To ask about psychosis?

[BobbyBiscuits]

This is incredibly traumatising but basically my DH had a psychotic episode about 8 years ago while I was away and threw himself out the window, he nearly died and was permanently disabled. Other than that he has severe depression/ anxiety (as do I ) but no psychosis.

Now, he has out the blue had another one and done the same thing, threw himself out the window, this time in front of me, this was about 4 metres. He has broken ribs and pelvis and is in major trauma ward in hospital.

I am wondering what kind of care he can get in the community to stop this ever happening again?

He says there is only one route he is allowed to follow which is through an addiction service (they are useless, he has not been an addict for 10 years plus but that's the only way he can get opioid pain medication for his nerve damage from last accident), I am desperately worried as you can imagine. I just don't even know what type of medication he could take when the episode starts, before it becomes life threatening.

Any help greatly appreciated. Just to add, I do wish to be with him through this as he is wonderful in so many ways, I've no intention of leaving him.

Is he under mental health services? If not he should be. Get a mental health assessment arranged for him as soon as possible - speak to the hospital ward doctor to request it, push for it if needed. Tell them you are not prepared to have him discharged home without an urgent mental health assessment and support plan in place. He will probably need seeing by a psychiatrist for medication for the psychosis.
I am so sorry that this has happened to you an him, how terrifying and traumatic. I hope he makes a good recovery both physically and mentally.

That sounds so scary, I’m sorry for your experience. Is he still in hospital? I would expect / ask for him to be assessed by the Liaison Psychiatry team as an inpatient. They can then review and make a plan. It’s likely he will need psychiatric (CMHT) follow up in the community - did he ever have any? They can then make a plan for medication - it may be that he needs long term antipsychotics.

Thank you, he is not under an MH team right now, but I need to make sure they get him one through the hospital. I actually wouldn't mind him being sectioned (bad as it sounds) but if he's no longer displaying the psychosis I doubt they will do it. He's in hospital now, this happened yesterday : (

@Emelene Sorry, in answer to your question, no he never had any community Psych stuff. They said they would last time but didn't. he had one from RNOH who was awful and did nothing but deny him medication and he has PTSD from the last one. Lawd gimme strength...

Many areas have early psychosis intervention teams now - as a PP said, ask for liaison psychiatry while he’s an inpatient and get a referral to the community mental health team and early intervention team. How is your health holding up?

Thanks @Toetouchingtitties (user name is creasing me up btw! haha)
Gawd, I'm OK. I seem like I kick into survival mode when others are unwell. Usually I'm pretty shite at life. I will ask him first but if he doesn't want me to I'm going to do it anyway, one fella came round making noises about support, and he has an 1:1 RMN right now. But the RMN can't really 'help', they just watch you and take BP etc.
I will try and move things forward tomorrow when I go there again.

You sound like a fantastic partner and I’ve no doubt you’ll be there to help him get the support he needs. His injuries sound like he may be in hospital for a few days at the very least, so he’s safe for now and that will give you some breathing space to arrange things.

Psychosis is scary, but the sooner treatments are started, the better the outcome. As for yourself, if you’re in survival mode, just be aware of the adrenaline crash that might be coming and take care of you too.

Long term antipsychotic medication is prescribed fairly often and given this is his second life-threatening event he may be a candidate. A thorough review of any medication he’s on with a psychiatrist should be the first priority.

You might also find that https://www.mind.org.uk/ can signpost you in the direction of useful help.

I have experience of psychosis in two close family members, with both it built up over a period of time and lasted a good while afterwards - I'd think it would be unusual to have an episode that was over and done with so quickly without any antipsychotic medication involved - has your DH had a mental health assessment? Has he spoken about why he felt he had to throw himself out of the window? With psychosis there would have been delusions involved making him think it was the only option he had. Has he spoken about his delusions?

Do you know what has caused the psychosis? Sorry a lot of questions here! With my relatives one (my DH) had a manic episode in his early 20s after he used to smoke a lot of cannabis and before we met - the cannabis was believed to be the trigger - followed by another episode a few years ago which was quite a while after stopping the medication he was given after the first one (but no more cannabis involved!) - believed to brought on by work stress. He is very likely to have bipolar but has been stable for a good few years now, he isn't stopping the medication this time and regrets stopping the first time as he clearly needs it!

Currently his dad has been diagnosed wulith psychotic depression so we think it runs in the family although it has only been affecting FIL more recently. FIL is having a relapse at the moment but thankfully not as bad as the first time as he has been on antipsychotics since.

It is very scary. I had a thread in the mental health section on here during DH's last episode and I still remember the support I was given at the time which got me through it. Someone said to me then it's a very lonely place to be - and although it took what seemed like forever we did get through it and now things are better than ever!

The other bit of advice - which I have now passed onto DH when we we are dealing with his dad - it that you can't rationalise with an irrational mind, no matter how hard you try!

Please make sure your DH gets a thorough mental health assessment. Mine started off on olanzapine which brought the irrational thoughts down fairly quickly - and he still takes lithium and an antidepressant to this day (religiously as he really doesn't want a repeat!)

I have psychosis. I originally went to the GP who referred me to EIP (early intervention in psychosis). EIP assessed me, prescribed anti psychotics which I may have to take for the rest of my life, and have provided intense therapy, a care coordinator and a support worker.

You must push for this for your DH. It literally is life changing. You can only be under EIP for three years (I have until June this year) and then you're referred to other community mental health services for continued support.

Thanks so much everyone for you advice and kind words.

@rubydoobydoo In answer to your questions, he was having visions and talking about enlightenment and stuff. He kept saying he was going mad, and was really paranoid. He then kept saying he loved me but in a weird way...then he went out.
He said afterwards at the hospital that he went out the window because he thought it would 'stop the madness' (?) I guess literally like a 'bring you back to earth' kind of thing...

He is not on any antipsychotics or antidepressants (the latter he has tried but they don't really work for him, or me for that matter). Apart from that there was nothing unusual other than he hadn't been able to sleep for a couple of nights (again, no idea why).

I will try and get him an assessment today, he needs something doing while he is in hospital (he can't physically move so he's a captive audience!)

Update fyi...He's being released today. They did MH assessment and I don't know what support they are giving in the community. He has been given sleeping tablets and a number for a crisis line scrawled on a tissue.
He seems completely OK now. The MH team asked me what caused it and I was like "I have no idea", I asked what he told them and they said the he had no idea either. So if he doesn't know how TF should I know? I let out a bitter chuckle. The people next to him were stabbing victims waiting hours too late for pain meds and the hospital was not cleaned once in a week.
Anyway...Let's hope it does not happen again, eh?

Hi OP, this is awful, I'm so sorry.

A few people mention the Early Intervention in Psychosis Team, how old is he? As he had his first episode of psychosis 8 years ago he'd have to be under 35 to meet criteria. If he's over 35, he could get support from the community mental health team if they deem him appropriate.

What happened leading up to this? Did he literally seem fine and then jump out of the window?

You said he had told you after, that he jumped to stop the madness... I would interpret it that he wanted his unusual experiences to end, ie the madness to end, and thus end his life, to stop it all? Does he seem depressed/suicidal at all? Has all of the bizarre thoughts/behaviours stopped?

Is he using any alcohol or substances?

OP this sounds really scary and you're a very supportive partner. I do know that sleep deprivation increases the risk of psychosis in general (not limited to those with mental health issues, but if he's susceptible perhaps he has a greater risk?) so perhaps he could look at a plan with the GP or MH professionals if he has problems sleeping again? It sounds like your only indicator so far but it's worth thinking about.

Thanks guys. Yeah, he's over 35. Hoping the community team can help him. He does drink beer and smoke cannabis but not a lot. He has been fine without it in hospital so hopefully will be cutting down now at home.

My brother is currently sectioned because of a psychotic episode that started around New Year's Day this year.

Antipsychotic medication has made a huge difference to him very quickly. He has gone from being literally unable to speak, open his eyes for hours or even at the very height of things control his bladder, to leaving hospital on "approved leave" to have lunch with his wife in a restaurant today.

Because he has been sectioned, he has a legal right to after care in the community and when he is well enough to leave hospital he will have a care coordinator overseeing what he gets, which should be a mixture of medication, talking therapy, occupational therapy and practical support with things like claiming benefits. Talking therapy in particular is in very short supply on the NHS but we are looking in to sorting it out privately (with the support of the care coordinator).

Mind and Rethink Mental Health have some good information on their websites.

Being sectioned is no picnic and it's difficult to say if being detained on the ward is helping my DBro or making him worse. But help for psychosis is out there, although it's not straightforward to access it.

Hi, I had postpartum psychosis when I was 38 and I was supported by the Early Intervention in Psychosis team, so it's worth speaking to the community mental health team to see if your husband can be reffered to EIP even if he's over 35. If you google EIP in your area it will give more info on it.

EIP (or the community mental health team) should be able to help your husband put a plan in place to help him recognise the first signs of psychosis, and what to do when it starts. Sending big hugs, it sounds like you're doing an amazing job supporting your husband.

It does look like short psychotic episodes which don't require antipsychotics to recover can be linked to substance abuse, so it might be he needs to cut out both completely to prevent it happening again. I'm sure the mental health team could advise on that.

The psychologists are going to think these are suicide attempts if all you and he are telling them is you don’t know why he jumped out a window.

You need to tell them about “he was having visions and talking about enlightenment and stuff. He kept saying he was going mad, and was really paranoid. He then kept saying he loved me but in a weird way...”

Psychosis can come with memory black outs or the person has no idea they are acting and thinking strangely in the lead up.

Heavy cannabis use is linked to psychosis. He needs to stop all of it.

@BabaBarrio You would think they would think it was suicidal wouldn't you, because that's actually more rational, there is a reason. He has zero suicidal ideations and both me and him told them that. If he had of they would've prob sectioned him. I did tell them the stuff I said on here. That hospital has zero MH community support directly.

He has cut down a lot on the cannabis and drink, and is doing really well. Eating more, sleeping. Mentally seems good, positive etc. Physically he's able to do stairs (slowly).

He's hopefully getting community help as the hospital claim they will tell the other service which no longer meets his needs to release him to this new team. We live in another borough to the hospital.

Thanks everyone for all your advice and support, It's been tough but you've all helped.

Sorry, just to clarify, I described everything that I said on here ( about his symptoms) to the psych docs, but at no point could I identify the reason why it was happening (other than lack of sleep). They were obsessed with me giving them a reason it happened and I simply couldn't. I was not trying to be obstructive at all.

For this to come on, and then disappear, so quickly it sounds like it is most likely drug induced. He needs to stay away from the weed.

@StormKevin I guess I have seen him smoking weed moderately for 20 years and this has only happened twice. Also I smoke too so I'm very pro-cannabis. Which biases me fully I know. I think it's something in his head to do with his psyche, he said his border between reality and non reality is very tenous. I don't disagree in the case of the accident. Gawd knows tbh but it's been OK so far at home. I've just realised how normal I am. I've always been the nutter of the family kind of thing. I'm coping really well tbh.

@BobbyBiscuits sending big hugs, it's such a scary thing for you both to go throufh and you're doing really well supporting him ♥️

You say you're pro cannabis @BobbyBiscuits , and this has only happened twice, but throwing himself out of a window "only twice" isn't a minor thing! I agree with PP the random occurrence means it is likely drug induced. He needs to stop smoking and drinking and focus on his health and building habits and behaviours that support his mental health.