Our ignorance about psychosis has a real-life impact

We’ve stumbled into an age where mental health awareness is everywhere, and that’s almost great. Yes, I’m thankful that my anxiety attacks and bouts of seasonal depression are recognized by most as natural, and that I get fewer weird looks when I mention my therapist. I consider myself lucky that I only suffer from lighter cases of the most “mainstream” mental health issues, because most people have a fundamental understanding of what I’m going through, and many sympathize. However, those living with psychotic disorders like schizophrenia, and those living with bipolar disorders, are regularly misdiagnosed, misrepresented, and misunderstood.

A close relative of mine, who I will refer to as “Daniel” in this article, suffers from a psychotic disorder, though it’s specifics are undiagnosed. He’s in his early twenties, and has experienced one psychotic episode of which we are aware. This episode could have likely been avoided if only we were aware of the signs of psychotic and bipolar disorders.

In school, we’ve been given lessons on stress management and how to deal with anxiety around school work, and have been told to speak to an adult should we feel sad or upset. It’s absolutely amazing that the new B.C. curriculum supports and educates students as they figure out how to live with anxiety or depression, but the fact that those might be symptoms of other mental illnesses is often ignored. For example, the prodrome (beginning) of a psychotic episode often includes a depressed mood, which usually occurs in adolescence, and patients living with bipolar II are often misdiagnosed with depression. Many people tend to only see the mood, and forget to look into other aspects that alone may seem like nothing, but when the dots are connected, form a very different image.

To provide some context, I surveyed 223 people including my peers in grade 10 and 11 as well as the Facebook contacts of my parents, about their personal experience with mental illness, their mental health education in school and their sense of their own awareness of a variety of disorders.

86% of respondents believed they could explain depression to a friend, and 84% felt they could explain anxiety. However, while approximately 60 million people live with bipolar disorder worldwide, only 49% of participants in my survey believed they had an adequate understanding, and only 32% could explain schizophrenia, which affects 23 million.

Daniel fell into a noticeable depression when he was a teenager, which is not uncommon, as around 20% of adolescents are affected by depression. His family helped him as they could, seeking professional help to aid him in recovery. He was prescribed antidepressants and sent to therapy, the logical proceedings when you have a depressed teen. This is all well and good, but they didn’t know what they were really dealing with: a psychotic disorder, which showed many characteristics of bipolar II, though medical professionals are currently unprepared to diagnose it as anything other than “unspecified psychotic disorder.”

Suddenly, around the age of 20, Daniel became more energetic, which was very out of character for his behaviour during the five years leading-up to that point. In hindsight, this conformed to the “manic” phase of a bipolar disorder, but was very quickly diagnosed as ADHD by a psychiatrist. This led to the prescription of a stimulant, which can be very beneficial to those with ADHD, but can be incredibly addictive to those without. Stimulants can also trigger psychotic episodes, and indeed, shortly after he started taking the drug, Daniel experienced his first recognized psychotic episode. He became addicted to the stimulants.

A psychotic episode is a loss of touch with reality, and can be caused by genetic predisposition, use of street drugs such as cannabis, and other factors like stress. The removal from reality may include hallucinations, delusions, and disorganized speech or behaviour. You may think that these symptoms are always very grand, such as believing you’re the President or seeing bugs on the wall, but most of them are very realistic to those experiencing them and don’t always start out being wacky. Common delusions include feeling like they’re being watched or plotted against, or convinced that certain things are directed to them, such as a “hidden message” in a song or broadcast. The most common hallucinations are audible, such as voices or music.

The easiest symptoms to miss are disorganized speech and behavioural patterns. Disorganized speech can include going off-topic, providing answers that don’t make sense, talking about things that have nothing to do with the subject, and jumping from thought to thought seemingly without logic. Disorganized behaviour can consist of inappropriate emotional responses, difficulty performing daily activities such as personal hygiene or cooking, or wearing clothes that don’t fit the weather.

When you notice these symptoms individually, they don’t seem like much. When someone goes off-topic or spits out ideas like rapid fire, you may dismiss them as a chatter-box or simply someone without a filter. When someone expresses the feeling of being watched or being plotted against, it will likely come across as simply concern for their own personal safety. That’s why we need to be educated about these symptoms–because they may not cause major concern when recognized individually.

There needs to be awareness that advises us on how to put two and two together, both for us to recognize symptoms in those around us, as well as being able to recognize our own mental health and our own vulnerability. Those with psychotic disorders often suffer for years before receiving help, assuming they get it at all. Who knows what kind of life Daniel would be living if his symptoms had been recognized sooner? There is absolutely no reason that symptoms should be written off as anxiety, depression, or ADHD, simply because other mental illnesses are forgotten.

For your own personal mental health, and for the well-being of your loved-ones, I strongly encourage you to educate yourselves on a variety of mental illnesses, keep tabs on one another, and remember that help is always available. Some great websites to learn about mental illnesses and general mental well-being include Early Psychosis Intervention, Psycom, and Very Well Mind. As one participant in my survey phrased it, “Don’t go through it alone! You are loved, people care about you!”

Image: Google Arts & Culture