Psychosis (young people)

Lucy

Female
Age at interview: 22
Age at diagnosis: 21

Brief outline: Lucy experienced psychosis and depression after suffering from two head injuries. When she took an overdose the crisis team asked about her psychotic experiences. Medications have not helped and she has suffered bad side effects.

Background: Lucy is White British. She was unemployed at the time of the interview. Since the interview she has started working as a tax assistant.

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Lucy had a head injury in 2012 which lead to daily migraines that continued for three years. She experienced depression at the time but didn’t seek help until a second head injury lead her to start experiencing psychosis. She had thoughts in her head that were like a voice giving instructions and she didn’t feel she was in control. She later heard external voices and experienced visual hallucinations and unusual thoughts and delusions. 

When she had her first experience of psychosis Lucy remembers being very stressed, but there were no real warning signs other than low mood. She was driving in her car with friends when she had a sudden thought to crash the car and felt shaken afterwards. After a few weeks she started having hallucinations: for example the figures of people on the street signposts seemed to be jumping out at her. The only time previously she had had anything like that was when she was on strong painkillers and had to look twice at everything to double check what she was seeing. 

Some months later a concerned work colleague took her to her GP to get help. The GP put her on antidepressants for several months and gave her weekly sick notes. It wasn’t until she took an overdose and was seen by a crisis team and a psychiatrist that she was asked about the hallucinations and delusions she was having. Although she was prescribed anti-psychotic medication no one sat her down and gave her a diagnosis. It was only when she researched the medication online that she realised she had been experiencing psychosis. Lucy finds it frustrating not to have had a diagnosis. She thinks she would feel more confident about assessing her chances of getting better if she knew what she was dealing with.  

Lucy had been working full-time when she had her first experience of psychosis but she became too ill to work. She eventually resigned her job and she now worries that potential employers will be scared off if she tells them she has experienced psychosis. Going from working full time to being unemployed has meant a big change financially for Lucy. She bought a flat the year before she first experienced psychosis and that has meant that she cannot access the same benefits as those who are renting. Although she gets just enough to live on, this impacts on her social life as a young person. If her friends want to have dinner out for example, knowing that the evening would cost a fifth of her income for the week changes how she feels about going out. 

Lucy has always been honest with friends about her psychosis and she says friends have been the best thing and the worst thing. She remembers saying things to close friends when she was having a really bad time and wasn’t aware it would upset them. A few of her friends stopped speaking to her but Lucy still has good friends who come over to see her and keep her company when she’s had a really difficult night, or cook for her, or take her out. 

On a day to day basis the psychosis has also affected Lucy’s sleep and worsened her low mood. Lucy spends four or five hours trying to get to sleep some nights. Hearing voices during the night means Lucy used to not feel safe in the house, and would go for long walks (up to eight hours), not returning home until she was so tired she could just fall asleep. The psychosis has also worsened her depression and low mood. Seven out of the eight times that she has taken an overdose she heard a voice in her head telling her to do it. Once she overmedicated just to try to stop the voice from telling her to kill herself. 

She was under the care of her local Community Mental Health Team (CMHT) initially but they referred her on to EIP. Her EIP team are now talking about referring her back to the CMHT and she feels as if no one seems to know how best to help her. She was told to attend a series of group counselling sessions (CBT focused) by her GP and had to do this before being referred to a mental health team. She found that she was too unwell by that stage to engage with the group and found it unhelpful. The other people in the group had more moderate depression and saw improvements, whereas she didn’t. 

Lucy has tried a lot of different medications. She has never felt a benefit from taking medication, and it has often made her feel disconnected and empty. On top of this she finds that she is prone to experiencing the worst possible side effects from any medication she is taking. She took quetiapine (anti-psychotic) for seven months. It made her feel tired all the time, made her gain weight and it made her psychosis worse. Eventually she insisted that her GP take her off. She suffered withdrawal symptoms such as being unable to eat or even sip water without being sick. Her mental health team suggested her head injury made her more likely to suffer with withdrawal symptoms but she thinks she was taken off it too rapidly. Lucy found that as soon as she stopped taking her medication the hallucinations and external voices stopped and the internal thoughts/voices have almost gone. 

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