Welcome to MENTAL

A collection of stories ON mental health experiences

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“Psychiatrists will tend to err on the side of prescribing too much rather than too little, at least in my experience.”

One of the first things I remember following my return home from the psychiatrist’s surgery was the hazy fog that engulfed me due to the medication I was taking.

I would bump into walls, my jaw would become tight, my tongue wouldn’t move properly in my mouth. I would consequently slur my words. Mum was very concerned. Perhaps shocked (or maybe mortified) would be a better description.

Fortunately, I was far too gone to register her distress at my condition. I had my hands full just trying to cope. I felt like a walking hospital patient trying to describe to my parents where it hurt, what I could and couldn’t do, through the blanket of chlorpromazine that obstructed my every communication. ‘Zombie’ is a good description of how I was for that first while.

Medication that is used to arrest a psychotic episode is extremely strong. Apparently, left untreated these episodes can last as long as a year before they run their course, by which time untold psychic and physical damage will have been wreaked upon the sufferer - let alone what catastrophes he or she may have inflicted in the world, so to speak. That is, if one survives. It doesn’t bear thinking about. This extreme period of mental illness needed to be treated in order that it could be arrested and equilibrium, or at least stability, could again be restored, or at least sought.

It is important to remember that this was 30 years ago. Drugs have improved since then. A surgeon friend of mine still refers to psychiatric drugs as ‘blunt instruments’. And he has a point, no pun intended - but then he likes to cut things from people’s bodies, which I’m not so keen on.

The psychiatrist who saw me at the time thought I was probably suffering from schizophrenia, a condition which unfortunately does require stronger medication to control. In the acute phase, manic-depression/bipolar 1 and schizophrenia can be difficult to distinguish and are treated similarly, yet most of the time the drugs needed to control manic depression/bipolar are not as strong, with fewer side effects.

Psychiatrists will tend to err on the side of prescribing too much rather than too little, at least in my experience. This is probably because too low a dose won’t be sufficiently strong to arrest the momentum of the acute phase. Outside a hospital setting the patient is ‘safer’ to himself and others on a higher dose, as the illness is less likely to ‘break through’ - especially since the psychiatrist is not in constant (or even regular) contact with the patient, and is less able to monitor the patient’s condition.

When I was sent home from the psychiatrist’s surgery the year was 1987. This was well before C.A.T. Teams (Community Assessment and Treatment). It was still the era of giant psychiatric institutions, where one was typically sent for life. I was in fact very lucky to avoid this fate and to end up at home, even if loaded to the gills with psychotropic medication.

Those initial days at home were I think quite frightening for my mum and step-dad, to see me so altered by such a ‘chemical straitjacket’, but for me it was just about trying to cope. I wasn’t frightened. I had been extremely frightened before when I was ‘unwell’. This was recovery. It wasn’t pleasant, but it was real.

Following my initial diagnosis and treatment with medication, I returned to school. I can’t imagine how I managed to do that and can’t really remember it at all. It was a long time ago, and unfortunately the nature of psychotic episodes themselves means many memories are lost, even before the deleterious side effects of the medication.

Later, I was referred to a private psychiatric hospital named Selwyn Hospital, coincidentally sharing the same name as my secondary school. Some of the private Auckland psychiatrists would use this facility with more acute patients as an alternative to the public system, but its function, as I understand it, was really to provide individuals diagnosed with mental illness somewhere to rest and recuperate.

I still have clear memories from that time. However, I certainly don’t remember everything. Mum tells me now that I was in there to change my medication. Initially I was pretty ‘zonked out’ (a highly technical term) on the schizophrenia meds, but this changed as time went on and the chlorpromazine drained out of my system and the lithium took over. I was in there for about three or four weeks.

My room was comfortable, if small. It reminded me a little of a motel room without a bathroom. For some reason I remember a pale green colour. That could have been the walls. There was a ranch-slider to the garden outside. It was situated in the leafy suburb of Epsom, off Coronation Road. Unfortunately it no longer exists - but then I guess Epsom residents are probably pleased about that. Still I do remember fondly a couple of slow walks I took with one of the older patients along those leafy lanes once I had regained my appreciation for the world around me.

At some stage I recall noticing the name tag on my door had changed. I can’t remember if there were two name slots or only one but there was definitely a metal slot for the doctor’s name to be inserted on a piece of thick paper or thin cardboard. There may have also been a slot for the patient’s name. This seems unlikely today in the world of privacy concerns, but was quite possible back then.

All I know for sure is at some stage the name changed and it was no longer Burrell but Turbott. I thought this was a little odd and in my confused but curious state determined to remove the card from its slot and found that Burrell was written on its underside. Thus I discovered that my doctor had changed, though I am not sure I really understood this at that instant.

It was however to prove a beneficial relationship and John Turbott was my psychiatrist for a further 12 years or more, until his permanent retirement from private practice. He even generously saw me at his home for a year or two after his return to public hospital work.

Following my discharge from hospital, I stayed at home for the remainder of the year and didn’t return to school. 1987 was not a great year for me. Annus horribilis, as they say. I had started the year by missing most of the first term with glandular fever. By the time I eventually arrived at school, they were already suggesting that if I missed any more days I wouldn’t qualify as being present for enough of the school year. After my return, the mania gradually took hold, so that my behaviour at school became progressively more outlandish, bizarre and downright crazy. Then I had a car accident, in which I nearly died and suffered severe concussion giving me perhaps some post concussion syndrome effects as well as days in hospital (regular hospital) and stitches in my face, gums and tongue. After recovering from that my mood became truly psychotic, leading to Dr. Burrell; the injections; ultimately psychiatric hospital. Quite a year.

Summer was a long period of recuperation, which unfortunately passed too quickly, and I was into the new school year, trying to cope with a drastically altered level and way of functioning. It felt like my mind had been shattered and I now had to piece it back together. That is the very image I used at the time to try to explain the experience to others.

“Try and imagine your mind being like a clear crystal ball”, I would say, “which is then smashed into millions of glass shards by the psychosis and which you then have to glue back together again. The task is interminable and seemingly impossible, and at the finish you are not left with the clear crystal ball with which you began, but a fractured opaque distorted ball held together with glue (the meds).”

Back then I didn’t think I would ever heal that ball and make it clear again, but somehow, magically it did happen, though it did take a very long time. Returning to school was perhaps the hardest thing I have had to do. I attended a co-educational secondary school, and the previous year I had been floridly psychotic, quite openly mad, while at school. I was still a teenager just 17 and had to return to school and face the music so to speak. The only comparison to how I felt is ‘the fear’ you have if, having drunk too much at a work party the night before, you awake the next morning not exactly sure of what you’ve said or done, but, fearing the worst, you have to face your colleagues at work with no recollection apart from a feeling that it really wasn’t good. If you take that feeling, dial it up to its most extreme, extend it over a period of months, and remember that I was a teenager at school (who hadn’t been drinking) you can begin to imagine my apprehension.

There is also the fact that I was still adjusting to my medication. I was much slower, still a bit clouded from the effects of the antipsychotic drugs of the year before, and getting used to the mood stabilising drugs I was currently taking. There was also the associated weight gain due to the medication and the fact that I had missed most of the previous scholastic year. I was fundamentally not the same person I had been six months before. Though in some sense I was still there.

It took a long time to find my way. I became very tired. Subjects that I had previously found a doddle were now difficult. Not only because my concentration was initially affected, but because I had unintentionally missed so much school. It wasn’t as though I had decided to accelerate my learning as friends at some other schools had done between fifth and seventh form (years 11 and 13). I had just had a year of my education removed. I managed for most things, but when it came to something like maths, it was a real problem. I went from being at the top of the class in year 11 and tutoring others, to needing tutoring myself in year 13.

With my friends it was interesting, too. Someone had said to me that you will find out who your true friends are; and I did. A lot of people didn’t want to know me, but a few did, and I am eternally grateful for that. I’m still friends with those people today.

Somehow, I managed to get through that year. It was a real struggle. I think it is the worst I’ve ever done at school. I still managed to get an A bursary by the slenderest of margins and I was accepted into Law Intermediate and Commerce the following year at University. However early on I realised that scholarship examinations would be beyond me, which the year before or especially two years before would have been unthinkable.

Still, I lived to fight another day; and really at the end of it all isn’t that what counts?

 

Tim,  47, from Auckland, married with a young daughter

“People experiencing psychosis don't need your fear, we need your compassion and understanding, your patience, your friendship.”

“What had started as a simple commitment to weight loss had become an interminable battle with my anxious thoughts, perfectionism, and insecurity.”