A funny story about psychosis, in which I discuss Occam’s Razor

Let me tell you a funny story about psychosis.

I know, I know, psychosis is no laughing matter. It’s incredibly distressing to many who experience reality in different ways to the rest of us, and a huge source of stress to those that love them. What is also not funny, is that people with mental health issues and physical health issues tend not to be believed. They die sooner than people without mental health issues. They suffer greater tooth loss, diabetes, obesity, heart disease– you name it, people with mental health problems are more likely to die of it than most other people.

I would like you to refer to Occam’s Razor, at this point. Occam’s Razor holds that in the event of two conflicting explanations for an event, a behaviour etc, then without further evidence, the most simple explanation should be held to be true.

For instance, if a person with a mental health problem says “I have crushing chest pains”, the best response according to Occam’s Razor (not to mention common humanity) is to ensure they get prompt medical attention for the chest pains, ruling out any acute issues. It is not to think “well, this person has psycosis, so maybe rather than a problem with their heart, the chest pains must relate to anxiety due to the belief that the CIA are in control of their TV”. That theory is far more complex than the first, so it should be rejected.

In my case, I returned from the hospital after having my baby, spending time on the transitional care ward, then back to the post-natal ward as she improved. My return home was monitored pretty closely by the perinatal mental health team, who were concerned I might develop post-natal psychosis as a result of post-natal depression.

Why were they so concerned? I’m sure some of it was to do with statistical probability; but it probably didn’t help that I couldn’t drink much. Not talking about drinking alcohol- I wasn’t able to drink anything prepared at home. I was thirsty, but every time I raised a glass or cup to my mouth, I was overcome with the smell of urine and I would turn down the drink.

“Sorry,” I would say “I can’t drink this because it smells of pee”.

My other half had resorted to buying bottled water for me, which he would open in front of me ‘to convince me’  they weren’t contaminated.

Let me break it down for you. There were two competing explanations for what was happening here.

  • One was that my hypersensitive sense of smell (common to many pregnant and lactating women) was detecting the odour of urine and I was avoiding drinking tainted water to protect myself and my new baby.
  • One was that I was developing post pupereal psychosis, possibly with obsessive-compulsive tendencies related to contamination, or the belief I was being poisoned. I was having a psychotic experience, smelling urine every time I was trying to drink, therefore putting myself and my baby at risk of dehydration.

Which explanation does Occam’s Razor recommend we believe?

Which explanation would you believe?

Commonly, people with mental health problems do find that they can’t get people to take physical symptoms seriously. Assumptions are made with some regularity that either they wouldn’t benefit, wouldn’t be interested, or wouldn’t be prepared to change behaviour that leads to poor health outcomes. Similarly, there is some neglect of physical health systems during mental health treatment, as mental health symptoms can be prioritised. Additionally, many mental health staff may not have had any training in physical health issues, or be aware of the increased risks of physical illness in mental health services users.

I was in receipt of Home Care Services because I couldn’t dress or wash independently, I couldn’t carry the baby on the stairs, and I needed help with personal and domestic tasks. We subsequently discovered that the Home Care lady was consistently using the same cloths for cleaning the floor and the dishes. We assumed I was able to pick up the smell of urine from the use of the cloth on the floor (potty training big sister had lots of accidents to mop up).

Solution? Magic marker on all the cloths in the house, detailing each one’s specific use.

Bingo. No more “psychosis”. If only all mental health issues were so easily treated.

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2 Comments

  1. Seriously she was using the same cloth fr floor and dishes without washing them?! Would she do that in her own home.

    I can only imagine how sick you must have felt smelling urine. The brain is an odd beast.

    Reply

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