What Causes Psychosis ?
A number of factors have been identified as playing a key role in increasing the risk of developing psychosis and/or psychosis like experiences, particularly in individuals who might already have a vulnerability. Some of these factors have included childhood trauma (e.g bullying ), drug use ( e.g cannabis ), migration, and common stressors associated with urban lifestyles.
Research on many of these factors is ongoing, and it is not at a stage where it can confidently be said that there is a single cause. In fact, the pattern of evidence suggests that psychosis is unlikely to be attributed to any one single cause. However what the research suggests at this moment in time that there appears to be a number of different factors ranging from genetic and biochemical to social and psychological, which contribute towards a vulnerability to psychotic experiences. The importance of any one of these factors will vary from one individual to another.
Genetics
For some individuals, inheritance can play a role in the development of psychosis. An example of this is when someone in the family already has psychosis there may be a greater chance of another relative developing psychosis ( when compared to those individuals with no relatives with psychosis ). The chance of developing psychosis varies depending on the type of relationship. There is a higher risk if a very close relative has psychosis ( e.g parent or sibling ), but not significantly higher than for the general population if psychosis is present in a cousin, uncle or aunt.
Inheritance, is however unable to explain why psychosis occurs in some people but not in others. It is also important to remember that just because one member of a family has psychosis, does not necessarily mean that it would occur in another family member. Neither does it mean that a person with psychosis should not have children. It is usually the case that people with psychosis are actually the first people reported in their family to have it.
Biochemical
There is evidence to suggest that there may be some differences in the brain chemistry of individuals with psychosis ( when compared to those without psychosis ) that seem to be associated with their difficulties.
Similarly, there has been evidence to suggest that there may be some differences in the brain structure of individuals with psychosis. These differences might not in themselves cause any problems indeed it has been argued that they sometimes can have positive effects such as being able to think more creatively or unconventionally.
Vulnerability – Stress
Increased stress can affect anyone badly, but people with psychosis may be particularly sensitive to stressful life events and situations, and usually have experienced more stressful life events.
Stress is widely acknowledged as one of the main factors which can trigger psychosis and will also cause psychosis to return following a period of improvement. It has been proposed that an individual’s increased sensitivity to stress combined with a pre-existing vulnerability ( e.g a close family history of psychosis ) could increase the likelihood of an individual developing psychosis.
Families & Psychosis
There has been a lot of speculation about the role of Families in the development of psychosis, but to date, no definitive evidence exists to suggest that families cause psychosis.
However, once problems have appeared the Family ( i.e relatives/carers/friends ) can play an important part in helping the person to recover and reducing the likelihood of further episodes of psychosis.
Can you recover from Psychosis
What it means to ‘recover’ can vary from one person to another, it is very specific to the person with psychosis.
Despite different meanings about recovery, what is certain is that individuals with psychosis often improve with treatment, e.g individuals might find that they are able to think more clearly and their unusual experiences ( Gifts, which I will talk about in later posts ) decrease and/or become less severe and distressing.
For some individuals, recover may be slower than they or their relatives imagined or hoped for, furthermore, recovery may not always be complete. Therefore some people may continue to experience difficulties. This can be frustrating for the person with psychosis and their families. Overall, evidence suggests approximately 25% of people will have a single episode of psychosis from which they recover and have no further episodes.
A larger proportion of individuals experience more than one episode, which can occur within weeks of their recovery or some years later. There is a small number of individuals who have a limited response to the treatments provided.
In between episodes, some individuals will carry on and do the normal things they have usually done. For others, they may feel that it takes them a longer time to get things done. They may say very little when in the company of others. They may also lose interest in things and may go through the day doing very little. This may lead to difficulties in being able to get a job and they may remain unemployed for long periods of time. If the individual lives at home with their family, the family may often find that housework and usual chores remain undone or occur following considerable prompting which can lead to disagreements and arguments with members of the family, the result being the rest of the family need to help out more often.
Following recovery from an episode, the person may not be as involved in the family as before. They may appear aloof from family events and gatherings and seem much less affected by them. For relatives of someone with psychosis, it is important to bear in mind that these sorts of things are not done to annoy you. They may be partly due to the medication(s) your relative is taking, the effects of the psychosis, and the person’s own attempts to avoid becoming upset and unwell again.
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