With all the awareness of mental health, why is psychotic illness never really mentioned?

I havent RTFT but if you dont already know him look up a singer called Ren. Such a talented artist who uses a lot of his own experience of Lyme Disease, Psychosis, depression and anxiety in his music. Quite inspiring

Your entitled to the benefits and the support
That's what the benefits system is for , genuine cases who need the help .
Would you be willing to share how you were diagnosed

Agree strongly with this. Warehousing is a very apt term.

I had a relationship with an AuDHD boyfriend who experiences episodes of psychosis. I don’t know if it’s down to hard drugs when younger, or his traumatic relationship with his mum - he was glad when she died. The two episodes during our relationship were with people watching and authorities involved. To say it opened my eyes such a lot is an understatement.

We’re long distance, 200 miles, and I never witnessed an episode first hand but I could hardly believe what he told me had happened. He’s been committed to institutions on a few occasions too, before I knew him. He was only hospitalised for 24 hours once when we were together. I know he’s not told me everything about his past, either.

We finished after he attempted suicide (for about the 10th time in his life) and as much as we still adore eachother, he said it wasn’t fair on me to keep us going. I was out of my depth with it so it was a relief, in a way. I can’t help or provide practical support from 200 miles or four hours drive away when it matters. We’re still good friends, we meet up for weekends and have fun - I’ll always be his biggest supporter and he knows that. But I find it easier to less emotionally involved and I hate that I do. I attended therapy to help myself deal with his attempt and if/when he tries again I hope I’ll be better prepared.

Luckily, now he’s in his 40’s he’s very self aware and does everything he can to regulate and help himself. Very strict with his antipsychotic meds and knows so much about therapy now he’s taking night classes to be a therapist himself! But for various reasons these episodes happen, and they will do again.

I’ve learned so much from him and because of him. I can’t believe how ignorant about serious mental health issues I was before. But if I bring him and it all up people just don’t want to know or clearly quietly judge him and me for “putting up” with him! Aside from my therapy sessions, which were a bit rubbish, I’ve never been able to talk about it all.

Thank you for creating this thread OP.

A lot of SMI people are especially invisible because they are effectively warehoused in psychiatric units, not really receiving any particularly thorough treatment but more just indefinitely imprisoned so that the community mental health team can offload its liability and so that the (usually privately-operated) units can keep hoovering money out of NHS trusts. Shoving people in an institution to keep them out of sight is really not a thing of the past at all.

It’s because of the stigma of those kinds of mental health illnesses. The way the media portrays them, films, newspapers, tv series etc. People with those types of illnesses are seen as being dangerous, where, in fact, schizophrenia is the least seen in prisoners with mental health disorders.

I also find a lot of messaging about eating disorders quite trivialising. The people who make themselves the spokespeople of, say, anorexia recovery tend to generalise their experience of short-term, body-image-focused restrictive eating as though it has anything to do with the experiences of people with enduring eating disorders which tend to have very difficult comorbidities and/or be rooted in absolutely horrifying early life trauma.

I'm a MH nurse and absolutely agree.

Public understanding of SMI (particularly things like Schizophrenia) is very poor, and stigma remains high. People on the SMI register are significantly more likely to have poor health outcomes, poor work outcomes, be socially isolated, experience financial hardship, and so on. People absolutely do not understand that these are often relapsing illnesses which make people very poorly indeed. People do not understand that the drugs required to keep people stable are really quite horrible medications with high side effect burden for many people. Also what 'well' looks like is a huge spectrum for people with SMI. One person with Schizophrenia might be stable on meds for years and hold down a job, run a house, etc. Another may not have psychotic symptoms, but might experience a lot of the negative symptoms and therefore has a low level of functioning. Others may be quite impaired due to years of antipsychotic use and need supported living and carer support. Same with Bipolar- you get some people who get very cyclical depressive episodes, but very infrequent manic periods. You get people in and out of hospital due to have very stress sensitive manic episodes. I have a patient who roughly every 3 months is bed bound due to her depressive episodes. She has been that way for years, and unfortunately, despite treatment, that just appears to be how she will always be. I also think there are a lot of misconceptions around delusions etc- people only think of paranoid delusions about others (which is fuelled by the media imo). Other psychotic symptoms like hallucinations (auditory, tactile, olfactory, etc) and things like disorganised thoughts are poorly understood.

Unfortunately I also sadly think people still associate Schizophrenia with violence towards others, when in reality most people are more a risk to themselves (either due to suicidality or significant self neglect). I work with older adults, and in my experience, Schizophrenia also makes some adults far more vulnerable to harm from others in terms of exploitation, etc.

Also, employment is not always accessible. I get angry when people moan about people with mental illness getting PIP etc. In reality, who is going to employ someone who many need to attend Clozapine clinic once a month, who needs time off to see their mental health nurse, who needs later starts due to heavy sedative medications, who may have long periods off if their illness relapses, etc etc?

I think it's great there is acceptance of depression, anxiety, etc, now, however I still think acceptance only goes as far as 'it's okay to feel your feelings' and all the other diluted insta type fluffy stuff around self care. The reality of depression might be not brushing your teeth for days, lashing out at others, drink problems, chronic suicidal thoughts, and so on.

There really needs to be a good public health campaign around different types of SMI. I also think this would be very helpful for carers/loved ones. These illnesses are also hard on family a lot of the time.

Anyway. I could go on forever 😂 good on you OP for making a thread about paranoid Schizophrenia. I think that takes a lot of courage, and things like this encourage people to ask questions and breaks down stigma.

Completely agree, and in fact I've been saying the same thing myself. Tabloids capitalise on the fact that most people's conception of mental illness is a sort of exaggerated low mood. I've known people to have self harmed to an extent that they've severed the tendons in their own arms; people with single-digit BMIs; people on such high doses of antipsychotics that they can't stay conscious during the day. I can't help but think it must be a charmed life fot those so totally ignorant of these things that they genuinely don't understand why a mentally ill person can't just buck up their ideas and get to work scrubbing toilets because paying taxes aggrieves them.

My dad has had serious episodes too where he absconded from the home and believed he would be arrested if found. He too is on long-term meds (which have to be changed every few years as he gets resistant!!!). Psychosis is horrible and I'm sorry your family has been through this too.

Thank you for posting a thread on this and talking about paranoid schizophrenia.

My brother has paranoid schizophrenia. About ten years ago I did a collection for charity on Schizphrenia Awareness Day, it was interesting how many people stopped and gave, and stopped to have a chat - more people know someone affected by schizophrenia than talk about it.

Best wishes to you OP.

I pressed the wrong button!! Yanbu, its a difficult and misunderstood condition, best wishes x

Could be, it's quite hard to say. When in psychosis people do believe all sorts of things which aren't rationally/ logically true, it can take all sorts of forms from auditory and visual hallucinations (seeing and/or hearing or even physically feeling things or voices which aren't there), to paranoia/ persecution delusions (a common one is believing the police or FBI or other shadowy forces are out to get you) to delusions of grandeur (believing you are are god or have supernatural powers). My brother starts to believe there are signs and secret messages in pictures and adverts on the telly and that announcements / departure boards on public transport are sending him signals/codes.

The thing about these 'episodes' or experiences if you will are that they are very, very real to the person experiencing them, and no amount of rationalisation or denial by loved ones will change that (in fact telling the person that what they're experiencing is untrue or not real can be very distressing for them). After the episode is over, sometimes they can't remember the delusions/hallucinations, sometimes they can and then it's very hard - the rational part of them knows or suspects the experiences were part of an illness but the feelings and memories are so vividly real it's kind of impossible to reconcile and again I think it's often quite upsetting. As a loved one/carer of someone who suffers with this horrible illness I quite often want to talk to him about his delusions but generally that's me processing stuff rather than him so I don't push it against his will.

What can you do, it depends a bit on what triggers the episodes, with my brother it's depressive psychosis so keeping his underlying depression under control, the right mix of medications and avoiding known triggers like excessive stress or anxiety. Basic mental health self-care like practicing mindfulness, getting enough sleep, eating well, socialising, avoiding alcohol and drugs, although in many ways totally inadequate for care of this complex illness, as this thread has shown, are also actually really important in keeping him well (no good once he's in an episode, only anti-psychotics work then). So I guess generally being there for your relative, not challenging their version of the past unless it's actively hurtful/damaging to you personally, providing social/practical/emotional help, keeping an eye and encouraging them to seek crisis help if you see early warning signs of an episode (look up hypo-mania symptoms as they are quite useful indicators for all sorts of psychotic illnesses) - and get them to emergency care (a&e or crisis team) if they are a danger to themselves and others is what I'd recommend.

This sounds very difficult OP. I hope you don’t mind me hijacking your thread but it seems a lot of people on here might be able to help someone I know who I’m certain has this type of condition.

Without giving too many details they have had what I assume are referred to as ‘episodes’ - in one instance they tried to seriously hurt someone close to them, in another they claim to have been involved in a series of events which physically are not possible due to timings etc but they believe this 100%, to the point of having a tattoo related to what ‘happened’ and other mementoes. They have been seen by medical and legal professionals at various times in relation to these incidents but nobody has ever diagnosed them.

My question is, does this sound like the same type of disorder referred to in this thread and if so how can I help them? They refuse to take medication or discuss with a professional again due to not having been believed previously.

And this comment is why I'm not "out" about having bipolar. This is why I don't tell doctors I have it.

You don't speak for me about what is "very much part of the illness". It might be your relative's experience but you can't extrapolate your findings.

Nothing like a sweeping assumption about what bipolar "looks like" to lose friends, further ignorance and derail a career.

My sister has bi polar. It is very difficult to live with someone with this condition. Her children ended up living with their grandparents in the end. I don't think people are wrong to assume you could be difficult. It's very much part of the illness, sadly. Obviously when medication is under control it is a much more calm place.

The same thing's happened with autism. I'd give you some brilliant links, but need to take my mental health to bed before attempting anything organised 🙄 A renowned expert on autism was hounded out of a high-level conference on autism by all the autistic spokespeople who function well enough to publish research, organise campaigns and speak at large conferences.

Last I heard, he was struggling to hold onto his career as his reputation was being systematically trashed. Funding is moving from the silent, severely affected 50% to the 50% who can effectively advocate for themselves. It's very sad.

Every so often, I try and gently raise awareness about things that often affect daily life, such as transient psychotic episodes. I'm always met with outrage at the mere suggestion it happens often! The fear's incredible - people will prefer any other explanation, no matter how bizarre.

I love the potted user experience stories on the Mind website. Wonder if they could make a set of video shorts along those lines?

I didn’t get diagnosed with bipolar until I was 50 but I can remember my first episode at 19. I take antipsychotics to control my symptoms. The unmedicated years nearly destroyed my life and the lives of my family.

I am lucky to have found a medication which keeps me well but it does make me a bit boring. However, after the chaos of life between 19 and 50 I will happily take that!

I am not embarrassed of having bipolar but I am mortified at some of my past behaviour, particularly when in the throes of hypermania.

I am bipolar and I agree. I think as bipolar has some commonality with how others experience mental wellbeing it can be easier for people to relate especially with the moderate depression and hypomania but I do agree with @MiraculousLadybug there is a lot misconceptions about bipolar especially type 1.

There are two aspects of bipolar that people seem to struggle with and that is the idea that you will have repeated episodes, even if you take your meds and eat well and offer up your soul to the north star or what ever else is in the media to help with mental wellbeing. I remember one mental health awareness day at work where we had a coffee morning talking about our experiences. I mentioned that often I can moderate my mood by listening to music opposite to my mood. A little while later I mentioned that I had a difficult episode where I was getting messages in the music I was listening too and someone pulled me up on the fact that the two stories were the contradicted each other. They had missed that they were two separate episodes as to them mental illness is a one of things. The psychosis I think is just hard for people to grasp. I almost think people are going to think "yeah but surely you really knew that it wasn't real".

The other is the psychosis. When I start talking about severe depression, mixed episodes and mania that's when I very careful pick who I talk too.

I was admitted to hospital in the summer due to extreme fatigue in pregnancy. The admitting midwives classed me as having an acute mental health episode and needed an urgent psychiatric assessment. I had seen my psychiatrist and Obstetrician a few days earlier as my physical health was declining and thankfully they got the hospital back on the right track. They were originally planning to change all my medications and looking at an mbu admission. I was diagnosed with severe ICP (Cholestasis) and was borderline for HELLP an unusual form of preeclampsia. They had to put me on medication to treat these and induce me as the Cholestasis was putting me at risk of a still birth and if I did develop HELLP I could have got seriously unwell. I dread to think what might have happened if the consultants hadn't advocated for me. My psychiatrist said she has had patients where they have gotten unwell because physical issues have been ignored and put down to mental health.

It’s not a race to the bottom. And type 1 bipolar is a psychotic illness. I have it. It is every bit as stigmatising. Some countries won’t even give me a visa. I think a lot of people on this thread don’t know what bipolar disorder actually is. Likely think it’s “I’m so happy now I’m sad now angry” which is actually borderline personality disorder. Also extremely stigmatised. As is anything that actively prevents you using basic social skills to “engage” with help when your brain catches metaphorical fire. And feck off with the little head-tilt “I’m sorry you feel this way” nonsense. Just begone with it.

Is bipolar not a divergence? Sorry OP totally with you and don’t want to derail the trail. My point is I think every condition eventually gets its time in the sun, at even the more know ones are subject to misconceptions

OP I have psychosis in my family (not yet diagnosed schizophrenia but possible if it happens again) .

I think the simple answer is the same reason people in psychosis are so vulnerable- active psychosis is too strange for the general public to deal with.

How can a healthy brain process that someone who is not being killed, thinks people are coming to kill them?

how can a healthy brain process someone telling you there are patterns in the number plates of the cars they’ve seen?

how can a normal brain process someone running away and hiding in a bin store because their family put witch craft on them?

we can conceptually deal with these ideas. But we can not relate to the reality of someone with a broken brain having delusions. Many people can’t even accept that the person is question truly believes the delusions are real.

what a broken brain can do is very uncomfortable. I don’t think people can relate to it in any way. Human instinct is to freeze or flight from those people.

it’s tragic. I want to cry when I read DM idiots claiming PS is an excuse.

I think people on this thread are significantly minimising how bad depression and anxiety disorder can be I'm diagnosed with bpd and although its had a significant impact on my life I would still say my anxiety disorder has definitely been worse at times. I didn't leave the house for 2 years because of anxiety my bpd never did that to me

Thing is I don’t believe it can’t be fixed all the time. If you catch it early enough the odds are not that bad! It’s not a given and it’s still 50/50. But without really fast help (and I am talking hours/ days) that’s it really. Odds of a full recovery/ permanent remission are quite slim.

And therapy does work too. I had CBT and therapy; they made a difference.

It’s also interesting the rates of function across the globe. Lots of people in India have schizophrenia with very good function. It seems to be that cultures more spiritually tuned seem to have good psychosis rather than scary psychosis. Yoga weirdly has also had good results.

Also in the scandi countries they are trialling not medicating after the initial acute period (weeks or months as opposed the years standard in NHS). The long term hasn’t been done but the idea is that it gives a chance to those who might be the lucky ones to actually fully recover. That one’s a bit of a paradox though. For some people that will make things worse. So it’s a gamble. But it worked for me.

I wouldnt have known about the medication thing if it wasn’t for a close friend who does research in evolutionary psychiatry in Switzerland. It’s interesting because their newest theories is that schizophrenia is actually an evolutionary trait. A highly valued one at that which is why it’s not been bred out by darwin evolution. They have studied tribes and the ratio 1:100 is roughly equal to the number of shaman to tribe members. The difference being these shamans were taught by elder shaman and guided through their schizophrenia journey to it being embraced and spiritual. Ie. A good psychosis rather than scary psychosis.

It is so fasincating. We do have a lot to learn!

This exactly and beautifully put.

OP, I don't have PS but I have bipolar and experience psychosis when I'm unwell, sectioned multiple times. I strongly agree with you about bipolar being slightly more acceptable and an so sorry for your negative experiences.

Like others, I get so frustrated with the medicalisation of emotions. SMI is a completely different kettle of fish.

I do work but struggle. I've got a very supportive manager but do worry about the impact on my career. I'm aligned with a professional body and live in fear of them finding out.

Don't get me started with "It's OK not to be OK". For people living with SMI, disclosure can carry a lot of risks.

I do not recommend this to ANYONE, but I choose not to disclose my condition to medical professionals other than my GP. I can guarantee my broken leg will be thought secondary to it.