Psychosis and Young People
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The word psychosis is used to describe when someone loses touch with reality. The symptoms can affect a person’s beliefs, thoughts, feelings and behaviours. Psychosis can cause someone to misinterpret or confuse what is going on around them. For example, a person who is experiencing psychosis may hear voices when they are alone. The voice is heard internally and is very real to them. When someone becomes unwell in this way it is called a psychotic episode. An episode is a period of time when someone is having symptoms of psychosis that interferes with normal day-to-day life.
Psychosis is most likely to occur in late adolescence or in the early adult years. Psychosis can be treated and most people make a full recovery from the experience.
The symptoms can be different for different people. Someone may have a range of symptoms or just one. Some symptoms of psychosis include:
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Confused Thinking
Everyday thoughts can become confused, making sentences unclear or hard to understand. A person may have difficulty concentrating, following a conversation or remembering things. Thoughts can seem to speed up or slow down.
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False Beliefs
These can also be called or known as delusions. Often someone will think strongly that something is real, but is not. However, it is difficult to convince him or her otherwise. For example, someone may be convinced from the way cars are parked outside their house that the house is being watched by the police.
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Hallucinations
In psychosis a person can see, hear, feel, smell or taste something that is not actually there. For example, someone may hear voices that no one else can hear, or see things that aren’t there. Things may taste or smell as if they are bad or even poisoned.
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Changed Feelings
How someone feels may change for no obvious reason. They may feel strange and cut off from the world with everything moving in slow motion. Mood swings are common, and they may feel unusually excited or depressed. A person may seem to feel less or show less emotion to those around them.
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Changed Behaviour
A person with psychosis may behave differently from usual. A person may be extremely active or have difficulty getting the energy to do things. He/she may laugh when things don’t seem funny or become angry or upset without apparent cause. Often, changes in behaviour are associated with the symptoms already described above.
What are the Types of Psychosis?
Everyone’s experience of psychosis is different and attaching a specific name or label to the psychotic illness is not always useful in the early stages. Sometimes, though, giving a diagnosis can be helpful in knowing what treatment to provide.
When someone has psychosis, a diagnosis of a particular psychotic illness is usually given. Diagnosis means identification of an illness by a person’s symptoms and the diagnosis will depend on what brought on the illness and how long the symptoms last.
Drug-induced Psychosis
In some instances, using or withdrawing from alcohol or drugs can lead to psychotic symptoms. Sometimes these symptoms will rapidly disappear as the effects of the drugs/alcohol wears off. In other cases, the psychosis may last for a long time after stopping use. For example, someone who is using cannabis may develop psychotic features that are not part of being intoxicated and may continue for days or weeks after they have last used.
Brief Reactive Psychosis
Psychotic symptoms arise suddenly in response to a major stress in the person’s life, such as a death in the family or change of living situation. The person makes a quick recovery in only a few days.
Schizophrenia
Schizophrenia is a psychotic illness in which the changes in behaviour or symptoms have been continuing for a period of at least six months. Contrary to previous beliefs, many people with schizophrenia lead happy and fulfilling lives, with many making a full recovery. It is not a 'split personality' that has sometimes been referred to in movies or the media.
Schizophreniform Disorder is just like schizophrenia except that the symptoms have lasted for less than six months.
Bipolar (Manic-depressive) Disorder with Psychotic Features
When someone has Biplar Disorder with Psychotic Features they experience changes in mood by having extreme highs (mania) or lows (depression). Someone with bipolar disorders may experience psychotic symptoms when in the high or low mood phases. For example, people who are depressed may hear voices telling them they should commit suicide. Someone who is unusually excited or happy may believe they are special and can perform amazing things.
Schizoaffective Disorder
This diagnosis is made when the person has symptoms of both a mood disorder (such as depression) and psychosis. In other words the picture is not typical of a mood disorder or schizophrenia.
Psychotic Depression
This is severe depression with psychotic symptoms mixed in, but without periods of mania or highs occurring at any point during the illness.
What Causes Psychosis?
A number of theories have been suggested about what causes psychosis, but there is still a lot of research to be done.
There is some indication that psychosis is caused by a combination of inherited biological factors that may make someone more vulnerable (or more likely) to experience psychotic symptoms. These symptoms can be a response to stress, drug use or social changes in vulnerable individuals but it is different for different people.
What can you do...
Try to seek help as soon as possible. Tell someone you trust such as a parent, teacher or friend if you are having some strange experiences that you cannot explain.
Treatment for psychosis is available and the earlier you seek help then the better the outcome and the quicker the recovery. Most GPs and mental health clinicians at your local mental health service know a lot about the early signs of psychosis and will be able to help you get treatment if it’s needed.
Treatment for psychosis can involve the use of medication, education about psychosis, counselling, family support and practical support (such as to help you get back to school or work). There are ways of trying to prevent symptoms of psychosis returning, such as not using drugs, reducing stress and adopting good ways of coping with stress. A counsellor, GP or mental health clinician can provide you with some tips on how to get better at coping with stress.
Try to be calm and supportive as it can be a frightening and confusing time for a young person who is experiencing psychosis. If you see persistent changes in the young person and are worried, then seek help from your GP or local mental health service. Support the young person to get professional treatment as early as possible as this helps in reducing the effects of psychosis and aids recovery.
It may be helpful to assist the young person practically so that the situation around them remains as safe and secure as possible. This may mean helping them to pay bills/rent and assisting them to get to appointments as people who are experiencing psychosis sometimes find it more difficult to organise things than they used to.
If a young person is expressing thoughts relating to harming himself or herself then call your local mental health service or hospital so that the young person receives urgent specialist mental health support. It is important to remember that the young person experiencing psychosis may be responding to things that are real to them but do not make sense to you. Being there for a young person and understanding that the illness may be influencing their actions can help. There are support groups for family and friends of people with psychosis that may be helpful to you, as supporting a person experiencing psychosis can be stressful.
Young people experiencing psychosis are not always able to understand or willing to explain what is happening to them. Most fear they will be labelled as 'mad'. Many do not seek help on their own. Workers working with young people may be in a position to identify a young person experiencing psychosis and assist the young person to get the help they need. If you are working with a young person you think may be experiencing psychosis and you are not sure what to do, it is always best to contact someone with experience in this field and discuss the situation with them. Treatment of psychosis should be carried out by workers with training and experience in dealing with mental health problems.
This information was produced in conjunction with ORYGEN Youth Health.