Psychosis & Schizophrenia
Easily one of the most highly stigmatised mental disorders, psychosis is an experience that is portrayed in the media as a dangerous and relentless illness, the sufferers of which are usually either criminal or in a high-secure mental institution
Written and compiled by Matt Geer & Hattie Butterworth
What are the facts?
The facts are far different to the vision of psychosis and schizophrenia we have been fed by the media. Many people may experience psychosis at some point in their lives, most going on to lead a full recovery. This page will give an overview of common psychotic disorders, how they might impact musicians and how musicians can find help and support when suffering from psychosis.
More about psychosis and related disorders
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Psychosis (also called a 'psychotic experience' or 'psychotic episode') is when you perceive or interpret reality in a very different way from people around you. You might be said to 'lose touch' with reality.
The most common types of psychotic experiences are hallucinations, delusions and disorganised thinking and speech.
Psychosis affects people in different ways. You might experience it once, have short episodes throughout your life, or live with it most of the time.
It's also possible to experience an episode of psychosis (one of the most common symptoms of schizophrenia) without having any particular condition.
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Schizophrenia is a complicated mental health problem related to psychosis. There's lots of misconceptions about it. Even mental health professionals don't all agree about it. But the reality is that about 1 in every 100 people get this diagnosis at some point in their life. As many as 1 in 10 people will hear voices at some point in their life.
Many experiences and behaviours can be part of schizophrenia. They can start suddenly, or they might develop gradually over time.
Each person's experience is unique. A doctor might suggest you have schizophrenia if you experience some of the following:
a lack of interest in things
feeling disconnected from your emotions
difficulty concentrating
wanting to avoid people
hallucinations, such as hearing voices or seeing things others don't
delusions (strong beliefs that others don't share), including paranoid delusions
disorganised thinking and speech
not wanting to look after yourself.
Hallucinations and delusions are types of psychosis.
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Schizoaffective disorder is a mental health condition where you may experience mood symptoms such as depression and/or mania alongside psychotic symptoms such as hearing or seeing things that aren’t there.
The word schizoaffective has two parts:
‘schizo–‘ refers to psychotic symptoms
‘–affective’ refers to mood symptoms.
Every person who lives with schizoaffective disorder has a different experience. There are three types of schizoaffective disorder:
- Bipolar / Manic type: Elevated mood alongside psychosis
- Depressive type: Low mood alongside psychosis
- Mixed type: Changes between elevated and low mood alongside psychosis.
People who live with schizoaffective disorder struggle with experiences related to their mood. You might hear these different experiences called mood episodes or states. You can read more about them in our page on bipolar moods and symptoms.
Some people also experience ‘mixed episodes’ (which is different to the ‘mixed’ type of schizoaffective disorder). A mixed episode means that the sufferer may experience a high and low mood simultaneously. For example, you may feel very energetic and impulsive, but also very upset or agitated.
You might have times when you struggle to look after yourself, or when your doctors consider that you lack insight into your behaviour and how you are feeling. But you may also have times between episodes where you feel well too.
Episodes can vary in length. Some people have repeated episodes, but this does not necessarily happen for everybody. Symptoms usually start when you are a young adult.
Some people have suggested that schizoaffective disorder sits in the middle of a continuum, with schizophrenia at one end and bipolar disorder / clinical depression at the other. However, schizoaffective disorder is recognised as a separate diagnosis to both schizophrenia and bipolar, despite sharing many similar symptoms. People diagnosed with the illness will often talk about schizophrenia and depression or bipolar in relation to their psychotic and mood symptoms respectively.
Are people with psychosis dangerous?
One of the most common misconceptions about people suffering from psychosis is that they are a risk to society and may be physically violent. Although rare cases of this occur, it is sadly far more probable that someone with psychosis will hurt themselves rather than someone else.
You Are Not Alone
In September 2020 I spoke to composer and pianist Matt Geer about his experiences with schizoaffective disorder and the ways in which his condition has impacted his life as a musician.
Matt’s website is here
Famous musicians with psychosis
Alastair Campbell
Anyone, regardless of intelligence or personality can suffer a period of psychosis. Tony Blair’s Press Secretary Alastair Campbell suffered a psychotic breakdown following a period of stress and heavy drinking whilst working as a journalist in the 80’s. He takes you through his journey with psychosis, depression and addiction in his book Living Better-How I Learned to Survive Depression.
John Ogdon
Winner of the 1962 Tchaikovsky Piano Competition in Moscow, John Ogdon established himself as one of the most renowned pianists of the latter half of the 20th century. A remarkable ability to sight-read and memorise, Ogdon’s mind was revered as one of true genius. Until his mind suffered from severe mental illness in the early 70’s and he endured psychosis, suicide attempts and bipolar disorder. A fascinating biography of his life Piano Man by Charles Beauclerk is available here.
Things to read…
Tracy Harris
Tracy Harris is a flautist whose life was turned upside-down by schizoaffective disorder in her early 20’s. Read her gripping memoir here
Erika Nielsen
Read Erika’s incredible book, Sound Mind, about her experience with bipolar disorder alongside life as a professional cellist.
Can people make a full recovery?
Treatment
Treatments for psychosis, bipolar and schizophrenia typically combine medication, talking therapy and community mental health support.
You can self-refer to mental health services via the NHS IAPT (improving access to psychological therapies) in your local area. Find your local service here
Medication for these disorders may include anti-psychotic and mood stabilising medication. Anti-depressants are also sometimes used, but with great caution among those with schizoaffective disorder and bipolar, as they can increase manic symptoms.
For more information on medication for schizophrenia, click here
If you are unable to look after yourself or keep yourself safe, you may be referred for inpatient treatment at a psychiatric facility. These spaces can be frightening, but can be an important buffer for people to access the care they need. It can be easy to feel ashamed if you are facing inpatient treatment, but remember that your are suffering from a genuine and severe illness and have every right to the help you need.
Dealing with symptoms
Symptoms are often improved with medication, but some people find that they will still experience symptoms most days. For other people living with schizophrenia or similar disorders can go through periods of experiencing no symptoms at all.
Cognitive behavioural therapy (CBT), as well as dialectical behavioural therapy (DBT)and compassion-focussed therapy have shown to have success in helping people manage their symptoms.
Some people find mindfulness and meditation to help them manage and accept their symptoms. These practices are most helpful in conjunction with talking therapy and medication.
We will list organisations below, supporting people dealing with symptoms of psychosis, schizophrenia and bipolar disorder.
Dealing with stigma
Sadly, traditional views surrounding psychosis, bipolar and schizophrenia are still in circulation. It can be difficult to advocate for yourself when you’re going through something like a mental illness. This is why we are working towards change.
Find your allies, people you can trust and online support groups. These can be valuable safe spaces to feel seen and safe.
It is important to communicate your illness, if you can, whilst you are suffering. Don’t be afraid to ask for time off if you are struggling to cope. Most universities and music colleges have deferral policies to allow you to take the time you need to finish your course.
More places to explore
