Early Signs of Psychosis in Young People
Hello and a warm welcome to my hub. This hub is intended for anyone whom feels they may be suffering from some early signs of psychosis, a loved one may be, they are concerned for their mental health or they are just curious.
I would like to add in a little disclaimer that I am not a mental health nurse, a doctor or a professional. I am a woman living with Schizophrenia and will apologise in advance if anything I say doesn't make sense or sounds erratic. I will do my very best to make it legible.
This hub will be split into sections, the Myths Vs Facts will be at the bottom so if you want to read them first you're more than welcome to.
What is Psychosis?
Psychosis is a medical term used to describe acute symptoms of a mental health disorder. There are many symptoms to look out for, but there are only a few forms of true psychosis:
- Bipolar Disorder
- Obsession (OCD/other)
- PTSD (Post Traumatic Stress Disorder)
- Anorexia Nervosa
Those are the main forms and each one has many different symptoms. Only a medical professional can truly diagnose you and it may take anywhere from a few days to a few years depending on your situation, your loved one or how cooperative the person is.
Psychosis: A medical term used to describe someone having a psychotic episode.
Who does it affect?
It affects men and women equally and usually begins from the age of 16-30. It can affect all genders, races, religions and can happen to anyone. People who have someone with a form of psychosis in the family (see above) are more at risk of developing symptoms from their genetics. In rare cases, psychosis can appear in children.
What causes it?
Scientists are not fully sure on this question as it can be a nature VS nurture debate. There are some genes linked to the development of certain psychotic disorders e.g. Bipolar Disorder. Immense stress, a traumatic event in the childhood or a sudden surge of chemicals in the brain. Psychosis is usually described as a chemical disorder.
The Early Warning Signs Psychosis May Be Developing
It is important not to feel alarmed if you or someone else is experiencing psychosis or symptoms of it. When I started having my first symptoms, I barely even recognised them. I put it down to being lazy, to being tired, bored, listening to too much music and even just my personality. Often the symptoms can creep and many times it can be a family member or a friend that notices something before you do.
The Earliest warnings:
- The person becomes socially withdrawn e.g. they stop going out with their friends, they are unable to speak to their parents or they shut themselves in their room/house and lose friendships.
- Losing interest in things they enjoyed e.g. socialising, playing games, swimming, arts and crafts, music. They may not want to take part in activities and seem to be doing "nothing" with their time.
- Deterioration of personal hygiene/ appearance or a sudden drastic change e.g. going from very plain to very goth, shaving all the hair off and getting lots of piercings, refusing to bathe or wash the hair or shave body hair when previously they always have.
- Disorganisation. Inability to be on time, take the right things, keep their phone charged, respond to messages, keep a tidy living space, dress appropriately for the weather e.g. layers of clothing in the summer.
- Sudden outbursts of emotion e.g. crying at nothing, becoming hyperactive or elated for no reason, becoming enraged at the slightest thing or seemingly being void of emotions.
- Talking about/thinking about death excessively or becoming worried about illness, disease or death.
- Inability to work, go to school or attend clubs like before (not physically unable)
- Sudden surges of odd behaviour e.g. blurting things out in public, believing they have special powers, frantic organisation, becoming very theatrical or freezing in a strange or forced position for a period of time. Coming out with strange or distorted beliefs.
- Sudden obsession with self-image, weight or an interest in health and fitness.
- Rapid changes in mood that are not due to hormonal problems e.g. outbursts of anger, depression, excitement or sadness or seemingly having no mood at all.
- Speech problems e.g. talking very fast, very slowly, skipping words, stuttering that wasn't present before, making up words or mixing languages together.
You or the person you are searching about may only have one of these symptoms that you know of, or they may have all. The symptom(s) has to be or appears to be having a negative effect on the person's life whether they agree or not and it must not be linked to a hormonal issue e.g. only appears around the time of menstruation or sudden male development. For psychosis to be determined, the symptom(s) must be fully active for a minimum of six months.
Bipolar VS Depression VS Mania - What's the difference?
Many people often assume Bipolar is the same as Depression, Mania is a form of ADHD or they are a form of attention-seeking or a hormonal imbalance. Over the past few years I have met several people suffering from each of these.
So what is Depression?
Depression is the term used to describe a very low mood along with other negative symptoms. Depression can be utterly devastating to the person or other people around them and can have a serious impact on life.
- A feeling of hopelessness as though nothing good will ever happen and you will not succeed in anything you do.
- Extremely low mood, literally feeling depressed, down, negative and extremely pessimistic about life, relationships and general things.
- Being unable to carry out daily activities for feeling they are pointless if you do not get a prize or something good out of it at the end.
- Feeling tired most of the time.
- Aches and pains especially in the muscles.
- No desire to socialise or do anything with life.
- Loss or sudden increase in appetite.
- Suicidal thoughts
- Obsession or high interest in death
- Giving away person items/ writing a will/ thinking about your funeral/ planning suicide or continually thinking about when you will die.
- Being unable to get out of bed, get on with things because of mood changes.
- No motivation and or little interest in things you once enjoyed
- Poor concentration
Many people know when they have depression or someone else has it, but it isn't always that easy to tell. If you feel you or someone else is having these symptoms you need to speak to a healthcare professional to determine the exact cause. Symptoms should be present for two or more weeks at a time, impact on your life/ the person's life, not be linked to hormonal issues e.g. menstruation.
So what is Mania?
Mania is the term used to describe very hyperactive, energetic or suddenly elated actions. A person who suffers from Mania may also go through periods of depression or a lack of mood (See Bipolar below) Mania can be a shocking, frightening or dangerous thing to suffer from and often the person suffering loses all sense of conscience and does not understand their behaviour is dangerous or frightening.
- Sudden elated mood where you feel overly excitable, happy or agitated.
- High self-esteem - behaving arrogantly, believing people are in love with you.
- A feeling of being on top of the world, as though you are soaring or you are high.
- Hyperactive behaviour
- Excessive facial expressions of joy, excitement.
- Partaking in risky intimate behaviour, possibly with strangers.
- Losing all sense of danger, risks, fear and feeling untouchable and immortal.
- Lack of insight.
- Dangerous actions e.g. trying to jump from a building and fly, taking off clothes and running around, abusing drugs or alcohol, playing near train tracks, unprotected intercourse, running a marathon with no training, trying to do things you/the person cannot or wouldn't normally do.
- High insomnia.
- Loss of appetite.
- Inability to sit still.
- Having many new ideas and goals that are often strange, unobtainable or excessive.
- Odd behaviour e.g. dressing up in costume and running around, stripping naked, physically much more active than normal, taking very loudly or saying very rude/explicit things in public.
- Rapid speech which may jump form topic to topic.
- Forceful behaviours e.g. slapping someone on the backside as they pass, trying to kiss people you don't know/ don't want it, rough housing, fighting, invading personal space excessively when the other person is uncomfortable with it.
Mania can come in many different forms, symptoms must be present for at least six months and it may come and go in patches lasting from several weeks to several months at a time. It must not be due to hormonal problems and must be not confused with childhood disorders or often with ADHD. Mania is extremely common in people with Bipolar disorder.
So what is Bipolar Disorder?
Bipolar disorder presents symptoms of both Mania and Depression. It is not a hormonal condition and it is a chemical condition in a form of psychosis. The symptoms can be devastating for the person suffering and other people around them. Bipolar Disorder is usually diagnosed in the later teens or early twenties but can be diagnosed beforehand and symptoms should be taken very seriously and investigated by a professional.
- Mania. Going through periods of sudden happiness and excitement e.g. extremely high self-esteem, feeling overly positive, powerful, hyperactive behaviour, insomnia, needing very little sleep or food but feeling full of energy. Behaving in a manner you wouldn't normally e.g. intimate behaviours with strangers, blowing large sums of money, trying to run a marathon or partake in a sport you never have before, losing all self-control and feeling on a constant high.
- Depression. The Mania may crash and burn very quickly or over a few days or weeks and will fall straight down into Depression. Feeling worthless, low self-esteem, feeling like everything is pointless, hopelessness, self-harm, alcohol/drug abuse.
- Suicidal thoughts.
- Behaving in a risky or extreme manner with little thought or care for own behaviour.
- Mixed symptoms of Mania and Depression at the same time (Manic Depression)
- Making sudden goals, ideas or feeling extremely positive and motivated in life, often trying to or planning to do things the person cannot (unobtainable goals)
Bipolar disorder is a mix of both Mania and Depression sometimes together but more commonly they happen at two separate times. The symptoms must not be related to any form of hormonal disruption and must be present for at least six months for Bipolar itself to be diagnosed. Manic Depression is the combination of the symptoms at once. People with Bipolar disorder may be heavier on Depression or heavier on Mania or equal on both sides.
Schizophrenia and its Unusual Forms
Schizophrenia is a very hard thing to diagnose for many people and it has so many different forms it is often left unspecified for a period of time so the person can be monitored. Often the person does not see things in themselves and the doctor may pick them up. Schizophrenia has several main categories:
Paranoid Schizophrenia: The feelings or belief someone/something is out to get you e.g. aliens, the police, government or people you know, that a family member is trying to kill you or you are being sold into slavery. The feeling you are constantly being watched, on a television show or people are stalking you e.g. believing the government and police are working together to sell you into the adult film industry and lock you in a cage. Believing people are monitoring you to steal your special powers or to kill you.
Disorganised Schizophrenia - Being unable to function properly in daily life e.g. unable to have or maintain a tidy living space with no care for how messy or dirty it is, not keeping your phone charged, getting to places on time, being mentally unable to do things you physically can e.g. put the washing on, take a bath, go to work. Poor concentration, disorganised speech e.g. rapid talking, slow talking, mixing words or languages. Unable to pinpoint thoughts, make plans, change ideas and thoughts regularly, unable to set proper goals.
Catatonia Schizophrenia - Can also present with disorganised. May suddenly go into an odd or forced position e.g. a vampire snarl, a tense defensive position, or as though frozen in time during an act of violence, may also just be perfectly still and unable to move for several minutes or hours. Poor personal hygiene e.g. body odour, terrible breath, teeth in worse condition than before, dirty hair, not changing clothes. Becoming violent, dangerous or sudden expressive behaviours e.g. not being able to stand still, repetitive actions or speech, high cynicism, criminal acts.
Schizoaffective Disorder - Symptoms of Schizophrenia that lean onto disorganised or upsetting thoughts, unstable or lack of emotions. Symptoms are of both Schizophrenia and mood disorders but neither one fits correctly for present symptoms. Thought disorder.
Undifferentiated Type - Having symptoms of Schizophrenia that do not fit into one type e.g. paranoid obsession mixed with catatonic or disorganised behaviours.
Residual Type - When the prominent symptoms of Schizophrenia have gone away or have been absent for a period of time, the person appears to be close to cured or may not have had an episode in several months or years. This does not mean it won't come back and the person may still be having symptoms just on a milder basis.
Generalised Symptoms of Schizophrenia:
- Lack of motivation or interest in things once enjoyed e.g. playing games, going swimming, going to work, socialisting.
- A deterioration in social skills e.g. becoming withdrawn, feeling as though there is nothing to say, saying inappropriate things in public or at the wrong time, lack of speech, rapid talking, inability to stay on topic, not speaking at all.
- Outbursts of anger are very common and can happen over the slightest thing e.g. telling them to put something away, looking at someone funny or something not going right immediately.
- Talking to or shouting at inanimate objects as though they are alive e.g. yelling at your internet for being slow, shouting at a door handle for getting caught on your clothes, yelling at something for knocking over or at the remote for not changing the channel the immediate second you tell it to. Often accompanied by bursts of rage.
- Lack of empathy. The difference with Schizophrenia to Disorders such as Aspergers or Anti-Social Personality Disorder is that Schizophrenia's often DO understand how the other person is feeling but they have no care or interest in their emotions and are blank to it.
- Inappropriate emotions e.g. laughing at violence, grinning at a funeral, becoming angry at nothing.
- Feeling that people are out to get you, hurt you, kill you or sell you to slavery.
- Delusions e.g. beliefs that are strange, incomprehensible or that have little or no logical basis. Believing you have magical powers, you are special or some other being e.g. an alien, an animal, etc.
- Hallucinations e.g. smells, hearing voices - often critical, hearing your thoughts spoken out loud, music playing in your head/ears/around you when there isn't any, a bad taste in the mouth or suddenly being able to taste things you haven't eaten/smelled, seeing colours not related to rubbing eyes.
- Hateful or aggression or violent thinking when something slight happens that upsets you e.g. someone makes a nasty comment, someone looks at you funny or you see something you don't like. Thoughts may be very vicious, hateful or threatening and beyond your control.
- Cynicism - doubting people, suspicions, wariness.
- Strange sleeping patterns e.g. sleeping in the middle of the night, napping at odd times, insomnia.
- Feeling as though other people can hear your thoughts, read your mind, control you or that they put ideas/thoughts into your head or take them out. Feeling as though people are taking things away from you before you know what they are.
- Inability to concentrate.
- Short term memory becomes poor.
- Inability to carry out tasks e.g. keep a tidy living space, dress properly, wash self, brush teeth, get anywhere on time, take the correct items, do things when asked to do them, maintain things to a certain standard.
- Suddenly dressing oddly, frequently changing appearance, seeming as though hiding behind something e.g. glasses, facial piercings, hair, clothes, etc. Wearing too many clothes in high heat, stripping off in winter, wearing things that do not match or do not fit.
- Repeating words, notions or mimicking someone's behaviour as they do it. Repeating the same small thing over and over again e.g. washing hands, writing the same word over and over again, making sounds.
- Singing or saying things randomly and without control.
- Suddenly catching in an odd or forced movement e.g. snarling like a dog and being frozen for hours, making scary faces, posed oddly, standing ramrod still and remaining that way from minutes to hours. May also not move until they are moved by another person.
- Loss of response vocally or emotionally. Appears to have little or no facial emotion but emotion is still present.
- Being unable to control actions e.g. stealing a car, spending money.
Symptoms must be present for a minimum of six months and must be assessed by a doctor. Symptoms differ in severity and may appear in episodes where they are severe and then there are little or none at all.
Obsession and OCD don't necessarily mean the same thing. There is a difference between being obsessed with something and having the psychotic episodes of Obsession.
Symptoms of Obesssion:
- Being unable to live without the certain thing e.g. a person, an object, a ritual or a television character but it could be anything at all.
- Being heavily focused on the thing in question so much so the person is unable to function properly.
- Being certain or obsessed that a celebrity, person or power or that anyone that sees them is falling in love with them.
- Behaving in a dangerous, frightening or threatening manner to someone that has left them e.g. ex-boyfriend or girlfriend that cannot and will not let go of them even after a period of time has passed e.g. stalking, harassing, destroying their things, making accounts online, obsessively checking their social networking, talking to their friends or family, wanting to know everything about them and be close to them again. Possessive behaviours.
- Becoming dramatically upset when the thing in question is taken away e.g. TV show, book, person, object. Often taken by another person.
- Heavily researching a subject e.g. wanting to know every member of someone's family tree, every detail about them, collecting every picture, wanting to know as much as possible and more.
Often people with obsession do not realise they are obsessed and pass it off as being caring, loving or enthusiastic and curious. Symptoms can be diagnosed rather quickly.
Obsessive Compulsive Disorder (OCD)
OCD comes in a variety of problems. It is a combination of obsessions and compulsions, compulsions meaning the person HAS to do the action, ritual, behaviour or speech otherwise terrible things will happen, or they cannot control it.
Symptoms of OCD:
- Obsessively checking things e.g. the oven is off, the lights are off, the doors are locked, the keys are where you checked them. This is done multiple times and it is a compulsory act otherwise the person becomes very distressed, confused or upset.
- The person may have to touch everything they see quickly or in a certain order, it may appear odd or as though they are having jerky, uncontrollable movements.
- Needing to have things in a perfectly organised manner, nothing out of place, everything must be facing the precisely correct way in absolute order and if anything is slightly disturbed it will be extremely upsetting.
- Obsessive washing, cleaning or sterilising of items. This doesn't mean washing hands a lot to make sure you won't get sick, this means being unable to stop yourself from washing them, paranoia about them, wanting to make sure everything is immaculate and perfect.
- Being a perfectionist.
- Counting. Counting things obsessively, or a certain number of times something has to be done, counting and checking the numbers in everything and being unable to stop it from happening.
- Habitual or odd little movements.
- Obsessive thinking.
- Ritualistic behaviour e.g. trying to ward the house from vampires, having certain little actions, shrines or sentences that protect them, help them or make them feel closer to God.
- Excessively good personal hygiene, tidiness, etc.
- Sudden urges to apologise and powerful surges of guilt even when they have done nothing wrong.
- Being unable to disturb items e.g. hanging a coat up perfectly and being unable to leave the house because they cannot disturb it, being unable to move a teddy bear out of panic it will wake up.
Obsessive Compulsive disorder is a very complex thing to diagnose as it shares symptoms with other forms of Psychosis. It must have been present for at least six months and have a negative impact on the person's thought process/life. Symptoms of this can start in childhood as well as teen and adult years.
Post Traumatic Stress Disorder. This manifests itself as, you guessed correctly, a stress disorder after a traumatic event. This can happen to anyone at any given time at any age from childhood to senior ages and for many different reasons. Some people are more disposed to it than others.
- Panic attacks
- Obsessively thinking about traumatic event
- Emotional numbness, refusing to allow oneself to feel certain emotions e.g. happiness, guilt, sadness.
- Powerful feelings of guilt.
- Reliving the experience when sleeping, through visions, hallucinations or just general thinking.
- Avoiding speaking about the event, thinking about it or doing anything that reminds of it e.g. burning all items bought for them by the person or at the time it happened, obsessively cleaning things, poor speech, blocking it out of your mind.
- Being easily startled, constantly on the edge, anxious or paranoid.
- Headaches, muscle aches, dizziness, stomach pains, IBS is brought on by these.
- Constant feelings of anger, stress, emotional problems. Mood swings.
- Obsessive negative thoughts.
- Suicidal thoughts
PTSD is brought on by a frightening, disturbing or traumatic event e.g. physical abuse, a death in the family, a violent accident, extreme pressure or stress, intimate abuse, childhood trauma, identity crisis, horrific experience e.g. in hospital, at work, in a certain place, witnessing violence or death. It can be very difficult for other people to tell exactly what happened to cause these symptoms and sometimes the person suffering does not understand why they are having some of the symptoms and it takes a long time for the realisation to kick in or to fully remember what happened.
Anorexia Nervosa and Other Eating Disorders
This can be an upsetting and frightening subject for many people. Often they are not diagnosed or recognised until it is too late and there are some debates as to whether or not it is psychosis. Anorexia is one of the most devastating eating disorders on the planet, it is not someone wanting to diet and be thin, it is a devastating mental illness that causes obsession and frightening or uncontrollable thoughts. Symptoms can often be hard to spot and the person suffering does not always understand what is wrong. But things to look out for are very important.
Things to Look Out For:
- A sudden obsession with dieting, health and fitness when previously the person wasn't bothered.
- Staring to wear baggy or very loose clothing that covers the body or figure.
- Skipping meals or claiming they have already eaten.
- Self-harming or self-harming marks/scars.
- Signs of depression.
- An obsession with physical image/beauty.
- Low self-esteem especially about the figure and weight.
- Weight loss.
- Emotional outbursts.
- Losing interest in other activities.
- Teeth deteriorate in condition (if vomiting)
- Vomiting, stomach pains or going to the toilet excessively.
- Laxatives, diet pills or other such things in the house or the person continually complains of having IBS or constipation and take laxatives regularly.
- Hair, skin and nails become poorly conditioned, brittle, dull or lose luster. Person begins to look sickly.
- Loss of period
- Knows a lot about calorie counting, foods.
- Shivering or complaining of being cold, having headaches or aching joints.
- Pulls food into smaller pieces or cuts it up a lot and eats very slowly.
- Becoming obsessed with weight gain, metabolism, exercise, diet and health.
- Continually seeing self as fat, disgusting, ugly.
- Hearing voices criticising weight or personal appearance.
- Missing meals in order to lose weight and or lying about having eaten.
- Calorie counting, knowing exactly what is in foods, only eating low calorie food
- Cuts food into tiny pieces or pushes it around the plate.
- Mood swings.
- Loss of menstrual cycle
- Hair, skin and or nails begin to deteriorate.
- Counting the ribs, checking body in mirror, looking at naked self from all angles checking for fat or imperfections.
- Feeling of being controlled, judged and hated.
- Loss of self worth.
- Skin breakouts
- After a period of above symptoms, refusing to eat, checking foods, skipping meals and losing weight, the metabolism begins to slow down.
- Pains in the joints e.g. elbows, knees, etc.
- Dehydration, inability to pass urine
- Dizzy spells, headaches, feeling cold all the time after above symptoms are present.
- Constantly feeling overweight despite other people telling you you're too thin, skinny, etc.
Symptoms can be very hard to see or diagnose and if you suspect you or someone you know is suffering you should seek professional help IMMEDIATELY. Symptoms differ from person to person.
MYTHS VS FACTS
So now we're onto the second from last portion of the hub.
Myth: People with a mental illness are dangerous.
Fact: People with a mental illness pose a small threat to other people. They are often not dangerous and are more likely to be dangerous to themselves than other people.
Myth: People with Bipolar are just hormonal attention-seekers or teenagers.
Fact: Bipolar disorder is not hormonal and usually affects late teens and adults more than children or younger teenagers.
Myth: Depression is for the weak and it can be stopped.
Fact: Depression is beyond your control and caused by a chemical imbalance in the brain. It can also be genetic and is a serious health problem.
Myth: Teenagers don't have mental health issues, they're just bratty, moody and hormonal.
Fact: One in ten teenagers will be diagnosed with a serious mental health condition unrelated to hormones or age.
Myth: People with Schizophrenia hear voices and are crazy and dangerous.
Fact: Many Schizophrenia's do not hear voices or see things nor are they crazy or dangerous.
Myth: People with mental health problems are criminals/ more likely to commit a crime.
Fact: The vast majority of criminals are people WITHOUT mental health conditions.
Myth: Children do not suffer from psychosis.
Fact: Psychosis is rarer in children but it does occur and is often misdiagnosed as autism.
Myth: People who experience psychosis should be thrown in a mental institute.
Fact: The majority of people who experience psychosis do not need hospital treatment and are often not on any type of medication.
Myth: Medication is good for you.
Fact: Medication for psychosis can be extremely dangerous and cut 20 years off of a person's life. It can be extremely beneficial to treat people with severe symptoms but must only be analysed by a healthcare professional and mutually agreed on.
Myth: Mental illness is just an excuse for being anti-social or doing bad things.
Fact: Anti-social behaviour is not a form of psychosis. Social difficulties or communication problems are, but are not actually classed as anti-social disorders.
Myth: If your parents don't have a mental health problem then you can't have one either.
Fact: Mental health problems (if genetic) can be passed down through several generations and often it is a grandparent, uncle or cousin that the trait comes from rather than a mother or a father.
Myth: People with mental health problems shouldn't be allowed to have children.
Fact: People with mental health problems rarely pose a threat to children, are nearly always capable of caring for them and may not pass their condition on to the child.
What do you think?
Is this hub helping answer your questions/ do you feel it is informative?
Thank you to all of those who have read my hub. I have done my best to make it as good as I can and as informative and easy to read. I hope this has helped answer your questions and improve your understanding. Please remember this is not a professional diagnosis and these psychotic episodes go into far greater detail than I have on here and should only be diagnosed and treated by a professional.
If you'd like, please leave a comment below and share your concerns, experiences or extra information. Anyone that posts derogatory, abusive or hate will be deleted and reported.
Best wishes to everyone, feel good and stay strong!