Does city life contribute to psychosis?

Is life in the city contributing to psychosis in Denver?

A study published this week in JAMA Psychiatry showed urban settings contributed to more acute cases of psychosis than rural areas. “We found that compared with rural neighborhoods, neighborhoods characterized by urbanicity and environmental exposure (i.e., air and noise pollution) were unilaterally associated with more severe psychotic symptoms, but that more severe depression and anxiety symptoms were specific to individuals residing in urban neighborhoods that also had high area deprivation (i.e., poor housing conditions, health outcomes, and socioeconomic disadvantage),” according to the study. “These findings remained significant after controlling for individual-level characteristics such as age, gender, race, ethnicity, education level, and household income.”

I have no doubt that the urban atmosphere contributes to psychosis. I would become agitated during homelessness and begin yelling at motorists if they honked their horns for any reason. Yelling at cars that honk their horns will wear you out fast in Denver, as honking often becomes a contest amongst angry drivers.

I used to sleep on a couch discarded in the lot across from Salvation Army Crossroads homeless shelter. One day a big Cadillac pulled right up next to the couch, so I could feel the exhaust fan, and the driver laid on the horn and shined his brights. It was a rude awakening I never will forget. These sorts of traumatic events over and over again will make you psychotic.

Drivers don’t respect pedestrians. You can be nearly hit in a crosswalk three times in a day in Denver. Once I was struck by a woman driving a car. Luckily, I was not injured. She looked remorseful but kept driving.enver dangerous for pedestrians

Walking around the city used to trigger my PTSD every few minutes. I would walk up and down 16th Street Mall like I was programmed to never leave that strip. It made no sense for me to hang out there as I constantly was being disturbed or offended by other people. Drunk guys like to pick fights with people experiencing homeless. Once, I was cold cocked by a female impersonator.

The study on the stressors of the city said clinicians must look beyond treating individual symptoms in urban patients exhibiting psychosis. “To create sustainable change, these multidimensional problems will require systemic, multifaceted solutions to tackle detrimental neighborhood conditions through comprehensive approaches,” the study recommends. “Policy changes must address housing conditions and lack of infrastructure (e.g., resources, economic growth) that contribute to social disadvantage. For instance, removing structural barriers to accessing public transportation and the provision of subsidized public transit passes, especially for those who reside in low socioeconomic communities, has the potential to increase mobility, access to services, and improve economic opportunity.”

Homeless people constantly traumatized

Other stressors people experiencing homelessness in particular experience amidst urban settings are aggressive security guards at places like RTD stations. They will throw you off the property for looking homeless. See what that does for your mental health. Or police that rouse you from sleep because you are violating the camping ordinance. Don’t expect things to turn out well.

I was completely psychotic during homelessness and brought it out in others. I would say nasty things at random just to be inappropriate. I felt so angry that I decided I had earned my outbursts. I was cutting off my nose to spite my face in every possible way.

And then I was arrested and ended up in the state mental hospital in Pueblo, which proved to be an oasis of peace for almost a year. Life in the city most certainly had aggravated my psychosis to the point of rage at times. It was an exhausting state to be in.

Urban destinations can wear on your nerves

As Denver has grown, urban stressors have become pervasive. The study says such urban stressors can do real damage. “Several social determinant frameworks have linked exposure from neighborhood-level factors to the activation of mechanisms that contribute to chronic stressors, which ultimately lead to increased mental health symptoms and psychosis risk,” according to the study. “Future studies should explore potential mechanisms similar to those outlined in the social determinants model for psychosis such as lack of safety, high attentional demands, social capital, and limited environmental enrichment to shed light on potential clinical targets that serve to interrupt the adverse impact of neighborhoods.”

The study reported that residing in certain neighborhoods can lead to aggravation of risk factors for mental health conditions and increase their severity, including early psychosis. “Focusing on how one’s physical environment (i.e., neighborhood) affects psychosis and mental health provides an alternative lens that moves beyond our understanding of how individual-level factors alone are associated with severity of symptoms and psychosis risk,” the study found.