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 Of course some of them are floridly ill - many others are withdrawn, or havily sedated.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.