My Name Is Anna
My name is Anna, and last summer I had a psychotic episode.
In April 2017, the first symptoms of the most serious health condition I've ever had began to emerge. The following four or so months were the most frightening, isolating and difficult of my life, as I progressed from perfect health to acute psychosis. It's a year since my illness began so, to mark the occasion, I'd like to share with you what happened to me and why it was such a distressing and traumatic time.
I'll be covering what psychosis is, how I became ill and what my recovery looked like, in the hope that more light can be shed on some of the most stigmatised mental health conditions in our culture. I hope that this can support anyone in recovery, and perhaps help those of you with no direct or indirect experience of the illness to learn about it, and avoid becoming unwell in the future.
What is psychosis?
You've no doubt heard the word psychotic, and some of its synonyms, used before.
"She was acting so crazy... like, to kill someone like that you would have to be psychotic." "Yeah he was mental, definitely a schizo." "What's wrong with you, are you some kind of psycho?"
Though "psychotic" is a specific medical term, in our culture it also stands in as an equivalent for deranged, incomprehensible and even dangerous. While we've come a long way in acknowledging the realities of depression and anxiety, there remain a number of other serious mental health conditions that hover outside of our understanding and, most crucially, our acceptance.
In case psychosis has never crossed your path before, this is when an chemical imbalance in the brain leads a sufferer to struggle to recognise what is real and what is not. They may feel extreme paranoia, experience delusional thoughts and even have hallucinations that could affect any or all of their five senses. These symptoms may disappear entirely once a person has recovered from an episode, but in some cases can remain with a sufferer for the rest of their lives.
The exact causes of an episode vary from person to person but are often due to extreme stress, a genetic predisposition, or a poor reaction to drugs. Around 3% of the population will be diagnosed with psychosis; for some it is a one-off episode, while others may discover they have a longer-term condition such as bi-polar, schizo-affective disorder or schizophrenia. Over 90% of us would enter a state of psychosis if we were placed under extreme stress and deprived of sleep for a long enough time.
The end of 2016 and beginning of 2017 turned into an unexpectedly tough time. Though I had found my passion in my freelance career, I was convinced I needed to push myself harder than ever before and measured my success in the hours I gave to my business. I started work before 8:00 am, forewent breaks throughout the day and would regularly continue into the evenings too. I would work on weekends also, and for months I refused to take time off.
Added to this, the early stages of my illness saw me growing increasingly obsessive in nature. As well as my compulsion to overwork, I found that I was following the news constantly, feeling a close proximity to the events of Brexit and the 2016 US election. I've always felt linked to global events thanks to my linguist background, so this particular point in time truly felt like a waking nightmare. I found myself exercising fanatically (I call this my "stress yoga" stage) and would get up early to work out every day, no matter my mental or physical state. I was also compelled to tidy my room, organising and re-organising with ever greater frequency, throwing possessions out until my room was eerily pristine.
As a result of all this I began struggling with insomnia that was unlike any other previous instance I had experienced. The stress and anxiety I felt during my waking hours refused to shift when I tried to switch off at night. Despite my exhaustion I remained determined to "push through", convinced I could function as normal with minimal rest. I continued "working hard", denying the truth: I was teetering on burnout and ignoring its signs. Instead I took pride in how much I could do on just a couple of hours sleep a night. Days turned into weeks as I remained determined to "keep on keeping on".
Slowly at first, the reality of my illness began to unfold. It started when I became convinced members of my family wanted to do me harm. The trouble with psychosis is that everything feels real, no matter how far from the truth it might be. In my case, I was gripped by false memories that filled me with terror. Sure that my life was in danger, I fled to a friend's home, lying to my loved ones about where I was and cutting off contact with them almost entirely. Though my bestie was no doubt shocked and confounded by my story, I was so sure of my situation that she did her best to help in every way she could.
Whilst there, I continued to work, sure that I wanted to move out with my friend and convinced that I wouldn't be able to afford should I took a break. I continued to sleep for (at best) a couple of hours a night. Instead of my fears subsiding, they developed dramatically until eventually I was sure that I was in danger at my friend's family home too.
With each passing day, then each passing hour, my thoughts became more and more alarming. As sleep deprivation saw my health spiral out of control, I detached further and further from reality, delusions gripping me day and night. I stopped sleeping all together. I later left my friend's home, sure I had to sleep on the streets, sure I had nowhere to go. I made my way to Birmingham, and crumpled to the ground by the side of the street, unable to go any further.
A stranger came to sit with me. I can't remember now what I said to him, but I remember his unconditional kindness. He was a street preacher, and helped carry my things as we made our way to the Cathedral. We walked around and, knowing I was a photographer, he encouraged me to take photos. We talked about religion and he shone with confidence that I would be okay, but as the day wore on, my symptoms grew more and more apparent. Gradually it became clear he knew something was seriously wrong.
Sweetheart, I have something I would like you to do, he said, as we stood in front of a small inner city supermarket. He handed me a tenner. I would like you to go into that shop and buy us a pint of milk, a newspaper, and a loaf of bread. Do you think you can do that?
Yes, of course, I said with a smile.
I walked into the supermarket and my senses, dialled up to a thousand, completely overwhelmed me. My mind raced with delusions and I wandered the aisles at a loss, deafening paranoia shrieking in my head. I had no idea what I had walked in for. After what must have been fifteen endless minutes I made my way out, handing my helper his tenner back. I'm sorry, I said, tears falling. I can't do it.
It's okay, it's okay... he said. He looked me up and down. I think you need to go home, sweetheart.
We made our way to the station and I bought a ticket back to Northampton. It took three times longer to use the machine than normal. I made my way back and found my friend had bought himself a ticket for part of the way, recognising I couldn't make the full journey alone. We sat side by side and I was restless, paranoia and fear pushing me further from reality more than ever. The passengers surrounding me stared, leant away, or stood and walked to sit elsewhere.
It's okay, sweetheart, said my stranger. Your name is Anna and you are going home and you are going to be okay. Your name is Anna and you are going home and you are going to be okay. Your name is Anna and you are going home and you are going to be okay. He repeated this over and over, like a mantra, while I shifted and struggled in my seat.
Somehow, somehow, I managed to call my parents, telling them I was on my way back. I was unsteady on my feet as I made my way out of the train and down the stairs of the station. Eventually I found them and broke down with relief.
I was home.
Once I was back in Northampton, the wheels of my recovery began to move fast. My parents saw immediately that things weren't right but, having not spoken to them for over six weeks, they had no idea what exactly had happened. I kept sharing distressing thoughts with them that made little sense and was experiencing hallucinations, so that night they took me to A&E. We left at 4 am and at 10.30 am the next morning I had a meeting with a psychiatrist; for the two weeks thereafter I was seen my Northampton's Crisis Team.
I told the Crisis Team that I thought the world was ending, that I thought the TV was talking about me, that I was convinced I was a dangerous criminal on the run, and plenty more besides. The team began treating me with Olanzapine, an anti-psychotic drug that is one of the quickest-working drugs for psychosis. I was also prescribed Lorazepam to treat the extreme anxiety I was experiencing too. Though the meds were quick acting, my mum was forced to stay at my side every hour of the day, trying to get me to eat, brushing my teeth for me when I couldn't myself, afraid to leave me on my own.
After seeing the Crisis Team I was referred to NSTEP, Northampton's early intervention psychosis team. The unit is compromised of psychiatrists, psychologists, CPNs (community psychiatric nurses), employment specialists and more, to help treat psychosis and integrate those affected back into society in multiple ways. I feel immensely lucky to have had access to what I can only describe as top-rate care; I'm not sure my recovery would have been as fast if I hadn't had the team to support me.
Once I began seeing NSTEP's team regularly, I also saw my incredible former GP on a weekly, fortnightly and then monthly basis. He left our practice in December and I genuinely wept on his departure; he helped truly normalise my experience and showed empathy and professionalism at every one of my visits. I still see my CPN on a regular basis too, again decreasing in frequency to where I am now, around once a month. She has been amazingly innovative in her approach to care, helping me to come up with a care plan (should I ever relapse) and educating me on what psychosis is. There are also weekly group sessions I go to when I can, where other folk in recovery meet up to play pool or go bowling and bond over our experiences.
Lastly, I was referred to a psychologist and have become a shameless advocate of therapy ever since. My psychologist is incredible and has helped me build up a picture of why my psychosis happened, whilst also deepening my understanding of myself while healthy. I cannot truly recommend psychology highly enough.
SO HERE I AM.
It's been almost a year and, though it's a lesson I hated learning, I've found that I, and all other psychosis patients, are far stronger than we could ever have imagined. Though I would never wish my experiences on anyone else and would never want them to be repeated, there is some power in knowing I recovered from an illness that nearly claimed my life. This is not to belittle the extraordinary help I had along the way, but only to echo what my CPN said to me last week: You overcame it.
My relationships with my family and friends, have, thankfully, been strengthened. Tested beyond their very limits, I will forever be grateful that they showed me unconditional love while I was most unwell, least like myself. I can only imagine what it must have been like for them to see clearly what I can barely remember, but I cannot fault their care. I've been able to be open and honest with them about every one of my fears and feelings throughout this process; though I was terrified to speak up about my illness at first, everyone I have told has been nothing short of incredible.
I cried several times writing this post, but of all the posts I have written for you, this is the one I felt needed to be shared most. What's vital is that we bring all mental illnesses into the light of acceptance, even and especially those that are most stigmatised. Though I recovered quicker than most, I still went through unimaginably dark days, particularly while I struggled with all the internalised prejudices I had about psychotic episodes. I can't help but think that had I seen more examples of the illness being portrayed realistically in the media, I would have felt far less isolated, afraid and ashamed.
I'm also fortunate that, touch wood, I had a one-off episode. I am completely sure it would have been far more challenging had I found that I was living with a long-term condition, like schizophrenia, bi-polar or schizo-affective disorder.
If something doesn't feel right, please go to your doctor. You're not weak, you're not different; you have every right to treatment, no matter how small or big the problem. If I learned nothing else from this experience, it is that there is no shame in seeking help.
For those of you who are in recovery, please know that I do not think there is one "right" way of getting better. Take the time you need; no one should pressure you to go back to work sooner than is right for you. Tell only those you trust; just because I am able to talk about my experiences doesn't mean you have to. Ask for second opinions if your treatment isn't meeting your needs; you deserve to be treated with care and professionalism. And know you should never be ashamed of what happened to you.
Thank you so much for reading this post. It would mean the world to me if you could share it; I never usually ask you folks to do so, but I would be so, so grateful if you could. In the meantime, take care and look after yourselves – Anna's orders.