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Shame and Psychosis article for Time to Change

My latest article for Time to Change, a campaign in the UK aiming to end mental health discrimination. (name has been changed)

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Three years ago last month, my mind lost touch with reality in a very rapid turn of events that culminated in an acute manic episode of bipolar affective disorder. Having been diagnosed with bipolar in 2004, I had not experienced any mania or hypomania (a lesser manic state) in ten years, although I had fallen into a suicidal depression just six months earlier. So when my brain fell into full blown psychosis – with delusions and grandiose thoughts, fearful thoughts about loved ones and being in danger and a complete change in rational perception – it ripped apart the fabric of my life and all I knew. I am writing this to explain what psychosis is really like.

I was just 25 and although I had experienced a mixed state which left me hospitalised at 16 (and had experienced some psychosis then), this was by far the most challenging, lengthy and painful bout of mania and psychosis that I had experienced. I began to believe that my step father was behind why I was in hospital and wouldn‘t let him see me, I thought that the doctors and nurses were a gang holding me hostage. I was fearful of everything, talking and singing to myself, unable to sit still and became quite agitated at times with the staff and patients, which is completely out of character for me. I simply didn’t know what was real or unreal and I was so frightened of the staff and others while my brain was in this state. Eventually, I recovered after about two months of being given anti-psychotic medication and tranquilisers to help me rest (often I was pacing around due to agitation/ mania), in combination with individual and group therapies. I left hospital after three months.

I rarely talk about my psychotic state, which led me to be sectioned under the Mental Health Act. This is due to shame: I was ashamed of myself even though it wasn’t my fault – rather down to faulty brain chemistry and my medication that had stopped working. There is still a huge amount of stigma about psychosis and anything that makes you lose your sanity. My psychosis is part of my bipolar illness and happened completely out of the blue. My mood stabiliser hadn’t been holding me for some time but no one could have predicted quite how rapid my descent into psychosis and illness could have been (it took only a number of days and escalated at a weekend, leaving me to be admitted via A&E, which proved traumatising).

The shame of losing your mind is great and also acting out of character shatters your self-esteem. When I left hospital, I sunk into a depression due to the shame of how I acted in hospital and how my brain and its chemistry could go so catastrophically wrong. Kindness goes a long way when you are feeling ashamed. If you have a friend or family member struggling with this – be calm, show kindness, and show up for them. They need your support at what is an incredibly painful time. Let the person with feelings of shame about their illness know that they are human, that they are an important friend to you, and stand by them.

What truly helped me in those dark days was the attitude of my psychiatrist in hospital and in the day recovery unit I attended after. Despite being psychotic and unwell in hospital and quite agitated at times, my doctor persevered to get me on the right medication and put up with my changing moods. She knew that if I took anti-psychotics and then agreed to go on lithium carbonate (the main mood stabilising medication for bipolar disorder) that I would recover – even if it took me months to get there. It was a slow recovery but I got there in time. Her patience, perseverance and kindness saved me from a very acute episode of illness. Similarly, the psychiatrist and all the staff at the Day Recovery Unit helped me in my down days starting on lithium and having regular blood tests, recovering from being very unwell and they treated me like a human being, when I had felt so ashamed.

If it wasn’t for the Doctors, nurses, occupational therapists and other staff who looked after me  and helped build me back up, I wouldn’t be here today.

There is no need to feel ashamed, although you may do.

Although I still find it hard to talk about my descent into a psychotic state – I am so grateful to the NHS for all the help I was given and have been well for some time. I hope this article helps others in a similar position – you are not alone and don’t let anyone make you feel ashamed.

https://www.time-to-change.org.uk/blog/there-should-be-no-shame-experiencing-psychosis

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