One Man's Psychosis Was Triggered By 2016 Brexit Result, Says His Doctor

"Political events can be a source of significant psychological stress."

A man suffered a brief episode of psychosis triggered by the 2016 EU referendum, according to his doctor’s published case notes.

Writing in the BMJ Case Reports journal, Dr Mohammad Zia Ul Haq Katshu described how his patient, who remains anonymous, was taken to hospital by paramedics in an acute psychotic state three weeks after the June 2016 referendum.

The man, in his 40s, was said to be confused and agitated, with disordered thoughts and speech. He believed people were spying on him and planning to kill him. He also thought radio and TV discussions were targeted at him.

His doctor, from the Institute of Mental Health at University of Nottingham, has since warned that political events can take a serious toll on mental health.

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Psychosis is a term used medically when a person perceives or interprets reality in a different way from those around them. They might experience hallucinations, delusions or disordered thoughts, where they become confused. It’s thought one in 100 people will experience it sometime in their lives

The man in the BMJ case report recalled how he had daydreams which dominated his concentration. At other times, situations were brought to life through hallucinations or by him misinterpreting what he was seeing or hearing.

“Although each scenario seemed random, most of them were connected somehow in my own mind and all I believed to be real,” the patient said.

The man remembered lying on his bed on the top floor of his house with arms and legs spread-eagled. “I was convinced that one of my wife’s relatives was going to shoot a missile at me using heat seeking technology and I wanted to provide him with the best possible target,” he said.

“That evening I was paralysed by the choice of which bedtime story I should read to one of my children, because in my mind there was a right book and a wrong book depending on whether I would die that night or a subsequent night.

“This was in the summer of 2016 and, as well as my own anxieties about Brexit, it was also a time when a friend of mine was experiencing immense anxiety about what was happening around him in the US and we were talking together on social media about racial issues.”

“I started to believe that I was under surveillance. I remember my ears pricking up when a voice said, ‘he’s very observant!’”

Another time, the man said he was at work and remembered hearing the TV on in the background. “I started to believe that I was under surveillance,” he said. “I remember my ears pricking up when a voice said, ‘he’s very observant!’

“I remember driving and hearing the radio presenters talking about me as if they could see me and knew what I was thinking. Many times, during these scenarios, I felt quite petrified.”

The report details how the man’s wife told doctors he had found it increasingly difficult to come to terms with political events around him since the referendum result – worrying about racially-motivated incidents and having difficult sleeping.

Despite being prescribed drugs to alleviate his agitation and insomnia, the man’s mental health worsened and he needed urgent hospital treatment. He was admitted to a psychiatric unit, given the tranquilizer lorazepam to calm him down, and prescribed an antipsychotic (olanzapine) for three weeks.

The man made a full recovery and was discharged after two weeks, since when he has had no further episodes to the date of his last check-up in June 2019.

There was no history of mental ill health in his family, but in the run-up to the referendum he had experienced work and family pressures, both of which may have contributed to the deterioration in his mental health, noted his doctor.

This is just one case that applies to particular circumstances. Nevertheless, stressful life events are present in up to half of those diagnosed with an acute bout of psychosis, said Dr Mohammad Zia Ul Haq Katshu.

“Political events can be a source of significant psychological stress,” the doctor wrote, citing a US survey in the wake of the 2016 presidential election that found two thirds of respondents identified the country’s future as a significant stressor, while over half felt stressed by the existing political climate.

Comparable surveys in the UK since the EU referendum have shown that Brexit is a major sources of anxiety among the young, he added. One in three Brits believe Brexit has had a negative impact on their mental health, a survey by the British Association for Counselling and Psychotherapy (BACP) found earlier this year – and counsellors are witnessing this, too.

“Generally, Brexit is creating a lot of anxiety,” Lesley Ludlow, chair of the BACP’s private practice division and a counsellor of more than 18 years, previously told HuffPost UK. “It’s on the news all the time and I think people are feeling really unsettled.”

Those who are already prone to mental illness may be especially vulnerable, said the author of the BMJ case study. In this case, the patient had had a psychotic episode 13 years earlier, which had been related to work stress. This had been much less severe and he had recovered within a few days, but it suggests he may have been psychologically vulnerable, his doctor said.

Identifying the early warning signs of psychotic episodes, particularly during stressful situations, is important to ensure prompt treatment and quick recovery – which can lead to a better long term outlook and recovery, he concluded.

Useful websites and helplines:

  • Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
  • Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
  • The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk
  • Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.