Mental Illness - Treatment and Support
Discussion of Current Issues in the NHS
Raised by the disturbing book "To Walk on Eggshells"
and the real-life story "The Naked Bird Watcher"
Current Mental Health Issues and Topics
Downside of medication
Chemical imbalance
"You'll Never Recover!"
Cathartic Self-injury
The "down-side" of medication!
Anyone who thinks that medication and psychiatric consultation offer a quick or easy option for fixing mental health problems should read this book! The psychiatric obsession with medication as the only way to control symptoms, I find quite appalling and alarming. This is not to say that medication is unimportant, of course I do not believe that. However, I was quite shocked at the lack of any mention, in the journey of responding to this illness, of Psychotherapy, Cognitive therapy, Breathwork, Body work, Bioenergetics, Healing, Martial Arts (aggression-release, self-discipline, self-esteem), Chakra work, Assertiveness training, Meditation, Yoga, Psychodrama, Cathartic techniques, Emotional intelligence training, etc.
Personally I bristle whenever drugs used to control bipolar disorder, or manic-depressive psychosis, are referred to as "treatments". I feel that if we are more honest we will refer to them as "suppressants" or "symptom control agents". Referring to them as "treatments", "treating the condition", is one of the things which blocks the search for non-drug means to cure or alleviate symptoms. I offer more discussion on this topic below.
In acute psychiatry, high-level medication has been described as "a chemical straitjacket" and this is probably a more accurate description than "treatment". There is no doubt that psychiatric services need "a chemical straitjacket" approach in many cases - psychiatric professional have a difficult and sometimes dangerous job to do. Let's hope that medical research will keep looking for more humane and more therapeutic approaches than mere "chemical restraint" but, in the meantime, it seems that we have to accept it.
In the same vein I was unhappy with Jean's use of the word "recovery" in relation to the stabilisation of her daughter's acute symptoms by life-long medication. I personally feel that the word "recovery" should be reserved for the situation where constant medication is no longer necessary. This is not intended to take away the praise for the long hard journey this carer and her patient have taken together. The journey from nightmare to stability is a vital one. I wonder if carer and patient might one day make another journey, the journey to living without constant medication and moving even further down the road from carer/invalid to purely mother/daughter?
An experience of bipolar medication side-effects: Raza's Story
(Raza has been off medication for 4 years now and works for SPN mental health network)
"It's a chemical imbalance in the brain!"
I was also shocked to see that Jean had been sold this tired old mantra about depression and bipolar disorder. When will some sections of the medical and psychiatric professions wake up to 50 years of research showing that emotions create chemical changes in the brain?
Emotionally-driven changes in brain chemistry drive particular lines of thinking e.g. depressive or manic thoughts, which in turn generate more emotion, which in turn generate more chemical change etc. This is the vicious cycle that spirals downwards in the experience of depression and spirals upwards in the experience of mania. A vicious cycle which can be damped by drugs (alongside damping of some healthy functioning) or broken and re-directed by the variety of non-drug measures mentioned above.
"She will never get better!"
This dire prognosis is one of the many very important gripping topics that the author, Jean, deals with in the book. What a terrible pronouncement! How devastating for patient, family and friends! How does a mother feel when she hears this ominous prediction and how does she cope?
Jean takes the tragically common line of swallowing this gloomy prognosis "hook, line and sinker". Sinker is the appropriate word for this psychiatric grave prognosis, because it is very likely to be both depressing and self-fulfilling. With all hope securely removed, the search for real solutions (other than control by drugs) by those affected, or by their clinical care team, can be safely abandoned! Care becomes focussed on the simple strategy of "adjusting medication".
I have to say that "You will never be cured" really makes me angry! In my view, for any doctor, psychiatrist or clinical psychologist to say this to a patient is a matter of disgraceful professional conduct - a matter for disciplinary action by their professional body.
Why do I say this? Well, firstly, because no clinician can predict the future. Medical research is constantly progressing and many previously incurable diseases have eventually become curable - including psychiatric disorders. What might be true to say would be "No-one has so far managed to cure this condition". Personally however, I feel that "I have so far not been able to cure this condition" is an even better statement of the truth (few Doctors and Psychiatrists are able to keep abreast of the explosion of medical research and developments all over the world) plus it has the added advantage of the clinician taking personal responsibility via the pronoun "I" for their lack of curative competence at the present time.
A further reason why I take the view that "This condition is incurable" is a matter for professional disciplinary action is that I keep meeting people who were given this pronouncement, but subsequently found ways of living or curing their mental illness without constant medication. In fact I myself was given this pronouncement and spent 2 years on medication, but as a result of healing experiences, psychotherapy and learning better stress management skills, I have now been off medication and off the "psychiatrist's couch" for some 13 years!
Cathartic Self-injury
Suzy's own account of her own illness and self-harm behaviour with razors gives a valuable insight into the experience of self-harming. This self-harming seems to me to be a self-generated cathartic action and sufferers tell us of the relief it brings them - at a serious cost of course.
This strengthens my view and personal experience that Psychodrama and Cathartic techniques have an important role to play in the relief of mental distress and are seriously underused. I suspect that a lot less medication would be needed if selected mental illness patients were taught or guided in simple, low-key, catharsis and psychodrama techniques. Would patients harm themselves less if they were taught and encouraged in safe ways to physically express powerful held-in destructive emotions and impulses? - I would expect so, but have not personally worked with this type of problem.
(Discussion by Dr. Michael Meredith - a UK Stress Management Trainer , Healer and ex-sufferer from bipolar disorder)
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