What caused my first psychotic episode?

Hello everyone, I had a first psychotic episode when I was 19 years old in 2018. It lasted about a month and a half. Details of the episode and symptoms I had are in this post I made a while ago if you are curious:

I have been well since the episode without any relapse of symptoms and I stopped my meds about 4 months ago. I was on olanzapine 10mg initially then gradually dose was lowered.

I’d like to hear your opinions on what potentially triggered the episode. The actual diagnosis I believe was affective psychosis due to severe anxiety.

I am going to give my opinions on some possible causes and what my life had been like in the lead up to the episode. I’ll go into detail after I state a possible cause but you don’t have to read all of it if you don’t want to. Here they are:

  1. Possible early life trauma from having childhood cancer:

From the age of 3 until 6 I had leukemia that was treated with chemotherapy. I don’t have a full memory of that period but do remember being in the bed of paeds ward, getting chemo administered into the catheter that was put in my chest for the entire illness. I hated having to get blood taken from the back of my hands. I remember waiting with my mom before getting lumbar puncture surgery and the surgeons putting me under anesthetic for the surgery. I missed lots of school because of this. Personally at the time it didn’t feel too stressful but there’s a possibility it did traumatise me in ways. And of course it was a difficult period for my parents.

  1. Being totally obsessed about getting into medical school in the years/months leading up to the episode which put chronic psychological stress on myself:

In September 2016 I started my final year of high school and was determined to do well in my A Levels or SAT exams the equivalent for wherever you come from, essentially crucial exams to get into university. I was resolute in trying to get into medicine (or medical school for those in US) since the three years prior to then knowing well I’d have to work hard and sit an important medical aptitude test that would determine if I’d get in or not. So the entire final high school year I studied very hard. Gave up all physical exercise as I saw it as time wasted. Attended several tutors every week as well. Looking back my parents said I studied too much and didn’t have any balance. So the final exams ended in May 2017 and in June I got my results from the medical aptitude test. I failed it and was devastated but resolute on repeating it the following year in 2018. So in September 2017 I got my overall exam results and did very well and decided to take up a science degree in a nearby city’s university. I was in student accommodation with other friends from home who were going to the same university. I found it very hard having to share classes with other premed students, being extremely jealous of them. I didn’t really get to know anyone one in my class at the time either and was generally quite shy. The nights I would go out socialising and drinking with friends I would get into bad mood and feel very down and would often go home early. I had also started studying again for the medical aptitude test that I failed previously. By the start of 2018 then I stopped going to lectures,stopped socialising other than talking to my friend at night whom I shared my room with, stopped all exercising too with all my focus and energy on studying for the medical aptitude test. I would write affirmations every day and night saying I would pass the test and I would fantasise passing the test every night before falling to sleep. That non stop studying and lifestyle continued for about 2 months until the exam was over (which I felt I did poorly in again after due to test anxiety on the day). So after the exam was over there was still about 2 and a half months left of the college year. I came back with a bang, making a groupchat with all my friends and the new ones I made in the student accommodation sending in a huge message jokingly explaining a made up story why I had been not going out for so long and then invited them all for drinks. Anyways those 2 and a half months were pretty hectic. I was really enjoying life in general. Going out several times per week sometimes 3/4 nights in a row while drinking copious amounts of alcohol often blacking out not remembering how I got home. Probably going out too much but hey we were first years lol. Also stopped going to lectures as well and just spent time with new friends. Despite all this I continued to write my affirmations everyday that I’d pass the test and the whole obsession of passing it would be on my mind pretty much everyday. The results of the test wouldn’t be out until months later. Start of the summer came then just as the college year ended and low mood and anxiety just came on very suddenly and along with that came the psychotic episode.

  1. Not really a possible cause here but a potential contributor to triggering the episode: taking half a pill of MDMA for the first time about a month before the psychotic episode

Thanks for reading, all thoughts and opinions welcome :blush:

most likely biological factors , it is just sth wrong with our brain(body), not everything need /had a reason

SZ is a genetic disease if you’re not using drugs.
Its no one’s fault.

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I heard the voices in the music and cars

Genetics + environmental factors… Stress and trauma could play a part, sure

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And I thought people were following me

Hi, Jesse have you discovered what NLP and triggering and anchoring is yet, as having an understanding of it can lessen the chances of being triggered by some of the dark stimuli.

Biological? Can you name me some biological markers that have a bigger than 0.0% correlation with schizo, depression, etc? If an ilness is biological, it has to have biological markers with bigger than 0% correlation, same as alzheimer, progeria, etc. have.

You can read on Wikipedia. There are many genes that cause SZ. Some of them are known but the majority is not and there is no way yet to treat these genetic defects. I still believe you can rebalance brain chemistry with antipsychotics instead of modifying genes.

Name me a single gene that has a correlation bigger than 0.0% with schizophrenia. Like, if you take 10.000 people with schizophrenia and try to find a gene that is more prevalent in them than in a non-schizo population, one gene might pop up as being present in X% of the schizo group. As far as I know there is no gene with a correlation bigger than 0.0%. There are such corelations for other ilneses in medicine, but not for schizo.

There is no doubt that dopamine is above normal while in a psychotic state, but it’s not above normal prior to the psychotic episode or after. There are many paths through which a person can enter such a state. One path is that of delusion. Somebody starts with a simple conspiracy theory that gradually develops and eventually it ends up in a psychotic state. How did it happen for you? Did it start with a conspiracy theory/delusion, or was there a different mechanism at play that lead to a temporary psychotic state?

Are you a scientist or a psychiatrist? I would rather believe my psychiatrist who said its mostly genetic.
From Wikipedia:

“Estimates of the heritability of schizophrenia are around 80%, which implies that 80% of the individual differences in risk to schizophrenia is associated with genetics.”

“… deletions at 22q11.2, duplications at 16p11.2, deletions at 15q11.2. Some of these CNVs increase the risk of developing schizophrenia by as much as 20-fold, and are frequently comorbid with autism and intellectual disabilities. The genes CRHR1 and CRHBP have been shown to be associated with a severity of suicidal behavior.”

If you know so much about SZ can you explain me what these genes do and how to fix them?

Trust me you will make billions if you fix these genes!

I’ll touch on this once I’m done heat therapy.

From the same wikipedia page:

The largest most comprehensive genetic study of its kind, involving tests of several hundred single nucleotide polymorphisms (SNPs) in nearly 1,900 individuals with schizophrenia or schizoaffective disorder and 2,000 comparison subjects, reported in 2008 that there was no evidence of any significant association between the disorders and any of 14 previously identified candidate genes [RGS4], [DISC1], [DTNBP1], [STX7], [TAAR6], [PPP3CC], [NRG1], [DRD2], [HTR2A], [DAOA], [AKT1] , [COMT], and [ARVCF]). The statistical distributions suggested nothing more than chance variation. The authors concluded that the findings make it unlikely that common SNPs in these genes account for a substantial proportion of the genetic risk for schizophrenia, although small effects could not be ruled out.

It’s an intuitive theory, but so far zero gene correlation. Science means believing in evidence not in intuition. You can’t fix those genes if the problem is not due to the genes.

How it started? I started hearing voices at 16-17 y.o. until I tried suicide at 21 to end the vouces and was diagnosed SZ at 21.

And what is SNPs? A specific form of genetic mutation? There is many forms of genetic mutation not only SNPs.

And before starting to hear voices, what happened? Were you holding some unusual ideas? Were u having problems with self-esteem?

Your quote does NOT say that SZ is not genetic.
Your post makes no sense.

I took psychology courses at university and SZ is genetic, if you scan brains of ppl with SZ you will see that they have smaller and shrinking parietal lobes.

No, I had no unusual beliefs that came after and the hallucinations are caused by genetic defects of parietal lobe. Its responsible for processing perception.

It may or it may not be genetic. What concrete evidence do we have for it being genetic? I want to see X gene with X% correlation with a schizo population, same as we do for genetic ilnesses from normal medicine or from neurology. I want to see a percentage, something that ends in “%”, not “might”. “Might” is not the same thing as a percentage.

Why you believe its not genetic lol?
I took psychology, neuroscience, anatomy and physiology courses.

I know twins with PhDs in engineering, they both developed SZ around the same age and can’t do anything other than playing videogames.

Why did both get it at the same time?
Because of genetics.

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