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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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My daughter, 25, had a major pychosis last year. She absolutely

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My daughter, 25, had a major pychosis last year. She absolutely refused all medication and was eventually sectioned. She got rapidly worse in hospital and I believe this could have been a reaction to the enforcement. High doses of anti-psychotics and anti-depresants didn't help, she baffled the doctors and stopped eating, peeing, walking and opening her eyes because God was telling her to. She was admitted to a general hospital to forcbly catheterise the huge build up of urine. Then they used ECT and she rapidly improved. Her section was taken off, she made a good recovery, In May this year she fairly rapidly stopped all medication and started living with friends in London, she came to see me a week ago and is very withdrawn, depressed, preocupied, uncommunicative. She says she is not hearing voices but has troubling thoughts and does a lot of face-twitching and face-touching. Her CPN (who is very good) says that she must go back on medication or she will inevitably get seriously ill again. I know she will never take medication voluntarily. If they section her I believe she will get worse, she is trying very hard to keep well with yoga, meditation, eating well and exercising. My question is - is it inevitable that she will get worse and need to be sectioned? or can this illness be managed without drugs as long as she is taking care of herself? If she is able to function is it damaging to allow her to remain in this half-way condition? I am worried that any pressure from me or her CPN will make her escape back to London where I cannot keep an eye on her. Would it be worth getting St John's wort ? she will take herbal remedies and takes vit B complex.
Submitted: 6 years ago.
Category: Mental Health
Expert:  Dr John B replied 6 years ago.
Hi. I'm very sorry to hear your daughter is unwell. It is impossible to speak directly to your daughters specific case but I can give you some information regarding Psychotic illnesses that will be relevant. I realise how upsetting this can be and I apologise if what I write is too blunt - but it's important that I am clear about some important facts. It is impossible to predict whether a person will have a second Psychotic episode as Psychotic illnesses vary (massively) from person to person. If a person has experienced a Psychotic episode as a result of taking drugs then it is less likely they will have a second episode (assuming they aren't taking more drugs). If there is a family history of Psychotic illness then it is more likely a person will have a second episode. Regardless, when a person is first treated with anti-psychotic medicine it is common for a Psychiatrist to prescribe medication for a year after the episode even if there are no further symptoms. They do this just to make sure. Suddenly stopping anti-psychotic medication is extremely risky as it can (but not always) cause some serious physiological problems and can also induce another Psychotic episode. Often when people are experiencing a Psychotic illness they can go through periods where they are not acutely unwell (e.g. delusions, hallucinations, bizarre behaviour) but exhibit residual symptoms (appearing withdrawn, poor personal care, confusion, poor concentration) - this is usually considered to be a very serious sign that a person is unwell. It is also generally believed that recovery from a Psychotic episode becomes more difficult the more often they happens. The more acute episodes a person has the more likely they are to have more in the future. For this reason is extremely important that a person is treated appropriately. Unfortunately people often don't want to take anti-psychotic medication and this is frequently the major obstacle to effective treatment. St John's wort is used to help lift mood but when a person is having difficulty with Psychotic symptoms or they are taking anti-psychotic medication they should not take any kind of medication/supplement whatsoever without consulting with their Psychiatrist first. People with a Psychotic illness can sometimes react very differently to medications/supplements and it is therefore important that they are being supported by a professional. Can people sometimes manage themselves without medication? Yes. In some cases they can. However, there are many people who cannot and it is therefore a big risk to take. The prognosis for people who have a Psychotic episode can be very good but it is crucial that they be consulting regularly with a Psychiatrist. Being sectioned can be very traumatic (any major stress can impact on a Psychotic illness) but this (should) only happen when it is necessary. Often legal orders can be put in place that require a person to take medication whilst in the community. They can be required to attend a clinic to receive medication regularly and this can be the best approach for some people. I hope this has been of some help, please don't hesitate to ask more questions or ask for clarification of any of the points I have made. Best of luck.
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