Posts tagged mental
Posts tagged mental
This Is What Developing Acute Schizophrenia Feels Like
By Daniel Smith, Vice
A year ago this winter, I began to not recognize myself.
Sleep was the first thing to change. Progressively, over the course of about two weeks, I began struggling to drift off. As a 24-year-old man with a good supply of hash, this had never been a problem before. It was so odd. Seemingly out of the blue, I’d get into bed at night and not be able to shut off my brain. Thoughts would grow tendrils and loop onto other thoughts, tangling together like a big wall of ivy. Some nights, I’d pull the covers over my head, grab my face hard in my hands, and whisper, “Shut. The. Fuck. Up.”
Eventually I would be able to get to sleep, but I’d wake up feeling peculiar, like I had forgotten to do or tell someone something. Hunger wasn’t as aggressive as it usually was during this time, either. Normally I bolt downstairs to pour a heaping bowl of Frosted Flakes the second my eyes open. Instead, I woke each morning with a sick, creeping feeling in my gut. Still, I carried on as normal, thinking I’d just lay off the hash for a bit. That was probably it. I wasn’t panicked.
I carried on my work at a local wine shop and tried to push what was happening during the night to the back of my mind. I got through the days OK, if slightly bleary-eyed—but looking back now I can see that I had started to struggle with simple conversations.
If my boss told me to check a delivery, it’d take me a few seconds to process what he was saying, like two or three people had said it at the same time and I couldn’t make out the clear instruction. Looking at morning delivery slips and trying to make sense of them in my head was like trying to make out a tree in the fog—possible, but hard.
Everything felt misty. I started to think that stuff was about to fall all the time—I’d look at a shelf of bottles and see one or two about to topple over, then look again and they’d be fine. I also kept thinking I could hear phones ringing, at all different pitches, even though there were no phones in the warehouse. Again, I wasn’t panicking yet—I just told everyone who asked if I was OK that I wasn’t sleeping well and thought it was all down to that. Sleep deprivation does weird things to people. A friend at work gave me some sleeping pills to try out, and they seemed to help for a bit, even though I’d wake up and feel like my head was full of wool. I stopped caring about going to bars or playing soccer on the weekends. All I wanted to do was sleep. Conversations were too much work.
I’d say it probably took two months from that initial sleeplessness for me to actually think there was something seriously wrong with me. The thought octopuses, as I ended up calling them, got weirder and weirder at night. I’d have the TV on and start being unable to identify what was noise coming from the screen and what was my own noise. It was frightening. One night, while watchingHomeland (of all the shows), I had what I thought at the time was a panic attack. I knew what a panic attack was because one of the girls I used to go out with had them—she once had to lie down in the movie theater and do deep breathing to stop herself from retching. It was horrible to watch. That night in bed, though, I started trembling like it was freezing cold—only my skin was boiling. My legs shook against the bed sheets and there was this cacophony in my head, like a crowd of people were chatting beside my pillow. Nothing dramatic, just a steady, confusing noise. By the flickering light of the TV, I began to lose my mind.
I didn’t sleep at all that night. I felt paralyzed. My bedroom door had become the very end of my world, like the paper set Jim Carrey rows into in the final scene of The Truman Show. The noise came and went in waves, but it felt like someone, or something, had replaced my body and mind. It wasn’t me who was too scared to go to the bathroom to piss, so I decided to do it into an empty glass, spilling it all over the floor. It wasn’t me who threw all my bed sheets off, only feeling comfortable completely naked against the bare mattress. It wasn’t me who pressed the tip of a boxcutter into my heel to try and snap myself out of the despair. In that room, as the sun came up and my alarm went off for work, I thought, I need my mom.
Luckily, she was only a staircase away. I hadn’t gotten myself together to move out of home yet—couldn’t afford to, really. I called her from my phone because I thought that if I left my bedroom my insides were going to fall out. I genuinely believed crossing the threshold of my bedroom doorframe into the hallway would make my skull come apart and my bowels fall out of me like a bucket of pig swill. She answered the phone and said, “Oh for goodness sake, Daniel,* stop messing around,” or something similar. I started crying, apparently in big, whooping sobs like a little boy, and heard her throwing her phone on the floor through the ceiling.
When she opened my door, she gasped. I don’t remember doing it, but apparently I’d pulled apart my TV remotes (I had, like, four of them) and my bare mattress was covered in little circuit boards, piss, and blood (from my heel). I sat there in my underwear, crying, and told her that I’d been “taken over.” She called an ambulance.
Again, I don’t really remember this properly, but apparently when the paramedics arrived I thought they were both taking pictures of me. I got really angry and tried to punch them. I screamed at one of them, telling him it was against the law to take my photo and that I had rights, all while seated in a pair of soaking wet boxer shorts with blood all over my leg.
All I remember from the drive to the hospital is my mom holding my legs down against the bed, but she says I was screaming that I didn’t want to be driven on the highway because there were people crouched inside the speed cameras. My memories of the hospital that night are colorless flashes of needles, soft voices, and arm restraints.
All the above is what’s called a psychotic episode, and it’s emblematic of acute schizophrenia—the illness I was diagnosed with. Psychosis is defined as someone having a loss of contact with reality. It can happen quickly, or—most commonly in those who develop schizophrenia—can be a slow burner and then suddenly snap. That’s what happened to me. I was hospitalized for about a week and a half and started on a course of antipsychotic medication immediately. I don’t remember much of this time, either, only that I felt sick a lot and found it hard to talk to anyone. Oh, and that the guy in the room next to me constantly shat himself on purpose. The smell was like the death I felt in my brain.
I remember the day I started to feel like I’d clicked back into reality, when the new chemicals I was taking found their footing in my body and didn’t just make me want to cover my head in blankets and sleep. My brother came in to see me with my mom (they’d been coming in every day but mostly just talked to the doctors and nurses—I was incapable of conversation), and we watched three episodes of Breaking Bad in a row on the iPad in the visitor’s lounge. My mom held it against her knees with one hand, while occasionally stroking the back of my neck with the other. I laughed at something Saul said and felt like I might be getting somewhere, like the curtains that had been drawn on who I once was were starting to flicker. I even ate a full meal that evening, and I’ll now never take mashed potatoes for granted again.
The road to recovery was filled with potholes. Namely, debilitating panic attacks when I had flashes of what had happened weeks previous. But the mental health team at my local NHS hospital were amazing—save a couple of nurses who treated me like a baby. I hated that. Once I was allowed home I had a social worker come and see me every week to check on the medication, ask about what I was doing each day, and encourage me to go for walks with my mom and start talking to my friends again. I’d been too embarrassed to, and thought they wouldn’t understand. Or, worse, just write me off as a nutjob. I couldn’t have been more wrong.
My best friend, Sam, said he’d been so worried about me that he actually hadn’t been sleeping at night. Stupid bastard. One by one they all started texting me again—I think they’d been frightened of saying the wrong thing, mostly—and said they couldn’t wait to start playing soccer again, that I’d be back on my skinny legs in no time. It was amazing how mature they all seemed.
The mental health unit arranged a course of outpatient therapy with a straight-talking man called Gregg. The antipsychotics were really sedating for a while, and I often felt like I was wading through molasses, but there was a strange calm in my brain that I’d not felt for months and months. Gregg helped make sense of what had happened to me, teaching me techniques for when panicked thoughts came into my brain about that night when I snapped (he says it’s unhelpful to talk about “losing” your mind—the mind is still there, it just got ill) and how to not live in fear of it happening again. He encouraged me to start seeing my friends again and told me about how the mind doesn’t stay the same, how it’s possible for it to recover, and that the medication had worked so would continue to work, but that I had to be realistic with myself and accept that I had become ill. All I needed was time.
Accepting it was the biggest thing, actually. Frustration is, as I’ve learned, too close to anxiety. On the days when I’d go out for a walk (my mom made me go every afternoon for at least an hour, leaving me on my own halfway through and giving me a task, like buying a pint of milk or some butter) and start thinking about everything, thoughts would flash into my brain: For fuck’s sake, why can’t you just be normal? I had to stop, inhale a few times and say to myself out loud, “I am normal. I just got sick and am having a break.”
Within about six weeks of leaving the hospital, I started going to my friends’ houses again. I always felt a little twinge of discomfort when the TV was too loud, or when everyone talked at once, but I just told them when I felt strange. No one laughed at me. No one pitied me, either, which was amazing. I feel like if one of them had gotten sick like I had, I’d be like an overbearing mother, constantly asking if they were all right.
Within ten weeks I was back at work part-time. My boss couldn’t have been more sympathetic. Apparently, when I went into the hospital he called my mom to let me know that the job was waiting for me as soon as I felt well enough, and that I could take it at my own pace. Initially this made me angry—I didn’t want to go back as some sort of invalid. I was 25 (I celebrated my birthday in a medicated fog watching Friends reruns), not 60, and wanted to be thought of as the same guy when I returned. It took me a while to accept people’s sympathy and care for what it was, not a slight on me as a person.
Going back to work was the best thing for me. Having a routine, people to talk to, and tangible tasks to complete was very medicinal. I had days when I’d wake up and feel frightened, when it would take me a couple of hours to shower and leave the house, but nobody questioned me. I called Gregg a few times from the warehouse—being in the place where my reality had started to slip was, on occasions, pretty odd—and he wasn’t always available, but sometimes just leaving him a message was enough. Eventually, he said I didn’t need to come and see him anymore—that he trusted me to work through the thoughts and techniques on my own.
It’s a year on now, and I’ve not relapsed. I’ll have to take this medication for a long time, I think, but I’m OK with that. I have precious little sex drive (even though I can still get it up) and have put on a bit of weight, but those are small prices to pay for clarity of mind.
I wanted to tell this story because, until I became schizophrenic, the word represented a death sentence in my mind. When you hear of people being schizophrenic, you imagine them locked in rooms with padded walls, rocking backwards and forwards into a two-dimensional future of heavily-medicated conversations and drool-covered pillows. You imagine a future of hearing voices and seeing phantoms. This is far from the case if it’s treated well. With the right treatment, and especially if it’s caught early, you can recover incredibly well from acute schizophrenia, as you can from other mental illnesses.
I’m realistic about my prognosis: I might have a relapse at some point in the future, and do sometimes feel depressed about that. But now I know that I can recover well, it’s less scary. I’m back at work, socializing, keeping fit, and playing soccer like I was a year ago. I’ve even been on vacation. I’m not quite ready to move out of home yet, but that might be due to laziness more than anything.
My biggest piece of advice to anyone who starts to experience any psychological symptoms they’re not used to is to tell someone. Anyone. Make it a conversation rather than something you carry around yourself. Mental illness is no different from physical illness—it just involves a different organ: the brain. Don’t worry about asking for time off work, or about telling your boss that you’re feeling unwell, like I did. Looking back, hallucinating that invisible phones were ringing when I still had some grip on reality should have made me reach out to someone. Shame can play no part when it comes to looking after your mental well-being, and we should be as finely tuned to our mental symptoms as we are to our physical ones. Being a master of disguise, like I was to even my own mom, is nothing to be proud of.
If you’re feeling out of sorts, talk to your doctor. Demand emergency appointments if you have to. Even if you think it sounds silly, or like something that will blow over, telling someone about how you’re feeling is the best thing you can do. I was dealt with as a psychiatric emergency, and as we all know, the hospital is astounding in an emergency. I don’t know what it’s like for others that don’t present like I did (I’ve read all sorts of horror stories about shoddy, delayed treatment online), but I do know that staying silent about feeling unwell is the worst thing you can do. People are always far more sympathetic than you think they’ll be.
It’s 2014. We need to stop treating mental illness as something taboo, something that will stain us forever. And that can only start with ourselves.
*This and other names have been changed.
World Mental Health Day drove a massive social media spike in people discussing schizophrenia - but what is it like living with the condition? Channel 4 News spoke to two musicians.
The global event saw tweets on “mental health” rise from less than 10,000 per day normally to nearly 50,000, and tweets on “schizophrenia” increasing from 1,000 per day to over 4,000 on Friday.
But there are still many misconceptions associated with schizophrenia - most specifically that those who suffer from the mental health condition are dangerous.
Channel 4 News went to meet two mental health service users, both who have been diagnosed with paranoid schizophrenia, to ask about how the condition affects their daily lives (see video, above).
Devon Marsten (drums) and Roger Brooks (vocals) were both diagnosed with schizophrenia in their early 20s. The condition is most commonly diagnosed in late teens or early 20s.
The pair play music at Sound Minds, a south London arts charity founded by Mr Marsten, and are also involved in a charity that provides peer-to-peer care for people with mental health difficulties who are leaving hospital.
One in four people suffer from mental health difficulties, and schizophrenia affects almost 300,000 people in the UK.
But media representations and a lack of knowledge about the condition, have created a reputation that those with schizophrenia are unstable or dangerous.
The Liberal Democrats have said they are prioritising mental health - with Deputy Prime Minister Nick Clegg announcing that mental health will be brought in line with other NHS services with the introduction of waiting time standards.
Under an initiative being brought in from April 2015, backed by £40m funding this year and £80m next year, people with mental health conditions will be guaranteed treatment in between six weeks and 18 weeks.
Last month a Channel 4 News investigation found that two-thirds of mental health trusts who responded to a Freedom on Information request had had their funding cut, and that a shortage of beds was threatening patient care.
“There is not one of us in whom a devil does not dwell.
At some time, at some point, that devil masters each of us.
It is not having been in the dark house,
but having left it, that counts.”
- Teddy Roosevelt
Eighteen years ago, in the fall of 1996, I plunged into a major depression that almost killed me. On the evening of my admittance to a psychiatric hospital I saw the above quote from a documentary on Teddy Roosevelt. For the next ten months, it informed my experience, as I did everything I could to leave the dark house I was in. Eventually, I was healed without medication and wrote about my experience in my memoir, When Going Through Hell…Don’t Stop: A Survivor’s Guide to Overcoming Anxiety and Clinical Depression.
Over the next eighteen years I took what I had learned in my healing and put together a mental health recovery program which I taught through my books, support groups and long distance telephone coaching. In the process, I counseled many people who were in the same desperate straights that I had been in. I shared with them what I had learned through my ordeal—that if you set the intention to heal, reach out for support, and use a combination of mutually supportive therapies to treat your symptoms, you will make it through this. And in the cases where people used these strategies and hung there, they eventually were able, like myself, to emerge from the hell of depression.
During this period, I was aware that that major depression was a recurring disorder, and that while one could successfully mange the symptoms, there was no cure. As Andrew Solomon, author of The Noonday Demon said,
“Depression is recurring and cyclic. What we have is treatments, not cures. You’re never really free of it; you always have to be prepared for a recurrence and be ready to stave it off as it could creep up on you.
Thus, I knew that I was still vulnerable, but after such a long period of “emotional sobriety,” I thought that I might have finally turned a corner.
Then one day, when I least expected it, a series of personal losses led me back into Roosevelt’s dark house. In the midst of my grief reaction, the old symptoms of depression–chronic sadness, lack of pleasure, disrupted sleep, loss of appetite, heaviness in the chest, lack of energy, hopelessness and periodic agitation—were all painfully present.
Now that I am back in the underworld, I am called upon to practice those very techniques that I had been teaching others. Of course I have been using these tools all along as part of my “maintenance program,” but now there is a big difference
I am using them not to stay out of hell, but rather to get out. What makes the latter far more difficult is that you cannot will yourself out of a clinical depression any more than you can will yourself out of a tumor or an advanced case of pneumonia. There is no ten-day course of “brain antibiotics” which you can take and have the condition clear up shortly. In my case, I have learned from my previous episodes that antidepressants do not work for me.
If, then, I cannot directly make the depression leave, what can I do? As I have told my clients, “You have to muddle through and hang in there until things improve. “ Here is how I am attempting to muddle through.
I start with AA’s serenity prayer: God grant me the serenity to accept the things I cannot change, the courage the change the things I can, and the wisdom to know the difference.
Here is what I cannot control and must accept: the biochemical changes in my body and the painful sensations and feelings they bring.
Here is what can I control − how I respond to those sensations and feelings. Here is what I am doing at this time:
Those words reminded me what a social worker told me during one of my hospital stays–‘The best predictor of the future is the past. You have emerged from these episodes before, and you will do so again.”
Meanwhile, I am still in the dark house. I have been in this prison for two months. I don’t know how much time I have left before the cosmic warden will grant me a reprieve. But I have faith that if I keep “muddling through” and do the things that support my healing then one day, when I least expect it, that reprieve will be granted and I will emerge from the darkness into the light.
Schizophrenia affects around 26 million people across the world and is the focus of World Mental Health Day this year. The Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.
October 10th is World Mental Health Day
We’re helping to shine the spotlight on those affected by schizophrenia - from the 26 million people facing this affliction daily, to their family, friends and society as a whole.
What is Schizophrenia?
According to the World Health Organization, schizophrenia is a severe mental disorder, characterized by profound disruptions in thinking, affecting language, perception, and the sense of self. It oftentimes includes psychotic experiences, such as hearing voices or delusions. It can impair functioning through the loss of an acquired capability to earn a livelihood, or the disruption of studies. Schizophrenia typically begins in late adolescence or early adulthood. Most cases of schizophrenia can be treated, and people affected by it can lead a productive life and be integrated in society.
What is the aim of the 2014 World Mental Health Day?
"To ensure that people with schizophrenia get the best possible care and support to manage their illness and to help them recover." - Mental Health Foundation
To that end, Routledge has compiled a collection of resources in support of those affected by schizophrenia. Get 20% off your order by entering the code WMHD4 on checkout.
Aidan Scott has been selected as one of five Faces of Mental Illness for 2014. ”The Faces of Mental Illness courageously share the stories of their lived experiences to show Canadians that mental illness touches us all and that by working together everyone can play a role in ending stigma and aiding recovery,” said Florence Budden, CAMIMH Campaign Chair 2014.
Aidan’s mental illness emerged from a history of childhood abuse. Aidan has faced challenges such as nightmares, anxiety attacks, and even dissociation. Clinically, he has been diagnosed with Anorexia, Post Traumatic Stress Disorder, and Dissociative Identity Disorder. Aidan initially sought support through peers online before seeking therapy. He also reached out to friends, professionals, and in times of crisis the support of Kids Help Phone.
Aidan wants others to know that the road to recovery isn’t always straightforward, but you can get there. He believes in ACT!ON for people across the mental health spectrum, particularly those who are either early in recovery, or are yet to come forward with their struggle. He now regularly speaks to high schools and conferences notably, the BC Patient Safety & Quality Councils Quality Forum, and the Vancouver Healthy Minds Youth Summit: Building a Mindful Community.
Aidan has made it his mission to reduce stigma and expand accessibility to professional care, he therefore launched SpeakBOX, a first of its kind company developing digital mental health treatment services paired with the support and inclusion of peer support programs. For Aidan, ACT!ON is part of the journey.