Everyone has a little bit of psychosis vulnerability, but not everyone develops psychosis. When someone does, often triggers can be identified (with the wisdom of hindsight) that have led to the psychotic problems. Not enough sleep, social stress or drug use, are common examples of triggers.
Visible and common triggers
Looking at many different patients and their psychotic experiences, gives us some insights about common triggers for developing psychosis. Identifiable triggers include:
- Drastic life events such as losing a loved one, divorce, relationship problems or losing your job;
- Lack of sleep;
- Pregnancy and childbirth;
- Quitting breastfeeding (with postpartum psychosis);
- Stress, such as from being under high pressure to perform at work/education for a long time, or from a build-up of personal problems that make you lose your grip on life;
- Drug use;
- Alcohol (addiction);
- Having no human contact for a long time (isolation).
Other illnesses leading to psychotic symptoms
Some illnesses are known to also bring about signs of psychosis. In this case these psychotic signs are a symptom of another illness and do not point to psychosis vulnerability in itself.
- Brain diseases like Parkinson’s disease, Huntington’s, and some chromosomal disorders;
- Brain tumours or cysts;
- Dementia (including Alzheimer’s disease);
- HIV, syphilis and other illnesses that infect the brain;
- Some types of epilepsy;
After one or more triggers, you could suddenly become psychotic. But in most cases, the psychosis appears not simply out of nowhere, but arises after a prolonged combination of circumstances, with a build-up of several risk factors and not enough protective factors (like cognitive ability, social resources, mental resilience). Finding out what your triggers are, and what is helpful for you, are important steps in your recovery process once you have realized your psychosis vulnerability.
Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. He is also Visiting Professor of Psychiatric Epidemiology at the Institute of Psychiatry in London. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare.
Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’.
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