Psychosis (young people)

Joe

Male
Age at interview: 23
Age at diagnosis: 21

Brief outline: Joe experienced psychosis and depression in his second year at university shortly after finding out, over the summer, about the death of four people he cared about. He works full time and has found ways to manage the voices and hallucinations.

Background: Joe works full time in IT and at the time of the interview worked as a Ward Clerk in a Cancer care ward. He is white British.

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When Joe started university, it was the first time he felt happy. Then, during the summer after his first year, two of his friends, his favourite teacher and a relative died in quick succession and he began having anxiety attacks as well as experiencing depression. He worried about people close to him being hurt and began hearing voices, having visual hallucinations and remembering events in the wrong order or having false memories of things that hadn’t happened. 

When Joe told the university counsellor that he had started hearing voices, the counsellor referred him to the psychosis clinic. After the referral he was seen by seven different professionals in two weeks, each giving him different explanations for his experiences, before he was finally referred on. He was having a bad episode at the time and, he describes how for him, seeing so many new faces was not helpful: “faces just kind of morph, and go weird and awful and scary”.  

Although he graduated with a degree in biology, the psychosis, and the medication and regular outpatient appointments in his second year, made it difficult to study. He was taking on average two days off a week, either for outpatient appointments, or because he was unwell, and this could be unpredictable, so that some weeks he would make it to all his lectures, but other weeks he’d attend none.  

Over the course of his treatment he has tried a number of different anti-psychotic medicines which all had unpleasant side effects. The first medicine he was given was olanzapine which gave him bad nosebleeds. He then started taking aripiprazole, but this stopped him sleeping so he was then prescribed quetiapine which made him drowsy. The worst medication for him was risperidone which made him experience very bad dizziness. 

Joe no longer takes medication and tries to manage his symptoms in different ways and to approach them logically. His friends have been a big source of support for Joe and he believes he would not be alive without them. He has had group CBT therapy and has found it helpful hearing other people’s experiences. Knowing that others were having similar or worse experiences made it easier for him to cope with his own. Joe notes that it is important to be “adaptive” in the way you manage your condition. Sometimes things that wouldn’t have worked in the past do work now. For example, Joe has now “made peace” with his voices - this is something he doesn’t think he could have done before. Although he gets some visual hallucinations, such as seeing rats in places where they shouldn’t be, he hasn’t had any false memories in a long time. 

Joe has not been given a formal diagnosis, which he believes is a positive thing. He thinks that people sometimes “live up to” the their diagnoses and that it can become a “self-fulfilling prophecy” 

Joe recognises that stress can trigger his psychosis and finds that mindfulness techniques and meditation can help in certain situations. He also believes that psychosis is a fear response – that hallucinations are the brain’s way of trying to warn you about something and trigger a fight or flight response. When he is having hallucinations, trying to be more aware of what is happening in the moment can help. Joe tries to keep positive and uses the idea of a “misery quota” where you decide how much misery you can deal with in a day. This helps him on a daily basis to focus on the good things and not just be taking on the bad. It’s also important for him to have some background noise around him and he often listens to music or an audio book because “silence feels like it’s full of things that are going to suddenly start shouting”.

Keeping busy is important for Joe to manage his condition. At the time of interview he was working full time as a ward clerk on a cancer ward, and he changed jobs to work in IT within the health sector shortly after the interview. He also has hobbies such as theatre acting and production, a role playing board game (Dungeons and Dragons) and keeping and studying insects. In the future he hopes to do a master’s degree in Theatre. 

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