Psychosis

[OldTinHat]

No idea how to NC but a close friend had an assessment today after failing mental health and she has been diagnosed with psychosis.

I'm worried she doesn't understand as she's pretty much in her own world. She's asked if I'll go with her to see the specialist doctor next week when she gets her antipsychotic prescription (which of course I will), but are there any questions I could ask or suggest she asks so at least I can (if she doesn't grasp anything) get an understanding of what's happening? She has no family and I don't mean to sound mean but I'm worried and she is so scatty in a sweet but concerning way.

Anyone?

That'll be a no then...

No help, but I'm replying to bump the thread for you.

Hi there. You are great for supporting your friend. You could ask if they are referring to a Psychosis intervention & early recovery team. PIER. There is a huge amount of NHS funding for these teams & they will help her.

I'm a mental health nurse - if this is her first episode she should have been referred to a specialist team early intervention in psychosis? may be worth her getting information on the medication, as many can have some side effects, and for a care plan of what support she will have such as a community nurse, how often will she see a psychiatrist etc. Normally under this team if this is where she has been referred there is a lot of support and interventions, including talking therapies. Make sure she gets contact numbers she can call if she is in crisis or needs help and if you have these too you can call on her behalf if she consents to this. Sounds like you are really supportive hope this helps a bit

Oh and they are likely to ask about her background, life etc so may be useful if you know her well to help fill in any gaps if she is unable to!

She should get early intervention, and contact with the community mental health team.

Does she accept that she is having psychotic episodes or not? If you think she will not take medication, which is relatively common, then you should find a way to let the doctor know as they may be able to offer a depot injection instead of oral medication, because a jab once a month is much easier to manage than remembering medication every day for a patient who doesn't think there's anything wrong in the first place.

Also, if she has no family, ask her if she would like to apply to the county court for you to be named as nearest relative. This means that if things go wrong and she has a deterioration, you are allowed to help safeguard her rights. It's a better idea to have this in place even if it is never needed than to find she has been sectioned and there is no nearest relative in place.

Thank you @gingernaught! I have replies!

@GemmaFoster thank you for replying, she has had the diagnosis from the early intervention team which I think she was expecting but is very upset about. Apparently I can attend appointments with her permission to support her but I don't know what questions to ask or how best to help. She has retreated into her shell this weekend and I don't want to be another pressure but want to help without being overbearing.

@Karmaviolet Some great points, thank you. She knows what she's experiencing isn't 'right' and has said to me that she sees, hears, smells and feels things which scare her and logically she knows they can't be real but when it happens they are real to her. She said she thought she was being haunted.

That's an interesting comment about the medication. She's seeing the specialist doctor tomorrow to be prescribed anti psychotics, I'm going with her and will ask about the injection. Also good suggestion about the court. Thank you so much. All things I would not have thought of.

I'm going to suggest she moves in with me for a while until she's stable. Or me move in with her. Not sure if that will help but it worries me that she's scared and alone and what she might do. I'd hate for her to be sectioned.

@karmaviolet - I've just replied but can't see it on the post!

In case it doesn't appear, and apologies if it does and I'm repeating myself, she knows what she's experiencing isn't right but it's very real to her. She has an appointment with a doctor via the early intervention team tomorrow that I'm going with her to, great suggestion about the injection. Also good advice about the court. I just don't want her sectioned if I can prevent that in any way so I'm going to suggest she move in with me or I move in with her until she's stable. I hate the thought of her being alone and scared.

@tired sorry, thank you as well! I know general bits of her background and she has asked if I can attend appointments with her so hopefully I can prompt or fill in any gaps. I'm so upset seeing my scatty yet intelligent friend changing so much and it seems to have happened so fast.

@tired forgot the bit about the phone numbers! Great suggestion. I'm seeing her later and will get her to put the numbers in her phone (she said she was given a booklet which has numbers in) and I'll put them in my phone too.

She's very lucky to have a friend like you.
Even if when she retreats stay close as she will appreciate it when she comes through the other side

My dh has had many episodes and it's like you said they know it's not rationally possible but it's so real at the time they can't ignore it

If she lets you in with the dr then great for when dh was bad first time we met I went with him now he's more in control I don't go but it meant that I understood more and saves me asking him lots of questions

Don't feel silly for asking anything ask whatever you think is necessary I don't think any questions is wrong.

If you are worried emphasise the fact that she has no support other then you

Do you feel she is in danger?

Also look after you these things can be overwhelming and creep up on us after the
crisis has calmed x

I wouldn't move in with her. You sound very well intentioned but that might be counter productive. I work in psychosis services for young people and always try to discourage parents from giving up work etc in this situation. It's easy to become dependent.

Ask about what side effects to expect from medication, what therapies she can access and what other support she can get to help her achieve her goals. It's worth her thinking beforehand what she wants in terms of functioning in life, e.g. managing her own finances, getting her own shopping, work or volunteering or education etc. They can support that.

I wonder if you would find this information from Mind useful?
www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/
Good luck to both of you today

An early intervention service (often referred to as EIP, PEI, or FEP servjces) will provide quite intensive intervention over a couple of years. Their goal is generally to respond really strongly to the first episode as evidence shows it really improves outcomes for the person over time.

Sorry meant to say that her understanding of psychosis and "why it happened" is a process that she will undertake with them - it's completely normal for someone 3experiencing a first episode to take time to understand what is happening and why

Hi OP.
What a fantastic friend she has in you.
I suffered a severe psychotic break in 2016 and had to be sectioned due to God and other voices telling me I didn’t need to eat and nor did my children as we were now Godly. Yes, like I said it was a very severe case but God is quite common in psychosis. I also refused my meds. I know you said you don’t want her to be sectioned but it truly was the safest place for me and I do not remember a lot from this time. They kept me safe and you can go and visit her many times and have good phone communication with staff as to how she is getting on. I just wanted to say that because my partner felt truly awful it had to come to that but I was a risk to myself (God wanted to kill me) and it truly was the safest place for me until I stopped refusing the medication.
Another thing I will say is that there was no way you could make me understand what was happening in any way, that realisation came much, much later.

It was the most terrifying time of my life and I struggled with severe depression and anxiety for many years afterwards. It’s vital your friend gets the care she needs and you remain as loyal and patient as you have so far.
Take care - of yourself and your friend and talk to us anytime you like.

Thank you everyone and I've taken everything on board. She's under EIP and I've spoken with them on the phone for just general advice. They also echo that she remains 'as is' and that I don't move in or move her here. (Thanks @nutella!)

Her specialist doc appointment is tomorrow and she's happy for me to go with her. It seems so inconceivable because apart from being withdrawn a bit she's her usual bubbly self. I really don't understand it.

PP with your DH - how do you manage? My friend seems perfectly fine but she says it's when she's at home or in certain places that she has problems with reality.

Sorry for not acknowledging everyone! Just gone back to re-read and have taken everything on board but not personally thanked you all. I do appreciate everything you've all said, I'm floundering somewhat but I know my friend would help me as much as I want to support her. I also get that I shouldn't be smothering her.

I think I need chocolate...!

If you are going to be that involved, I think you should ask what carers support is available for you. And do you know how/who to get help from if she becomes suddenly unwell, especially out of hours?

@Vallmo47 thank you for sharing your story. My friend feels like she's the only one in the world going through this and I've not experienced it before with anyone so it's the same for me. She's been prescribed anti psychotics and has to have a CT scan (waiting for the appointment) in case its something sinister causing this. I went with her and I was happy that her case worker was also there, I'm relieved knowing she has professionals on her side as it were.

I have another friend who was sectioned due to an adverse reaction to steroids that she was prescribed, it was on her notes that she wasn't to take them but her GP did (one legal case later...!) and what she told me about how she was treated in the hospital fills me with dread. I didn't know her then but it happened in the last ten years. I'd hate for anyone to go through what she described.

@OldTinHat I’m sorry for what your friend went through when sectioned. I think it’s a bit like everything else - if you listen to every horrific birth experience you’d be absolutely petrified. You very rarely hear people talk about these things in real life. I’m not dismissing what your friend went through at all, but do you know what I mean? You are more likely to hear about the horrific experiences, a bit like a bad review.
I must say I have heard of a couple of others who have gone through psychosis and their experiences have been massively different to mine. Maybe it was a combination of how severe my case was, because I had the crisis team and the early intervention team visiting several times a day to start with. Hopefully that means your friend suffering isn’t a severe case and has been caught early.
I’m here to talk anytime you want, or just listen. I truly, truly understand how awful it is for both sides. The stuff I put my partners family through, my goodness. But they all know how ill I was and that it wasn’t me.

There are psychosis forums online as well that you can join when you are supporting a family member or friend through psychosis. I believe there are a few options if you just type it into Google.

Just remember that it’s not really her at the end of the day and one day you will both be able to look back and smile. We keep it very light hearted in my family - my other half says “Don’t you start talking to your buddy God” and we do laugh. At the time we cried and cried and cried. But it’s just our way dealing with it. You will get there also. Your role now is only to listen, support her and absolutely insist she keeps taking the medication as it takes a while for the voices to go. It’s not an instant fix, it will take time.
Good luck 🤞

@vallmo47 your reply really addressed a lot of issues. Thank you. My friend has been referred for a CT scan to rule out anything sinister. I just want to give her a hug tbh. She's more of a sister than my own sister.