What do you mean by psychosis?
We use the word 'psychosis' or psychotic symptoms to describe experiences that are seen as unusual or odd by most people. These include hearing voices, seeing things, extremely odd ideas and paranoia. One thing to remember is that most people recover from psychosis and live a normal life.
What is it like to hear voices?
Hearing voices or noises that other people can't hear is actually quite common. For example lots of people hear voices or noises when they are falling asleep or waking up.
These voices are very real and can be loud or quiet; it can be one person's voice or lots of people. Some people recognise their voices whereas others don't. Sometimes the things that people hear can appear to come through the walls, from the radio or TV or even from ghosts.
Voices can say all kinds of things, sometimes these can be quite supportive or funny. If they don't upset you in any way or get in the way of your life, there is no reason to consider them a problem. Unfortunately, some people hear voices that are pretty upsetting.
They can sometimes say threatening or abusive things or tell you to do things that you don't want to do. Voices can last from minutes to hours, can happen daily or very infrequently. It seems that stress has a part to play: when people are stressed out they are more likely to hear voices.
What do you mean by 'odd ideas'
We all get odd thoughts and ideas from time to time that others mightn't agree with, such as believing other people are out to get us, having a thought about harming someone close to us or doing something similarly bad.
Just because we have a thought about something doesn't mean that thought is a fact or that we want to act on it. We all get bizarre thoughts that flash through our mind from time to time, but most of the time we ignore these and pay little attention to them.
Sometimes however, we can't dismiss an idea or thought, we think about it all the time and find it distressing. When these beliefs are something beyond what people believe normally, such as the belief that our actions might be controlled by an implant, or the idea that people on the television or radio might be sending us personal messages, then we often call these psychotic beliefs or 'delusions'.
In reality it's difficult to work out what the cut off is between a 'normal' belief and a 'delusional' belief as there is no clear divide. Usually how much you believe something, how much it seems based on reality, the level of distress and how much you think about it are used to decide whether there's a problem or not.
Examples of some common psychotic beliefs (delusions)
- Thoughts are being interfered with, this may include having thoughts put into your head or taken away.
- That other people know what you're thinking.
- That people are out to get you (paranoia).
- Personal messages are being sent via the television, radio or through newspapers or magazines.
- That you are the centre of a conspiracy.
- People are constantly watching you and might be recording what you do or say.
- That you have an implant in your head or body.
- That people are not who they say they are (such as your parents, who are actually imposters)
- That you are someone special e.g. Jesus, the Anti-Christ, a celebrity (or related to one), have unrecognised brilliance, special powers or gifts etc.
Will I get better?
That's a difficult question, because these experiences vary from one person to the next and there's no way of knowing how it will work out for different people. What we do know is that one person in every five who has psychotic type experiences will have them for a short time and then will never have them again.
Others may have lots of episodes at different times throughout their lives. Overall, we know that a good number of folks who have these experiences (around 50%) will have a good outcome in the long term and will no longer be bothered by them and will be able to get on with their lives.
Are my problems inherited?
In the past it was felt that psychosis was an illness that was passed down through your family. These days thinking has changed and research has shown that genes can't explain everything but play a part.
Other factors in a person's life experience are more important. These factors can include bullying, physical, sexual and emotional abuse, where you were brought up (we know that psychosis is much more likely when a person is born and raised in a city). To find out more about this see the section on 'Why is this happening to me'.
Do I have schizophrenia?
Schizophrenia is quite uncommon, about 1 in 100 people will be diagnosed with this. Although people who get diagnosed with schizophrenia will have experienced some of the experiences that are outlined above not everyone with these symptoms has got schizophrenia or even a mental health problem.
If you are worried about whether you have schizophrenia you will need to see a mental health professional to find this out. Even if you do get this diagnosis however, it is not the end of the world. Although in the past people thought it was impossible to recover from schizophrenia, we now know that a favourable proportion of people will be able to get on with their lives.
Will I become violent or dangerous?
People with psychotic experiences sometimes worry that they might become violent. One reason for this is because they have heard in the media of someone with schizophrenia or psychosis hurting someone.
A survey of TV dramas found that nearly three quarters of characters with a mental illness were also portrayed as violent. TV and newspapers hugely exaggerate the amount of violence committed by people with mental health problems. In fact, this is very rare. The vast majority people who are experiencing psychotic experiences never commit violent acts, it is much more likely they will have been a victim of violence. It is quite common to worry about being dangerous however.
Do I have a split personality?
People often think that psychosis means that a person will have different personalities at different times that they have little control over, like Jeckyll and Hide. This is not true of schizophrenia and other psychotic disorders.
Will I have to go to hospital if I seek help?
Usually hospital can be avoided if you form a good relationship with mental health services. It is only as a last resort that people are admitted to hospital. If this does happen it should be done for the shortest amount of time necessary.
Mental health workers can see you at home or in other places of your choice to support you through your problems. When people go to hospital, they are usually admitted on a voluntary basis, however on occasions if someone becomes very unwell and is behaving in such a way as to become a danger to themselves or others they may be admitted against their will under a section of the mental health act for assessment or treatment. Again, this is a last resort and would only be for as long as necessary.
Will my children be taken away from me?
For the majority of parents with mental health problems the answer is no! (And having psychotic experiences doesn't mean you necessarily have a mental illness). Social services consider each person and their children on an individual basis and so there are many factors they will consider. They will assess whether the child's basic needs (safety, food, warmth, shelter) are met before they recommend any actions.
Many people with mental health problems have children and most of these people manage to provide their children with a good level of care. It is important that people recognise when they are becoming unwell and do something about it if they can.
Doing something about it may mean speaking with your GP or mental health worker, taking your medication or speaking with your partner, family, friends and/or children.
Can anything be done to help me?
Absolutely! A number of interventions have been developed for people who have experiences such as those described above and who are upset or stressed out by these. Medication is nearly always offered. Also, we know that talking treatments, particularly Family Interventions (helping the family to understand a person's experiences and to deal with the stress and difficulties that often arises as a result of these) and Cognitive Behavioural Therapy (CBT) can be helpful.
These interventions should be available at local Early Intervention in Psychosis (EIP) Services. These services have been set up across the UK for young people aged 14 to 35 who are suffering with a first episode of psychosis. As well as accessing medication and talking treatments you would also be able to access a range of help, everything from sticking with or finding employment or educational courses, help with your finances, to help getting out and meeting other people.
Contact details of your local EIP service can be found by clicking here. If you are over 35 you can go to see your GP who will refer you to an appropriate mental health service.
Do I have to take medication for the rest of my life?
There is firm evidence that medication can be helpful in people experiencing psychotic symptoms. How long you stay on the medication will depend on how things go when you take the medication. Decisions about how long you take it for should be made jointly between you and your doctor.
Will I lose my job?
Not necessarily. The extent that having psychotic experiences impacts on ability to work differs from person to person. It is up to you how much you tell your employer about your experiences. When people do have to go have go off sick we know that one of the most helpful things is to maintain links with your employer.
This will help them understand how they can best assist you to return to your job when you are ready. This may be on a gradual or part time basis and mental health professionals can be involved with this process to ensure you and your employer get the support you need in a way that's acceptable to you. Sometimes people may feel the need to change their jobs as they are too stressful. However, many individuals carry on working successfully and continue to reach their goals.