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krostenvharles42 karma

Not OP, but I'm a therapist for people with severe mental health struggles. An important piece of mental health first aid is exactly what OP said - it doesn't really matter the diagnosis/symptoms, as much as knowing basic intervention skills that will help across the board: staying calm and patient, offering choice, keeping statements simple, being direct about options, not arguing with delusions, etc.

Specific symptoms of psychosis that an officer might see in an agitated person would be high levels of paranoia or beliefs of persecution; extreme grandiosity (ie: belief that they are God or on a special mission, belief they are famous); ideas of reference ("the tv talks to me," "that billboard is about be"); of course, hallucinations, typically auditory, which can look like talking to unseen others or just responding to something within one's head that others don't hear (giggling, intensely focused eyes, etc); beliefs in mind-control or that other people are taking their thoughts; and very high levels of fear and anxiety, because let's be real - believing any of the above things are happening would be pretty intense and scary.

I'm talking specifically about psychosis, because most people with mental illness in my community, who interface with police often, have an illness that includes psychosis. Personality disorders are a whole different ballgame (and I'm not an expert in them), but often look like extreme reactions to circumstances that seem relatively mundane. So extreme anger, irritation, hysterical crying, appearing to be totally irrational (with the absence of psychotic symptoms), etc. on a day where maybe the police were called for something like a noise complaint. The personality disorders that are most likely to increase police contact are here. More about psychotic disorders here.

krostenvharles3 karma

There are many things that contribute to mental wellness/illness, and schizophrenia has its own set of conditions. The fact that adolescent brains are rapidly changing does affect the development of many mental illnesses, including thought disorders.

Other factors are things like the social pressure of "growing up" (going to college, moving out, getting full-time work, etc.), rapidly changing friend groups as people come and go, genetic predisposition, environmental factors, substance use (which usually starts/picks up in the teen years), changes in hormones, and increased development in the prefrontal cortex (which is a part of the brain greatly affected by schizophrenia).

krostenvharles2 karma

Not OP, but I have my MSW and work with young folks experiencing early symptoms of psychosis, either before they have a full psychotic break, or during/after it. If you're interested in working with that population, I'd advise getting your MSW and focusing on direct human services (as opposed to community-based advocacy or administration (which were the other tracks offered in my program)). Assuming you live in America, the ACA has mandated that all states have an early intervention program. In my state, it's called EASA (Early Assessment and Support Alliance (check out easacommunity.org)) and it's fantastic. Such rewarding work, and we are always looking for new people who want to help change the stigma and increase hope around thought disorders. Please feel free to PM if you have any questions or just want to talk. I love my work and welcome the opportunity to share.

krostenvharles1 karma

The difference between them is subtle. Schizoaffective disorder basically means someone will have psychotic symptoms even when their mood component is not present. So it'd be like someone having cycling depression, but always experiencing some psychosis.

Having bipolar affective disorder, or depressive disorder, with psychosis means that their psychosis is linked to their mood, and they will not experience psychosis if their mood is stable.

Again, though, these definitions are semantic and real life rarely falls into such neat boxes. Making an accurate diagnosis is often very difficult (and, one could argue, largely unneccessary). Diagnosis is mostly for insurance/billing purposes, and treatment should always be tailored to meet an individual's needs.

krostenvharles1 karma

The classification of paranoid schizophrenia is from the last DSM, so it actually isn't used any longer. It used to mean a person living with schizophrenia primarily experienced hallucinations/delusions (as opposed to disorganized thoughts or catatonia). Now there is just schizophrenia, and the clinician is supposed to indicate primary symptoms. One of those symptoms is often paranoia. If someone with schizophrenia has a high level of paranoia, it does make the work more difficult, but not necessarily twice as difficult (that's hard to quantify, anyway).