Psychosis
Views about causes and triggers for mental health problems
Most people thought there was no one single cause of their mental distress. However, they could discuss events that played a role in their mental health problems, as outlined below. Other people weren’t so certain and wondered why they had developed serious mental health problems. Research also suggests that a number of factors may interact to contribute towards the development of mental health problems, such as physical, social, environmental and psychological factors
At the same time, doctors, service user groups, researchers, mental health charities and counsellors often disagree with each other about what causes psychosis. Possible physical causes for problems include people’s individual genetic make-up and the ways that this might put some people at more or less risk than others. Some experts think that the misuse of substances like cannabis can result in mental illness, or even that viruses like the flu can affect a baby’s development in the womb, and later influence their mental health.
Underlying factors can include poor attachments in early childhood and dysfunctional families. People living in a deprived neighbourhood are more likely to experience problems. Traumatic events in particular - such as child abuse, the experience of racism, sexual abuse or homophobia - can also be linked to mental health problems. Significant life events like relationship breakdowns and work stress can precipitate mental health problems.
People also mentioned things that could reduce the chances – or impact - of mental distress. Having good relationships with parents in early childhood and strong social support later in life appear to be significant protective factors. For discussion of these complex issues see websites for Rethink, The Hearing Voices Network or The Institute of Psychiatry, Psychology and Neuroscience (IoPPN).
Not everyone spoke about traumatic experiences in their childhoods; in fact several people described their childhoods as ‘happy’ or ‘normal’ (for more see ‘Childhood and life before diagnosis’). However, many people said past trauma in their lives had contributed to their problems. Several people we spoke to had experienced emotional, sexual or physical abuse when they were children, including being the victims of severe bullying. They reported abuse perpetrated by family members, child minders, or priests. Dolly’s father had left her alone in a vulnerable situation, and she had subsequently been sexually abused. Other difficult experiences included being brought up in institutional care, or having a parent with mental health problems or who misused alcohol.
Pete started to hear voices at the time he was sexually abused by a child minder, but he was...
Pete started to hear voices at the time he was sexually abused by a child minder, but he was...
Ceridwen's grandfather sexually abused her and she has only recently realised how serious this was.
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Ceridwen's grandfather sexually abused her and she has only recently realised how serious this was.
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I’m supposed to be having psychological counselling at the moment, but it’s not happening. Because I was abused when I was a kid by my grandfather, severely. And I’m supposed to be having counselling for that, but they don’t seem to care enough. I’m almost at the point of giving up on them and finding someone else. The psychology at the hospital is, there’s not, there’s no regular appointments, no apparent continuity of care. I, I don’t need that. I’m going on the 10th December I think I’m going to say, “Thanks but no thanks. I’ll find someone who’s regular and reliable”. Because I don’t want to be messed about, you know, if you’re going to talk about something so horrible at least give me some continuity of care.”
And have you found anybody else you can talk to ….?
Not as yet, but I’m looking at it, on the internet, I’m looking for people, because I do need to talk about it. But I need to talk about it with someone I can trust to talk about it. Does that make sense?
Yeah, absolutely. And have you always wanted to find somebody to talk about it or is this recent…?
No, I bottled it up for a very long time. And it recently hit me, just how bad what he did was. Because he told me he loved me. And I believed that, and I associated love with pain. And then I, over the last three or four years, well he may have loved me, but it was a twisted form of love. It’s not right, it’s not normal. And that’s not okay, and you need to talk through that and make sure that you know that someone loving you does not involve what he did to me. And I do find, I find relationships very, very difficult. I had a boyfriend at Uni, and he just, I couldn’t cope. Because I couldn’t fathom a normal relationship in my head, you know, and I need to [3 sec pause] to work through that. I know that what my granddad did wasn’t normal, but sometimes in your head you think, well he did love me. Do you know what I mean?
Rachel said she developed anorexia as a result of being sexually abused by an elderly uncle, and that her mental state rapidly deteriorated after that. Dolly said her dad was a ‘monster’ who physically abused her and her siblings, and left them vulnerable to later sexual abuse. People said it can be difficult to get proper professional care for the psychological aftermath of abuse.
Two members of Kirstys family sexually abused her, and she was shocked; the psychologist and...
Two members of Kirstys family sexually abused her, and she was shocked; the psychologist and...
The thing, what had happened when I was younger, and I was being abused, was, I would pretend I was dead or it wasn’t happening to me, and I wasn’t there. And that, so it was the same survival coping mechanism or whatever, that helped me out with the hallucinations. Hm.
And was it abuse by a member of your family?
Yes. Yes. Two, two different members and that so. I mean obviously as a child I thought I was being persecuted and I thought it was only me, and I mean it wasn’t until some years later that I realised there was a word for it at all. And unfortunately, the... the psychologist that I’d had when I was younger, and I was having behavioural problems at school, it would appear that she breached confidence, and I got, backlash at the dinner table that night. And that just completely blew, blew any, any trust or rapport, or, you know, chance of sorting things out then. And then later on, when I came out to live with my Mum, and I spoke to the psychiatrist briefly about had happened, he was just, in my mind, I mean I know there’s a better awareness of it now, but in my mind, he was completely negligent, he just said, “Oh, you know, so you’re not scared of the sight of a stiff prick then.” You know, because I told him that my sex life was a bit like Piccadilly Circus, you know, where I’d become promiscuous and that. And you know, I mean I see now that its completely irresponsible of him, you know, because it’s a, it’s a destructive behaviour and that, you know, but... yeah. I’d been let down, you know, I’d been let down by the immediate authority, the people who are supposed to protect and provide for you, and whatever, you know, and also the bureaucracy, you know, proper authority and that, so … I’ve, you know…
Garys childhood was very difficult - his parents fought all the time, he was sexually abused and...
Garys childhood was very difficult - his parents fought all the time, he was sexually abused and...
My Mum is an obsessional, my Dad was in the Army for a long time. And he came out of the Army like and was told he’d never work again because he had something in his brain that made him black out all the time. So he became an alcoholic.
When I was growing up. First of all I got mentally bullied by children at school. Then it became physical, [tch] then it became quite extreme. Where I was getting beaten every day. Some of the things they used to do me, because like, because I don’t like heights, they were dangling me off like a cliff or they would beat to the ground and then like urinate over me. So I’d have to go home smelling of urine.
So my life was, I’d wake up in the morning. My Mum and Dad would be shouting at each other. My Dad would become drunk… I’d go to school. I’d get beaten at school. I’d get beaten after school. I’d go home and my Mum and Dad were like shouting at each other. I’d have to go out and play with kids that were supposed to be my friends, so they would beat me again. At weekends, sometimes my Dad used to sexually abuse me.
I didn’t have any escape, apart from reading. Sorry, this is why these things are so precious to me. All my friends are dead, Walter Benjamin, Spinoza, C G Jung. They’re all dead, but this was my only escape. I started to read story books at first, but I couldn’t read them. I don’t know. I couldn’t, I still don’t understand why, but I couldn’t read storybooks, I couldn’t get involved in reality.
Naveed talks about many different reasons for his difficulties, including mental illness in his...
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Naveed talks about many different reasons for his difficulties, including mental illness in his...
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My mental health problems… because they’re triggered off by something or something happens, but some people have them genetically and it’s genetic. It runs in the family so… I mean on my Dad’s side, even on my Mum’s side like one of her brothers used to have mental health problems. He’s also had epilepsy as well. And on my Dad’s side, and I think it’s skipped one or two generations, but I ended up with it so.
And what do you, I mean you’re saying what the doctors think of what causes your experiences, what do you think?
I think I was born with it you know, only people like this, you know, is born with the condition. And life’s events sort of made it worse. You know, so I already had it, you know, but life’s events sort of adds up to it, and makes it worse. Especially the bad experiences. Because I mean I can sit here, and I can stand in front of people like. I could tell them stories, like, and you could write novels like some of the bad things that have happened. Some of the good things that are quite touching like, you know, and some things that you don’t know whether to cry or laugh you know. But I just think that yes, I was born with the condition and life’s sort of added to it and made it worse, you know.
So what things have added to it that have made it worse?
Others felt they had been neglected or had been through other troubles, e.g. lonely childhoods, relationship problems.
Johns dad was a heavy drinker and his mum had bipolar affective disorder. He was brought up...
Johns dad was a heavy drinker and his mum had bipolar affective disorder. He was brought up...
What was life like in care?
It was quite tough. It was quite tough. Because yes, I mean, when I first went into care it was okay. I was living in a children’s home in [place name]. Life up there was okay. But when I moved to the children’s home in [place name] it got a bit more difficult. Because there was a kind of, there were kind of different children, who were a bit more hard edge and tougher, and I learnt to kind of stand on my feet pretty quickly and there was enough, you know, there’s always a hierarchy within children’s homes, and because I was the new guy, they wanted to know how tough I was and I was picked on and bullied quite a bit and then it got to the stage where I could kind of stand up for myself and I got into a few fights there and so yes, it was quite tough. But it wasn’t, you know, don’t get me wrong, it wasn’t like I was fighting seven days a week. It was just that yes, it could be quite difficult at times and it’s not an ideal situation for any children let’s put it that way. You’re removed from your family, you know, with your brother and sister and everyone so it’s not, it’s not easy.
Some people said that the death of a close relative or friend in their childhood had triggered their problems. A couple of people found that their mental state suffered at each anniversary of the death. Devon, a musician, thought that mental illness sometimes occurred when creative people couldn’t express their creativity properly. Karl felt that somehow black people’s experience of slavery had been passed down in their genes. However he rejected West Indian herbal treatments thinking they would not tackle the cause of his problems.
Devon had broken down while grieving for his granny and not looking after himself. He thinks that...
Devon had broken down while grieving for his granny and not looking after himself. He thinks that...
Robert thinks that his dad's death, his own drug taking and his daughter's death in distressing...
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My childhood was, I suppose you’d call quite normal really. I went to Catholic schools, and you know. I suppose everything went downhill from about my last year at school because my old man died pretty much in my arms when I was about 15 years old like. Ah of course that didn’t give me a very good start.
I didn’t bother with school after that. I did …never bothered turning up like [laughs]. Got into drugs, as you do, and starting drinking and hm. I suppose from there, that’s all I’ve done for years is drugs. You know, and it…and as I say it relates to my mental health. If I knew then what I knew now, I’d have chose a different path. But hindsight is a funny old thing isn’t it?
Yes.
I suppose the mental health side of it, didn’t really appear until sort of... about sort of four or five years ago. I’ve always been one... years ago the drug used to be called Speed. But now they’ve changed and it’s called methamphetamine. And the psychosis involved in it alone is frightening.
I suppose the death of my daughter didn’t help much. Because when my daughter died like, I was married at the time, right. And I spent I don’t know fourteen years with my wife like. And we were pretty close like. But we just went that way. Like just couldn’t live with each other. Couldn’t you know. I mean to say even now she’s like. I suppose I go and see her like. Still be a good friend like. But it destroyed us. Absolutely destroyed us.
And I suppose some of the mental health things come from round about then. Because I just started drinking and you know, you just go… drinking and drugs like that’s all I done for months and months and months to try and get my head around it like. And of course after that as I said about the police knocking on me door. That didn’t help much. I remember being sat in me front room with my mate, [name], and this bloke walked down my steps in a suit, and before he put his foot on the second step I knew he was a copper. Child Protection Team. And that’s didn’t help. That didn’t help at all. That took me years and years and years to get over. It’s, I used to drink and get in fights and end up in jail and, you know, but its just one of those things. Its just one of those things that. I don’t know I just couldn’t get me head round I suppose. How someone could be so... I don’t know. Nasty? That doesn’t even go, describe the way I feel about it.
I suppose that didn’t help. Because you get into drinking and you get into drugs and things just start slipping.
Tim thinks that schizophrenia isnt caused by bad families and that he had a good relationship...
Tim thinks that schizophrenia isnt caused by bad families and that he had a good relationship...
And you were saying that they tried to take you away from your Mum?
Yes.
Who had tried to do that?
Doctors they thought it was bad for me. You see this is the stupid 70s theories, like R D Lang and all that nonsense about schizophrenia being caused by bad families or upbringing. Well if schizophrenia is caused by bad families, so their all relative bad families and it’s crazy it doesn’t happen like that. And also if schizophrenia was caused by family, what about my brother and sister. They haven’t got it and they had the same upbringing. And now they tried to force me away from Mum, the doctors. They thought it was bad for me. But I loved my Mum and for 23 years we went to the same bed and breakfast down in Cornwall near place called [place name]. you know, [place name]. I adored Mum and she sacrificed her life for me. She could have got married again. She was an incredibly beautiful woman, but she decided to take care of me. She was a family woman.
Janey talks about being a molecular biologist, her understanding of genetics and her experiences...
Janey talks about being a molecular biologist, her understanding of genetics and her experiences...
I, well having a background as a molecular biologist, I think there’s definitely a genetic component, but also there is an environmental component and there’s a lot of research done at the moment in an area called epigenetics, where environmental components can change the way the DNA expresses. So even if you have a perfectly reasonable gene anywhere, if you do certain things then you can actually get that gene switched off. And that’s why they see things passed down through generations. Heart problems especially. So mothers who do things wrong in pregnancy pass it on to the children, who will have that gene switched off, and of course if it’s behavioural, if you’ve got behavioural genes switched off you’re going to be doing the same sorts of things. And so then it just passes on down the generations. So looking for genes is a complete waste of time as far as I am concerned. And some of the research I’ve seen would support that. It would probably make a lot more sense to have a look at environments, especially growing up, and perhaps during pregnancy as well.
And I guess relating that back to you? What do you feel about your environment, growing up and so on?
I’m not sure how much I messed myself up smoking cannabis at university.
I didn’t have an easy childhood.
But my sister and brother got through it okay. So... so… I really don’t know completely where it came from. It’s a difficult thing to sort out.
As well as talking about possible causes of mental health problems, people also talked about experiences that could make them feel worse, like experiencing rejection or feeling stressed by something (For more see ‘Strategies for everyday coping’).
Andrew has a predisposition to psychosis and describes several stressful life events.
Andrew has a predisposition to psychosis and describes several stressful life events.
Whatever explanations and understandings people reached in their own lives, most people thought that the causes for mental distress were complex and poorly understood.
Last reviewed July 2017.
Last updated April 2014.
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