At times we can all have strange, bizarre or odd ideas. These are easy to dismiss and don’t last long or bother us. Psychosis is different. The word psychosis is used to describe some loss of contact with reality. The strange thoughts and feelings dominate life and make it impossible to do ordinary things. It can be a very frightening and distressing experience.
Who is at risk ?
Psychosis is most likely to occur in young adults – men aged 16-25 and women aged 16-35. Around 3 out of every 100 young people will have a psychotic episode. The risk of experiencing psychosis is increased if you have a family history of a similar condition, if you use drugs (including cannabis), if you drink heavily, or if you are experiencing extreme stress. Most people will make a full recovery from the experience.
What are the symptoms?
The early signs (called the Prodromal stage) of psychosis are often vague and hard to define. People can become oddly distant and lethargic. There may be a sharp decline in functioning in college or work, suspiciousness about people and social withdrawal from good friends and relations. This can be frightening as the person doesn’t understand what is happening to them. It will also be alarming and confusing to family and friends as they feel the person becoming distant and changed.
As psychosis develops there will be very clear changes in mood and thinking and the development of abnormal ideas:
Confused thinking
Thoughts seem to speed up or slow down. Everyday thoughts become confused or don’t join up properly. People may have difficulty concentrating, following a conversation or remembering things. ‘Everything was a total mess in my head.’
Delusions
A delusion is a fixed belief in something that isn’t true. The person is so convinced of their delusion that nobody can make them change their mind. For example, someone may be convinced from the way cars are parked outside their house that they are being watched by the police….or that their thoughts are being controlled by someone else……or that the people on TV or radio are speaking specifically to them and sending them messages…..or that their food has been poisoned.
Hallucinations
When someone hallucinates they see, hear, smell, feel or taste something that is not really there. Their experience of the event is as vivid and real as any other experience and it is totally convincing to the person having the hallucination. The most common hallucination is hearing voices. These voices are not imagined. The person who describes these voices is actually hearing them – they are created inside their head but experienced as if they were coming from outside.
‘I have these voices in my head telling me to do things. They sound completely real. It feels as though the voices are coming from outside of my head but other people can’t hear them. Sometimes they come from the TV and other times through the window. Sometimes they talk to me directly, or to each other about me. Sometimes they are friendly but at others they are abusive and critical and just won’t leave me alone. It all gets so weird because when I answer the voices people don’t know what’s going on or who I am talking to’.
What are the different types of psychoses ?
Psychosis can be induced by drugs such as cannabis, amphetamines and cocaine, particularly in those who are already at increased risk because they are vulnerable to developing the illness. This psychosis can last up to a few days, and is often characterized by hallucinations, delusions, memory loss and confusion.
Sometimes people experience a brief psychotic episode in response to a major trauma in their life such as a bereavement or severe assault. This can be very distressing as the person may suddenly experience hallucinations and delusions. However it is usual for there to be a full recovery from this condition within a matter of weeks.
Schizophrenia refers to a psychotic illness in which the changes in behaviour or symptoms have been continuing for a period of at least six months. The symptoms and length of the illness vary from person to person. Schizophrenia is a word that many people associate with violence and disturbance, probably because the media so often describe it in this way. However this is incorrect. Very few people with schizophrenia are violent. People also have the idea that anyone who suffers with schizophrenia is unhappy. In fact many people with schizophrenia lead very fulfilling lives.
Bipolar disorder (sometimes called manic-depression) can sometimes produce psychotic symptoms. Everyone has occasional highs and lows in their moods. But people with bipolar disorder have extreme mood swings. They can go from feeling very sad, despairing, helpless, worthless, and hopeless (depression) to feeling as if they are on top of the world, hyperactive, creative and with an exaggerated idea of their own abilities (mania). If psychotic symptoms happen they tend to fit the person’s mood. So people who are depressed may hear voices telling them they should harm themselves whilst someone with a very high mood may believe they have some kind of special power and ability beyond what is normal.
Sometimes people who are suffering from a severe depression can experience psychotic symptoms. These will tend to disappear when the depression lifts.
What treatment is available?
If you are worried that you may have some of these symptoms then you should arrange to see your doctor as soon as possible. We do know that treatment for psychosis is most effective if it is given when people are first unwell. If you have a relative or friend that you are worried about then you should encourage them to get help as quickly as possible. The symptoms of psychosis can be frightening. It is helpful to speak to someone who can make sense of what is happening to you. The longer that psychosis goes untreated the more damage it does to people’s lives.
There are effective treatments for psychosis and your doctor will be able to refer you to a service that will be able to assess your condition and offer you the best treatment. Some areas of the UK (including Camden) have specialist teams for helping people with their first episode of psychosis (known as the Early Intervention Service). Your can speak to your doctor about the possibility of being referred to this service.
Psychosis can happen to anyone and most people will make a full recovery from the experience. Sometimes psychotic symptoms resolve rapidly and people resume a normal life. Other people take several weeks or even months to recover. A smaller number may need treatment over many years.
For more information on Psychosis take a look at the Get Help section or go to these websites:
