Psychosis (young people)

Ruby

Female
Age at interview: 22
Age at diagnosis: 19

Brief outline: Ruby has had several diagnosis including Borderline Personality Disorder with psychotic features. She experiences troubling hallucinations that relate to childhood trauma and has been in hospital regularly for three years. Ruby volunteers to help others.

Background: Ruby is a part-time student with the Open University. She is single and White British.

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Ruby had a difficult and traumatic childhood and began self-harming when she was nine years old. In her teenage years she developed an eating disorder and has attempted to take her own life in the past. Her father was abusive and very controlling and did not allow her to see any medical professionals to get help. When she did manage to get some counselling through her school, he found out and stopped her from going. By the time she was 19 things had reached breaking point. She went to ask her GP for help, and her father made her homeless. Her mental health deteriorated and she was admitted to hospital and assessed by a crisis team.  

Over her life she has received several diagnosis’ including Borderline Personality Disorder with psychotic features and Depression. 

When she was 19 Ruby began to hear the voice of a man speaking to her and then of a child crying. The voices seemed very real and the child’s screams worried her so much that she would often go looking for her. The man, who she now calls Darren, would make unkind comments to her and tell her to hurt herself. Ruby now thinks that the man and child represent her abusive father and her younger self. She sees her hallucinations, which are visual, auditory and tactile, are her brain’s way of trying to process what happened to her when she was younger. Understanding this has made things a little easier but when she has the hallucinations it still causes her a lot of distress and can put her in dangerous situations. For example, once she visualised the child, who she calls Alice, on a rail track. She put herself in danger trying to get Alice to safety. On another occasion when a friend had an epileptic seizure in church, Darren told her that if she didn’t hurt herself in a specific way, her friend would continue to have fits. There are times when she believes that Darren can control other people’s minds. 

Ruby has been in and out of hospital, both general wards and mental health wards, regularly over the last three years and has had periods when she would be in A&E three times a week. Now she has some good days. She still sees things that other people can’t see on a daily basis, but on a good day she isn’t as disturbed by them. There are still bad days, about once a month, when she is faced with distressing situations, flashbacks or situations that act as triggers, and she needs help. 

Ruby has attended her local Mind wellbeing centre for courses. The support she has had from the staff there has been very good in helping her set goals that are important to her. This can be anything from sorting out her flat (unpacking boxes from when she moved in), to reducing the number of visits to A&E in a given period. She has achieved things with their support that she didn’t think would be possible. Sorting out her flat had a huge impact on her mental health because it created a comfortable space where she could have friends over. 

Medications have helped her. In particular sertraline, an anti-depressant, and quetiapine, an antipsychotic, which help her to sleep better. 

Ruby has Joint Hypermobility Syndrome, which means she has increased adrenaline in the body. This in turn affects her mental health because the higher levels of adrenaline increase her anxiety symptoms. This also makes it difficult for her to exercise because her adrenaline levels go too high. 

Ruby’s mother wants to do everything she can to support Ruby but has a heart condition herself, which is exacerbated by stress and anxiety. Ruby doesn’t like to worry her, so won’t always tell her when things are bad. When Ruby was a child her mother nearly passed away a few times and she is afraid of losing her. Recently, however, when Ruby took an overdose in hospital, her mother was informed and it allowed Ruby to open up about everything that she was experiencing, and it has brought them closer together.  

Ruby is managing her psychosis better now and lives in independent housing. She is pro-active in helping others in need of support. For example, transferring out of Supported Housing meant lots of big changes. While her own housing association was quite good at providing information about what to expect, her friend, who also moved out of supported housing at the same time, had very little guidance or support. Ruby and a group of her friends have now produced a pack to help others moving out of supported accommodation, and everyone moving into independent housing in her local area now gets one of their packs. She has also been involved in volunteering with her local Personality Disorder Service and is a young champion with Time To Change. 

Ruby is positive about her future and is currently studying part-time with the Open University. She accepts that her emotions will always be changeable, but she is finding new ways to respond to them. Her hope for the future is to keep on learning to deal with what she experiences. She has accepted that those experiences may not go away, but also that her life is worth living regardless of what happens. 

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