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

I have 2 boys with adhd and autism. I’ve always counselled them to stay well away from weed due to this link.

I smoked weed, recreationally, as a young adult but have kept it from my kids as I don’t want to think I condone it in any way.

Fortunately they gave the type of autism that gives the serious discomfort about rule breaking.

Thanks for bringing up this topic, OP. It's certainly something that ends up brushed aside in all the modern 'mental health' chat, which I agree is mainly focused on the worried well or people with mild anxiety or depression. And I guess people don't like to talk about the link to drugs triggering it because they're worried about sounding uncool, God forbid.

I have an older family friend who was diagnosed with schizophrenia after an episode at university in the nineties. She has had a pretty good life, married and raised three kids. Never worked but has a creative sideline that clearly brings her joy. I think her husband has been the main reason why she has managed so well - they have a close and loving relationship and I am sure he has advocated for her on many occasions, to get her sectioned if she needed it, or talk her into taking her medication when she lost the knowledge of why she needed it.

It's cruel that this condition robs people of insight into the help they need, just when they meed it most. I hate how the medical system often leaves them to struggle right up until the point they are obviously cripplingly unwell and only then steps in. There has to be some sort of middle ground. Perhaps it is because people don't want to think of self-awareness as a flickering thing, sometimes there sometimes not. Our society is obsessed with perfect independence and maybe would rather leave someone to struggle for too long to give them the benefit of the doubt, than reach out to help them if they have lost capacity temporarily.

I don't know what the answer is. I'm glad my friend is not stuck in an institution as she would have been generations ago, but I do worry for her if her husband gets ill/becomes disabled, and what will happen if she is at the mercy of an overstretched community mental health team who won't notice her and help her the way he does.

Definitely needs more education about this. I am pretty sure it triggered/worsened my ex's paranoid delusional disorder (not sure if it's the same as schizophrenia but that's what was written on his diagnosis papers). He had smoked on or off since his teens and was diagnosed bpd, then later on got prescribed cannabis for back pain by a private doctor and everything got much much worse and he was in and out of the psych ward for the last few years of his life.

I think this is the crux of it.

People like to talk about the mental health problems that can be fixed....by people. With a bit of understanding, checking in, support, maybe therapy. And that's great.

There's no point in having cosy feelgood chats with someone who needs professional psychiatric help and medication.

both DS and DB are schizophrenic.

It is a most distressing condition, and for large parts of their lives they exist in a living hell.

I've always felt there are two broad types of Mental Illness - psychosis and neurosis.

Thanks OP for this interesting thread and to everyone for their contributions. My brother suffers from chronic depressive psychosis and I have been involved in caring for him for years so I have a little insight. I totally get that feeling of frustration that with all the developments and advances in mental health understanding and societal acceptances we will seem to know so little and frankly, care so little about the causes and treatments for chronic serious mental health disorders like schizophrenia, psychosis etc.

I have to say the care my brother gets from his GP is actually excellent and I do think the programme of widening access to talking therapies and general societal willingness/ promotion of care for (for want of a better word) mild mental illnesses is a great thing for the population - but like others have said 6 weeks of CBT or a nice chat over tea does very little for people like my brother with lifelong enduring illnesses. On the (sadly way too many) times he's ended up in acute crisis and hospitalised that care has also been very good, like OP I just regret that there isn't more in the middle. The thing I find most frustrating is that as his carer I can tell immediately when he's deteriorating/ stopped his meds / going hypo-manic, just from his speech patterns and expressions even before any behavioural changes - but I am totally powerless to do anything, I can't force him to take his medication (and nor can the nurses/doctor), there's very little by way of services to help someone like him even if he was willing (which mostly by this stage he isn't, he's either manic and feeling on top of the world or paranoid and deeply fearful of any healthcare or authority) and essentially no-one can intervene until he deteriorates to the point of being a very obvious danger to himself and those around him. My greatest fear is that one day he'll come to serious harm or hurt someone else (he's rarely violent thank god but extremely impulsive with no self-control whatsoever) and if I will have seen it coming for days/weeks and been unable to do anything 😢 I don't know what the answer is, I wouldn't want to live in a world where we force people like him into accepting compulsory care against their will or institutionalise them like the bad old days. But more research and funding would be a start!

As to why it isn't spoken about more - I think the sad fact of human nature is that we're more drawn to publicly supporting causes and want to take action on things that are emotionally appealing to us, e.g. that we are able to emphasise with because if affects 'people like us', and also that have easy solutions. It's why for instance cancer has such good marketing compared to say stroke or heart disease (sounds awful but that is what it is at the end of the day) - cancer sufferers are often children or attractive young people (on the telly anyway) and there's the enticing possibility of an almost magic cure and total recovery - compared to diseases that mostly affect older people and where treatment is either preventative or symptom management. Sadly I would chronic serious mental health illness just aren't marketable in that way, having witnessed my brother and others mid episode it's very very frightening - not just the possibility of violence or harm to bystanders but just seeing someone lose themselves so entirely (the meaning of the expression 'out of your mind' really hits you) and in such profound distress is really, really upsetting. And then when he's well he just seems like a basically ordinary person so again nothing to see (other than the general wreckage of his life, finances etc. caused by the acute episode of course). Like others have said, deeply unglamorous. You can see why it's not something most people really want to engage with really despite it being relatively common...

OP you look after yourself and thank you for this post. I am only recently on the ‘diagnosed’ journey of MH illnesses. I was finally diagnosed about three years ago, I’m in my 50s now.

diagnosed with PTSD from being raped and attacked as a teenager by a stranger and two very abusive relationships, I’d been struggling with all of that since 21 when I tried for the first time to get some help. Also clinical depression, that’s the reason I asked for help as I was really bad for 6 months no idea Hoe I survived tbh. And then due to it taking 4 years for anyone to bother to help me or diagnose me , as well as the lockdowns, I got crippling anxiety and agoraphobia. So that’s me now. The only help I have had is ten sessions of talking therapy after being diagnosed, no treatment whatsoever for the ptsd as the therapist had to choose to focus only on the agoraphobia to make my life a little better so I could get out and about again.

the recluse stuff you mentioned is how I am and thrn it’s so hard to get out again. I’ve had a bad bout of covid and been stuck at home for three months so I’m now panicking about going out around people again. It’s a big vicious circle.

Anyway the reason I’m replying is so that you know I’ve heard you. And yes all I hear is someone’s signed off with stress or a bit of anxiety. No one has a clue that when I say I have similar illnesses I mean what I mean. It affects every part of my life and my body. I cannot work. So the oh I’m a bit anxious posts everywhere are really not helping at all.

The hormonal link should def be more explored. We know that after childbirth some women have psychosis that can be life threatening - I think it’s the rapidly changing hormones that throw them off kilter. Makes sense that this also happens during peri/menopause and teen years.

It is thought that estrogen is protective and this is why schizophrenia tends to come on later in women as well

Great thread and a very good point too.

'Mental Health Awareness' nowadays seems to be more concentrated on mental wellbeing as opposed to actual mental health conditions. I don't think a single person has never been anxious or depressed... both are normal human reactions, but they are so different to a diagnosed anxiety disorder or clinical depression.
I do think looking after your mental wellbeing is important, but very few MH campaigns now deal with illnesses at all, let alone more severe ones like Schizophrenia.
People are squeamish about things like psychosis and mania. They are all "you can talk to me if you are feeling low", but if you are manic or psychotic... they disappear.

I too am unable to work due to several MH conditions, and claim benefits too. I surround myself with people who understand and are in the same boat.

If your friends and family are ignoring and sidelining you following you telling them @GreenPoms then you need better friends and to distance yourself from family

statistically speaking, schizophrenia is one of the less common mental health illnesses i - so makes sense not talked about to the same (very high!) extent of chatter about other types.

It's a very good point and I don't know the answer.

The only think I can think of is the amount of people I know with either anxiety or depression is far greater than those I know with schziophrenia or bipolar.

I only know 2 people ever who suffer from schziophrenia and even then their experiences are very different. One seems to be fortunate enough to manage it relatively well with medication. The other seems to have never found something that helps and spends a lot of time as an in patient. One is someone I knew in school and the other a former neighbour so I really only know the basics.

I know no one with bipolar that I am aware of.

Also just realised I've had mental health training with both work and part of charity work and both only covered anxiety and depression. (Work with neither is mental health related).

Not sure if you've an interested in doing an AMA but I'd read it as it's something I know very little about. I would even know how to recognise it whereas depression, stroke, heart attach etc, they are all well documented and have lots of awareness campaigns.

Your right OP!

I have had psychosis and been sectioned and I don’t tell anyone really (close friends and family know).

I do think this needs a nationwide campaign as a matter of urgency.

I was so lucky. My family somehow managed to get me sectioned and nhs threw the kitchen sink at me. My psychiatrist said I think you have schizophrenia but I am not going to put that on your record. She said ‘I shouldn’t be here’ - ie. Didn’t fit the typical stereotypes and risk factors - being upper middle class, white, a woman. Even though I had my first episode bang on 27. Typical age for schizophrenia in women.

It’s now nearly a decade on. I am not medicated and so far haven’t had a positive relapse. Sometimes I have negative symptoms but is that just me being me. It’s hard to know and I do trip myself out sometimes thinking do I have it, did I have it, can I get it again?

I have spoken to quite a few people in obscure corners of the internet (as mental health professionals are quite careful what they say to your face); and it fascinates me how little is still known about this illness. It fascinates me that it is seen as uncurable yet 25% of people with a diagnosis make a full functional recovery from psychosis and live a normal life. And part of me also thinks about all the people at the pre - diagnosis first episode psychosis level. How many of them were ‘cured’ before developing permanent schizophrenia. I am sure they also exist. But how can you prove a negative.

But yes in short I think we need a national campaign about first episode psychosis and getting rapid help. Every couple of weeks on here I see a post from a family member who has a relative who is clearly having a psychotic episode. But they can’t see it. And every hour let alone day counts! It should be like the campaigns we had for stroke awareness. On tv, on tubes, on radio. That’s going to save a lot of lives. And hopefully reduce stigma.

I also want to add that there is no research on being the adult child (or any child) of a psychotic parent. I grew up with my DF's psychotic behaviours and am only just healthy myself. It has taken a lot of self-educating to grow out of ideas of the devil following me, being told that people are evil/jealous/out to get me, warding off suspicious thinking, trying to keep myself clean (verging on OCD) and trying to ward off weird voices and repetitive phone calls from my psychotic parent. If only someone had sat me down and told me it wasn't ME but the genes I have inherited and the fucking dire conditions I was subjected to through poverty and life with a psychotic parent.

I have bipolar disorder. I would agree that it is slightly more acceptable due to having famous spokespeople. Also because it is often episodic even though still symptomatic, there is more opportunity to communicate and educate.

I have been in hospital on many occasions and have thought schizophrenia was even less socially understood.

I watched the documentary about Heston Blumenthal and bipolar and, in this, he contradicted my thoughts in an interview with a health data expert by claiming a lot more financial investment went into researching schizophrenia.

I am heavily medicated and have accepted this now (at the age of almost 60). I think in both illnesses the side effects of the drugs are horrific. If blood pressure medication caused comparable effects, vast amounts of financial resources would be spent finding alternatives. But that is just the nature of medicine.

Mental illness acceptance is a nice idea until it inconveniences people. It isn't pleasant, it's horrible. I think there is a vague hierarchy of illnesses that are tolerable for others. Full blown psychotic mania and schizophrenia don't figure highly on this scale.

Thanks. I couldn’t agree more in regards to the link between Menopause and psychosis. Practically nonexistent research. It’s only recently I’ve begun to see those two things being openly linked.

There’s a flip side to this as well. I was put into early menopause due to chemo and having to have my ovaries removed (I’m a BRCA 2 fault carrier). My mental health improved enormously afterwards, and thanks to issues with HRT I now know that I have quite severe progesterone intolerance. I suffered for years with PMT, PMS, couldn’t take the pill because I needed ever stronger doses to keep it working, depression during pregnancy, and major post natal depression with suicidal ideation. I’m saner now than I have been since I was about 12.
Progesterone is not my friend.

Because it's messy and not at all pretty or glamorous, and it has unavoidable consequences for everyone in the person's life. You can't fake your way through life with it (being medicated for it obviously isn't faking it). Anyone who's lived with someone with a psychotic illness knows there's nothing attention-seeking about it. It has teh capacity to be ugly and massively negatively impactful. The opposite of "a touch of the vapours" or being "of a nervous disposition".

I think you're right, OP.

When individuals, organisations and celebrities talk about "raising awareness of Mental Health" most of the time they are referring to Anxiety and Depression. Whilst it's great that there is a better understanding of these conditions, other mental illnesses, in particular psychotic illnesses and personality disorders are still widely misunderstood.

Like many young women at that time, I was mis-diagnosed with a highly stigmatising mental health condition as a teenager only to be told later in life that this was totally incorrect and that my difficulties were due to Autism. The response I get when I advocate for myself as an Autistic person is very different to how I was treated by HCP's when I had my previous diagnosis.

I have a relative currently sectioned with schizophrenia, thought to be triggered by drug misuse in their early 20s. They had a lot of promise but it’s detailed their entire life. It’s very sad.

My brother has PS and depression. His medication just about keeps him on an even keel, but only just.
The public focus on mental health has inevitably deteriorated into just another pop culture artefact. Its not uncommon now to see (often self diagnosed or just highly exaggerated) mental health issues used for sympathy clout or as an excuse for poor behaviour, and the idea that everyone should be oh so supportive and understanding all the time never addresses the fact that some people with severe mental health problems can be absolutely horrible and draining to be around, for instance, my own brother can be very verbally abusive and tends to have poor personal hygiene. All the focus is on the softer, more functional side, so the intractably difficult and messy side just gets swept further under the carpet. You can’t make tearful and aesthetically pleasing TikTok’s about thinking MI5 are out to get you, while sticking pins in yourself.

It is also a feminist issue. The link between psychosis and menopause is grossly under researched. I am not doing a good job of explaining this, but nobody tells newly divorced women that they are pretty vulnerable. Psychotic episode is not discussed in terms of extreme anxiety and sleep issues, it’s just clumped with schizophrenic-type illness and sort of mystified. Another aspect that is under discussed and dismissed is acute confusional migraine. my family member (who is actually a psychiatrist) thought she was having a stroke.It started a whole cascade of delusional thinking which, in retrospect, she believes was linked to hormonal imbalances in perimenopause.

@NightTerrier For you as well as my post above. 💐💐. I know from personal experience how debilitating and distressing severe mental health conditions can be. I'm glad you are taking all your medications , the alternative is worse and I truly wish you all the best. I understand what you are saying.