Brexit could be sending people crazy – literally

The resulting political uncertainty and racism has been linked to psychosis. Paul Biegler reports.

It turns out that Brexit might actually be sending people crazy. 

Jack Taylor / Stringer

A man from a self-described “multicultural” family had a florid psychosis triggered by the 2016 Brexit referendum, according to a psychiatrist writing in the journal BMJ Case Reports.

The incident may signal wider mental health issues for ethnic minorities facing political uncertainty – a UN committee noted a sharp increase in racist hate crimes around the time of the Brexit campaign, which it said featured “divisive, anti-immigrant and xenophobic rhetoric”.

According to the man’s wife he became increasingly preoccupied with sharing his thoughts on social media in the three weeks after Britain voted to leave the European Union in June 2016.

This was followed by worries about “racial incidents”, insomnia and a descent into psychosis, including fears he was being spied on and delusions that two different women he saw were the same person.

After being taken to the emergency department the man, in his forties, said that radio shows he heard were about him, something known as a “referential” delusion. He also believed the two ends of a maths equation came from the earth’s twin poles, called a “bizarre” delusion.

The man attempted to burrow out of the department using his hands as a digging tool.

Author of the report Mohammad Zia Ul Haq Katshu, a psychiatrist and a clinical associate professor at the University of Nottingham, says the man was diagnosed with acute and transient psychotic disorder (ATPD) and admitted as an involuntary patient under UK Mental Health legislation.

ATPD features delusions, hallucinations and altered perception. It can include a thought disorder called “knight’s move thinking” which, after the chess piece’s counterintuitive right angle move, involves a rapid and unexpected switching of ideas.

ATPD usually resolves within weeks to months and is sometimes preceded by a stressful event. In this case, writes the psychiatrist, the event was Brexit.

“Concerns have been expressed about the potential negative impact of Brexit on the mental health of Black and Minority Ethnic people,” he writes, citing a recent letter by three academics in The Lancet Psychiatry.

Katshu also refers to a report suggesting antidepressant prescribing rates underwent a relative rise of 13% post-Brexit.

The phenomenon of politically-induced psychosis may well cross the Atlantic. A case report last year documented an elderly Hispanic-American women who experienced a first psychosis in the wake of the inauguration of President Trump, apparently triggered by fear of deportation.

“Political events can be a source of significant psychological stress,” writes Katshu.

According to a 2018 study by the American Psychological Association, 62% of Americans cite the current political climate as a significant stressor with 57% of Gen Z respondents (those aged 15-21) reporting stress over the separation and deportation of migrants.

Stress elevates the hormone cortisol which may, explains the author, trigger dopamine release in a part of the brain called the striatum, an area implicated in schizophrenia. Individual vulnerability to psychosis may reflect changes in genes for catechol-O-methyl transferase, an enzyme that breaks down dopamine.

The man fully recovered with medication and remained well at most recent follow-up in June 2019.

By contrast, at time of writing, Brexit appears to be incurable.

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Paul Biegler is a Eureka-Prize winning journalist, bioethicist and former physician writing on all things health and science.
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