Having a relationship with spirituality is inarguably a beautiful thing. It can bring a sense of fulfillment to life, giving purpose and meaning when tragedy inevitably arises. However, too much of anything can veer into dangerous territory.

A social media conversation surrounding spiritual psychosis recently arose following the tragic death of well-known astrology guru Danielle Ayoka. Known by her community as MysticxLipstick, she once served as a spiritual guide for many, offering insight into how you can use the cosmos to heal and grow.

However, when Ayoka began exhibiting signs of delusion, irrational fear-mongering and incoherent messaging, things took a dark turn. It became clear she was experiencing mania and mental health distress. She passed away on April 11 in a senseless murder-suicide, shocking her spiritual community. Her mental health was clearly at risk, blurring the lines between spiritual ascension and a mental health disorder.

Ayoka may have experienced a spiritual psychosis, which is a state in which an individual’s spiritual experiences become overwhelming and impact their ability to distinguish between reality and their spiritual perceptions. This condition can manifest similarly to a psychotic episode, where the person may experience delusions, hallucinations and intense emotional disturbances.

There are plenty of psychological, genetic and environmental factors that can lead to someone experiencing spiritual psychosis. There are also many medications and psychotherapy treatments that can help anyone suffering. Mental health expert Ava Mohtashemi spoke with 21Ninety about the fine line between spiritual psychosis and a manic episode.

21NINETY: What is spiritual psychosis?

AVA MOHATASHEMI: Psychosis is typically described as not being rooted in reality, usually consisting of delusions or hallucinations. Sometimes patients might experience auditory or visual hallucinations in response to or related to a specific trauma. We’ve also seen adolescents come in endorsing AVH, but their visuals are super vivid and complex. This wouldn’t necessarily be an example of a psychotic disorder or psychotic state.

We had a patient recently who stated that she experienced a spiritual awakening. Her loved one brought her in because of a drastic shift in personality and safety concerns. When I spoke with her she seemed oriented to time, place, person, and was cooperative and willing to engage in treatment. She was coherent and rooted in reality, but also firm in her spirituality. I can’t provide more specific details because of confidentiality, but I think this is a good example of how some people might perceive certain behaviors as psychotic or concerning enough that would require hospitalization.

21N: What’s the difference between a spiritual awakening and psychosis?

AM: In general, things become “disorders” when they impact one’s daily living on a consistent basis. We all experience anxiety, depression or paranoia to some extent. [However,] we also need to approach the psychiatric field with nuance and more acceptance of neurodivergence or different behaviors and beliefs.

21N: Why does it seem easy for people to conflate having a “third eye” experience with a manic episode?

AM: Opening the third eye or an “overactive” third eye can sometimes resemble psychotic symptoms seen in mania. [It can] also manifest in things, like increased energy, racing thoughts, grandiose ideas, experiencing things super intensely and heightened. Mania is technically diagnosed by “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently goal-directed behavior or energy, lasting at least 1 week and present most of the day, nearly every day.” Substances can also induce psychosis or mania.

21N: How can you maintain a healthy relationship with your spirituality while taking care of your mental health?

AM: I think it’s important to know your limits and boundaries. In my mind, spirituality should be a strength and support. I feel like healthy almost always requires a balance and remaining grounded and rooted is just as necessary.

This article has been edited and condensed for length and clarity.