We need to talk about psychosis –in the young and old

A charity is raising awareness of psychosis among young people as they start university, often a time of stress and change which can trigger mental health problems, writes LINDA AITCHISON.

Psychosis affects 1 in 100 people and the first episode is most likely to happen between the ages of 18 and 24.

If you have psychosis, you perceive or interpret things differently than those around you.

This might involve hallucinations or delusions.

A psychotic episode can be brought on by overworking, traumatic experiences, extreme stress, drug use or a side-effect of medication. It can be a once-only experience or, for others, is a long-lasting mental health condition.

As young people head off to university, Rethink Mental Illness is calling on them to learn how to spot signs of psychosis.

These can include withdrawing from friends, expressing unusual beliefs or saying they can see or hear things that aren’t real.

New research shows that among young people aged 16 to 25:

◆ only a third (31%) would know where to get help if they or someone they knew were showing signs of psychosis

◆ over half (56%) think it’s less common than it is

◆ fewer than half said they were not confident they would be able to spot specific symptoms like hallucinations (47%) and delusions (42%)

Brian Dow, Deputy CEO at Rethink Mental Illness, says: “Going to university is an exciting time but it’s also a time of huge changes. We hear from lots of people who first encountered mental health problems while at university, but they and their friends were unaware of what was going on. It’s important for everyone to know where to turn if they need help, but many students don’t think to sign up to their university’s GP. We would urge everyone to look out for your friends … if they are showing any of the early signs then encourage them to see their GP or go to A&E if you are worried about their immediate safety.”

Ex-student, Luke, 26, of Dorset said:

“I first started having symptoms of psychosis when I was at school, and at university things got worse and worse. I didn’t tell anyone about what was happening and eventually I had to quit uni. I thought that if I could keep it to myself, I would have ownership of it. But now I know the opposite is true. By accepting help I’m now able to manage my psychosis.”

Recent media reports say that in some cases, psychosis may be a symptom of an underlying physical illness. Conditions detected by scans included encephalitis, brain tumours, infections, stroke or dementia. That’s why patients experiencing psychosis for the first time should be given routine brain scans to rule out any physical contributing factors, according to psychiatrists, in recently reported research.

Nicky’s story: When psychosis came for my mum

Nicky, a cleaner and former care assistant, of Wiltshire, says she wants to speak up and raise awareness to lessen stigma, whatever the age of someone affected by psychosis and their loved-ones.

Here, she shares her memory of how her mum started a journey to treatment. Nicky writes:

“When my mum was ill and people asked how she was, if I told them she had psychosis, they physically recoiled. I was heartbroken, my mum wouldn’t hurt a fly.

“To me, this revealed how a stigma still exists and how little many of us understand. Our family didn’t understand either.

“The day a psychiatrist came to see my mum, it was distressing, intense and desperately sad.

“My mum claimed my dad was plotting against her, to control and harm her. She told me he was doing the same to my sister too.

“I don’t know if he is twisted or plain bad,” my mum said, announcing the impending appointment (with a possible outcome of her being sectioned) was really for my dad.

“You aren’t going to like this afternoon much, it’s all about your dad. He has to see a psychiatrist because he’s such a control freak,” she said.

“In the half hour before the psychiatrist arrived, words tumbled out of my mum’s mouth, making no sense. There was barely a chance to take in what she’d just said before another disjointed ramble.

“There was no let-up in the accusations. Perhaps my dad was seeing prostitutes, or I had a secret brother, maybe my dad had vandalised their home.

All I could do was hug her and tell her I love her.

“She yelled at me that I wasn’t qualified to help.

“There was no way she’d take any medication, she said, insisting everyone knew doctors handed out pills like sweets.

“After the psychiatrist arrived, my mum looked smaller somehow, fragile, panicked, confused, and vulnerable.

“She returned to her delusions.

“Her stories meandered from one random imagined slighting to another, filled with more bizarre unrelated points. The psychiatrist shot me concerned glances.

“Then more tears come. And more accusations.

“Somehow after a barrage of lots more taunts and expletives from my mum, she accepted the psychiatrist’s recommendation that she should take medication. We jumped in the car to the chemist and began a long road to getting better.”

Refuting media scares

Lurid headlines do not help people with psychosis. When this condition is highlighted in the news, it’s most often connected to rare violent attacks.

Psychosis is the stuff of horror films and grisly murder reports. Yet these cliched portrayals are skewed.

Research from 2019 by Project HOPE: The People-to-People Health Foundation, revealed that even if psychotic and mood disorders were eliminated, 96% of violent acts would still occur.