FAQ

Whilst in society we often talk about ‘mental illness’, its important to start by
trying to understand what we mean by ‘mental health’.
“Mental health is defined as a state of well-being in which every individual
realises his or her own potential, can cope with the normal stresses of life,
can work productively and fruitfully, and is able to make a contribution to her
or his community.”
– World Health Organisation
Psychosis is a name used for a mental health problem in which there are
changes in the way a person understands and experiences themselves and
the world. Sometimes when people are experiencing psychosis they are said
to have ‘psychotic symptoms’, a ‘psychotic disorder’, ‘psychotic illness’ or
‘psychotic episode’.
If you are experiencing psychosis you may notice changes in your thinking,
for example it may be difficult to think as clearly as usual and your thoughts
may feel out of control. You may hear or see or feel things which others
cannot (hallucinations) or you may develop unusual beliefs (sometimes called
delusions). Some people with psychosis lose their motivation and interest in
things, or feel they have fewer thoughts or less to say than usual.The label
‘psychosis’ should only used when these experiences are severe and frequent
enough to cause distress or affect the person’s life.

If you are having difficulties that sounds similar to any of the above
symptoms, it may be helpful to talk to your doctor, psychiatrist or another
professional involved in your mental health care. If you are not in touch with
mental health services, a good start is going to see your GP.

Approximately 3% of people will experience a psychotic episode at some
stage in their life, although a first episode usually occurs in adolescence or
early adult life. Psychosis occurs across all cultures and levels of
socioeconomic status and affects males and females equally.
Psychosis can occur as a result of an illness, medical condition, drug use and
stress. Some conditions in which psychosis may be present include:
• Schizophrenia
• Bipolar Disorder
• Depression
• Brain Injury/ Brain Tumor
• A Thyroid disorder

Unfortunately, at this time there are many theories about what causes
psychosis, but no definite answers. Because psychosis occurs in a variety of
mental and physical disorders it likely has multiple causes. Biology, stress and
drug use are widely supported as being contributors to the development of
psychosis.

Biology

Neurotransmitters. There is strong evidence that psychosis involves a
dysfunction in neurotransmitters, the “chemical messengers” in the brain,
particularly dopamine.

Genetics

Those with a family history of psychosis seem to be at an increased risk of
developing it themselves. For example, the risk of developing a psychosis
associated with schizophrenia is approximately 1%. This risk increases to
13% if you have a parent with schizophrenia and 9% if you have a sibling.

Brain Changes

There is some evidence that those who have experienced some types of
psychosis have had changes in the brain. Possible causes of the changes
include: genetics, abnormal neurodevelopment due to pregnancy or birth
complications.

Stress

Stress or stressful events, such as loss of a loved one, divorce, giving birth, or
a traumatic event, can contribute to the development of psychosis. The
amount of stress that may trigger psychosis differs for each person and likely
contributes greater to those that are already vulnerable to developing
psychosis.

Drugs

Psychosis can be induced by drugs or can be drug assisted. For example, it
appears that amphetamines can cause a psychotic episode, while other
drugs, including marijuana, can increase a person’s natural vulnerability to
psychosis resulting in a psychotic episode.

“Early intervention in psychosis services seek to reduce treatment delays at
the onset of psychosis and to promote recovery and reduce relapse following
a first episode of psychosis”

National Institute for Clinical Excellence (NICE) Guidelines for Psychosis

Sometimes the experience of psychosis can lead you to feel scared, ashamed
or nervous. It is important to remember that health and social care
professionals are there to help you. Here are some suggestions on how you
might speak to them about your concerns:

• Write down any symptoms you’ve had
• Write down key personal information
• Make a list of all medications and drugs you are taking
• Write down questions to ask your doctor
• Take a family member or friend along

Discuss all of your symptoms with your doctor and describe how they are
affecting your life (e.g. racing thoughts that cause you to lose focus and not
get things done). Make sure to ask about all of the available treatments and
their benefits and side effects before making any decisions.

Treating psychosis often involves education, therapy, medication, close
monitoring of symptoms, stress management and creating a strong,
supportive environment.

Education – Becoming educated about psychosis is important for the person
and the family to help understand psychosis and how to recover.

Talk Therapies – There are many types of “talk therapies” and it is important tofind a therapist with whom you feel comfortable to speak openly. Cognitive Behavioural Therapy (CBT) is one type of therapy that has been found to help people understand and manage their thoughts, feelings and behaviours. Be sure to ask your potential therapist what their focus and style of therapy is to determine if it will suit your goals.

Medication – Medication can relieve symptoms of psychosis and is critical in preventing relapse. There are many different medications available to treat
psychosis. These medications are called antipsychotics. Your doctor can
discuss medication options and help you to monitor your progress with the
medication over time.

Stress management and coping skills – Stress can worsen a person’s
symptoms and ability to function. It is important to learn your warning signs
and triggers of stress and find ways to manage it, such as exercise, relaxation
techniques and finding artistic hobbies. An Early Intervention in Psychosis
(EIP) team will have clinicians who can help you to learn and practice these
skills.

Support groups – Groups can provide a safe environment to meet with
others who have been through similar experiences and can offer education
and support about psychosis and the recovery process.

The recovery process will vary from person to person. It is therefore
important to speak to your Early Intervention in Psychosis (EIP) team about
what works for you. Some people will recover from psychosis very quickly
and be ready to return to their life soon after. Other individuals will need a
longer time to respond to treatment and may need to return to their
responsibilities more gradually. Recovery from a first episode may take
months or last several years. The main thing to remember is that with the
right treatment, the majority of people do get better.
Some more strategies for staying well include:
• Setting achievable goals, including specific strategies for coping with
change
• Staying social and having a trusted support network
• Maintaining regular check-ups with an Early Intervention in Psychosis (EIP)
team
• Participating in positive social, recreational and work activities
• Maintaining a healthy lifestyle – diet, exercise, sleep
Other useful Websites related to Psychosis include:

Kings College London Online Course: Caring for Someone with Psychosis 
A two week course designed to offer an in-depth understanding of some of the key issues and questions relevant to carers supporting people with psychotic disorders.

IRIS Early Intervention in Psychosis Network
The Early Intervention in Psychosis IRIS Network supports the promotion of early intervention in psychosis. IRIS network brings together elected Early Intervention in Psychosis leads to share issues and solutions.

Early Psychosis Prevention and Intervention Centre (EPPIC)
An integrated and comprehensive psychiatric service aimed at addressing the needs of people aged 15-24 with emerging psychotic disorders in the western and north-western regions of Melbourne, Australia.

Time to change
Time to Change is England’s biggest ever attempt to end the stigma and discrimination that faces people with mental health problems.

Mind
Mind helps people take control of their mental health by providing high-quality information and advice, and campaigning to promote and protect good mental health for everyone.

Rethink
Leading national mental health membership charity, works to help everyone affected by severe mental illness recover a better quality of life

Voice Collective
Peer support for young people who hear, see and sense things others don’t

Young Minds
The voice for young people’s mental health and wellbeing

Mental Health Foundation
Working towards a world with good mental health, and ending the inequalities that face people experiencing mental health problems

Wellness Recovery Action Plan Mary Ellen Copeland
Developed by a group of people who experience mental health challenges, WRAP aims to support people to get back on track after experiencing mental health problems

Oxford AHSN