016, during a severe episode of psychosis, I was hospitalized at St. Michael’s Hospital in Toronto following a traumatic wellness call. What followed was a period marked by isolation, restraints, medication challenges, and a deep mistrust of the system. At the same time, I was experiencing homelessness.

It was during this time that I met Tarak, the social worker who would change the course of my recovery.

Our early interactions were difficult. I was fearful, reactive, and guarded. I pushed him away with anger and mistrust. Yet he remained consistent. He showed up daily, calm and present, even when I tried to drive him away.

What I did not realize at the time was that he was listening, not just to my words but to the pain beneath them. He recognized my trauma, my fear, and my desire to heal, even when I could not express it clearly.

At one point, he made me a simple offer. Give him a month. If I was not satisfied, he would step aside. That consistency, paired with empathy, allowed me to take a chance on trust.

Tarak supported me in finding housing, rebuilding structure, and reconnecting with life. He sat with me through small moments that became significant turning points. Over time, he became more than a social worker. He became a steady presence in my healing journey.

He saw beyond my Bipolar disorder and psychosis. He saw possibility. He helped me reconnect with my sense of self, my creativity, and my potential. That belief changed everything.

Final Thoughts

Speaking with MSW students was deeply meaningful. It felt like an opportunity to shift how future social workers understand mental health, not just as a clinical field but as a human experience.

Lived experience brings depth that textbooks cannot offer. It adds context, emotion, and reality to the study of mental illness. It reminds us that behind every diagnosis is a person with a full life, not defined by their most difficult moments.

Psychosis is part of the story, but it is never the whole story. Healing, growth, and emotional stability are possible. And when social workers are trained to see the whole person, not just the symptoms, they become far more effective in supporting lasting recovery.

But shortly after I turned 33-years-old I lost my voice. And I’m not talking about losing your voice because you have a sore throat. For three days this past January 2016, I lost the ability to speak and no one could explain why. I got up one morning and I felt physically weak, disoriented and dizzy. I lived alone so I had no opportunity to say a word until I left for work. I remember taking an Uber in because I felt so unbalanced I could barely stand. When the driver said ‘good morning’ I attempted to reply, and the words came out slow and slurred.

I immediately called my mother and when I couldn’t reach her, I called my Grama Judie. I told her my symptoms and she said I should head to the hospital. For many reasons I dislike hospitals and refused to go, instead choosing the nearest walk-in clinic. I was barely in the door before I lost consciousness and collapsed. I was taken into one of the exam rooms and the nurse had called an ambulance. She was trying to keep me alert by asking questions, questions that I tried to answer but I couldn’t. I was confused and terrified because when I opened my mouth the answers I formulated in my head just wouldn’t come out.

The ambulance arrived and transferred me to St Michael’s Hospital in Toronto. By the time I arrived at the emergency room I had managed to give them basic information about myself as well as my phone to contact my mother. The doctors ran every test they could think of, they feared I may have had a stress induced stroke. The MRI, EKG and blood work came back normal. Because I disclosed my history of mental illness, the next step was a psychiatric evaluation. This was what I had been dreading.

It has been my experience that when a person suffers with mental illness, doctors tend to overlook physical symptoms and label the problem a psychological one then pass you off to the ER’s Psychiatric Crisis Team for assessment. I was terrified of being admitted to the psychiatric unit. I knew that the likelihood was this was a reaction to a new antidepressant I was taking but to admit that would be to risk getting admitted. Though it was a struggle I managed to make my wishes clear: There’s something physically wrong, I am not crazy, I do not feel like harming myself or others and I want to go home.

After asking me a series of questions that I was all too used to answering, the ER psychiatrist advised that she feared this may be psychosomatic but not something to be admitted over. My mother finally arrived, and the doctors cleared me to go home and have her monitor me for the next few days. The relief I felt was overwhelming.

During those three days of silence, I really started to question how I had gotten to this point. Maybe there was another reason, hidden deep inside myself that I was failing to examine. Since the new year started, I have been taking on more, pushing myself harder mentally, physically and emotionally. I was beginning to feel pressure at work, I was lacking in sleep, my appetite was non-existent, and I was running from the depression that historically took over my mind every Winter since I was 17-years-old.

I was doing too much, and I was wrestling with the darkest parts of myself. I was overwhelmed and I knew it had everything to do with my mental health challenges. I was tired of running from it, I was tired of keeping the secret of my mental disability from my friends, colleagues and anyone I had any significant connection with. It was like a gaping sore that refused to heal, that was a constant source of pain as if trying to tell me: Until you deal with me, I am not going anywhere.

I had been thinking about telling my story, telling the truth for a while and during this experience my mind was in a constant state of remembering. Remembering the dark reality of my past, retracing my steps to see where I could have changed things, worrying that once the carefully constructed mask that I had relied on for so long was crumbling in the face of this truth. Even though my voice was lost, my thoughts were finding their way to the surface. All the lies I had told to protect myself, all the things that I could only remember pieces of from all the times I lost my mind to the overwhelming sense of failure I felt every day since I was a child. I knew it was time to face all that I had done, all that I had been through. My body’s betrayal at this critical juncture of my life was telling me that if I were truly going to move forward, I had to speak my truth.

I was ready and I was not ready. I was certain and I was not certain. I was terrified and calm because I knew it was time for the words to come out. I knew if my voice returned, I had to use it to tell the story of a woman who was abused in so many ways; a woman who lost her mind so many times only to find it again; a woman who has done things she was ashamed of; a woman who survived when the odds were stacked against her.

I knew my story could help people like me see that it is possible to go through things, terrible, life-changing, dark and destructive things and still come out on the other side fighting and hopeful and determined to achieve the impossible. To come through everything while still having faith that the next step, the next journey, the next dream will be the right one, the better one, the one that will finally make you whole.

It is possible to believe that you can survive your pain, only suffering as long as it takes you to learn your lessons. Then you take that newfound knowledge and change your life into something authentic. I want to be a force for this kind of change in people’s lives, giving them hope that happiness lies beyond the darkest waters.

I have always known this was my purpose, but I hid my light for reasons that seemed far away and inconsequential in the face of losing my voice. It was a new kind of pain to think that I had wasted so many years hiding from the world, hiding from myself that now, when I was on the precipice of taking my place and serving my purpose, there was this new obstacle that I was not sure I could overcome.

If all the world’s a stage like Shakespeare once wrote, then those three voiceless days were my version of stage fright. I learned that as much as I was afraid of the truth, if I continued to hold it in, I was in danger of losing the opportunity all together. The labour of having to force out every word, syllable by syllable, at a snail’s pace as if I had never spoken before was eye-opening.

I thought to myself, “What now Onika? You have all these words locked inside your mind, you have hoarded all your experiences, all that knowledge and wisdom never really sharing it with anyone and now you have finally found some courage to speak your truth, and you have lost your voice…you have lost your way.” When my voice did return slowly over the following days, the relief I felt was palpable. It was like being given a second chance to start my purpose-filled, passion-filled journey.

It’s time to embrace something that has always been difficult for me—change. I need to be fearless and learn to embrace change like a warm hug instead of running from the danger of the unknown. I have to embrace the journey I am on and pray to God that He will be there to catch me if I fall again and to keep me grounded when I finally rise.

Final Thought

In 2016 fear had a strangle hold on me. I was living a lie believing that if I told the truth about my Bipolar diagnosis to my new employer, colleagues and friends I feared rejection, I feared isolation and I feared I would lose my job. I believed my disability was a deficit and a detriment to the new life I was trying to build in a new city. After years of manic episodes, depressive episodes and hospitalizations I convinced myself running from the truth of my circumstances was the only way. I thought reinventing myself based on a lie would keep me safe and would lead to my ultimate success. 

But the opposite occurred, all the lying and deception and running away from my truth took a mental, spiritual and ultimately physical toll on my body. It was my mama that taught me the lesson “Speak the truth and speak it always cost it what it may.” and in 2016 not telling the truth about a significant part of my life cost me my voice. I became lost in a lie and I remember bargaining with God that if I got my voice back I would use it to share the truth about my lived experience with Bipolar disorder, the good, the bad and all the ugly bits in between. That experience taught me how dangerous fear can really be and I am so grateful my temporary paralysis lifted and I’m presently living in the light of my truth. 

A Bipolar Woman’s Self-Reflection on Fear is a series of entries that will allow you a window into my past and insight on my present and the lessons I’ve learned over the years that have put fear in my rearview mirror.