Causes

Before I met the Early Intervention Team things were pretty bad. I was withdrawn from society and under stress because of debt.

Anybody can experience psychotic symptoms if their brain is put under too much stress. In fact some scientists would argue that having the occasional brief but not distressing psychotic symptom, is entirely to be expected during a lifetime.

We are beginning to understand that there are many risk factors for developing a psychotic illness, these vary from individual to individual and occur in different combinations.

They can include:

Family history of mental health problems (genetics)

About 1% of people in the UK will develop a psychotic illness, usually in their late teens or early adulthood. For most, this means the chance of developing psychosis is 1 in 100; however these odds increase if a blood relative has ever experienced the condition. The closer the blood relationship, the greater the chance i.e. you have a slightly increased chance if an uncle has had psychosis but an even greater chance of the symptoms if it was your mother, father or a sibling that has experienced the condition.

We still do not know why this is, as there does not seem to be one clear set of genes driving the illness. Evidence also suggests that genetics alone cannot be the factor; as studies on twins, who have the same genetic makeup, show that it is possible for one to show signs of psychosis whilst the other remains unaffected. This suggests that environmental factors, such as stresses and major life events, physical health, diet and exercise or drug or alcohol misuse, also play a part.

Life stressors

Life stressors can be ongoing and include pressures in college, university, or at work. Stressors can include anxiety in social situations, financial and relationship difficulties. These pressures are not unusual, but it is when they are difficult to cope with, happen in combination, and are difficult to manage that they can trigger a psychotic episode in some people.

Drug and alcohol misuse

In recent years, scientific research has backed up our professional experiences within the Early Intervention Team, indicating that there are strong links between cannabis usage (and the use of other drugs) in the development of a variety of psychotic illnesses. Studies show that particular chemicals in cannabis are psychosis inducing; such chemicals are found in worryingly high levels in “skunk”. Research has also mapped out how the impact of these psychosis inducing chemicals would be much more severe for about a third of the population, who happen to be genetically sensitive to the effects.

For details of a study which found strong links between cannabis use and an increased risk of psychotic symptoms visit the BBC News site.  Our Team has also seen increasing numbers of young people who have had serious mental health costs from use of Mephadrone type drugs such as MCAT and so called “legal highs”. Fortunately, where it is substance misuse that is the risk factor in a person developing psychosis symptoms, then reducing usage, or better still stopping altogether, can substantially improve their chances of preventing future relapses.

These risk factors all have in common the fact that they cause imbalances in brain activity and the brain’s chemical messenger system.

We call these chemical messengers ‘neurotransmitters’. This is where the biological problem is if you experience a psychotic illness.

The neurotransmitter Dopamine and malfunction in the brain pathways where it is found is known to be particularly important in driving psychotic symptoms.

Other neurotransmitters and brain pathways also contribute to the development of psychosis, such as Serotonin, Noradrenlaine, GABA and Glutamate. Medications to treat psychotic symptoms are designed to affect these neurotransmitters.

Other Causes

Sometimes physical health conditions such as head injuries, infections or tumours can cause psychotic symptoms or even prescribed medication such as steroids. The treatment of these causes of psychosis is very different to the psychotic illness that Early Intervention Teams treat and if there are any hints that you might be suffering such conditions the team will arrange for them to be investigated prior to or during your assessment with the team, and if a problem is detected we will ensure that you see the correct medical specialist.

Other pages you might find helpful include:

What is Early Intervention? to learn more about the importance of early intervention.

Intervention for details of ways we treat and support people with psychosis.

© 2013 Cheshire and Wirral Partnership NHS Foundation Trust
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