How psychosis feels to me….
What is Psychosis? Recognising the key symptoms……
For those unfamiliar with psychosis and psychotic illness it causes immense distress — confusion — isolation — disruption to everyday living — symptoms that are life-inhibiting.
Periods of confusion, cognitive function issues, sleep disturbance and fatigue. Spells of hallucinations and delusions — seeing, hearing, feeling and smelling things that aren’t real— a cause of fear, terror and panic. Sensitivity to noise, light and textures can make days unbearable.
Motivation can vanish — feelings of being under surveillance and paranoia are a regular feature.
Whilst medication can help —it can also cause side effects. Having a toolkit of self-care, coping techniques and a good support network are crucial to effective management of crises.
The appearance and level of symptoms can be broken down into three stages:
In my personal experience I often miss the prodrome phase warning signs – often thinking the symptoms are linked to a different condition or sometimes not even realising that the way I am thinking and working is changing - therefore developing acute phase symptoms before I realise what is happening and can then take steps to do something about it…
Everyone experiences different symptoms…
How this affects me and the symptoms to look out for…
Typically, the types of changes in feelings, thoughts, perceptions and behaviours include:
· Cognitive impairment – trouble focusing, concentrating, processing, understanding and retaining information
· Difficulty screening out distracting information and sensations
· Changes in perceptual experiences – visual experiences may become brighter or sounds louder
· Feeling overloaded/overwhelmed
· Feeling disconnected from teams and groups
· A desire or need to be alone
· Sleep disturbances leading to prolonged periods of fatigue including vivid disturbing dreams
· Depressed mood – high levels of stress and anxiety
· Irritability
· Suspiciousness/paranoia
· Trouble thinking clearly and logically
· Restricted emotional and facial expression
· Restricted speech and verbal fluency
· Difficulty generating ideas or thoughts
· Reduced ability to begin tasks
All these symptoms can lead to a significant impact on everyday life and cause unexplained difficulty at work. There are generally two types of thoughts associated with psychosis:
Racing thoughts are when thoughts go through your head very fast. It can involve them racing so fast that they feel out of control - while flight of ideas is where thoughts move very quickly from idea to idea, making links, and connections and seeing meaning between things that other people don't. (Types of Psychosis - Disorganised thoughts and speech)
Potential triggers in the workplace…
‘Psychosis is associated with behaviours which evoke reactions such as discomfort, anxiety, anger or fear in co-workers, supervisors and others. (Encyclopaedia of Occupational Health & Therapy)
Recognising and understanding potential triggers – some examples…
· Shared live documents when others have the document open - Can give the feeling of being watched and a breach of personal space and security…
· Finding out that others have been discussing my work together without involving/informing me – can make it feel that I’m being excluded from the team and decision-making regarding my own work and experiences…
· Unexplained criticism or negative feedback without the chance to discuss the root of the problem – makes me feel paranoid and worried about what I may have done wrong, problems I may have caused and the impact this may have on others and my own work and relationships… if left waiting for answers this can develop into more sustained anxiety and lead to increased susceptibility to triggers…
· Fear of not living up to expectations and failing – Being compared to others (especially on time-specific tasks when working hours need to be considered) or feeling isolated or disconnected from the work the rest of the team is completing…
· Being part of large groups for discussion either in person or in Teams meetings – especially when I don’t know the people well – hard to be aware of who is talking and what they may be doing. Interpreting body language and making assumptions that comments are directed at me, especially if negative or worrying…can also make links and connections with isolated words, phrases or actions…
· Being asked to talk about myself/respond to a complex question without prior warning – leads to distraction from listening to what others are saying whilst frantically trying to come up with a response that sounds clear, specific and relevant…
· Being asked to send an email stating three facts where two are real and one is not – Difficult because of issues with knowing what is real and what is not…
· Completing training that has content that relates to past experiences which were highly distressing, without warning or any support available from colleagues due to remote working – takes me back to a very dark place that I don’t need reminding of…
· Sending feedback about a topic of discussion via email which should involve cc’ing in members of the team when feeling unsure about myself or the validity of my comments – can feel like people are waiting and watching to see what I can come up with and enables them to judge me… (especially if no one else has sent feedback before on this particular topic – can make me feel like withdrawing altogether – means I generally send a direct email and don’t cc others in)
Staying Well in The Workplace/Everyday Life…
Psychosis in the long-term stable workplace is a new experience for me, but it appears I am not the only one who finds this a challenge:
A study by Hampson, M. E., Hicks, R. E., & Watt, B. D. (2018), ‘suggests that public and professional beliefs may constitute significant barriers to the employment of people living with psychosis and may need to be challenged if people living with psychosis are to receive appropriate support to achieve their vocational goals’. (Beliefs about employment of people living with psychosis. Australian Journal of Psychology)
\Important factors to consider…
· Self-awareness of changes in behaviour patterns
· Taking anti-psychotic medication
· Practicing self-care – including eating, hydrating, moving & sleeping well
· Staying connected
· Managing stress and anxiety
· Solving problems
· Setting goals and moving forward
· Understanding cognition
· Educating employers in the recognition of symptoms I experience following the disclosure of psychosis upon entering employment
· Having difficult conversations with the people working closest to me in the team
· Having support from peers and co-workers – honest and open conversations when problems are identified with work or interactions with the team
It is Really important to me that…
‘Co-workers understand that these triggers, beliefs and fears are real and can be distressing – they are not excuses for altered interactions and productivity…
Nothing in this document is about blaming others or not taking responsibility for actions that I have taken or decisions I have made…
It is about transparency and feeling safe and supported in the workplace, being a valued member of the team and empowering myself and others to spot potential triggers as I learn more about managing the condition at work…
Recognising that its helpful to have colleagues willing to look for signs and to have honest conversations with me if they are concerned that I may be displaying symptoms…
Although this is a very personal experience it can also be utilised as a starting point for any future conversations with new employees, those who experience psychosis for the first time after entering employment, those who are looking to enter the workforce and potentially people who wish to be more inclusive as employers, whilst supporting colleagues to understand the challenges people with psychosis face’.
Supporting Articles/Information/Guidance
Canadian Mental Health Association: Psychosis Toolkit: Psychosis Toolkit Downloads
Workplace Strategies For Mental Health: Psychosis and how to help in a crisis
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