What is severe mental illness? Signs and symptoms of psychosis

by Rethink

We all know that our mental health state may vary from time to time, but for most of us this is just a temporary change. But for people who have a mental illness or disorder, their experience will be very different. They may experience a range of symptoms that can vary in severity.

Anxiety, for example, may be experienced as a general feeling of unease or be so severe that it disrupts the person's whole life. Rethink has a special concern for illness where the effects on the individual are more severe, but is also concerned to identify emerging illness in the early stages in order to reduce the effect on the individual.

Severe mental illnesses are generally seen to be those in which psychosis is likely to occur. Psychosis is the medical term used to identify symptoms where the individual experiences a loss of a sense of reality, where they cease to see and respond appropriately to the everyday world they are used to. People who have experienced this say it is very frightening. One of the reasons mental illness is alarming is that we all have a very real fear of losing our reason, and of losing control.

People with mental illnesses or disorders may experience a wide range of symptoms which can vary in severity.

signs and symptoms of psychosis

In general terms the signs and symptoms of psychosis are having hallucinations or delusions or certain types of very abnormal behaviour. Having Hallucinations means that someone may hear their own thoughts as if they are coming from a source outside their own body. They may see, smell or taste things that appear to be real but which are not being experienced at that time by anyone else. People who have hallucinations often try to find an explanation for them, and may invent and attribute them to beliefs that others may see as strange and which are called delusions. Examples of this might be that they believe that the voices they can hear are coming from the television, speaking directly to them. They may believe they are coming from someone who is plotting against them. The voices may be grossly critical and abusive. This kind of distorted thought pattern may cause very severe anxiety called paranoia.

Psychosis may also involve 'mania', a term used when someone's mood is very over active or 'heightened', There will be increased energy and physical activity, racing thoughts and speech, which may be confused and irrational. Or alternatively the opposite may happen, the individual may become extremely withdrawn, inactive, perhaps neither moving nor speaking for long periods. This is called catatonia. Professionals may identify groups or clusters of symptoms enabling them to recognise particular disorders, like schizophrenia or manic depression. Sometimes an individual may have symptoms of both these conditions together, involving episodes of psychosis during which the person affected loses touch with reality and experiences very high or low mood that affects the way they behave. Some people will only experience one 'psychotic episode' in their life while others will have recurring episodes at different times during their life. This leaflet includes a brief description of the mental disorders and their symptoms that are generally regarded as being severe. This does not mean that other conditions are not regarded as serious. People do not always fit neatly into the categories and many will have been given a different diagnoses from time to time. Reasons for this might be because:

• their symptoms tend to change over time.
• they may have more than one condition at the same time.
• their underlying condition is 'masked' by the use of street drugs or alcohol.
• psychosis is an umbrella term for a group of conditions which are still being unravelled and different doctors may reach different opinions.

In general terms the signs and symptoms of psychosis are having hallucinations or delusions or certain types of abnormal behaviour.

Hallucinations mean that someone can hear their own thoughts as if they are coming from an external source, or can see, smell or taste things which appear to be real but are not experienced by other people.

Types of psychotic illness

Incidences of psychotic illness were described back in the time of the early Greeks and yet even today the exact causes are still not clear. But it is generally accepted that there may be a genetic vulnerability in some people, that may or may not be triggered by an event in that person's life. Over the years, a great deal of blame has been attributed to both people who are mentally ill and their families, and it is important that the illnesses are seen as real and that the individual possible social triggers to illness are recognised. It may take time for psychiatrists to reach a firm diagnosis. Some are reluctant to 'label' people because of the stigma and adverse social effects that surround the illness. What really matters however, is not the diagnosis itself, but that the symptoms are identified and treated promptly using medication and psychological therapies. The importance of involving the ill person in decisions and the positive effect this has on their self esteem is also now recognised.

What really matters, however, is not the diagnosis itself, but that the symptoms are identified and treated promptly using medication and psychological therapies.

There are several illnesses of which psychosis is a symptom. These include:

• schizophrenia
• bipolar disorder (manic depression)
• clinical depression, and
• personality disorder

Information about each illness can be obtained by clicking on each link.

There is a great deal of overlap in these illnesses and recognising that, it is not always possible to distinguish clearly between them.

Some people will only experience a 'psychotic episode' once, while others will have recurring periods of problems, perhaps at times of particular stress in their lives.

Coping with severe mental illness. Key principles

In recent years the understanding of severe mental illness, its treatment and care has improved. The arrival of newer more specific drug treatments combined with psychological therapies have meant that those developing illness today have greater prospect of recovery and of recovering a better quality of life.

The arrival of newer more specific drug treatments combined with psychological therapies have meant that those developing illness today have a greater prospect of recovery and of recovering a better quality of life.

key principles

The importance of identifying symptoms and early intervention is backed up by research indicating that the earlier treatment starts the better the eventual outcome. Early intervention is a key objective of both Rethink and Government.

We at Rethink recognise the importance of promoting independence and self-management for all those people with mental illness and of voicing praise for their courage. Rethink have an active self-management project and have developed a self-management course for users. For more information contact David Martyn on (020 7713 8986 or email [e-mail]

We have found that it is also important to provide information and training to families in order that they understand severe mental illness, and that it is not their fault but emphasising their vital role in recovery.

The importance of changing the culture and attitude of professionals and promoting an image of mental illness that it is possible for the public to accept and support is also being recognised. Rethink is actively involved in tackling stigma at every level.

In recent years the understanding of severe mental illness, its treatment and care has improved.

Become a Rethink member and help us to speak out for everyone affected by severe mental illness. There are nearly 8,000 Rethink members and you can help us make our voice stronger.

Together we can overcome the prejudice, ignorance and fear that surrounds severe mental illness.

About the Author

www.rethink.org
Rethink is the largest severe mental illness charity in the UK. We are dedicated to improving the lives of everyone affected by severe mental illness, whether they have a condition themselves, care for others who do, or are professionals or volunteers working in the mental health field.