Friday, 11 December 2009

Schizophrenia re-examined

It is quite odd - last night I failed to write a blog entry for the first time since I started this. I think because - taking myself by surprise - I talked myself through the illness to the point where I decided I might not have it at all, I kind of felt there wasn't much left to say.

However, I feel it would be a pity to stop blogging - I have been enjoying it so much. Apart from anything else, it is a regular writing routine, which I badly needed. Last night I was feeling quite poorly - I had been far too busy during the day, and the cold that I thought I had shrugged off earlier in the week crept back and snaffled me up. But I still missed my tapping session.

Also, there is a lot left to say, in particular about the glaring injustices present in the mental health system. And the lack of information available out there. For example, I was never told that schizophrenia is liable to burn itself out by the age of fifty. I was expressly told the opposite, by my notorious 'Team' - that I would just go on getting worse and worse as I grew older. My outlook was correspondingly bleak.

It was only because a friend of mine, a psychiatric nurse who married one of her former patients, shared this news of 'Schizophrenic Burnout' with me, that I was aware of it. In a stroke my attitude was changed - to fear of what would happen to me as I got older, to the immense relief that came with knowing that whatever happens now, I will be well in the future. What a revelation - so why was this the first I had heard of it? Even if it isn't true (and my friend certainly believes it is - she only mentioned it in passing, and was surprised I hadn't known it already) it makes me feel better. Which raises the question of why was I given such a gloomy prognosis in the first place? Surely rather than effectively informing me that life as I knew it was over, the psychiatrists coould have admitted that the prognosis was uncertain, and perhaps even said that there was some hope that I would go on to live a full and happy life. I might not then have lost the best part of my twenties in an extremely scared and vegetative state, living in fear of myself as a schizophrenic, paralysed by the knowledge that things could only get worse.

I find that when you first enter a mental hospital, the most striking aspect of this most alien of places is the uniformity of the patients' condition. Of course some of them are floridly ill - many others are withdrawn, or havily sedated. But what I am referring to is the physical condition - these people are almost all thin, shabbily dressed, and chain-smoking cigarettes.

Their thinness is soon remedied - unfortunately, in fact it is over-corrected. The medication takes care of that. The most common side-effect of psychiatric drugs is to increase the appetite. Obviously, because patients become extremely hungry, they rapidly put on weight. Then, because of the next most common side-effect of the drugs - over-sedation, they find it difficult to shift the weight, and so the cycle continues. The end result is an assortment of overweight, sluggish, demoralised and rather depressed individuals, who are however - hurrah! - not floridly mentally ill. These individuals are then sent out into the world to fare as best as they are able.

So, their extreme skinniness has been effectively remedied. Smoking is not discouraged in mental hospitals however - in fact mental hospitals, along with prisons, are virtually the only exception to the new laws against smoking in public places. I find this very odd - the medical profession know better than anyone the risks of smoking, so surely they should actively campaign to stop smoking in all hospitals? Why treat the mentally ill differently from anyone else in this respect? Does their health matter less? Or is there some fear that without the stress relief provided by their cigarettes mental health patients will become uncontrollable?

I have given some thought to this matter, and I still cannot fathom it. I speak as an ex-smoker, one who is aware that smoking is bad for mental and physical health. I have stopped and started smoking on several occasions over the years, and it is one of the clearest indicators as to my state of mind. I have often warned my husband that if I should start smoking again he should immediately contact the mental health services.

I am sure that this ties in with my third point, about the fact that patients are shabbily dressed. What I am getting at here is not of course their attire, but their poverty, and thus their place in society. The mentally ill, almost to a man, are down on their luck, destitute and thus desperate. I have seen this time and time again in the people I have been hospitalised with over the years - and of course in myself.

Having said this, I am not quite sure what can be done about it. I just feel that something should be done - why should a lack of money equate to such suffering? An effort to assimilate people back into society as quickly as possible, preferably through the workplace, would be ideal. But I know from my experience that I was laid so low after hospital that I would have been quite useless in the workplace. This is why there are so rehabilation centres, or half way houses, like the day centre that I attended for years after my second breakdown.

But these places set their standards far too low - no-one is expected to do anything, or think anything. Televisions are on all day, and most of the patients sit around smoking. It is certainly not the right atmosphere to foster motivation in anyone.

By contrast, those people who can afford private treatment fare much better. There is far less stigma associated with a stay at the Priory - indeed, such a stay might be seen as a badge of honour, or a status symbol. And I am sure that at the Priory, and other such hospitals, patients are involved as early as possible in programmes to attempt to educate them about playing a part in their own recovery, and that they are not just allowed to sit around smoking and watching TV all day. This is all pure guesswork, and I am not the betting type, but if I was I would wager that in the Priory nobody is allowed to smoke indoors - because the issue is treated with the gravitas befitting a hospital.

Enough for now. I have no idea how long I have been writing for - I am glad to be back on track though.


  1. Keep writing. If it works, then it's defintiely worth doing. And interesting to read x

  2. Thanks so much for your post, and your blog. Millions of Americans suffer from a diagnosed, misdiagnosed or undiagnosed mental illness. Silver Hill Hospital has clinicians trained in evaluation, diagnosis and adult and adolescent psychiatric treatment and provides hope for people who may not have been getting the right care. Talking/blogging about mental illness can be extremely helpful not just for yourself, but for others in need. Keep up the good work.

  3. Your writing is very enlightening. I am living with a son, now 46, who was diagnosed as schizophrenic at age 20. He was hospitalized twice then for 5 days each time and last released in late 1989. His last medication that he took was in January 1990 because he is noncompliant with his medication - feeling like a Zoombie with them. I pray for a complete healing from his illness, which shows only "talking to himself". Lately he has been "quiet" and I am thinking, could this be what my friend mentioned as burnout schizophrenia? I hope so as I beleive in the power of God in healing things.

  4. Hi, and thank you for your comment.

    I really hope that your son recovers fully - it may be a matter of time (still) in that he needs to regain some confidence or find some meaning in his life - employment, a partner, a home of his own, etc.

    I have had real benefits from a recent course of CBT - I thought anxiety was something that I just had to live with, that it was just a part of my personality, but have now realised that it is both disabling, and treatable.

    Perhaps something similiar would help your son - or perhaps, as you say, the illness has already burnt itself out. He may actually be quite well now, but because of the diagnosis he may nor dare to think of himself as well, if he has been told (as I was) that recovery is impossible.

    I wonder if work would help (perhaps he is already working and a change of work would benefit him?) He could do voluntary work, or ever peer support work, or some sort of therapeutic programme (gardening would be a good option at this time of year!).

    There is lots more information around - the Mad in America site is a great resource. Also, there is a blog called 'Spiritual Recovery' and another called 'Spiritual Emergency' run by the same person, who also writes another two blogs (how?!) and they are really useful resources. As is Ron Unger's site (I am afraid you'll have to Google the name, as I am temporarily forgetful).

    It must have been a long and difficult journey for you and your son for all these years - Rossa Forbes writes movingly about her son's experience of mental illness on her blog 'Holistic Recovery from Schizophrenia'.

    As far as medication goes, unfortunately psychiatric drugs are not very effective and can be harmful, so it stands in his favour that he has not been dependent on them all these years.

    Good luck - and please stay in touch!

    Louise x