want to know more about psychosis? A YoungMinds Booklet

Transcription

1 want to know more about psychosis? A YoungMinds Booklet

2 About this booklet This booklet describes how psychosis might affect you and explains some of the words you might hear health professionals using. It also looks at some of the ways you can help yourself. At the end, there is a list of addresses and telephone numbers of other places where you can get more information. What is psychosis? page 2 page 3 Psychosis is a type of mental health problem, or mental illness, that can seriously affect the way you think and feel. It is a lot more common than you might think many well-known people have had an episode of psychosis at some point in their life. Psychosis can happen to anyone it is not your fault - and like any other illness, it can be treated and there is a lot you can do to help yourself. How psychosis can affect you Everyone is different and it is important to remember that psychosis affects people in different ways too. You may experience all of the things described in this booklet or only some of them. Also, if you have some of the things described in this booklet, it doesn t always mean that you are experiencing psychosis. The two most common forms of psychotic illness are schizophrenia and bipolar affective disorder. Both can have a number of different symptoms. A symptom is a problem caused by an illness. For example, a runny nose is a symptom of having a cold.

3 page 4 For psychosis, symptoms are often broken down into three main groups: Positive symptoms Negative symptoms Mood symptoms Your doctor can explain which symptoms you may be more likely to experience and the pattern of illness you may have (see page 15 for more information about this). Positive symptoms something added that you didn t really want Positive symptoms involve experiencing something unusual that you did not experience before you had psychosis. They can sometimes leave you feeling very muddled about what is real and what isn t. There are three types of positive symptom: hallucinations, delusions and confused thinking. page 5 Hallucinations Hallucinations are experiences in which people believe they hear, see, feel, smell or taste things that are not really there. Hearing voices is the commonest type of hallucination. At times the voices can say nice or funny things. At other times the

4 voices may say nasty things. Voices can be scary and may also tell people to do things that they don t want to do. I destroyed some of my clothes. I took them off and I took them downstairs and threw them away. I was hearing voices. The voices were telling me to do things. Delusions This is when you may believe something that isn t true to most people. You may be sure that this belief is very real but often it is just the psychosis making you think that way. Here are some examples of types of delusion that you may experience: That another person or group of people wants to harm you. Sometimes you might even believe that family or friends are page 6 page 7 against you when in reality, it s not true. This can leave you feeling scared and unsure whom to trust That people on the TV or radio are talking to you or passing on messages That you have special powers, for example the ability to read people s thoughts That your thoughts are being controlled by somebody else That something is wrong with part of your body even though you have been checked out by a doctor I was all alone, by myself. Nobody to support me. They were all fighting me. That s what it seemed. I thought I had AIDS. I was feeling ill

5 page 8 page 9 Confused thinking Sometimes if you have psychosis, you can feel that your thinking is messed up or confused. You may find it hard to: Concentrate Remember things Follow conversations Some people find that their ideas may get jumbled up when they speak, so that other people find it hard to follow what they are saying. Or they might feel like their thinking is speeded up or slowed down. Negative symptoms something taken away from you Sometimes when you have psychosis, you may: Lose energy or motivation Lose some of the everyday skills that you had before you became ill You might: Lose interest in some of the activities you once enjoyed Find it harder to enjoy yourself Find it harder to get up in the morning and to get yourself washed and dressed

6 page 10 page 11 Feel that you have lost your emotions - things around you may not seem so funny any more or you might find it hard to react in the way that people expect You may find that your thoughts feel very fixed and it s hard to change your mind Mood symptoms Sometimes people with psychosis can find that it affects their mood. You may: Have odd feelings that don t fit or feel that your emotions are mixed up like feeling stressed and afraid when everyone else seems relaxed and cheerful Feel very down (depressed) or high (doctors call this mania ) It s normal to have ups and downs in life everyone can feel sad if something bad happens, or on top of the world if they pass an exam for example. Sometimes with psychosis though, these feelings become exaggerated and overwhelming. You might have heard some people call these mood swings.

7 page 12 page 13 If you are feeling down or depressed, you might: If you have mania, you might: Lack energy and find it hard to enjoy anything including seeing your friends Feel there is no hope for the future Find it hard to get to sleep because of worrying thoughts going round and round, or you may wake up much too early in the morning. On the other hand, some people find that they sleep too much and can t get out of bed in the morning Have no interest in eating You can think of being high (or mania) as being the opposite of depression. People with mania may feel fantastic, the best ever - but sometimes they can feel irritable and frustrated because they have so much energy inside, or because other people can t keep up. Talk too fast and have lots of energy and find it difficult to keep still Find that your thoughts seem speeded up. Sometimes this feels good, but it can also feel out of control and scary Have much less need for sleep Do things that you wouldn t normally do, such as getting too close to someone who you think is attractive, or talking really loudly in a public place. You might hear some doctors call this disinhibited behaviour Both depression and mania can be accompanied by positive psychotic symptoms (see page 5 for what these are). When this happens the symptoms are usually in keeping with the type

8 page 14 of mood change. For example, someone with psychotic depression might hear voices that are nasty or have a false belief that something has gone wrong with their body. In the same way, someone who is high might believe that they are writing the songs for a wellknown pop group or that they are related to somebody famous. Depression and mania are not always clear cut. Sometimes the symptoms can get mixed in together at the same time and sometimes people find that they switch quickly from one to the other in a short space of time. It s important to remember that if you have some of these symptoms, it doesn t mean that you are psychotic. These kind of feelings and thoughts happen to a lot of people, but if they become too overwhelming or scary, you might want some help in coping with them. What patterns can psychosis follow? With psychosis you may have: page 15 A one-off episode. Some people have just one episode of psychosis, they get better and the problem never comes back Episodes that come and go. This pattern is more common with bipolar disorder but can occur with other types of psychosis as well. Some people can be well for many years between episodes, while others find that the problem comes back more often Problems that don t completely go away. Some people find that not all the problems go away. Even with this pattern of illness, there is still a lot that can be done to help

9 page 16 Why is this happening to me? This is a really good question and one that no-one really knows the answer to. We do know that psychosis is most likely to develop in your teens or early adult life and that genes play a part in causing psychosis. Genes are the information that gets passed on from one generation to another - you look like your mother and your father because you have some of the same genes that they have. Someone with a close relative (a parent or a brother or sister) who has psychosis has a higher chance of getting the problem themselves. This chance is about 1 in 10. Psychosis is not just caused by genes however everyone is different, but there are certain factors that seem to make it more likely that some people grow up with a vulnerability to stress and to developing psychotic symptoms later on. Beliefs are often very understandable when you look back over your background and experiences. For example, if lots of frightening things have happened to you in the past, it would not be surprising if you viewed the world as rather a dangerous place or felt worried and confused. This is why understanding things that happened to you in the past can be very helpful in explaining how psychosis is affecting you now and what things might have triggered off the start of an episode. But remember page 17

10 page 18 page 19 If frightening things have happened to you and you start experiencing some of the things mentioned in this booklet, it might mean there is something else wrong, not psychosis, so it s important to see your GP as soon as possible or tell someone you trust (eg. a teacher at school) so that you can get help in sorting out what s going on. Possible triggers for a psychotic episode Taking drugs like cannabis Breaking up with a girlfriend/boyfriend Bereavement Not eating and sleeping properly Problems with family or friends Bullying or other frightening experiences Pressures at school or college Stress with racism Abuse Worries about sexuality Sometimes if the same stresses continue or new ones start, it can affect how likely you are to recover or to experience another psychotic episode. Some other things that can affect how long you experience a psychotic episode for include: Being worried about being labelled as mad Being worried how people will treat you A lack of support Not feeling good about yourself Stopping your medication too quickly

11 page 20 What helps? Talking to someone you trust, eg. a family member, friend or a teacher can be very helpful. If this is the first time you have started to worry about some of your thoughts and feelings, it is important to speak to your GP who may arrange for you to speak with someone who knows about psychosis and is trained to help, eg. a psychologist, psychiatrist or psychiatric nurse. They can help work out exactly what s happening and what support you are likely to need. They can also help you to learn/understand more about psychosis and how to manage any distressing experiences. If you have had these experiences before and already have people supporting you, it is important that you contact one of them to let them know you need to see them. page 21 Getting help early gives you the best chance of getting better faster so watch out for warning signs such as worrying about things more, losing interest in things you usually enjoy, feeling confused about what s real or not.

12 page 22 page 23 Worried about talking to someone? There may be lots of reasons why you might not want to talk to anyone. Some people don t want to seek help or treatment because they believe there is nothing wrong or that the things bothering them will just go away on their own. You may feel: Embarrassed ( I ve done some really silly stuff ) Frightened ( if I say anything, I ll be kept in hospital longer ) Helpless ( no-one will understand ) Alone ( it s only me that has experienced these things ) Lots of young people will have had similar feelings and the sorts of professionals who you may see won t be surprised by anything you say and will understand your worries. Helping yourself It s important to find ways to cope. You may already have noticed things that can affect the voices or scary thoughts when you are actually experiencing them and can make them better or worse. Here are some ideas you might like to try out you may need to experiment to find what works for you: Some people find that listening to music on a personal stereo can help to block out voices. This can also be relaxing Do something you usually enjoy like watching TV Listen to a relaxation tape Write things down in a journal Go for a walk

13 page 24 page 25 Have a relaxing bath Try some simple breathing exercises such as closing your mouth and breathing in through your nose to the count of six then breathing slowly out through your mouth to the count of six If you hear the voices, try saying something to yourself like It will be OK. I know what to do. I know they won t last long. I should focus my mind on something else until they go away On a day-to-day basis, some people find it helps to try and avoid particularly stressful situations and to plan something into their day that they enjoy. If you hear voices, it can help to agree a set time each day when you will listen to them and then try to ignore them at other times. It can also help to look carefully at what seems to support the beliefs that are causing you distress (we sometimes call this evidence) and what just doesn t seem to fit. Ask yourself what evidence you have for the belief and what goes against it. Is there an alternative explanation? Test out these ideas. Talk to an adult that you trust (eg. your teacher or doctor) about how you might do this. It can help to set yourself small achievable goals, eg. to go shopping, to telephone a friend. It s also important to keep focused on your goals for the future such as getting back into school or college or repairing relationships with friends. Medication Medication can be very good at getting rid of symptoms and stopping episodes from coming back in the future but many

14 page 26 people feel worried by the idea of taking medication. This is a normal reaction and very understandable. The best way to overcome fears about medication is to talk to your doctor or other people who are involved in your care. A good doctor will always be happy to explain medication choices to you and to look at worries that you have. Medication is much more likely to help you in the long run if you are able to trust the advice that you are given and feel like you are working together with someone to solve a problem. Most people taking medication for psychosis don t have side effects that really bother them but if you do get side effects (eg. you feel sleepy all the time, or your appetite changes) there is a lot that can be done to get rid of them or to make them less severe. It might be something as simple as changing how much you take. page 27 A good thing to remember about medication is low and slow this means starting off with a small dose and gradually increasing it to find the level that s right for you. Medication may also take a few weeks to start working properly and works best when you take it regularly rather than stopping and starting all the time. And even when you feel better, medication may be helping you stop the psychosis from coming back so it s always a good idea to talk to your doctor or nurse first before deciding to stop your medication.

15 page 28 Things to remember Everyone with psychosis will be affected differently You may not have all of the symptoms that we have talked about in this booklet You may experience different symptoms at different times Some symptoms may be quite mild, others may be more severe But remember, psychosis can be treated Who can help? It may help to contact some of these places: The Who Cares? Trust Linkline (freephone): (Mon, Wed, Thurs, 3.30pm 6pm) Website about being in care: Offers advice, support and information to young people who are in or have left the care system. Children s Legal Centre This website is designed for young people, carers and parents and contains frequently asked questions on legal issues affecting children. page 29 Youth 2 Youth Helpline: (Mon and Thurs 6.30pm-9.30pm) talk@youth2youth.co.uk The confidential helpline run by young people for young people up to 19 years of age who need emotional support. Contact Youth2Youth by telephone, or online chat. There 4 Me Website: For all year olds. Provides on-screen advice and an agony aunt to help with any problem. Their NSPCC advisers can be ed in confidence for a reply within 24 hours.

16 page 30 Frank Call free and confidentially on: (24 hour service. If you call from a landline the call is free and won t show up on your phone bill. Also provides language translation service.) Textphone: (24 hours) frank@talktofrank.com Confidential information and advice for anyone concerned about their own or someone else s drug or solvent misuse. Mind MindInfoLine: (Mon-Fri 9.15am-5.15pm. Also provides a language translation service.) Textphone: (when using BT Textdirect, add the prefix 18001) Legal advice line: (call on Mon, Wed or Fri 2pm-4.30pm and ask to be transferred to the legal advice line) info@mind.org.uk Offers support and information about mental health. ChildLine Carers UK Carers helpline: (Wed & Thurs 10am 12pm; 2pm 4pm) info@ukcarers.org Provides advice and information for people who care for partners, relatives or friends. Freepost NATN 1111 London E1 6BR Freephone: (24 hours) Textphone: (Mon-Fri 9.30am-9.30pm. Weekends 9.30am-8pm) ChildLine is the free, confidential 24 hour helpline for children and young people concerned about any problem. Lines can be busy, but please keep on trying. Freephone: (24 hours) Textphone: (24 hours) Asian Freephone: (Mon Fri 11am 7pm) CYMRU/Wales Freephone: (Mon-Fri 10am-6pm) help@nspcc.org.uk A confidential service offering counselling, information and advice for children, young people and families in need. NSPCC Child Protection Helpline Youth Access Tel: (Mon Fri 9am 1pm, 2pm 5pm) admin@youthaccess.org.uk Provides details of local advice, information and counselling services for year olds. Eating Disorders Association Youth helpline for callers aged 18 and under: (Mon-Fri 4pm-6.30pm; Sat 1pm-4.30pm.) Youth talkback@edauk.com Textphone: (Mon-Fri 8.30am-8.30pm) Adult helpline: (Mon-Fri 8.30am-8.30pm) info@edauk.com Provides information, help and support for anyone affected by eating disorders. Rethink page 31 Website for young people which includes information about severe mental illness.

17 To obtain further copies of this and the other booklets in the series, contact YoungMinds. This booklet (ref B08) was reprinted in YoungMinds With thanks to: Richard Corrigall & Sophie Browning, Snowsfields Adolescent Unit, London; Marie Blair & Jillian Wragg, Parkview Clinic, Birmingham YoungMinds, Clerkenwell Rd, London EC1M 5SA. Tel: , Parents Information Service: (freephone supplied by MCI WorldCom); Reg charity no