Peter

Age at interview: 24

Brief Outline: Peter experiences intrusive self-critical thoughts that can be so invasive that he cannot hear others talk. He has had depression and anxiety since his early teens and has social paranoia and delusions. He has not sought a diagnosis.

Background: Peter is single and describes his ethnicity as White British. He has graduated and is unemployed.

More about me...

Although Peter has always had depression and anxiety, he only started having counselling while he was in his second year of university after his father passed away. At the time he began having very invasive negative thoughts, hearing his “own voice”, which he could not stop. He also felt very paranoid, particularly in social situations, and had delusional thoughts that people were out to get him. The counselling he received focused on his grief and he did not mention the invasive and delusional thoughts to his therapist at the time. Later, when he was studying for a masters degree the paranoia and negative thoughts returned. He was spending a lot of time alone working on assignments and would find himself “talking back” to the thoughts. 

For Peter, the invasive thoughts, delusions and paranoia are particularly prominent in social situations and he continues to experience low self-esteem. In particular he worries a lot about what others will think of him and finds it hard to stop self-critical thoughts. Although he thinks this may be a common thing, his experience is on the extreme end. For example when he is speaking to someone on the phone, he hears his own voice telling him “that sounds stupid… you sound like an idiot”. These thoughts can be so invasive that he cannot hear what the person on the other end of the phone is saying. 

While he was studying for his masters degree Peter was offered CBT group therapy for anxiety. While he found it helpful having someone to talk to he didn’t think that ‘anxiety’ accounted for all of his experiences. Around this time he was interviewing people for a dissertation about the effects of talking therapies, and some people who had psychosis talked about experiences very similar to his own. As he researched mental health further, and met others with mental health experiences through volunteer work for a mental health charity, he began to think perhaps he had depression more at the extreme end, like bipolar disorder. When he researched online he found that his paranoia and the intrusiveness of his negative thoughts seemed to fit exactly within some parts of the definition of psychosis. It made him feel this was a “genuine issue” rather than something everyone has.

Peter doesn’t tend to see his GP about mental health issues and only mentioned his depression by chance a year or two ago. He has, however, seen his GP about a persistent stomach ache, which he thinks may be related to his anxiety. One of his GPs said that he could take medication for his anxiety and depression, but that he would have to take it for a long time. He would prefer not to take medication because he is afraid he would end up taking it indefinitely, and because his mother takes medication for depression. He has never mentioned his belief that he suffers from psychosis to his family or to his GP, or even to people in the mental health community, because he sees there being a presumption that people who experience psychosis are more of a risk compared to people who have anxiety and depression.

He can’t think of there being a time in the future when he won’t have intrusive thoughts but he is hopeful that in the future he will get support through counselling.

Peter has not been to see anyone about his experiences but when he heard the stories of others who had experienced paranoia, and other similar experiences to him, he began to self-diagnose.

Well, two things really. I suppose firstly I was doing - they asked us to do a dissertation which was, my masters was in social research. So you can research any area of society as long as you can relate it to something sociological.

Right.

So I started to think - I’d already had thoughts that I could do something mental health related. Something based on therapy, and mine happened to be on CBT for people who’d had various different issues. And they would - I would interview them, and they would talk about various different things. So they wouldn’t, often they wouldn’t have just had CBT, but they’d have had other things as well like DBT, or they might have had counselling therapy, or taken medication. And they would say CBT is good for this, but it’s not good for something else which I’d had. And I think one or two of them had even mentioned sort of having paranoia, and having psychosis, and having thoughts where CBT wouldn’t be. So I was starting to think ‘oh actually, maybe I’ve got something similar’. Because what they were talking about was very similar to what I had been going through.

Right. So you identified with their description of the sort of paranoid thoughts?

Yeah. I remember one person in particular had mentioned having paranoia and sort of. I remember thinking - you know, I didn’t really think. Maybe I should have done, but I wasn’t really thinking paranoia was something that you would necessarily relate to your mental health. Obviously it seems quite, like common sense almost, to relate it to something with thoughts. But I was kind of, before that I was probably thinking that paranoia is just something people get. And then, you know maybe I had it a little bit more extreme than other people. That maybe it was just something you go through, with anxiety. So - I think that sort of influenced me to try and seek out something about it. And then when I was - After university had ended, or around about that same time I started doing volunteering with people.

Okay.

And you meet - I met like eighty-odd other people. And there’s a lot of other people who have had very similar experiences. And at this kind of point, I was sort of thinking - I was self-diagnosing with quite a few different kind of things. So I remember just basically looking online, because I’d always done that anyway, and several years ago I’d looked sort of online and found out about things like not just depression but also other issues, which still are still - people are a bit uncertain around. Even medical professionals. So there’s kind of like de-personalisation, and things like that. And I’d started to, started to think more about kind of depression at the extreme, more extreme end. So like bipolar disorder and maybe whether it was something, maybe I’d got one of those type of issues. Like something you can kind of put a name to almost, rather than just calling it depression. And then I came across sort of, I thought well I wonder if kind of like, people have had experiences of having thoughts running through their head constantly, and finding it difficult to get rid of them. And sort of having paranoia and all these kind of things. And that’s when I just started to search online, really. And found - I think it was just the NHS website saying this is what psychosis- well it was - it got me onto the page of psychosis, where it was talking about - because it had been talking about delusions and hallucinations, hearing voices, and. Yeah, it got me onto the page of psychosis, when I was thinking - kind of looking through it and thinking ‘well I haven’t got that necessarily, but this seems very similar, or exactly what I’ve got'.

Peter’s thoughts are like a “running commentary” that make it difficult to concentrate or have a conversation with someone on the phone.

And so I’d always had kind of depression and anxiety. But I’d never really sort of noticed how deeper it went, or kind of how much worse it got during this period. And so I think it was during this time I started to notice things like voices in my head. My own sort of voice became a lot more vocal in my head. I started to talk, talking to myself a lot more, and started to hear my own voice doing like a running commentary a lot. Yeah. A lot of the time it was mostly at night time as well, when you kind of, lay in bed trying to go to sleep and then you can notice a running commentary in your head. But yeah, it was probably just during this period when I was kind of noticing it more. But not really at first thinking of what to do about it. Because I’d always kind of heard about things around depression and how it can have - sometimes they call it like intrusive thoughts. Things like that, or. And I’d always just kind of assumed I suppose that most people had kind of a running commentary, or had their own voice talking to them a lot. So I didn’t really sort of think of it as anything too serious, just something to kind of go through with. I suppose sort of until about a year ago, probably while I was at a different university. I started to notice it a bit more because I was kind of going through a difficult time at university. Yeah, while it was sort of - I was noticing a lot more kind of thoughts going through your head, and kind of related to things around paranoia. So kind of a lot of delusional type things. Like hearing voices and things like that. So I was noticing that more, and I was thinking 'oh, this is getting - seems to be getting worse', as an effect of stress.

Peter suffered depression and anxiety for years which got worse after his father died, and he began to notice his own “voice become a lot more vocal” in his head.

So I think probably maybe a couple of years ago, while I was still at university. I kind of - I think a few years ago I’d entered sort of a deep kind of depression episode. Due to various different things, but also kind of around my Dad die- passing away, about into my second year. 

And so I’d always had kind of depression and anxiety, and. But I’d never really sort of noticed how deeper it went, or kind of how much worse it got during this period. And so I think it was during this time I started to notice things like voices in my head. My own sort of voice became a lot more vocal in my head. I started to talk, talking to myself a lot more, and started to hear my own voice doing like - yeah, like a running commentary a lot. Yeah. A lot of the time it was mostly at night time as well, when you kind of, lay in bed trying to go to sleep and then you can notice a running commentary in your head. But yeah, it was probably just during this period when I was kind of noticing it more. But not really at first thinking of what to do about it. Because I’d always kind of heard about things around depression and how it can have - sometimes they call it like intrusive thoughts.

Peter hasn’t told anyone about his experiences of psychosis. He doesn’t feel he could explain his complex experience to his GP in a 10 minute appointment and anyway doesn’t want to take medicine.

In a way I think if I had more sort of courage I suppose to pursue, to go to the doctor and say "I’ve got this." In a sort of way, with self-diagnosing, you kind of think to yourself, 'do I really need that sort of validation' or 'do I need somebody to say you’ve got this', and they might not necessarily understand. Because it is complicated, talking about it, and it is complex talking about them. And doctor’s appointments are only sort of short things, well they're only usually about ten minutes long. So trying to get it - trying to talk about everything at once would kind of be hard. And with the thing of not wanting to have medication necessarily, I’m sort of averse to doing that, although if it was something that they really wanted me to do - I suppose the having the label does kind of matter, because it would kind of feel like, 'this is the issue you’ve got'. It’s official that you’ve got this.

And now you’ve got medication for it, it kind of feels like - if you’re pursuing therapy for it, it’s kind of like 'you’ve got this issue, this is what’s going to be used to treat it'. But on the other hand, I don’t know if I’d be sort of that confident with saying to people, particularly family, that I’ve gone to the doctors and they’ve said, "You’ve got psychosis." Or, "You’ve got clinical depression." Or something like that.

Peter went to group therapy sessions. He describes a session where they were told to accept intrusive thoughts and instead of challenging them, to “let them pass through”.

I think there were different sessions. So, some were based on anxiety and some would be based on depression. And I remember going for like - they called it, well they called it cognitive behavioural therapy, CBT. And it was a group-based therapy. So there would be about six or seven of us, and I can’t actually remember if it was supposed to be based on one thing or another. I remember going to like a triage session where there would be like seeing if you were a suitable candidate, if you like, for the therapy. And I remember at the triage session she said, yeah, she’s talked about me, about what I’d been through, and I might have mentioned thoughts. I think I talked a lot more about depression, and I might have mentioned thoughts and feelings as well. But in that, they sort of covered what they would call I think, I can’t remember if they called it intrusive thoughts, but they dealt with like what you can do with thoughts when they pop into your head. And I remember thinking, or I remember the big thing was that she said that when you get these kinds of thoughts it's probably more important or better for you as a person to just let them pass through a lot of the time, rather than challenge them, or attack them. But she was saying it was more to do with recognise that they are there, and accept that they are there, and then just sort of quietly let them pass through. And then think, and then try and change your thought pattern, by focusing on what’s actually - on how it might be false. Things like that, or. But not necessarily challenging it, which is what I would tend to do. So yeah, I think a lot of the time I would sit at home a lot and, when you’re sort of on your own a lot of the time, you sort of go through your thoughts, and you develop sort of delusional thoughts which you kind of - it’s sometimes difficult to kind of say they’re wrong.

Peter hasn’t spoken to anyone about his “intrusive thoughts” as he is wary of the stigma around psychosis. He uses social media, with care, to talk about his experiences to others within the mental health community.

One thing I'll do is be kind of careful with social media. A couple of my family members are on like things like Facebook whom I’m friends with, but I’m always like more sort of - a little bit more vocal about mental health and my own mental health.

When it was - I don’t know if I can mention this, but the organisation ran a day where you are encouraged to talk about things, and that was just last week.

Time To Change. Yeah that’s okay to say that.

Yeah, Time To Talk day, yeah.

Yeah, Time To Talk day.

Yeah. Yeah they ran a Time To Talk day, which was last week. And I was careful not to post too much on Facebook where members of my family are on. And I was more sort of - because they were encouraging people to talk about, and have conversations, I had posted more on a different social media. So I was on Twitter. 

Okay.

Posting where people from my family can’t see what I’ve posted, and where its people from the volunteering from Time To Change who can see it instead.

And how was that sort of, twittering about your experiences?

That felt okay, yeah. I didn’t put too much in there, but I was - It was kind of similar to doing the testimony training thing. Which is one of their training things, where you do like a 5-10 minute talk, intended for like schools or workplaces. Where you talk about - like give a timeline of how, of your mental health.

And that I always mentioned a lot more. I always felt better reading it out. I didn’t feel confident reading it out at the actual training session, but the woman - the person running it said, "If you want to, we can arrange a phone call and you can try and read it out to me over the phone." Which I did, and I felt better for doing that. And that was kind of similar to going on Twitter and writing about it. Neither of them kind of mentioned psychosis, because I wanted to focus on more the depression and the anxiety side of things.

Yeah.

But I think there is still that kind of thing inside of me, stigma inside of me what kind of says depression and anxiety are okay-ish to talk about to people.

Okay. Yeah.

But maybe when it comes to talking about thoughts and when it gets on to things like paranoia and psychosis, kind of - I’m a bit more reluctant to mention them even to people in the mental health community. Because it’s maybe - I see it as something a bit more - like I don’t know, maybe it's seen as something where you’re more of a risk or something.

Since he left university, Peter has found it hard to socialise and thinks his self-critical intrusive thoughts make it harder for him to trust others.

Does it affect how you socialise, going to do hobbies, or?

Yeah. Yeah, because I’ve kind of got into a, a thought pattern now of, kind of because I’m not doing anything in particular, or anything big, or yeah, definitely affects me sort of like that. Because I have - not necessarily purposely, although maybe I have done, where I have sort of distanced myself from people and not - Because you don’t see people on a regular basis anyway, it’s kind of easier to sort of lose contact with people. And, yeah. [siren in the background] I’ve kind of not so much gotten to that point of giving up contacting people, but sort of just kind of like - you get that sort of 'why bother' type thing, and. Yeah, I definitely haven’t met up with people as much, or done social things for quite a few months really. For a while. With sort of the exceptions of graduating. But yeah, I definitely think it kind of affects relationships, as well.

Right.

I think it definitely affects your trust in people, and things like that as well. Yeah. I think it makes me sort of not do things, if you put sort of a simple term on it like that. It makes it a lot easier to say "I’ll just stay at home and do nothing, or just do this," if I can’t be bothered to do something.

It makes it a bit easier to say no to people and stuff, you know. 

Peter was already feeling low when his father died. The “shock” of losing a family member made his brain “zero in on” his negative thoughts about himself.

I just - I think maybe, they’d always sort of - I'd always kind of had running commentary in my head, and thoughts what go through your head, when you're kind of anxious or nervous and sort of, or feeling low. When you’ve got a low mood. And sort of your brain tells you that you’re not worth anything, or you know, you’re not sort of, yeah. And I - maybe when that grief came, it kind of zeroed in on it a bit more. I think just the shock of it all happening, and then the sort of - maybe there was a thought, thoughts of kind of like, you know. When someone passes away close to you, there’s suddenly that thing of, somebody who had seemed like kind of - yeah, you kind of get shocked a bit because you kind of expect people close to you like your family to always be there. 

Peter has not sought help or counselling about his intrusive thoughts and can’t imagine not having them in the future.

I can’t really see a time when I won’t have thoughts going round in my head. Probably there might be something where people have said, "I’ve had therapy," or "I’ve had medication for it and it helps lessen them. And it helps do this." But I’m always, with it being a mental thing as well, I’m always a bit reluctant as to whether it is still something that needs to be treated, or whether it is still something which most people have got. I think - I can’t really see myself not having the thoughts, but I think maybe I’m hopeful of kind of trying to look for some sort of counselling. 

I haven’t really looked that much, yet. I know obviously about kind of local IAPT services, I know you can look online and try and find services through the NHS. And I know how difficult it is to get services for that. I’m not sure I would feel confident still going to the doctors and pursuing kind of therapy for it or anything, or medication. But maybe that’s something I should think about doing.