I grew up in a nice family home in an affluent suburb of Glasgow, achieved good grades at school, and in 2008 graduated with a good degree in Psychology, when I was accepted onto a PhD program. Yet in March 2014 I found myself in a local psychiatric hospital experiencing a psychotic episode. So what happened?
I first began to have concerns about my mental health at Christmas 2011. The year before I had moved out of the family home, where I lived with my parents and sister, into my own flat. As is common in Glasgow, I completed my undergraduate studies at home. I had a small but close group of friends, and at this time they began to become unavailable—through moving abroad, settling down with partners, and having children. Living alone was hard work, but I soon got used to it and focused on my studies.
In the summer of 2011 my participant money was stolen from the office where I worked. This was upsetting as I thought I was friends with most people in my department, and everyone I spoke to suspected it was “someone who I knew”—the only 2 of whom were friends. Soon afterwards the results of my experiments weren’t working out as expected, and I was under a lot of pressure to come up with a reason as to why. To compound matters, I then attended a conference in Quebec City, where I proceeded to burn the candle at both ends. While at the conference I spoke about my concerns with a colleague, which helped me to relax somewhat. When I returned to Glasgow I worked long days in order to test participants in the evening, working alone in my office. I soon spoke to my colleagues about feeling left out from social events, as they were based elsewhere. Within 4 weeks I had a brief visual hallucination.
This happened when I was asked a question I thought the questioner already knew the answer to, and was relatively benign. Yet for a millisecond I interpreted a smile as a sneer, which was like a veil had been placed over my eyes. I tried to relax by taking up yoga, and started to be included socially with my colleagues, which helped a lot. Yet these events had taken their toll, and I became concerned about the social damage I had incurred. By Christmas I was struggling to shop for Christmas presents and felt sluggish, and was experiencing low mood. By Christmas week I had worked myself up to going to see my GP about a mental health problem, which was a big deal for me, and I was prescribed fluoxetine. One night I could not sleep and I was concerned I was having a heart attack, so I took myself to the local Accident and Emergency unit. The episode turned out to be a panic attack. Another night I felt a horrible combination of low mood plus extreme agitation, but these effects soon died down and I began to feel somewhat better, although still ruminating. I now suspect I was experiencing prodromal psychosis at this time.
In the summer of 2012 I went to work at Canterbury for 3 months, returning when the center I was affiliated with had closed down, leading to the relocation down south and abroad of its staff. I focused on completing my PhD, spending spare time with a former colleague, a University friend, and a friend who had now returned to Scotland from abroad, and received much telephone support from a former colleague. I also got a pet cat. By the time my funding had ran out in late 2013, it made sense for me to seek work in the same location as this colleague.
By early 2014 I was becoming increasingly concerned about completing my thesis, and my lack of income. To compound matters I had placed myself under pressure to publish my work in order to try to secure a job in research, and I found it stressful to place my work for scrutiny in the public domain. I am also close to my family in Glasgow, yet was looking at jobs throughout the United Kingdom, and applied for one in the same city as a former colleague.
I experienced psychosis in the hotel room prior to my interview. While trying to sleep I started to get really upset about the potential move to a new city, but I remember thinking that I had to focus on my interview, and tried to push my emotions aside. It was at this moment I felt like my emotions became switched off. When I woke up I was hearing things about how I should kill myself. Later when outside I experienced auditory hallucinations/delusions about the people in my proximity and felt hyper-vigilant, but I managed to get through the interview and was even offered the job! I felt extremely stressed and low, but the psychotic symptoms had subsided, and went for dinner with a colleague before catching my return train home. I mislaid my ticket and had to speak to the guard to let me on the train, where I continued to experience auditory hallucinations, and I slept, or tried to.
When I got back to Glasgow I went straight to my GP and was prescribed diazepam. This started a 4-week period of increasing panic about completing my thesis and moving to a new city, and I vacillated between feelings of being a hypochondriac and feeling like I was losing my mind. I was also concerned about my sleep pattern, which had never recovered, and I did not feel up to working a 9 am–5 pm job, and working evenings to complete my thesis. I felt obliged to take the job as I had already committed to it; but I really was not prepared emotionally for moving away to England. I asked to be referred to a psychiatrist, yet when I received my appointment I thought it was ridiculous that I had gotten myself into such a mess, and I resolved to not go back there again. I went back to my GP and was prescribed fluoxetine.
This started a week of increasing paranoia, and I spent much time either lying down trying to relax and sleep, or pacing about my flat. I tried to hold it together, but I lost a lot of weight. By this time my parents were concerned, as I had taken to calling them at night, as I was concerned about their welfare. I went back to my psychiatrist, the day of my “leaving” lunch, and after a very brief discussion she suggested that I go to the local psychiatric hospital.
At this point I started to experience auditory hallucinations, which was like having really loud thoughts and like hearing a person talking to me, and my mind was going through all sorts of scenarios including that I was losing my mind. I was very distressed, and asked for a sedative in the car, which I was given upon my arrival at the local psychiatric hospital. I passed out in the street and do not remember much about my admittance. I was promptly referred to ESTEEM, the early intervention for psychosis service in Glasgow. My stay in the hospital was fairly pleasant; I had my own room and the food was ok; but I was not well, and I was bored, but unable to concentrate. I was discharged after almost 4 weeks. I received antipsychotic medication, which continued after discharge, and later psychological therapy too. My initial medication made me oversleep, and as a consequence I was later prescribed mood stabilizer, and then an antipsychotic and antidepressant, without such effects. I find it difficult to accept the continued professional opinion that I should take medication for my “condition” over the long term.
Two years later, I have completed my PhD and viva, although it was stressful, and published 2 first-author publications. My symptoms have resolved and I now feel alert in the mornings, which matters a lot to me feeling able to take a regular job. I have new friends and my existing friends, and my family, have been continually supportive. Increasingly, I have disclosed my experiences to friends, colleagues, and acquaintances, and have received much support and understanding. I have a diagnosis of first-episode psychosis and autism spectrum disorder, the latter of which has been an additional shock to which I am still adjusting. Thanks to the support offered by ESTEEM I feel I now have a good understanding of my vulnerabilities, and we are hopeful that I will not experience psychosis again in my life.