Psychotic illness

This group of severe illnesses includes schizophrenia and bipolar affective disorder and can affect anyone, regardless of upbringing, social class or personal faith. There are effective treatments in the form of medication and talking therapies. For the more severe forms, social support is often necessary and the local church has a huge role to play here.

What is psychosis?

This broad term describes experiences that are outside the normal. This can include hearing/seeing things that others cannot hear/see (hallucinations), believing things that do not seem to be true (called delusions: these seem very true to the person) and having extremely elevated moods (mania). Schizophrenia is a specific form of psychosis where delusions and hallucinations are common. Bipolar affective disorder is another form where high moods can be accompanied by grandiose beliefs and periods of very low mood. Psychosis is far more than ups and downs in mood or the odd unusual belief – it affects every area of life.

What causes psychosis?

The first episode is usually in early adulthood, though it can start in the teens and, for some, later in life. Genetics seems to be a major cause, but it’s a complex mix of genes – never due to just one gene or one parent. Psychosis can also occur after using drugs, some medications like steroids, a head injury or an infection. It can even occur after an extreme life event, such as a sudden bereavement.

Can it be treated?

Psychotic illnesses are severe and need a combination of approaches. Medication is central and it’s important to find a suitable form with manageable side effects. Psychological treatments can help with understanding, preventing relapses and the anxiety that often accompanies psychosis. Social activity, including both everyday activities and also hobbies and fitness, bring a rounded recovery. Often treatment is necessary for many years and must also focus on rehabilitation and living a meaningful life, which is helped by having a faith.

What about faith?

When people become psychotic or manic, they become very involved in things – often those things they were into before in a more measured way. It could be computers, or politics; it could be religious things. People who have a faith can see this get out of control – reading the Bible or praying for hours, believing they are pure, or evil, or even God. This says nothing about their underlying faith: it’s the illness speaking.

With hindsight, times of psychosis can also be genuinely spiritually awakening, as people explore things very deeply. It can also be very scary, and God can be their only source of comfort. There are several examples of psychosis in the Bible – Nebuchadnezzar’s ‘madness’ in Daniel 4 is probably the most accurate description.

People sometimes seem to confuse psychosis with demon possession – but the psychotic illnesses we know today look nothing like the ‘demon’ encounters in the Gospels and should not be mistaken as such. We urge all Christian leaders to defer to the medical community in the treatment of psychotic illness. If you are supporting someone in prayer, do this indirectly. If praying with others, always do this in a way that protects the dignity and confidences of the person involved. When undertaking prayer ministry of any kind, refer to your Child and Vulnerable Adult Protection Policies and work within the parameters of your denominational guidelines.

Psychotic illnesses often leave people needing support. Friendship may be helpful, as there can be a tendency to self-isolate. Practical help with shopping and household tasks can also be needed. Your church has an invaluable role to play – ask the local mental health team how you can help.

Helpful links:

  • Rethink - the national charity for psychosis

  • If you’re psychotic, how do you know that what you believe is real? This article explores the topic:

  • If you or someone you know struggle with hearing voices, this article will help:

  • 1 in every 500 births will see a woman experience post-partum psychosis. Read this testimony and about the charity Naomi has set up:

  • This detailed testimony gives practical advice on what to do if you’re feeling up or down, a lot or just a bit: