Psychosis (young people)

Luke

Male
Age at interview: 21
Age at diagnosis: 19

Brief outline: Luke experienced depression in his mid-teens and later had strong delusions. He was given a diagnosis of bipolar disorder. He has been sectioned twice and now manages his psychosis with self-help and medication.

Background: Luke is single and works as a management consultant. He is White British.

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Luke first saw a counsellor when he was 12 years old. He was having a difficult time with his family at home and was “disruptive” in class. But soon after the counselling began his family relocated and Luke moved to a new school. By his mid-teens (age 15-16) he started to experience depression. During this time Luke found it difficult to sleep at night and get up in the morning. He also began having problems with anxiety and at the age of 17 he started having his first suicidal thoughts. He was assessed by a psychiatrist who said that Luke had “tendencies of schizophrenia” and “a bit of psychosis in the background” but did not give him a full diagnosis. Luke was frustrated by this because he felt that without a diagnosis he didn’t have a reason for feeling low. It was some years before he was given a diagnosis of bipolar disorder, which he says was a relief because he was then given more appropriate support.

When Luke left sixth form college he had managed to get the grades he needed for a good job he’d been offered in a multinational company. He felt like he’d “achieved something massive” by getting through sixth form with good grades and had “overcome something huge”. However, two weeks after beginning his new job in September 2014 Luke experienced symptoms of psychosis. At times he would feel like people were watching him, and at other times his mood would change and he would feel like he had great ideas and that he was going to change the world. He could go three to four days without sleep. Luke’s father, who experiences bipolar disorder himself, immediately recognised Luke’s symptoms and sought help. After several visits to A&E he was finally given an assessment by a team of psychiatrists and was admitted to hospital involuntarily under a section of the Mental Health Act.

Luke spent five or six weeks in hospital and received intense care and medication. Catching up on sleep was also important. During his first week on the ward Luke described himself as being a “nutter” and “a bit destructive”. He says that when you’re psychotic and in hospital under section you feel a “little bit scared”, “trapped”. Being in that situation you become “violent” and “a horrible human being”. By the second week in hospital, however, Luke found that he was adjusting to his treatment. He began “indulging” himself in occupational therapy and found the ward was “kind of like an idyllic recovery place” for him. During his stay on the ward he made a few close friends and continued visiting the ward and members of staff after he was released. Luke was sectioned for a second time in March 2015.

While Luke recognises how catastrophic psychosis can be he appreciates that psychosis allows him to see things in more abstract ways and gives him a “different level of perception”. His experience of bipolar has made him rethink his career path and has made him more altruistic. He mentors someone younger than himself, who is now like a friend, and he finds being a mentor is like “looking into the past”. He has worked on and off over the last few years, but was signed off from his last job due to “manic depression”. It has been difficult financially, but he blames this partly on his own impulsiveness and love of gambling. Luke did apply for a Personal Independence Payment (PIP), but was refused (as he was told was the usual outcome) and he chose not to appeal. 

Luke receives a lot of support from his family and friends, and they regularly visited him in hospital. Luke was in a long term relationship in his late teens and is unsure what it will be like to start a new relationship with someone now he has a diagnosis of bipolar. He isn’t sure how or when he would tell the person about his mental health experiences. 

Luke has regular contact with a community practice nurse, who is “brilliant” – he really “listens” to him, whereas his psychiatrist, is just looking for a diagnosis. 

Day to day, Luke sees psychosis as a small part of his bipolar. Ideally Luke’s “game plan” is to reduce the regularity of his psychotic episodes. He manages his psychosis partly with medicine and partly through self-help. He takes quetiapine (anti-psychotic) and lithium which have side-effects such as weight gain, thyroid problems, and fatigue. Luke finds that listening to music helps him control his emotions. He also finds it important not to drink too much alcohol because he has found drinking (and being hungover) puts him at risk of having a psychotic episode. He has started walking more as it gives him a sense of achievement on days he is feeling depressed and unable to do anything else. He is currently having one to one CBT sessions which he feels may help his psychosis and also help him find out more about himself. Luke says he has a lot of energy and thinks he has reached a point where he feels ready to do a degree at university.

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