Psychosis: Just the facts

Many young people go through times where they have thoughts about things that make them feel worried, stressed, confused or upset. Often this does not last long and goes away by itself. However, for some people, these thoughts and feelings are so strong that they change the way a person experiences the world around them. For example, someone might feel worried that people or things around them are changing in some way. This can be a very frightening experience and may cause problems in many areas of a young person’s life and relationships.

If these experiences are really bad or last for more than a few days, they could be a sign that the person is experiencing a psychotic episode.

“Psychosis” is the word used to describe when a person’s thoughts, emotions and feelings are so disturbed that they lose touch with reality. Some of the main signs may include:

• Unusual beliefs that feel very real to the person experiencing them but which other people do not share and find hard to believe could happen. This might sometimes be called “delusions”
• Hearing voices or sounds other people cannot hear. Also seeing, smelling, tasting things or having physical sensations which other people do not experience. This is sometimes called “hallucinations”
• A strong feeling that people can no longer be trusted. This can be so strong that a person might feel someone is trying to harm or hurt them in some way. This is often called “paranoia”
• Disorganised thinking (switching from one topic to another with no clear link between the topics) or speaking in a way that might sound strange and is difficult for others to understand. This is sometimes called “thought disorder”
• A person might find it much harder than usual to organise their actions. This can make it hard for them to go about their usual day to day activities. A person might stop looking forward to things like they used to or feel disconnected from friends and family. They might have no energy or motivation to do things they previously enjoyed.

Often, in the weeks or months before an individual experiences an episode of psychosis, they, or the people around them, might notice some changes. For example, changes in their mood or an increase in anxiety. A person might find their thoughts are starting to spiral out of control or that the world seems unusually strange to them. They might start withdrawing from loved ones and might stop doing things they used to enjoy. They might find it hard to keep going to school, university or work. This is sometimes referred to as having an “At Risk Mental State”. These experiences might seem unusual but are more common than people think, especially in young people.

What causes psychosis?

There is no one cause of an ‘at risk mental state’ or psychosis. People think a combination of biological, psychological and social factors all play a part. It is perhaps better to think about what might make someone more vulnerable to developing psychosis. There are lots of things that might increase someone’s vulnerability:

• Experiencing traumatic events – A psychotic episode can sometimes happen after a stressful event or difficult period of time like a family member or friend dying, moving out of home for the first time or parents separating. It can also be a response to having witnessed violence, experiencing unwanted sexual contact or after being bullied or discriminated against in some way
• Stress – Feeling stressed at school, college or work. Having money problems or difficulties in a relationship can all have a negative effect on how a person thinks and feels about themself
• Family history – Having a close family member who has previously experienced psychosis or other significant mental health difficulty
• Drugs and Alcohol – Using drugs like cannabis or cocaine or drinking lots of alcohol, although many young people might use street drugs to help them cope with some of the experiences described above
• A lack of supportive relationships – Difficult relationships in childhood or adolescence can have a big effect on a person’s mental health. Not having someone around to talk to or who can offer support can leave a person feeling lonely and isolated and increase their stress levels
• Sleep – Lack of sleep or poor sleeping habits

What can help psychosis?

If this is happening to you then there are lots of things you can try that might help:

• Stress Reducing Activities – Many people notice that finding an activity they enjoy and can do regularly really helps. This might be playing a sport, doing some exercise or meeting up with friends
• Talking about what is happening – Talk to a family member, friend or trusted adult about worries or concerns you have. Being able to share what is happening is the first step to making it feel less scary or upsetting
• Focusing on wellbeing – Try to get plenty of sleep and eat healthily. If you drink alcohol or take drugs, then stopping or cutting back on this might help too

What support is available?

If the above don’t help then support is available. The type of support might vary depending on what is happening and how much of a problem it is. Talk to your school nurse or your GP who can help you find the right support. This might include:

• Talking with a mental health professional about how you can stay well
• Talking therapy, for example, Cognitive Behavioural Therapy (CBT)
• You and your family (if you want them to be involved) might be offered some family meetings to talk together with a mental health worker or therapist
• The chance to join a group with others who are also having similar experiences to yourself
• Support to help you with education or employment
• Some people may be offered medication to help make the unusual experiences less distressing

How to get help

If you have any more questions on this area or would like to speak to somebody about this topic, have a look at the links or search for your local services in the blue box below. Alternatively you can always contact your school nurse.

• w: The British psychological society
  
• w: Compassion for Voices