Standing Psychosis
under- standing psychosis
samh.org.uk contents
What is psychosis? 04 What types of psychosis are there? 06 Why do I experience psychosis? 08 How can I help myself? 10 What treatment and support is available? 12 How can other people help? 14 Useful contacts 16
This booklet explains what psychosis is, including possible causes and how you can access treatment and support. IT Includes tips for helping yourself, and guidance for friends and family. Further information To read or print SAMH’s information booklets visit samh.org.uk. If you require this information in word document format for compatibility with screen readers, please email [email protected]
For more information visit: samh.org.uk 3 Understanding psychosis What is psychosis?
What is psychosis? Is psychosis a diagnosis or a symptom? The word psychosis is usually used to refer to an experience. It’s a symptom of Psychosis (also called a psychotic experience or psychotic episode) some mental health problems and not a diagnosis itself. Doctors and psychiatrists is when you perceive or interpret reality in a very different way from people may say someone is experiencing psychosis rather than giving them one of around you. You might be said to ‘lose touch’ with reality. these diagnoses. Some people prefer this.
The most common types of psychosis are ‘The sense of shame Psychosis and stigma Here are some options for you to hallucinations and delusions. You might and guilt I felt There are a lot of misunderstandings think about: also experience disorganised thinking and because I was about what it means to experience • Show people this information to help speech. Psychosis affects people in incapable of psychosis. Lots of people wrongly think them understand more about different ways. You might experience it that the word ‘psychotic’ means psychosis. once, have short episodes throughout functioning day-to- ‘dangerous’. The media often shows • Talk to other people who experience your life, or live with it most of the time. day as an adult left people with psychosis behaving like this psychosis by going to a support group - me isolated from even though very few people who or setting one up for yourself. You may have a positive experience of others and experience psychosis ever hurt • Get involved in awareness raising psychosis. For example if you see the faces aggressive to those anyone else. about psychosis. of loved ones or hear their voices you may who cared and • Share your experience with others. find this comforting. Some people say it wanted to help.’ It’s important to remember that you aren’t Contact [email protected] helps them understand the world or makes alone and you don’t have to put up with • Know your rights. Our online pages on them more creative. people treating you badly. legal rights provide more information.
But you may find that psychosis affects your behaviour or disrupts your life, making you feel tired and overwhelmed. I’t’s an illness Hallucinations or delusions could make that can be you feel anxious, scared, threatened or confused. If you have delusions about treated just certain people or organisations, you may like any other. find it hard to trust them. I don’t choose or want to be psychotic any more than people choose or want any other types of ill health.’
4 For more information visit: samh.org.uk 5 Understanding psychosis What types of psychosis are there?
What types of psychosis are there?
Hallucinations Delusions Hallucinations could include: Lots of people have beliefs that many other Disorganised thinking and speech If you have disorganised thinking • seeing things that other people don’t people don’t share. But a delusion is usually Hallucinations and delusions can make you might: (for example people’s faces, animals or a false belief that no-one else shares. You your thoughts and emotions feel confused • speak very quickly and stumble over your religious figures) will still believe it even if logically it doesn’t and disorganised. But disorganised thinking words. Other people may find it difficult to • seeing objects that seem to be distorted make sense, or if experiences show that it (sometimes called ‘formal thought understand what you’re saying or move in ways that they usually wouldn’t can’t be true. disorder’) can also be a type of psychosis. • link words together because of the way • experiencing tastes, smells and For example, you might think you are a very they sound rather than what they mean. sensations that have no apparent cause important person - you may believe that Racing thoughts is where thoughts go This can mean your speech sounds (for example feeling insects crawling you are rich and powerful or that you can through your head very fast. If you have jumbled and doesn’t make sense to other on your skin) control the stock markets or the weather. racing thoughts you usually have flight people. This is sometimes called word salad • hearing voices that other people don’t These kind of beliefs are sometimes called of ideas too. (these could be positive and helpful or delusions of grandeur. Flight of ideas is where your thoughts • change the topic of conversation very hostile and nasty) Some delusions can be very frightening move very quickly from idea to idea, making quickly as your thoughts move from one and can make you feel threatened. For links that other people don’t. thing to another example you might feel that something • find it difficult to keep your attention or someone is trying to control, harm or on one thing kill you (when you have no reason to believe You may also have racing thoughts and this). These ideas are sometimes called flight of ideas if you experience mania or paranoid delusions. hypomania. If you only have them during a ‘Racing ide- depressive, manic or mixed episode then as flooded my you may be diagnosed with bipolar mind. It seemed as disorder. See SAMH’s booklet though my Understanding bipolar disorder for mind was more information. ‘I felt as though I was disintegrating, in wonderland. None of my inner life – my family or friends understood why... I had a my unconscious calling from a mind – started voice in sky. I was lost flooding my and lonely.’ consciousness without a break.’
6 For more information visit: samh.org.uk 7 Understanding psychosis Why do I experience psychosis?
Why do I experience psychosis? But you might also experience psychosis Psychosis can be a symptom of lots of different mental health problems.If you on its own. Some ideas about things that have one or more of these diagnoses then you may experience psychosis - make psychosis more likely include: and if you experience psychosis (and you have other symptoms too) then you may be given one of these diagnoses: • physical illness or injury - you may see • abuse or trauma - if you have or hear things if you have a high fever, experienced abuse or a very traumatic head injury, or lead or mercury poisoning. event, you are more likely to experience • severe depression If you have Alzheimer’s disease or psychosis. Parkinson’s disease you may also • spiritual experiences - some people • schizophrenia or schizophreniform experience hallucinations or delusions. experience voices or visions as disorder • drugs - you may hear or see things as a part of a spiritual experience. This may • bipolar disorder result of taking street drugs like be a positive experience for you - • schizoaffective disorder cannabis and LSD, as a side effect of it may make you feel special or help you • paranoid personality disorder some prescribed drugs or if you are make sense of your life. It could be a or schizotypal personality disorder coming off psychiatric drugs. negative experience - for example you • lack of sleep - you may experience may feel that you’re possessed by an • post partum psychosis hallucinations if you have a severe lack evil spirit or that you are an important • delusional or paranoid disorder of sleep. religious person. • brief psychotic disorder (you may be • hunger - you may experience • family inheritance - you are more likely given this diagnosis if you experience hallucinations if you are very hungry, to experience psychosis if a blood relative psychosis for a less than a month and have low blood sugar or if you are has also experienced it. your doctor doesn’t think that another not getting enough food. diagnosis describes your • bereavement - if you have recently symptoms better) lost someone, you may hear them talking to you. You may also feel that they are with you even though you can’t see them.
8 For more information visit: samh.org.uk 9 Understanding psychosis How can I help myself?
How can I help myself? Learn to relax Create a crisis plan These suggestions could help you cope with psychosis. You may • Manage your stress. During a crisis you may not be able to tell people what helps you. When you are choose to try them on their own or alongside treatment. • Try some relaxation techniques. Relaxation can help you look after your feeling well it can be a good idea to talk to wellbeing when you are feeling stressed, someone you trust about what you would Peer support Recognise your triggers anxious or busy. like to happen (or not to happen) when you are in crisis. It might help to create a Peer support brings together people It might be helpful to keep a diary recording, crisis plan. who’ve had similar experiences to support for example: Look after yourself each other. You could access peer • life events • Try to get enough sleep. Sleep can give support online or try a support group in • your mood you the energy to cope with difficult your local area. feelings and experiences. • your diet You can find peer support groups for • Think about your diet. Eating regularly • sleep psychosis through: and keeping your blood sugar stable • The Hearing Voices Network You could do this in a notebook or use an can make a difference to your mood and app or online tool.This can help you: • The National Paranoia Network energy levels. • understand what triggers your • Bipolar Scotland • Try and take some exercise. Exercise psychosis or makes it worse can be really helpful for your mental (See ‘Useful contacts on p.15) • think about what has been helpful in wellbeing.
the past • Doing practical things like gardening, • recognise warning signs that tell you cooking or making things can help you when you are becoming unwell feel more connected to the world around Once you have a better understanding of you. Being outside in green space can your triggers, you can try to take steps to help you feel more in touch with avoid them. If you learn to recognise your your surroundings. warning signs, you can take action early to try and prevent your psychosis getting worse. Family and friends may also be able ‘I think a routine to help you spot when you are becoming of structure, quiet unwell. and an unpressurised environment ‘I painted regularly - combined with something I hadn’t done medication, was for years but felt ultimately the key inspired to do.’ to my recovery.’
10 For more information visit: samh.org.uk 11 Understanding psychosis What treatment and support is available?
What treatment and support is available? What other support can I get? Community care For many people, there is no quick and simple treatment for psychosis. Early intervention (EI) teams If you experience psychosis a lot or it EI teams work with you during your first lasts a long time, you may be referred to However, with the right treatment and support, it is possible to manage the community care services to help you cope. symptoms of psychosis and recover. experience of psychosis. They usually include people who can help you in The phrase ‘com- munity care’ is used to different ways. For example: describe the various services available to help you manage your physical and mental This does not always mean that the What treatment is available? • psychiatrists symptoms of psychosis will go away health problems in the community. Talking treatments can help you • psychologists entirely. You may find that you still understand your experiences and develop This might include: experience psychosis during and after coping strategies to deal with them. • community mental health nurses • your community mental health team treatment. But that treatment helps you You may be offered CBTp. This is a form • social workers (CMHT) learn ways of coping so your ex- of cognitive behavioural therapy (CBT) for • support workers • nursing or social work support periences are less distressing and don’t people experiencing psychosis. The National Institute for Health and Care home help interfere with your life as much. • • Medication. Most people with psychosis Excellence (NICE) recommends that early • day centres will be offered antipsychotic drugs. You intervention services should be open to • supported accommodation How do doctors decide my treatment? may be offered other drugs (for people of all ages. But some places only Before you start any treatment, your example antidepressants or mood offer services to people under a certain Community care can also include crisis mental health professionals should discuss stabilisers) if you experience other age – usually under 35. services and early intervention teams. If you all your options with you and listen to what symptoms as well. You may also be become very distressed during an episode you want. They should look at all aspects offered drugs to help reduce side effects of psychosis you may need to be cared for of your life including your environment caused by the antipsychotics. in hospital. and any possible physical causes of your • Family therapy. You may be offered psychosis. family therapy (sometimes called family Your treatment may depend on whether intervention or systemic therapy). you are diagnosed with a specific mental Family therapy can help you understand health problem. An advocate can help you any difficulties you are going through get the treatment you need. as a family. • Arts therapies can help you express how you are feeling in different ways. They can be helpful if you are having difficulty talking about your experience.
‘My antipsychotic medication saved my life. It took many tries to get the right medication for me.’
12 For more information visit: samh.org.uk 13 Understanding psychosis How can other people help?
How can other people help? This section is for people who want to support someone who experiences psychosis.
It can be really hard to see someone • Focus on feelings rather than • Respect their wishes. Even if you feel Help in an emergency you care about experiencing psychosis. experiences. It’s hard to know how to that you know what’s best, it’s important If you are worried that your family member But you can help. Here are some respond when someone sees, hears or to respect their wishes and don’t try or friend is becoming very unwell or suggestions for ways you can sup port believes something that you don’t. and take over or make decisions experiencing a mental health crisis you them while also looking after your Instead of confirming or denying their without them. People tend to do less could suggest that they use their crisis plan own wellbeing. experience it can help to say something well if family and friends are very critical (if they have one). like “I understand that you see things or over protective. that way, but it’s not like that for me”. • Listen and try to understand. It can help • Family therapy can help the whole It’s usually more helpful to focus on how ‘The extremes of if your loved one feels able to discuss family understand what the person with the person is feeling about what they behaviour and their feelings and options with someone psychosis is going through and identify are experiencing. supportive and calm. Listen to their what is helpful and unhelpful for them emotions played experiences and ask them what would • Offer practical help. Ask them if they and for you. You might want to ask your havoc with my help. Our information can help you would like any practical help. For GP if this is available in your area. relationships and understand more about psychosis. example they may like your help to • Plan for a crisis. When your loved one daily functioning access a particular service or ask you to is feeling well you may want to discuss to the point where act as a supporter for them. how you can help in a crisis. This could the simplest include planning practical things like of tasks treatment and hospital visits. You might overwhelmed me.’ also find it helpful to state clearly ‘You can help by what you feel you can and can’t deal with lending an ear during a crisis. to talk to, • Get support for yourself. Seeing especially someone you care about experiencing psychosis can be distressing or even between visits frightening. Our information on how to from mental cope as a carer and how to improve health your mental wellbeing can help you look professionals.’ after yourself too.
14 For more information visit: samh.org.uk 15 Understanding psychosis Useful contacts for work?
Useful contacts
Bipolar Scotland Intervoice NHS Inform T: 0141 560 2050 W: intervoiceonline.org W: bipolarscotland.org.uk International community for people who W: nhsinform.scot Information, support and advice for hear voices. Information on medical conditions people affected by bipolar disorder and those who care for them. Mental Welfare Commission for See Me Scotland W: seemescotland.org Breathing Space T: 0800 389 6809 National programme to tackle mental T: 0800 83 8587 Service users & carers phone line health stigma and discrimination W: breathingspace.scot W: mwcscot.org.uk Confidential out of office hours telephone They protect and promote the human Support in Mind line for people experiencing low mood, rights of people with mental health anxiety or depression. problems and related conditions. T: 0131 662 4359 W: supportinmindscotland.org.uk Action for people affected by mental National Insitute for Health and Give Us A Shout illness. Care Excellence (NICE) T: 85258 ((text only) W: giveusashout.org T: 0845 003 7780 24/7 crisis text line. W: nice.org.uk Offers guidance on treatments for psychosis. Hearing Voices Network
W: hearing-voices.org National Paranoia Network Information and support for people who hear voices and local support groups. T: 0114 271 8210 W: nationalparanoianetwork.org Information and support for people who experience paranoid thoughts.
16 For more information visit: samh.org.uk 17 Since 1923, SAMH has represented the voice of people affected by mental health problems in Scotland. We are here to provide help, information and support.
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