Psychosis (young people)

Joseph

Male
Age at interview: 22
Age at diagnosis: 21

Brief outline: Joseph experienced a brief period of psychosis in his early 20s when he was working as a chef. He had delusions and was not his normal self. He spent less than four weeks in hospital. He fully recovered from his psychosis and does not take any medication.

Background: Joseph works as a gardener and after the interview began working as a Peer Recovery worker.

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Joseph was some months into a new job working as a high end chef when he first experienced psychosis. The work was demanding, with long hours, often working 75 hours a week, but rewarding. He had been pushing himself and had been promoted and he feels that he put more pressure on himself than others expected of him. The week before the psychotic episode he had been moved onto a new section of the kitchen. At the time he was getting less sleep than usual, about four hours, compared to his usual six, didn’t have time to eat properly, and was having a lot of caffeinated drinks. On reflection, when he left work that Friday he had a feeling that he might not be going back.

After a long weekend at home he became physically ill and collapsed. His girlfriend called an ambulance and he was taken to hospital. He remembers feeling a kind of relief that he was finally being “taken care of”, that he was now in “safe hands” away from the Intense lifestyle he had as a chef.

During the psychotic episode he had a lot of “intense thoughts” and was making connections between seemingly random bits of information. He was using his mobile phone to make notes about the things he was thinking. He also remembers using ‘google’ search engine on his phone in unusual ways, as if it could answer any questions he had, such as where his girlfriend was. On one occasion he remembers noticing that his girlfriend hadn’t posted on twitter for six months and thinking that this must mean she had died. He experienced real grief at losing her, which continued until he saw her again.

While some of the experiences he had during the psychotic episode were bad, there were times when he felt very good. He had a huge amount of energy and remembers cartwheeling along the corridor of the hospital at night when other patients were asleep. One time he experienced ‘euphoria’ looking out of a large hospital window at a view over the city. His sense of taste was heightened and whatever he ate, it was as if he was tasting it for the first time. 

But he also describes his senses becoming overloaded, for example he remembers finding one light near his bed painfully bright, and he was acting in ways that were out of character. He could get very angry and be violent. He remembers breaking a light and having to be restrained. He didn’t feel particularly aware that what he was experiencing was delusional at the time. 

Staff at the hospital were very good and always had time to listen to him. He remembers a psychiatrist telling him after he left hospital to be kind to himself, which he thinks was good advice. Rather than rush back to his old job, he decided to start work as a gardener and he thinks this has helped with his recovery. At the time of the interview he was considering working as a social care worker.

Joseph’s friends and family have been a good support to him throughout his experience and visited him in hospital, which he says was a very difficult experience for them. After he left hospital he moved back to his family home. It was a tough time for him, adjusting to the medication he was on, and coming to terms with what had happened and he appreciated his family giving him time to recover. 

While in hospital Joseph was prescribed sleeping tablets which had the opposite effect, and haloperidol (anti-psychotic), which took time to work and made him feel “weighed down”. Procyclidine (anti-cholinergic), which was prescribed to counter some of the side effects of the haloperidol, made him hyperactive and increased his emotional sensitivity so that even watching the TV felt like sensory overload. Although Joseph wanted to come off the haloperidol quickly, the psychiatrist reduced it very slowly over eight months, which was a difficult time. Joseph feels he only really recovered once he came off the medication. 

Joseph was never given a formal diagnosis, but the terms ‘manic episode’ and ‘psychotic episode’ were used by clinicians. That was enough for him to investigate more about his experience and he collected information about his experience from friends and by reading back through the notes, text messages and search engine history on his mobile phone during the episode.

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