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Natasha Devon blogs for SANE - Part two
Posted by Admin
20th Jul 2018

The following is an edited excerpt from A Beginner’s Guide to Being Mental: An A-Z from Anxiety to Zero F*cks Given, by Natasha Devon.

Of all the symptoms traditionally associated with mental illness, psychosis - having hallucinations, paranoid or delusional beliefs or hearing voices – is perhaps the most colloquially referenced. The established narrative – the Alice Through the Looking Glass model of mental illness – tells us that people with mental health difficulties have access to ‘other worlds’ and therefore behave in ways which seem bizarre to their peers. It’s therefore peculiar that the nature of psychosis continues to be chronically misinterpreted and misunderstood.

Technically, ‘psychosis’ is an umbrella term, used to describe a distortion of reality. It is not a mental illness in its own right, but rather a symptom most often experienced by people who have bipolar, cyclothemia or schizophrenia. Psychosis can also occur as a result of extreme stress, lack of sleep or drug use. It’s most common in people aged between fourteen and thirty-five.

In 1977, Zubin and Spring produced a simple graph denoting the difference between ‘illness’ and ‘wellness’. They proposed that it was a simple case of measuring the relationship between ‘vulnerability’ and ‘stress’. At its root, psychosis is caused by a combination of underlying vulnerability and increased stress.

Additionally, there is a genetic element. You can’t ‘inherit’ psychosis in the same way you can with physical conditions, but it has been shown that people who have a parent affected by psychosis are more likely to develop it themselves. For schizophrenia, for example, the risk across the general population is around 1%, but for people with a close relative who has the condition this jumps to 6.4%.

When communicating with a person experiencing psychosis, the most important thing to acknowledge is that what a person sees, hears or touches during an episode is real for them and that what they are saying makes sense to them. Straightforwardly challenging their world view is therefore only going to result in further confusion and potential conflict.

It’s important to be authentic in all communication, so never agree that you can see or hear something if you can’t. However, do acknowledge that they can and don’t laugh or ridicule them, however ridiculous their beliefs might seem to you.

For example, if someone asks you if you can ‘see those demons in the corner’ an appropriate response would be ‘I cant see them, but I believe that you can’. You can then move on to employing unjudgmental listening techniques by asking an open question like what are they doing?or describe them to me’.

It’s pretty much impossible to predict whether or not a person will experience an episode of psychosis. If it has happened to you and you therefore know you have a vulnerability to psychosis, ongoing management is all about recognising and dealing with the early signs. Use regular self-care to minimise stress. If you have bipolar or cyclothemia recognise that, whilst mania feels good at the time, there is just as much need to curtail and minimise it. Stabilizing mood reduces the risk of psychosis.

If you see or hear things you know others can’t, but they aren’t distressing to you and you’re able to function effectively, it’s still important to have some medical supervision. Build a safety net so that if your symptoms change there are interventions already in place - Remember that psychosis is more treatable the earlier it is identified.

It’s also crucial that the people around you understand how to support you. Some local authorities have ‘early intervention teams’ which work with families where one or more people have had an episode of psychosis so that everyone knows what they can do. It’s worth asking your GP what’s available.

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