My brother Tim

I am last of six. 3 girls, 2 boys. When I was grrowing up I doted upon the elder of my 2 brothers and really didn’t have very much to do with the other one. I suppose growing up we didn’t have very much in common and he was away at boarding school for much of the time.

I am the most educated in the family in that I can claim an M.A. Tim didn’t get past O’levels. But who is doing the better? He started as a trainee chef and through hard work, opportunity and risk taking he is now in charge of running the ‘hotel’ facilities for oil refinery workers in the Middle East. And me, with all my qualifications? Not alot.There must be a certain irony there. And I have alot more to do with him now. In some respects, and he’d probably tell me I am wrong, he was for awhile an outsider but now I think he has the confidence and the wife to recognise the family.

Ambitions

When I was little I had grand ambitions. We were living a privileged life in Jamaica but all round were signs of the opposite side of the coin. Going to the beach at the weekend meant driving past a shanty town; elsewhere shacks were abundant. So I figured I’d become a doctor and save the health of the third world. And then we came back to England and I onto to senior school where I realised I was lousy at science. But I still harboured grand plans of doing something useful even if I didn’t know what. Then onto university to study the very useful subject of philosophy. At the end of that I decided to go into law with the idea of helping the downtrodden,but that didn’t work out either. And then I got retired because I was spending more time in hospital than at work. Not to be thwarted I did voluntary work with the CAB until they closed the section down that I was working for and I was so pissed off at this that I wouldn’t transfer to another .Every now and again one has to stand up for ones principles.

All these grand ambitions and I am now working (Voluntary) for the hospital. I am the activities dept. When I started I was working alongside a paid employee. He left and was replaced by a secondment which wasn’t renewed. So that leaves me to entertain the patients. It is a bit of an uphill struggle because most of them don’t want to be entertained. Either they are too ill or too caught up in their boredom to be able to break free. So I organise arts and crafts (at which I am useless), shopping trips, cinema trips, sports days, outings to Blackpool and I find the take up tends to be low.At any one time there are usually only 4 or 5 patients interested. But hey, if I make a difference to one person’s day then I figure I have achieved something.

But it’s all a long way from my childhood ambitions.

Voices

I have only ever heard a voice twice. And both times it was pretty scary. There are people whose voices are constantly with them. It is not always a bad thing. People might have experienced voices for years and from an objective point of view are very impoverished – no job, no family, nowhere to go, nothing to do. However their inner life might be pretty good if the voices are kind and offer a sense of purpose.My CPN (community psychiatric nurse) told me of one of his clients. He was hearing voices and duly medicated to get rid of them. But once they were gone he was bereft – they were his only friends. Likewise delusions – if one is deluded that one is a very special person then it seems unkind to take that away if there is nothing to replace it with.

But there is no doubt that many people are plagued by their voices.A person with schizophrenia in an acute phase is often severely thought disordered and riddled with frightening delusions which are fed by the voices. But they will generally be convinced that they are fine mentally. In this state there is a higher risk of suicide and exploitation and without treatment they are likely to detioriate. So the medics step in and prescribe medication which, if necessary, can forcibly be dispensed. Is it a case of the nanny state interfering in individuals lives or a case of acting in the best interests of someone incapable of making a decision.

Assertive Outreach

I believe that i mentioned in a previous post about how intrusive I found Home Treatment. This turned out to be nothing compared to the  Assertive Outreach team (AOT).The raison d’etre of AOT is to engage those people in the mental health service who do not want to be so engaged.A classic example of coercion.You don’t want us in your life but tough, we are here to stay.

I spent alot of energy in my early years in the system dodging the system. It didn’t help that the services were so erratic – I would never know from one day to the next when I would be visited. At this stage I was self medicating and getting my prescription from my gp. Admittedly I took a rather random approach to the whole thing and would regularly miss my doses which really didn’t help anything at all.

One day the Consultant came round and said he would be sending a couple of nurses to take me for a coffee ( I wasn’t leaving the house at this stage). 2 nurses duly turned up the next day and announced that I was now under the AOT. There was no mention of the promised cup of coffee.

I don’t recall being particularly amused at this state of affairs. It was landed on me without any choice or discussion.And then i found that they really wound me up.The obvious question was ‘why should these planks be involved in my life?’ Again they used to turn up at random and expect me to be sitting waiting for them. Most of the time I didn’t bother answering the door. At some stage they took responsibilty for my meds but would deliver them any time up to 4.00 which is a tad late to be taking my breakfast ones. The whole thing was basically chaotic.

I then ended up spending 9 months in hospital on a section and didn’t see sight nor sound of them until the very end. For various reasons I was in a bit of a state when I came out and I then discovered what a good keyworker I had. A key worker is a member of the team who is usually, but not always, a nurse with specific responsibilty for a particular client. By a war of attrition I eventually managed to get them to agree to come at the same time every day which made life alot easier for both sides.And so my keyworker would duly turn up at 11.00, have a coffee and spend some time talking. This in itself is quite unusual because due to staff shortages etc the focus is on the medical model dishing out meds and depots ( a regular injection of medication). So I was quite privileged really. And then he retired.Damn. I was intitally very dubious of his replacement, mainly because I didn’t know him.In fact he turned out to be a bit of a star. And now he has just left and the jury is out on his replacement who, again, I hardly know.The one continum has been my consultant who has been there since my very first involvement in the system. If it hadn’t been for him I would probably have left the country long ago.

They bring me my medication everyday and sometimes take me out for breakfast at the weekend. Now I am working at the hospital during the week they bring the meds there and try to give them subtly to me. It would be much easier if they handed them over straight rather than going through this pantomime of holding them behind their back and slipping them to me.

I am now on 7 different mad pills (the physical ones are another story), see the consultant once a week and see a psychologist weekly. I guess I have come a long way from the early days of dodging the system and in that respect AO has been successful.

Depersonalisation

I think I mentioned depersonalisation in passing in a previous post. It is not a widely known ‘condition’ but it is one that i know a fair amount about. Not only have I been experiencing it from the age of 13 but I also wrote a dissertation on the subject for a M.A. It is very difficult to describe properly mainly because the descriptions defy rational understanding.

But I shall try. I look down at my hand and it doesn’t belong to me. I look in the mirror and see a stranger. Essentially I feel unreal and detached from my own body, thoughts and the outside world.I feel like an automaton.My emotions are numbed.Even touching and hearing are different.

I had my first experience of this when I was 13 and was quite convinced I was going mad. I spent the best part of the summer locked in my bedroom to the extreme annoyance of my mother. Over the following few years i had sporadic episodes, some fleeting, some longer. Each time it happened I felt I was going mad. I was unable to tell anyone partly because it is so difficult to explain and partly because they would think I was going mad. It was bad enough me thinking it without others agreeing.

Over the next few years the experience became more frequent until it reached the stage when it was more or less permanent. Somewhere around this time I managed to mention it to my psychiatrist. And rather than being horrified he sat back and said ‘that’s depersonalisation and you probably think you are going mad. But you’re not’. A huge sense of relief washed over me.

Nowadays it comes and goes and varies in intensity. It still spooks me at times but I have pretty much learnt to live with. I can recognise that simple things like lack of sleep or bright lights can make it worse. Alcohol ironically helps.

If depersonalisation wasn’t enough there is also derelisation. The outside world appears foreign and new. It’s not real. It makes things like driving very difficult as concept of space and distances change. Getting both at once is a real double whammy which effectively renders me immobile.

There are a couple of research projects on the condition – one in America and the other at the Maudsley in London. My consultant offered to refer me but when I found out that he meant the London one rather than American I wasn’t quite so enthusiastic.

It was Indian head massage afternoon at the psych unit today. The physio comes in twice a week to minister his magic powers. Sometimes there is no one interested but today there was a queue of eager people. I sat in for a couple as a chaperone. The first patient fell asleep, the second one didn’t stop talking (mainly to her voice) thoughout. It was as if she had to check what she was feeling with her voice in order to validate the experience.

Other than that the day was fairly quite. I walked to the local shops with one of the male patients. he has been in hospital for about 10months and no one seems to know quite why. He is in the unfortunate position of being on a Home Office section for some demeanour he committed long ago. He has never appealed this and when he was brought in this time it was under the pre existing section. Which meant that everything from moving wards to escorted leave to unescorted leave, to eating and breathing is regulated by the Home Office and their approval is needed before any change can be made.

He is a bit of a lost soul wandering aimlessly around the hospital grounds. He has just been given escorted community leave so I took him shopping for new clothes last week. It is important to get him out and about as much as possible to try and reduce the effects of institutionalisation. When he finally gets discharged it is likely he will find the change from hospital to real world very difficult.

Meanderings

I guess I first started becoming ill in my mid to late teens but it didn’t really become an issue until my mid twenties. I went through a phase for about a year around my a’level time when I believed people could read my mind. To circumvent this I used to count in my head so instead of reading my thoughts they would be hit by a wall of numbers. It made for interesting conversations as I’m listening, counting and trying to find a reply at the same time. Fortunately I didn’t tell anyone because I might have ended up with a diagnosis of schizophrenia. Quite how I managed to pass my a’levels I don’t know. I was also suffering from bouts of depersonalisation (which shall feature in a later post) and was pretty much in a state of confusion for alot of the time. Added to that were mood swings. I could be down for weeks and then sudenly get a burst of manic energy which i generally used for doing daft things.At least I never really got into drugs. I have come across numerous youngsters in their twenties whose problem first started with drug induced psychosis caused from smoking cannabis and then developed into full blown schizophrenia which is generally there to stay. I feel like an old fogey when I talk about all the wasted youth I see around me at the hospital.

On a completely different matter altogether I took a patient shopping today. It was a slightly bizarre experience as I was never sure whether she was talking to me or a non-visible 3rd party. Before making any decision she clearly consulted  this voice and went by what they suggested. I was unsure as to how much influence I should attempt to levy over her spending. She wanted to buy 20 mens shirts (4 for a tenner) but I managed to beat her down to 10. I also made her buy a purse because she was constantly losing her money in the depths of her handbag. Anyway she must have enjoyed herself because she wants to go again next week.

Great Escapes

In my younger and considerably fitter days I made an art out of escaping from hospital. Sometimes it was as easy as hopping over a fence and strolling nonchalantly in the other direction before making a mad dash for home.Other times it was a little more complex. Once, whilst on a 1:1 (whereby you have a nurse with you at  all times) I got out of a sash window by cutting the ropes, hopped onto a flat roof, down a drainpipe, over a ten foot gate. And home. Where of course they were waiting for me. In retrospect the front door  would have been easier. Another time I did make it through the front door – a fight on the ward had distracted the staff- got home, got my car and drove up the M6 to Scotland. Once there I pulled over somewhere and thought ‘what the fuck am I going to do now.’ So I turned round and drove home again. Once back here I thought I would be clever and leave my car on a friend’s driveway (it was 4.00 o’clock in the morning). I figured that if they came to the house and didn’t see the car then they would think I was elsewhere. The consultant didn’t fall for that one.

At some stage he got so fed up with me running off that he transferred me to the locked unit which was an interesting experience. I was the only women with 13 men for company, most of whom havd been transferred from the prison.

My bids for freedom are somewhat put in the shade by others I knew. One smuggled herself off the ward in a laundry basket and somehow made it up to the Orkneys.But track her down they did. Another recently made it to Jamaica where she ended up in a psychiatric hospital in Kingston. She returned pretty sharpish.A 3rd I know rushed away from her escort in the hospital grounds, rushed onto the main rd and stopped the traffic. She leapt in some poor and confused man’s car and got him to drive her to the main bus route into town. She hops on the bus without any money (and no shoes) and makes a beeline for the Hyatt Regency. She gets herself chucked out of there for throwing a drink over someone and then wanders in and out of night clubs dancing wildly before making it to a friend’s house where she was picked up by the police.

Hospital

The more astute amongst you will realise that I have not quite got the hang of this system hence 2 introductions. I did try to delete one but failed miserably.But since there is probably only one person reading this it doesn’t matter too much.

Unsurprisingly (and this is probably a repetition) I remember my first admission to a psychiatric hospital with some clarity.The long, long corridor with the old man shuffling along in his bedroom slippers.The building was in its last years of use and was run down and generally tatty. Ihad been given the choice of going voluntarily or going anyway. I chose the former but in retrospect would have perhaps been wiser to go for the latter option. At least then I would have had more idea of my situation. Generally people are ’sectioned’ under 2 sections of the Mental Health Act – S2 which is for up to 28 days and s3 for 6 months. S3 can be extended almost indefinitely but there are safeguards in place.There is also the right of appeal. That is your crash course in mental health law over. At least if I had been sectioned I would have had some idea of how long I would be incacerated for. As it was it seemed never ending. I was also under the impression that I would be free to come and go as I pleased. Oh no, fraid not.

I remember the consultant breezing in with what seemed like a never ending line of people behind him. My brain panicked and effectivetly ground to a halt. In fact it ground to a halt for the next few years. But the same consultant has stuck by me all the way even though his entourage changes regularly.

Finally he agreed to discharge me but it was on the condition that I subject myself to Home Treatment. This was a newly established team whose aim was to support people at home. This meant visits. And visits I didn’t like. Little did I know what was to come. The daily visits made me rush back to work with undue haste. When I crashed again within a few weeks they all told me that they thought I had gone back to work too early. Shame noone seemed fit to mention it at the time.

So that was my first experience of the mental health (illhealth) system.

PREAMBLE

For those not in the know Drogo is the Patron Saint of mental illness. And, inter alia, broken bones, cattle and unattractive people.So if you are ugly with a broken arm and mental illness then Drogo is your man.

I hold my hand up. I suffer from something which was once called mental illness but now is more often referred to as mental health problems.I have a diagnosis of bipolar (which was once known as Manic Depression) and get to take a fistful of tablets to keep the worst of it at bay.On the whole they work but sometimes I slip one way or another. Downwards is cheaper. Upwards and I develop a predilicition for spending money on things that I am certain I need and must have now.Unfortunately the email facilitates this. For a while I was addicted to ebay but have managed (more or less) to cure myself of that curse. Downwards and I tend to hermit myself.I fantasise about sitting in the cupboard under the stairs but there is too much junk in there to get in.

Once upon a time I was a solicitor but I became ill and was retired on the grounds of ill health. There is something quite demoralising about being retired in one’s mid-twenties.Although I have a sneaking suspicion that it might make for cheaper car insurance.Nowadays I do voluntary work at the local psychiatry unit. When I  started I was part of a team now I am the activity department. Sadly my talents for art and craft are minimal (my 3 sisters seeming to have inherited what skills there were.)My forte is driving patients to the post office to pick up their benefits. Oh, and dishing out cigarettes.

Drogo

For those not in the know Drogo is one of the Patron Saints of  mental health (illness even).He’s also in charge of such diverse areas as cattle, broken bones, unattractive people to name but a few.

I hold my hand up – I suffer from something which used to be known as mental illness but now is more often referred to as mental health problems.Why, I don’t know. I have a diagnosis of bipolar disorder (once known as manic depression) and get to take a fistful of pills to keep the worst of it at bay.On the whole they work but sometimes I slip one way or the other. More often downwards which is at least a lot cheaper than a high – I tend to spend alot of money on things I am sure I desperately need and can’t survive without. Unfortunately the internet facilitates this predilection. Ebay was my downfall for a while but I have cured (mostly) myself of that addiction.

Once upon a time I was a solicitor but I kept ending up in hospital so they retired me. There is something very demoralising about being retired whilst still in one’s twenties - although I do have a sneaking position that it keeps my car insurance down.So that’s alright then. Nowadays i do voluntary work at the local psych. unit. I am currently the whole of the activity department which would be great if I was any good at art and crafts. My forte is driving patients to the post office to pick up their benefits.

As perhaps to be expected my first incarceration is forever etched on my memory. Subsequent visits are more blurred. It was one of the old asylums which  now is part of the prison. Which makes a bit of a change from being turned into luxury flats as seems to have been the way of some many of these institutions. But I digress. I was taken there by ambulance and was escorted down a long, long corridor.Shuffling along in the opposite direction was this man in too short trousers and down at heel slippers.

The ward I was taken onto was an all female ward covering my locality. There were a few individual rooms and one large dormitory. Someone must have been being nice because I was given a room.

That is probably enough for now. Watch out for the next exciting installment.