Psychosis (young people)

Sam

Female
Age at interview: 18
Age at diagnosis: 17

Brief outline: Sam experienced depression from the age of nine and began hearing voices and seeing shadows of people who were not there when she was 15. She wants to study at college but has been turned away due to stigma about her psychosis. Medication has not helped her.

Background: Sam is White British.

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Sam was bullied a lot at school and was given support for depression from the age of nine. This support lasted for a few years but between the ages of 12 and 15 she stopped telling anyone how she felt and things built up inside her. She was self-harming and was bullied for being different. The teachers ignored the bullying and if Sam argued back to the bullies she herself got in trouble. She eventually stopped saying anything and slowly stopped turning up to classes. By the time she started secondary school she had extreme depression and anxiety which turned into psychosis. 

She was in year ten (aged 15) when she first started hearing voices, at first coming from inside her head, calling her name and then saying things about her that weren’t true. As this progressed voices seemed to come from the ceiling or from objects around her at school – one time she remembers having a full conversation with a pencil case. She told her head of house, who was supportive, but the school counsellor specialised in depression and wasn’t able to help her. CAMHS worked with her on her anxiety and she saw different psychiatrists through them, one of whom said she was “probably leaning towards psychosis” and told her “we don’t really deal with that”. She was 17 when CAMHS decided she needed to “switch over” to Early Intervention Services (EIS). 

The transition from CAMHS to EIS was not well managed. Her psychiatric nurse (CPN) didn’t turn up for their first two meetings, and when she did turn up she was late and Sam didn’t get on with her. She would take days to respond to Sam’s calls, even in a crisis. Eventually Sam asked to be assigned to someone else and now has a good CPN.

There was no out of hours support for Sam after she was discharged from CAMHS, and when she needed support she had to call 111 or go to A&E. On one occasion the person who took her 111 call reported her case to the police and they almost knocked her parents’ front door down, thinking she was going to hurt herself or someone else. She is now worried about calling out of hours support in case it happens again. 

Since her first experiences of psychosis the voices have got worse and she hears different voices telling her different things, for example to hurt others, although she has never acted on them. Sam was told she was experiencing psychosis by a psychiatrist at A&E. She thought it would mean no more college, no more education, no more social life. 

Sam has tried lots of medication including anti-psychotics (aripiprazol, risperidone, sulpiride and quetiapine) but nothing works. Although they have not helped her she has experienced negative side effects from taking medication such as weight gain, and interruptions to her menstrual cycle. Anti-depressants were eventually stopped because of concerns that they would increase the chances of her having seizures - she has experienced seizures occasionally since she was 4. 

Sam has tried to apply for financial support (PIP) but says that the process doesn’t work well as the people who go through the application don’t seem to understand mental health. Her psychosis means that she has good and bad days, and she says the people who assess you don’t seem to understand mental health and “unless you’ve got like your leg falling off” they don’t see that you have an impairment. She currently lives with her parents.

Sam wants to study and applied to go to college but has been made to leave two colleges because of her psychosis. The colleges didn’t go through the proper procedure for assessing her – they didn’t speak to her care worker for example – and they just saw on her notes “borderline psychosis” and asked her to leave. Even though Sam has no history of hurting anyone, one college safeguarder told her mother Sam couldn’t go back to college until a hospital had said she was safe to be around people. If she misses out on going to college this year she won’t be able to reapply because funding for full time college will no longer be available for her full course, and she is worried about the impact this will have on her future. 

Sam finds exercise is helpful and she has a “gym buddy”, organised by a local charity. She goes to the gym once a week and has also done rock climbing in the past.

Sam is in a relationship and her boyfriend doesn’t judge her for her psychosis. When she first met him he already knew something about mental health and guessed what she was experiencing. In contrast Sam has found it hard to keep all her original friends because some didn’t really understand what was happening when she was experiencing psychosis. She “cherishes” those friends who are still there for her.

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