How To Be A Better Mountain Medic ... High Altitude Psychosis (Part 1)

Posted by Jeremy Windsor on May 24, 2019

“I first met Jimmy on the Balcony, a cold windswept snow shelf high up on the southeast ridge of Mount Everest. At an altitude of more than 8200 metres our introduction had been brief, with little more than a muffled “Hello” and a few words of encouragement passing between us. Over my right shoulder, obscured by the bulky oxygen mask and the rim of down that smothered my face, I was sure I could see Jimmy moving lightly in the darkness. But despite him remaining close by me for the rest of the day, I didn’t see him again. At the time, it hadn’t worried me; instead I was warmed by the thought of human company and too breathless to question what seemed so real. If the truth be told, my thoughts were really nothing more than brief flickers of images or sounds that vanished with the onset of each new breathe…”*


In 2007 I was asked by the BMJ to write about my experience on Mt Everest. Of all the things I could have written about I chose to focus upon the hallucinations that I encountered during my summit day. Whilst researching the article I found that I wasn’t the only to have such an experience. Last year a team from Innsbruck scoured the internet and their own book shelves to identify 48 cases of psychosis in high altitude mountaineers. Not only did their study provide evidence of psychosis at high altitude, but they were also able to show that symptoms occurred in the absence of other medical conditions such as AMS, HAPE and HACE. This led to the conclusion that high altitude psychosis exists and that it should be considered as a separate medical condition alongside other high altitude diseases.

Building on this work, the team have devised the High Altitude Psychosis Self Rating Questionnaire (HAPSY-Q) questionnaire and plan to use it this spring as part of a prospective study on Mt Everest. Here's a preview of the questionnaire. If you've experienced any of these symptoms at high altitude would you be willing to share them on the blog?

Answer "Yes" or "No"...

1 You hear your own thoughts spoken aloud in your head so that someone near might be able to hear them.

2 You have a conversation with a person who is not really there.

3 You sense the presence of another being, despite being unable to see any evidence.

4 You feel like you cannot distinguish if you are awake or dreaming.

5 You see a person or person's face in front of you even if no one is in fact there.

6 You see shapes, lights or colours even though there is nothing really there.

7 You hear your own thoughts repeated or echoed.

8 You hear sounds or music that people near you don't hear.

9 You hear voices saying words or sentences when there is no one around that might account for it.

10 You find that your experience of time changes dramatically.

11 You see things that other people cannot.

For a copy of "Voices in the Air" please get in touch.

1 thought on “How To Be A Better Mountain Medic ... High Altitude Psychosis (Part 1)

John Laughlin commented 1 year, 4 months ago
How much of this is due to altitude and how much is sleep deprivation? These experiences are common in my expedition adventure racing experience, both personally and extensively with team mates and other competitors. It's known as the 'Sleepmonsters' - so common that the main adventure racing information website is!

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