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For me personally, I do not believe I would have developed schizophrenia had it not been for several environmental triggers. There is no person in the history of my family, living or deceased, for at least three generations back who ever has had a psychotic break. If I have a gene or genetic sequence related to schizophrenia, I must have been the only person in the history of both my parents’ families to be unlucky enough to have sufficient triggers to bring about this illness.
Yet, I don’t hear many people with my illness identify environmental triggers or at least speak of them. Most memoirs I read do not identify environmental triggers and instead describe a childhood and upbringing that did not have triggers. For my memoir-in-progress, Threads of Truth, I detail multiple potential triggers for my illness and how my trauma-riddled childhood could have contributed to my chronic mental health condition. In this post, I’ll just take a cursory look at potential triggers according to academic research.
I will say that identifying my potential environmental triggers and addressing them in therapy has helped tremendously with my emotional recovery from psychosis and schizophrenia. It has also helped for my psychiatrist to be aware of the environmental factors too. It also helps make my illness feel objective and straightforward instead of some type of enigmatic mystery.
My Potential Environmental Triggers
In terms of obstetric complications, my mother did have mild preeclampsia when pregnant with me, so was put on bed rest, [1] and I was born in January.[2] Other than those risk factors, it was a totally normal pregnancy and delivery, and I was a perfectly healthy baby born on my due date. I did experience strain in home life in early childhood that bordered on child abuse.[3] I was significantly bullied at school from as early as preschool up until I graduated from elementary school.[4] Due to bullying and home life, I had a hard time fitting in socially at school and struggled with self-esteem, depression, and anxiety. My psychotic symptoms began when I was overprescribed Adderall from a psychiatrist while in college and developed a substance-induced psychosis. After being hospitalized, I’ve been on an antipsychotic ever since. I had three more breaks in my early thirties and then was diagnosed with schizophrenia. According to a meta-analysis by Murrie et. al (2019), there is a 22% likelihood that a substance-induced psychosis caused by amphetamines will develop into schizophrenia.[5]
Why Identifying and Communicating Triggers Matter
I think for people with my illness, it’s meaningful to know that there are other people who have had similar triggers that led to the same illness. It reminds us that almost all environmental factors are beyond our control, especially in early childhood, and we are not alone or as abnormal as we think we are. Sometimes it is easy for the idea of environmental triggers to translate into “personal issues,” making psychosis less medical and more subjective—like a personal failing—but that’s not the case. For me, identifying environmental triggers felt like the opposite—it felt validating. Science is beginning to explain and show how these triggers specifically alter our brains—proving our illness is purely objective, totally real, and most of the time, beyond our control.
I think in order to treat the whole person with schizophrenia so they may achieve a full emotional recovery, environmental triggers and the trauma they have caused must be addressed by a therapist, worked through and processed, and at least recognized and acknowledged by the psychiatrist. I think it benefits a psychiatrist to be aware of major environmental triggers that could have induced psychosis and/or schizophrenia and could still be exacerbating the illness. Some environmental factors are not just present in early childhood and can persist throughout life.
Why Triggers Matter for Emotional Recovery
Part of the reason identifying environmental triggers is important is because they need to be addressed and treated in therapy. I believe that emotional recovery from psychosis leads to optimum quality of life, and part of making a full emotional recovery entails processing and resolving underlying environmental factors and traumas that contributed to the illness in the first place.
If you do not identify your triggers and address them, I think it makes it harder to move forward with a life free from the past. A great challenge after psychosis is to move forward and let go of what happened to you, but I think it helps to be able to let go and move forward from many of the environmental triggers identified by science.
It’s not a matter of pointing fingers or assigning blame for this illness. The triggers are what they are, and it’s up to the patient and therapist to unravel the footprints left by those triggers. Environmental factors are almost never a patient’s fault, but it’s really still up to the patient to identify triggers, address them and process them to cognitively and emotionally heal.
Psychosis Essential Reads
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