Q. Recently I feel like I’m going a bit mad. I was diagnosed with borderline personality disorder a couple of years ago but even then i thought the diagnosis was a bit off as I don’t personally think I fit the criteria. I am not particular compulsive and I don’t have abandonment issues among other things. I was prescribed a number of different drugs and saw a psychologist for a while. I was hospitalised under a section a little while later and when I was released, the section papers said I had a personality disorder, depression and schizophrenia. This was never mentioned to me by any professional so I came to the conclusion that, although they suspected this, it wasn’t the diagnoses on discharge.

Recently though, I’ve found myself getting extremely paranoid that agents are watching me because I did something wrong with my brain. I keep seeing shadows that apparently aren’t there and the voice in my head has returned with a vengeance. I’m also more depressed than i ever have been to the point where i don’t actually want to be here anymore. The real problem is that I am a student psychiatric nurse in my final year and i’m scared to tell anyone because i recognize that something is not quite right but if i tell the authorities then five years of study will have been wasted. I will not be allowed to register. probably quite rightly. I wonder if there is anything i can do to help myself and see if i can’t do this without involving anyone else?

A. I am not familiar with how the mental health system functions in your country. Is it true that if you sought help for your psychological problems, your school will be alerted and you would not be able to return? In the United States, if an individual receives psychological treatment confidentially he or she is not obligated by law to reveal this information to their school or employer. You might want to check the laws in your country to see if they engage in a similar legal practice of confidentiality.

You said that if you sought help for your increasing psychotic symptoms (paranoia and voices are symptoms of psychosis) that you might not be able to register for classes. You then made the statement that if you could not register for classes that it might be “probably quite rightly.” I assume this to mean that at some level you truly know that you are in need of help and that maybe attempting to attend school at this time might be an unwise idea. If you are experiencing symptoms of psychosis as well as depression so severe that you are thinking about suicide it is going to be extremely difficult to attend to school work and perform your duties as a nurse.

Furthermore, as a nurse you may be interacting with patients. If you’re psychologically unstable, it may not be safe for you to be caring for patients. In addition, by continuing to care for patients while you’re experiencing paranoia, voices and suicidal thinking, you may also be violating a nursing code of ethics. Your current mental health instability may endanger the lives of others. Because of this you may want to strongly consider delaying your return school for a short time while you seek treatment.

The sooner that you seek treatment the faster you can return to school to complete your nursing program. In addition, with treatment you may prevent a full-blown psychotic episode as well as possibly decrease the likelihood of having to return to the hospital. It seems that you have sought treatment in the past and it did not affect your nursing program. I would strongly advise that you seek treatment again and do so promptly. Based on your letter, you may be in the midst of psychosis and if caught early enough and treated you may be able to thwart a full-scale psychotic breakdown or hospitalization. Thanks for writing.

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Last reviewed: By John M. Grohol, Psy.D. on 11 Aug 2008

APA Reference
Randle, K. (2008). Student Nurse with Psychosis Problems: How Can I Get Help?. Psych Central. Retrieved on November 26, 2014, from http://psychcentral.com/ask-the-therapist/2008/08/11/student-nurse-with-psychosis-problems-how-can-i-get-help/