Psychotic illness: information for young people
About this factsheet
This is one in a series of factsheets for parents, teachers and
young people entitled Mental Health and Growing Up. The
aims of these factsheets are to provide practical, up-to-date
information about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children and young
people. This factsheet describes different types of serious mental
illness, and how and why they might affect you. It also offers some
practical advice about how to get help.
Introduction
The term `psychosis' is used to describe when a person loses
touch with reality. Teenagers often worry that they may be `going
mad' when they are feeling stressed, confused or very upset. In
fact, feelings like these are very rarely a sign of mental illness.
They can often get a lot better if you talk them through with
someone you trust.
`Psychosis' is much more serious and affects people of all
ages, but becomes increasingly common as you reach young
adulthood.
When a young person has a `psychotic breakdown', not due to
drug use, it can be difficult to know what the long-term effects
will be, and a definite diagnosis may not be possible.
Psychosis
Schizophrenia is the most common form of psychosis. Symptoms
include delusions, thought disorder and hallucinations (see
Factsheet 21 on schizophrenia).
Delusions are unshakeable beliefs that are
obviously untrue. For example, an ill person might strongly believe
that there is a plot to harm them - that they are being spied on
through the TV or being taken over by aliens.
Thought disorder is when someone is not
thinking straight and it is hard to make sense of what they are
saying. Their ideas may be jumbled up, but it is more than being
muddled or confused.
Hallucinations are when someone sees, hears,
smells or feels something that isn't really there. The most common
hallucination that people have is hearing voices. In schizophrenia,
hallucinations are totally real to the person having them. This can
be very frightening and can make them believe that they are being
watched or picked on. People who are having these experiences may
act strangely. For example, they may talk or laugh to themselves as
if talking to somebody that you can't see.
The symptoms of schizophrenia are sometimes mistaken as
moodiness or teenage rebellion. In young people, hearing voices is
not necessarily a sign of schizophrenia, but may be due to anxiety,
stress or depression.
Bipolar affective disorder
The main feature of bipolar affective disorder is extreme
changes of mood (see
Factsheet 22 on bipolar
affective disorder (manic depression)). When someone is high,
they can become very overactive and loud, and lose their
inhibitions. They can also suffer from delusions, for example, that
they are famous, or have special powers. Mania can alternate with
periods of depression. Some people with bipolar disorder experience
delusions and hallucinations.
What causes psychotic illness?
This is still not fully understood. In both schizophrenia and
bipolar affective disorder, there are abnormalities in the
chemistry of the brain. This causes changes in thoughts, feelings
and behaviour.
There are a number of reasons that can make a person more
likely to develop a psychotic illness:
- genetic factors play a part; probably by increasing the risk of
an imbalance in brain chemistry. Having a parent or close relative
with schizophrenia or bipolar disorder means that a person will
have a slightly greater than normal chance of developing the
condition.
- stress or extreme life events.
- physical illness.
- cannabis and mind-altering drugs such as LSD, ecstasy and speed
(amphetamines).
Getting help
The person with the illness may not notice that there is a
problem and deny that there is anything wrong. Your general
practitioner or school nurse can give you good advice. They will be
able to get you specialist help, if it is needed. A psychiatrist
may need to visit the person to find out whether or not they are
ill, and to offer the treatment required.
Medication is an important part of treatment
and often needs to be taken for a long time in order to stay well.
As with medication of any kind, there may be side-effects; the
doctor will be able to advise on what they are and about what can
be done to help.
Some of the medicines for the treatment of psychosis are
`unlicensed' in children and young people. This does not mean they
do not work for young people, but simply that the drug company has
not applied for a licence. If you are worried about this, you
should speak to the doctor or pharmacist. Further information is
also available from the Royal College of Paediatrics and Child
Health (
www.rcpch.ac.uk).
If the psychosis is due to drug use, the young person may need
help with this.
Other forms of treatment are also important. Both the patient
and their family will need help to understand the condition, to
cope successfully, and to prevent the illness recurring. Support is
often needed to rebuild the confidence needed to continue with
school, college or work.
The young person may need to be treated in hospital or in a
specialist in-patient service. Talking treatments can be helpful,
but need to be in addition to medication.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (4th edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (eds) (2001) 'Finding
the Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
- The Manic Depression Fellowship supports people with a
diagnosis of manic depression and their families. Castle Works, 21
St George's Street, London SE1 6ES; Tel 020 7793 2600;
www.mdf.org.uk.
- Rethink offers help to people with severe mental illness (not
only schizophrenia) and their carers. 30 Tabernacle Street, London
EC2A 4DD. National advice line 020 8974 6814; e-mail advice@rethink.org; www.rethink.org.
- For drug-induced psychosis, see www.talktofrank.com.
- Changing Minds: A Multimedia CD-ROM about Mental
Health is intended for 13-17 year olds; it talks about
addiction, stress, eating disorders, depression, schizophrenia and
self-harm. Further details from the Royal College of Psychiatrists:
tel. 020 7235 2351, ext.146;
www.rcpsych.ac.uk/info/mhgu/publications/auvideo/cmindscd/index.htm.
Or you may like to look at these websites:
- www.rethink.org
- www.sane.org.uk
- www.pendulum.org (manic
depression)
- The Mental Health & Growing Up series contains 36
factsheets on a range of common mental health problems. To order
the pack, contact Book Sales at the Royal College of Psychiatrists,
17 Belgrave Square, London SW1X 8PG; tel. 020 7235 2351, ext. 146;
fax 020 7245 1231; e-mail booksales@rcpsych.ac.uk, or
you can download them from this website.
© [2004] Royal College of
Psychiatrists. This factsheet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit is
gained from its use. Permission to reproduce it in any other way
must be obtained from the
Head
of Publications. The College does not allow reposting of its
factsheets on other sites, but allows them to be linked to
directly.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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