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Psychosis – an introduction and case study

Psychosis could include a whole range of symptoms but most people will at some stage appear to lose touch with reality. During a psychotic episode, the brain mis-fires and sends inaccurate or incomplete information to our conscious selves. As a result, we become bewildered and our mental state becomes unpredicatable. Our world looks and feels like a very different place, compared to someone who is not psychotic. This experience can be very distressing and will impact on behaviour and feelings in ways we can’t predict. Family and friends will begin to worry and the sufferer will become more confused and upset by the strange unfamiliar way people behave towards them.

 Early symptoms to look out for in your friends and family or even in yourself:-

  • Increased anxiety
  • Lack of sleep
  • Dramatic mood swings – manic to quiet to manic…
  • Staying in bed
  • Isolation and seclusion

If you or your friend is experiencing some of these symptoms, then at this stage it’s a good idea to talk to someone else about your concerns. Stopping the use of recreational drugs and alcohol could delay/stop a more acute phase from occurring. A lot of people are reluctant to ask for help with their psychological difficulties and in some cases are by the very nature of the event, unable to.  It should go without saying, but this i’s not the time to be shy if you think there’s a problem – if you’re  unsure then just ask someone who you think will take the issue seriously. Inaction could be a dangerous option to take.

 Acute Phase

When someone has reached an acute phase of psychosis, it’s likely they’ll be experiencing hallucinations of some kind, hearing noises or voices or seeing people who are not there. Lots of sufferers complain about feeling followed – they may think someone has put a transmitter in their head. They may believe that television programmes are interacting with them psychically – all of these symptoms are very common. As well as hallucinating strong lights and apparitions of people moving through walls and buildings, the sufferer may also see things disappear. They might hear music, feel as if they are electrified and they may not want to touch certain things and be in fear of their losing their life if they do. They smell and taste things for no apparent reason.

These are symptoms of psychosis but they are could also be flags – if you or your friend is exhibiting  any of these symptoms, treat them as a flag of the unconscious waving to alert someone who can help to rescue them. If it’s your friend –  you could be the rescuer in the first instance.

More flags to look out for…

  • Are you/your friend not eating properly?
  • Are you scared to eat and drink in case someone is poisoning you?
  • Are you happy to take clothes off all of a sudden – not worried about people seeing you naked?
  • Are you talking very fast or have you begun to talk very very slowly?
  • Are you too scared to go out in case you do something stupid? Or look stupid? Or say something stupid?

Symptoms are like flags – they tell us something is not right – if you see the flags, go and tell someone who can help. 


Case Study

Julie was 25 when she suffered her first bout of psychosis. She used to smoke weed very heavily. She also had a history of taking other drugs, including cocaine, acid, speed and MDMA as well as alcohol. Julie was fun loving, work shy and bright. A graduate she had a job working for a large media organisation in central London, in a typesetting department. She called in sick a lot. She had to recover from the after effects of very frequent all night parties.

The first symptoms of her psychosis began when the love of her life left her, to go and live in another part of the country. The rejection affected her deeply and she took to smoking even more cannabis than was usual. She stayed in a lot and read strange books. She became interested in ancient scripts and calligraphy to the point of obsession and spent many many hours in the library reading up on the subject. Soon she was beginning to ‘hear’ African voices telling her to secrets. They began to scream at her. The cast of East Enders spoke to her and the Queen came to her flat for tea. She saw people from the street walking through walls. And from the sky, the relentless noise of helicopters, the police were waiting to capture her. Soon, Julie refused to go out and couldn’t eat. At her bravest she ran through the streets naked, ‘to show the Lord how much courage she had.’ At her weakest she attempted suicide.

Julie spent the next two years in recovery. To recover fully, she had to change her lifestyle. She stopped taking chemical drugs early on – cocaine, speed, ecstasy.  That was easy. Being psychotic had opened her eyes to just how sensitive the brain can be. Not knowing the type of person who was cutting her drugs and  what they were cutting them with meant that really, she was handing her sanity over to so0me unknown gangster on the make. By ingesting, inhaling, snorting or injecting chemical substances of dubious origin was a risk she couldn’t afford to take anymore. She valued her mind more than she valued the comfort of  going along with what her mates. But it took her more than twelve months to stop smoking cannabis. She found it difficult to give up because she’d enjoyed taking the drug almost every day for a decade. But whenever she smoked the drug (or ate it), the feelings of paranoia were so overwhelming, she felt sick with worry she’d go back to becoming a psychotic wreck again. It took her more than twelve months to realise it was easier and more relaxing to feel mentally safe and well than risk it all for the kudos that came with being ‘one of the gang’.

Julie  does occasionally still have a puff for old times’ sake but gone are the days of waking up to a spliff in the ash tray. After 5 years, she made a near complete recovery. Very occasionally she does still experience bursts of psychosis but they are short lived and manageable. She knows she is one of the lucky ones.


  • If you feel worse after a joint /spliff, or alcohol, then don’t smoke or drink anymore and let your brain recover.
  • If you feel worse after seeing certain people, avoid them and get counselling help/support or go and tell your doctor.
  • If you feel worse at particular times of the day, exlplore why this time of day distresses you? Then try to avoid the stressors.
  • Get rest – tiredness exacerbates the symptoms.
  • Eat – dehydration and starvation also exacerbate the symptoms.


Recovery may be quick, may take weeks or months. The more quickly you get help, avoid triggers and seek support, the more likely you will recover quickly and completely. However, some people will need medication for life in order to feel OK again.

 Further support

There are some some self help exercises on Storyjug to help you cope with your psychosis. Click here to go to the self help pages.

A great film about psychosis produced and acted by people who have experienced it.




Psychosis Sucks

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