Psychosis and other mental or physical health experiences

Psychosis commonly occurs as part of other mental health diagnoses such as bipolar disorder or schizophrenia and sometimes also Borderline Personality Disorder and severe depression.
People we spoke to talked about other mental or physical health experiences that impacted on their lives, including:
  • Depression, severe anxiety and low mood
  • Autism
  • Asperger’s Syndrome
  • ADHD
  • Physical health challenges
A few also said they used recreational drugs and alcohol as part of their social life and that this affected their psychosis.
When other health experiences were at their worst, it could be harder to manage hallucinations and paranoia associated with psychosis.

When the funding for Andrew Z’s Asperger’s support was cut he got very stressed and the intrusive thoughts in his head got worse.

Age at interview 23

Gender Male

Age at diagnosis 20

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Depression, severe anxiety and low mood

Many people we spoke to were experiencing depression and severe anxiety alongside their psychosis. Some had been given a diagnosis of ‘depression’ but others had been seeing school counsellors in their early teens or had been referred to CAMHS for anxiety and low mood when they had their first experience of psychosis.
For some, depression, anxiety and low mood had been a part of life from a young age (sometimes due to bullying in school or traumas in childhood). Nikki, Peter and Luke experienced depression from their early teens and Joe doesn’t ‘really remember being happy’ before his first year of university. See low mood and depression more generally in young people.

Luke, who was diagnosed with bipolar disorder, experienced depression since his early teens. He started having delusions that MI6 were onto him soon after starting a new job and moving to a big city.

Age at interview 21

Gender Male

Age at diagnosis 19

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Peter suffered depression and anxiety for years which got worse after his father died, and he began to notice his own voice become a lot more vocal in his head.

Age at interview 24

Gender Male

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Sam had seen someone for depression at the age of 9. When she started secondary school her anxiety got worse and eventually turned into psychosis and she started hearing voices and seeing things others couldn’st see.

Age at interview 18

Gender Female

Age at diagnosis 17

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Andrew X has been labelled with all sorts of diagnosis which he finds meaningless. He becomes psychotic when he is stressed or in a depressed mood and thinks the term psychotic depression describes his experience better.

Age at interview 24

Gender Male

Age at diagnosis 14

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Some people who had never experienced low mood, anxiety or depression, noticed that periods of psychosis seemed to happen at times when they were stressed, and a few felt there was some link between them. Sameeha had never had low mood, but was highly stressed and anxious around the time of her first experience of psychosis.
Depression, low mood, high stress and anxiety could also occur after a period of psychosis: Luke described it as ‘the catastrophe that comes with [psychosis]’. Joseph said he had post-traumatic type symptoms and couldn’t deal with day to day activities like changing his bed sheets.

Self-harm and thoughts of suicide with psychosis

There is some evidence that people who experience psychosis are more likely to be at risk of self-harm and suicide (NHS Choices December 2016). However, psychosis is a very varied experience and not everyone we spoke to experienced self-harm or suicidal thoughts. Those who did, talked about specific things that led them to think about self-harming or about suicide: such as low self-esteem (‘self-loathing’), low mood and depression, or fear and anxieties caused by bullying or abuse.
Self-harm and suicidal thoughts, or attempts, had been part of life before psychosis for some people, but coincided with the first experience of psychosis for others. Nikki, Sam and Ruby had begun to self-harm before their first psychotic experience. When she later started experiencing psychosis Ruby’s voice would command her to self-harm. But Tariq, Luke, Andrew X and Lucy all had thoughts of taking an overdose or ending their life around the same time of their first experience of psychosis. Sometimes suicide attempts were what prompted people, like Lucy (below) to receive help with their psychotic experiences.

Lucy had been in hospital after she took an overdose. Afterwards she spoke for the first time about the thoughts in her head being like a voice.

Age at interview 22

Gender Female

Age at diagnosis 21

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Ruby hears the voices of her younger self and her abusive father, which she now calls Alice and Darren. Sometimes Darren tells her to do things that involve self -harm or putting herself in danger.

Age at interview 22

Gender Female

Age at diagnosis 19

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Ruby, Emily and Lucy still talk about self-harm and thoughts of suicide as part of their lives.

When Lucy felt numb self-harming was a way to get some emotional output. She still self -harms and finds it difficult to ask for help.

Age at interview 22

Gender Female

Age at diagnosis 21

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Autism and Asperger’s Syndrome

Several of the people we spoke to had received a diagnosis of autism or Asperger’s syndrome. When he was young Barry was diagnosed with autism and Andrew Z was diagnosed with Asperger’s. Because of their diagnoses, they both already had support in place when they began to experience psychosis later on. When Barry experienced psychosis his mother took him to a service run by CAMHS where he was seen by a counsellor who had worked with him, because of his autism, in the past. But Hannah, who had always struggled with making friends, only found out she had Asperger’s when she was assessed in hospital after seeing visions. She says her life would have been very different if she had known earlier.
People we spoke to had different views about whether or how psychosis and Asperger’s or autism may be related.

Hannah, who has Asperger’s, has always struggled to communicate with others and understand them and she thinks that the pressure and anxiety caused by this is closely attached to why she experienced psychosis.

Age at interview 19

Gender Female

Age at diagnosis 15

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Andrew Z says he’s had manic phases since he was a child and there’s always been a high risk factor that he would experience psychosis. But he doesn’st think his psychosis happens because of his Asperger’s.

Age at interview 23

Gender Male

Age at diagnosis 20

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Physical health experiences

A few people talked about physical health experiences. Sometimes physical health difficulties could be linked to stress and anxiety. Becky and Peter described having ‘crippling pain’ in their stomachs which they felt was stress related. Ruby had been diagnosed with joint hyper mobility syndrome and suspected Ehlers-Danlos syndrome. This means she is more likely to become anxious, because hyper mobility syndrome increases the body’s production of adrenaline.
Physical health problems that needed major medical interventions could also add to stress and trauma.

Tariq had open heart surgery because of a heart defect. He said that facing surgery when he was already depressed was damaging’s.

Age at interview 21

Gender Male

Age at diagnosis 18

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