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Psychosis
Psychosis is when a person does not experience reality as others do. They might hear voices, see or feel things that aren’t there, feel paranoid, or believe things that don’t make sense.
A person who is experiencing psychosis may not realize something is wrong. They may be acting differently than normal.
These symptoms will be there for several weeks.
James' story
"Looking back now, I remember how I started to see importance and meaning in the smallest things, making connections that weren’t real. I became fixated on the idea of a mass migration of people to a distant place. I tried to picture this place and even drew maps. I kept a book where I wrote down my ideas because my memory was so poor at the time, I was afraid I’d forget them. To me, everything made perfect sense, but to others, none of it did."
What causes psychosis?
We think psychosis is caused by a chemical imbalance in the brain. Scientists around the world are still working to determine the exact cause.
Psychosis can be due to a mental health condition, such as:
• Schizophrenia
• Bipolar disorder
• Severe depression
• Post-partum psychosis
There is more information about these conditions below.
It can also be caused by drugs, including medications (although this is rare) or illegal drugs, such as marijuana. In these cases, it is called “drug-induced psychosis”.
Schizophrenia
Schizophrenia is a serious mental health problem. It is only diagnosed when somebody has more than one “episode” of psychosis.
Schizophrenia is not always the same in every person, but there are some patterns, for example:
• Seeing, feeling, hearing, or smelling things that aren’t there (these are called hallucinations)
• Having beliefs that others don’t think are true (these are called delusions)
In schizophrenia, it is common that people to feel threatened, they may think they are being watched or manipulated by an external body (we call this paranoia).
Symptoms often start in the late teens to early 20s for men and the late 20s to early 30s for women.
If this problem is not recognized and treated, schizophrenia can be a very disabling condition.
Bipolar disorder
Bipolar is a disorder associated with episodes of extreme changes in mood.
These can be extremely high, which is called “mania”, or extremely low, which is “depression”.
These episodes last for days to weeks (not minutes to hours).
Bipolar disorder has previously been known as “manic depression”.
The symptoms of mania include:
• Excitement
• Racing thoughts
• Talkativeness
• Over familiarity/ reduced inhibitions
• Moving a lot
• Not sleeping
People experiencing mania may also have delusions. This is a belief in something that others do not think is true. This may include:
• Believing you have lots of money
• Believing you have special powers
• Believing others are out to get you
The symptoms of depression include low mood, tearfulness, hopelessness, guilt and worthlessness - see our page on Depression for more information.
There are no accurate estimates of the prevalence of bipolar disorder in Uganda, but globally it's thought to affect 0.3-1.2% of people.
Jeanette's story
"In my final year of university in 2011, I was studying for a degree in Economics in Kampala and living with my family. During the last semester, as the pressure of my final exams grew, my family started to notice that I was talking a lot and making strange comments about people. I wasn’t making any sense, which was very out of character for me, and they became concerned. I, on the other hand, felt extremely excited and full of energy. I knew my exams were coming up, but instead of attending classes, I spent entire days walking aimlessly. I couldn’t concentrate, and I was barely eating because I was so distracted."
Depression with Psychosis
Some people with depression will also experience hallucinations and delusions. This is a sign of severe depression.
Post-partum psychosis
The period after childbirth can be a high-risk time for women.
They may experience the first episode of psychosis, or a relapse of a pre-existing mental health challenge, most commonly bipolar disorder.
Researchers are still trying to find out the reason, but it is thought to be to do with sleep cycle changes and hormone changes.
The important thing is that the mother seeks help, and receives treatment so that she can get better and form a strong bond with her new baby.
Drug-induced psychosis
There are some drugs that can trigger a psychotic episode. This can sometimes lead to a mental illness, like schizophrenia, that continues even when the drug use stops.
Common drugs that can cause psychosis to include:
• Cannabis/marijuana
• Methamphetamines and amphetamines
• Cocaine
• Alcohol
• Psychedelic drugs e.g., LSD
• Club drugs e.g., ecstasy/cocaine
There has been a lot of research into the risk of schizophrenia from smoking marijuana. There is now evidence that smoking marijuana, especially in adolescence, increases the risk of schizophrenia up to 2.5 times, and that the risk increases with the amount of cannabis use.
The link to this study is here.
Find more information about substance misuse here.
Support for mental health challenges including psychosis is available in Uganda. Please find more information about where to get help here.
Mental health challenges are treatable. Treatment is free in Uganda.