Saturday, November 04, 2006


As previously mentioned Mr Man has had a change in medication over the past month. I was recently asked in the comments section how Mr Man was doing, and if there were any improvements in his symptoms since taking Abilify. At the time it was too early to tell especially as his symptoms are prone to slight fluctuations in severity anyway. Although he will openly tell me when the voices are worsening and causing him anxiety, he tends to keep his delusional thoughts to himself, unless a change in his behaviour causes me to probe deeper.

This was the case yesterday. We had had visitors in the day and it seemed to affect him quite strangely. I’m not sure how to explain it; sometimes I “sense” something but I can’t describe what it is. After our visitors had left he remained quite distracted throughout the day. He had this expression on his face, and I knew he was deep in thought, but when I asked him what he was thinking he just replied with “I don’t know”.

By the time we had gone to bed he seemed to be ready to open up. He told me that he felt that our visitors were spies. In fact he could only name a few people that he doesn’t feel that way about. He felt that he was being watched all of the time, and he said that the voices were telling him to get on with his “work”. Previously when he had skipped some medication I would find him sitting on the floor in front of the TV with a note pad and pen, taking down “codes” from the TV adverts. Now the voices are telling him to do this “work” again, and although so far he has managed to resist, he said that the voices are becoming very persistent and threatening. Of course, the voices telling him to do these things is one thing, but it's when he starts believing it that I start to worry, which he is. I said I would contact his psychiatrist on Monday to see if we can get his medication increased, but he refused saying that “She’s in on it”.

I’m hoping that this is just a “blip” caused by the disruption of medication levels during the change over, but obviously it is something that I am going to have to keep an eye on. He doesn’t seem to be preoccupied by these thoughts all of the time, as he was able to keep himself busy for some of the time yesterday, and we had some interesting discussions about music and such like. I’ll have to be very careful to make sure that he definitely swallows his medication though, as I know that once the delusions start that he is likely to stop taking them, believing that the meds are used to “control him”.

I know I said previously that I didn’t really want to discuss his delusions yet as I wanted to retell the series of events in order, but obviously that isn’t happening. I seem to be recovering now from my recent bout of exhaustion so hopefully I will be able to write about his first hospital admission soon.


Anonymous said...

Found you today, what a marvellous blog.

I recommend this to everyone but you should read David Healy`s " The Creation of Psychopharmacology". It`s the first definitive history. It begs a lot of questions about the medical model which in turn raises questions as to why psychotherapeutic interventions aren`t dominating.

In some ways it won`t fill you with much confidence but it will leave you in no doubt as to the huge impact your love and care has on your husband. Professionals, as you`ve already realised, don`t have all the answers.


Mr Mans Wife said...

Thanks Oldschoolbaby, I will definitely have a look at that. Any suggestions as to where I could find a copy?

Anonymous said...

I don`t think it`s sold in huge numbers which is a crying shame. There seems to be a lot of generic history`s of psychiatry but much fewer specific ones. To be honest, it`s probably because they wouldn`t show the mental health world in a very good light. Too much chasing of fashionable ideas with too many reasonable interventions left behind in the stampede.

Anyway, it`s out in paperback at around £13. Not sure if you can get it through the library service. If you`re flush use your local bookstore. If you`re in a hurry you can`t fault Amazon, they may have a second hand copy.

Mr Mans Wife said...

Thank you. I actually found it on Amazon UK after some searching, I thought I was going to have to get it shipped from the US!

I've been reading an online excerpt and it looks interesting but I might need a medical dictionary to understand it!

I know you said that you recommend this to everyone, but is there a particular reason why you think I should read it?

Anonymous said...

Our conversation is becoming a little fragmented but never mind.

This is a topic that has great potential to be dry and tiresome but it`s a very readable book. You will learn where the term schizophrenia originates from. What role a dopamine imbalance has in psychosis and how anti - psychotics were and are developed. And much much more. Hopefully, this will empower you to a greater degree when you and Mr Man discuss a medication regime with his RMO.

It will also give you much greater insight into the mental health world and it`s limitations. That will indirectly give you more self belief in the care you provide and hopefully give you more confidence to explore other types of intervention. Family, friends, work, hobbies, self help groups, community activity, even faith. I don`t know what combination will help your husband but the bigger the armoury the better.

Mr Mans Wife said...

"Our conversation is becoming a little fragmented" yes it is, but it's an interesting one!

Thank you very much for your comments and advice, it is greatly appreciated, although I still find myself feeling wary and defensive knowing that you're a psychiatric nurse, but I'm fighting those feelings.

"the bigger the armoury the better" I would definitely agree with this. Hobbies are a huge part of Mr Mans recovery, but it's taken him a long time to be well enough to engage in them. I think there is a wrong and a right time for "other types of intervention". Used at the wrong time would be of no help, or even make matters worse. Used at the right time it is amazing to see the benefits.

What's RMO?
Thanks again for your comments.

Anonymous said...

Sorry, for the fragmentation, my fault probably. I have points I would like to make but I want to keep them for future posts.

I am just trying to be honest. Mental health professionals are not a panacea and it is important that we admit that. Psychiatrists and Psychologists don`t like to admit it as they worry that they may be replaced by cheaper options. Nurses don`t like to admit it as everyone likes to believe they are effective at their job. Your task is to explore what we have to offer, take what`s beneficial and mix and match it with what you have found to work yourself.

Just take nurses as you find them. There are some I wouldn`t allow to dog-sit but there are others who astound me with their compassion.

RMO = Responsible Medical Officer = Consultant. When your typing is as woeful as mine you need every abbreviation you can get your hands on.

Mr Mans Wife said...

"Sorry, for the fragmentation, my fault probably. I have points I would like to make but I want to keep them for future posts." That explains a lot! At times I have been unsure whether to take offense or not, feeling that you were being deliberately evasive with some of your comments! (and of course bad past experiences were adding to my paranoia!)

Thank you for your comments Oldschoolbaby, I find your honesty refreshing re: professionals not wanting to admit their limitations.

I'm doing my best to "pick and mix" and thankfully we have a brilliant Psychiatrist now who is of the opinion that "it's a mistake not to listen to the carer" so we have even been able to refuse certain treatments that we thought wouldn't be beneficial without being criticised for that decision. I never thought I'd hear myself say that.

Anonymous said...

I love your b-log and an facinated about and u.....I am affected my a similar disorder of the brain called schizo-affective disorder....i don't know if u have heard about it but if u have kewl......

Mr Mans Wife said...

Hi there Anonymous, thank you for posting.

Yes, I have heard of Schizo-affective disorder but unfortunately I don't know anything about it. I'd be interested to know in what ways it differs from Schizophrenia though.

Thanks for reading, I'm glad you find it interesting.

Rhea said...


Haven't stopped by in a while (in the process of buying house/packing stuff/stressing)

Belated Anniversary wishes and I hope Mr Man's mood stabilises soon.

Mr Mans Wife said...

Hi Rhea, thank you for the anniversary wishes and well wishes for Mr Man. I really should post an update on Mr Mans mood, or just an update in general as it’s been ages since I last posted, but I keep getting distracted! (with my other blog, recording for my creative outlet, and helping Mr Man with numerous projects as well)

I hope your move goes well. Thanks for your comment.

Mr Mans Wife said...

Thank you for that explanation Michel. It sounds like a combination of Schizophrenia and Bipolar, would you agree? Psychiatry certainly is complicated.

Anonymous said...

Nothing is simple in psychiatry, mr mans wife.

Psychiatry has a "Bible", an American publication known as the Diagnostic and Statistical Manual (DSM). The first DSM, published in 1952 ran to 134 pages. It has been revised a number of times subsequently and the 2000 edition runs to 943 pages.

Optimists will say that psychiatry is developing impressively, that we are understanding more and that our diagnostic tools are so much more advanced. On the other hand cynics will say egotistical psychiatrists and psycholigists are manufacturing trendy diagnoses to make themselves look cutting edge. They`re enthusiastically supported by the pharmaceutical companies. More diagnoses = more treatment = more prescribing = more profit.

Personally, I lean more towards the cynic`s position. I don`t know what the truth is. As I keep telling you though, if you want to make a bit of sense out of it, you have to look to the historical perspective.


Mr Mans Wife said...

"I don`t know what the truth is. As I keep telling you though, if you want to make a bit of sense out of it, you have to look to the historical perspective."

Oldschoolbaby, you've read the book, and psychiatry is your profession. If you still don't know what the truth is what hope do I have?

I agree with your comments though, and I would probably settle somewhere in the middle. From the excerpt I read of that book I learnt that years ago everything was diagnosed as Schizophrenia, and considering in those days people were admitted simply for being "different" it's clear to see that psychiatry has come a long way. After the kind of staff I have seen at hospitals though, I don't doubt that some psychiatrists think up diagnoses for their own gain.

Anonymous said...

Believe me, mr mans wife, I am trying to help. As long as you`re not placing your eggs in too limited a number of baskets, growing in confidence with regard to trying different interventions and reassured as to the hugely important and effective role that you play. Then that should be progress.


Mr Mans Wife said...

Thank you Oldschoolbaby, I’m sure your motives are good ones.

Please don’t be offended by what I am about to say, as I’m sure you are simply trying to be complimentary, but you have mentioned this “hugely important and effective role” that I play quite a few times now, as if you think I somehow doubt the importance of my role as a carer. Let me reassure you that I am completely convinced that if Mr Mans care was left entirely to the medical profession he would be dead by now, so I am in no doubt as to the importance of my role in that regard. Not just in making sure he received the appropriate care, but also in my personal role as a carer at home. Obviously I don’t want to “blow my own trumpet” but I know that the love and patience I have shown has proved vital to his recovery, but balanced with that, I also know that I could have done much better. Unfortunately I am only human, and a very imperfect one at that.

You also repeatedly mention trying other interventions, as if you think we solely rely on medication for improvement of his symptoms. Let me assure you that this is not the case, although I do feel that in Mr Mans case at least, medication plays a vital role. In the past Mr Man has been so psychotic as to be unable to take advantage of some of the other interventions you have mentioned previously. I have not yet detailed the other forms of therapy that we find useful (don’t rush me!)

So I’ll make a deal with you: I’ll try to use more baskets for my eggs as long as you try not to hatch them all at once!