Wednesday, December 17, 2008

I Can't Think of an Apt Title Either...

I really don't know if I should link to this post or just try to forget that I ever read it or that it was even written. I can't bring myself to reproduce it in full on this blog.

*Mr Mans Wife stares at the screen for a while wondering what to write*

Umm... so here's the link.

Edit: Seaneen over at Pole to Polar has covered this topic too, and she has come up with a great title!

Thursday, December 11, 2008


It's been five years this month since the last time Mr Man was in hospital. Over those years Mr Man has gradually improved and there are things he can cope with now that he couldn't cope with back then - simple things, like answering the door when someone knocks. He still has his off days, but he seems to have improved even more since he stopped taking his Clozaril and had his Abilify increased back in July, simply because he is more able to occupy his mind now that he doesn't feel so drugged.

He's not been feeling very good for the past couple of days though. He tries to carry on as normal if he has plans to go somewhere, but the rest of the time he tends to sleep more to try to escape the voices.

Tonight I heard him moving around in the bathroom more than usual. Despite the fact that it has been five years since he last cut himself, I found myself rushing up the stairs to make sure he was alright. I still worry that this will happen, even after all this time. Will I ever be able to let go of the trauma of the past?

Thursday, December 04, 2008

Blog Awards Day - Way Overdue

I'm so sorry to all those who have given me awards in recent (or not so recent) months that I haven't responded promptly. I want you to know that my lack of response in no way indicates a lack of appreciation for these. I appreciate the awards very much, the most recent of which was the Kreativ Blogger Award, given to me by Barbara from In Sickness and In Health, a blog about couples dealing with illness. Thank you Barbara! Isn't it beautiful?

So apparently now I have to list six things that I am happy about before passing this on to six other bloggers. Blimey, six things to be happy about? That's a lot! Let me see...

1. I am definitely happy that Mr Man is still alive, recovering, and keeping himself busy and happy with various hobbies. (Does that count as three? :D )
2. I am also happy that I have found some hobbies that I enjoy and that help to bring me peace.
3. I am happy that my Mum is trying to give up smoking.
4. I am happy that my brother is recovering from alcoholism.
5. I am happy that my sister has conquered her drug addiction and has returned to being the caring and generous spirit that she always was.
6. Seeing my nieces and nephews always makes me happy, but I am happy to see that some of them want to share hobbies with Mr Man and I.

There, that wasn't so hard was it? I think the hard bit will be nominating six others, since I haven't been blog reading for quite a while and although I think all my usual suspects are deserving (Gadget, Seaneen and Mental Nurse for example), it's not very kreativ for me to keep awarding the same people is it?

Despite this, I would like to award Inspector Gadget, Seaneen and Mental Nurse. Gadget and Seaneen for their creative writing abilities, and Mental Nurse for their creative ideas for posts, such as caption competitions, weekly round ups of mental health blogs, and their quirky polls. I'm sure there are many many others who are equally as deserving but I just don't come out of my bubble that often to read them these days.

A long, long time ago I was awarded the Inspirational Blogger Award by Anonymous Mom over at Tenuous at Best. Yeah ok, I know it was over a year ago, but it's mine and I'm taking it!

It's inspiring to me to know that I inspire or move others, so I would actually like to award this to Anonymous Mom and all the readers, bloggers or otherwise, who leave comments or send me emails regarding my blog. I'd like to say a big thank you to all of these ones for inspiring me to keep going.

Additionally, I would like to award Tom Reynolds from Random Acts of Reality as his was the first blog I ever read and he inspired me to write my own. So without his blog, this blog probably wouldn't exist! Also, I would like to award Philippa King, whose art has moved and inspired me beyond belief. Thank you Philippa, and Tom.

So, I think that's it for now, although I do have a few memes to respond to...

Monday, November 17, 2008

Over Sensitive

Y'know, these days I have to be really careful about what I read or even what I watch on TV. I know some would say I am over sensitive, but reading or watching the wrong thing can (and does) send my mood plummeting. I'm not always sure what "the wrong thing" is to be honest. Injustice of any kind, I think. Watching a crime drama about a doctor who causes someones death and then covers it up and gets away with it is definitely "the wrong thing" for me.

When Mr Man was in hospital for the third time in 2003 one of the patients died. It was widely believed that the doctor had assessed the patient and decided that she was well enough to go home with her husband for the weekend, but then she killed herself. An easy mistake. If someone is determined enough (and pretty good at acting) it is possible that they could fool the doctor into believing that they are starting to make a recovery. It was a tragedy.

But, what actually happened was that the patient was on "level 3 obs" as they called it - she was supposed to have been checked every 15 minutes to make sure she was safe. She wasn't on home leave at all. During the inquest it was explained that the hospital was regularly under-staffed, making such observations difficult. The ward had two floors, with numerous exit points, which increased the difficulty further.

Actually, the truth is that at night the patients weren't allowed downstairs, and in the day the patients weren't allowed upstairs and their rooms were locked. It was impossible to leave the ward from the first floor anyway - all of the windows had bars across them on the outside, preventing them from opening more than a few inches. On the ground floor there were only two exit points, one of which was directly next to the office. In fact you couldn't walk in or out of the exit without being seen by whomever was in the office. So how did this patient manage to leave the ward?

It was nearly four years before the truth was finally established, that the patient's notes were falsified and recorded that she had been checked on - a full half hour after CCTV footage showed her committing suicide elsewhere in the town. She was missing for four hours before anyone noticed. The notes were falsified by the nurse whom I had witnessed on numerous occasions playing computer games in the office. Obviously the nurses were very busy because they were so under-staffed.

It makes me wonder what we would have found out if the case of Mr Man's attempted suicide on the ward a year earlier was fully investigated. Of course, it never was investigated because... well, he didn't die did he? So that made everything ok. That's what I was continually told anyway. I did meet with the Medical Director, to discuss this and other issues, and I was assured that Mr Man had been checked every 15 minutes, so the staff had done all they could to prevent it - it was in his notes so it must be true.

Friday, October 03, 2008

I know it’s coming

Some of this post has been deleted

Just like before
There’s a black dog
That scratches my door
He’s been growling my name and saying
You better get to running

It's been an extremely difficult year for my dear friend Philippa. Please give her lots of hugs and/or visit her blog to show her you care.

give Philippa more *HUGS*

Friday, September 19, 2008

And whilst we're on the subject of Ignorance...

I recently attended a very boring and yet equally as interesting meeting for teachers involved in adult education. It was a compulsory thing for my friend, and I went along as her chauffer. There was much emphasis on completing paper work and carrying out risk assessments – if you’ve worked in education (or any public sector) you’ll know what I’m talking about. Before you ask, the buffet was naff.

There was a panel of various key figures who took it in turns to give a little introduction of their roles in the education service, followed by the usual “if you have any questions come and see me later” and “my number is in this leaflet” whilst waving bits of paper in the air. And then a lady stood up and said: “My name is Josephine Bloggs and my role is to make sure that adult education is accessible to people with physical disabilities or mental health problems”. That’s when the evening became interesting. She said that teachers obviously know about their own subject, but need to be taught how to cater for the needs of such ones.

Raising awareness in this way is something I would quite like to do – explaining what mental illness is and isn’t, a few do’s and don’ts, and how best to be supportive, that kind of thing – after all, they’re not training to become mental health nurses, so a lesson in biology is probably not required! I enquired about it later in the evening and although I was told that the CPT would be handling it, the lady took my number to pass on to another lady who would be directly involved in this. During our discussion there were a few points that sounded a little odd to me, and when/if the lady calls me I shall no doubt be asking for some clarification.

Firstly, I got the impression that there were specific courses for people with mental health problems, such as painting, dancing, yoga, “subjects that are therapeutic” as the lady put it. Are they suggesting that people with mental health problems can only benefit from “therapeutic” subjects and not academic ones? Do they assume that people with mental illness do not have the mental capacity to learn something more challenging?

Secondly, why are people with mental health problems being segregated by being given their own courses? Aren’t they just ordinary people like you and I?

Thirdly, I was told that one way I could help was by being a “buddy” for a mentally ill student. Please tell me that this is not a paid role. Do they think they need to enrol people to be friends with those with mental illness? How is the person expected to gain confidence in their own social skills if “buddies” are provided? How would you feel if you were assigned a “buddy”? Wouldn't you feel like they were saying “You're so awful no one will like you so we've asked someone to be your friend”?

These courses are designed for people with “mild to moderate” mental health problems. I have read that Schizophrenia is the most severe form of mental illness. So if this is how they view “mild to moderate” sufferers of mental illness, they must think Mr Man is a complete cabbage! So let me just clarify a few things about Mr Man…

  • His table tennis skills are improving all the time, which is one of the fastest thinking sports there is. He’d now like to train to become a coach.

  • He is very proficient in web design and computer programming, being able to program in at least 10 different programming and scripting languages, flash animations, and other things that I can’t even explain to you because I don’t understand it – all self taught.

  • He has an amazing comprehension of various forms of mathematics which I have never even heard of – again all self taught. He even created his own mathematical formula to work out the day of the week of any given date in history or in the future - which he can calculate in his head.

  • He has composed hundreds of pieces of music of many different styles.

  • Believe it or not he’s even made some new friends all by himself.

My teacher friend pointed out to me that although there are specific courses for people with mental health problems, anyone can enrol on any course. This is true, but only the teachers who are teaching the “therapeutic” courses specifically for the mentally ill are being trained to cater for the needs of those with mental illness - the other tutors merely received an information leaflet that was so general that it could apply to almost anyone whether they suffered from a mental illness or not. Who’s to say what is therapeutic? Yes, I would love to paint and dance and let the wind blow through my hair, but these things are not relaxing or therapeutic to Mr Man. (For those things, please see the list above)

I realise that not every person who suffers from a mental illness is like Mr Man, but I just feel the whole scheme is patronising at the very least. It would be much better for all teachers to be better educated about mental health issues as part of a national or even global campaign to reduce ignorance and stigma, and to start treating those with mental illness as ordinary people living with extraordinary illnesses, rather than continuing prejudice by treating them as something subhuman under the guise of being politically correct.

Still, it ticks all the right boxes so that they can receive their government funding.

Thank you to Mr Ian for providing this link for Mental Health First Aid.

Sunday, September 07, 2008

Ignorance Breeds Ignorance

The BBC reports that in a study of 500 young people conducted by Great Ormond Street Hospital, almost half could not name a single mental health condition. Dr Jon Goldin, a consultant child and adolescent psychiatrist at Great Ormond Street, said the results were both worrying and surprising. But are they? Are the results really that much of a surprise?

I confess; before it was suggested to me that Mr Man may be suffering from Schizophrenia, which in turn led to my own research, I had no idea what Schizophrenia was. Like most people I think I thought it was a split personality – I had no idea about delusions or hallucinations. Lack of knowledge probably explains the strange reactions I have had from others once they have realised my “plight”.

Ignorance is rife at all ages. No wonder then that many of the Google searches that lead to my blog are strange questions such as: “is a schizophrenic capable of love?”

Dr Jon Goldin continues: “This ignorance is probably one of the reasons why for too long now there has been a stigma attached to living with a mental health condition.” And I couldn’t agree more. People living with mental health problems are presumed to be unpredictable, violent, aggressive; you name it – anything other than ordinary people living with an illness, and these beliefs are largely fed by various types of media. How many people ask the question: “Is a person with Multiple Sclerosis capable of love?”? Or “Are people with Cancer violent?”? How many times do we see the headline “Murderer was Dyslexic”? Never. Does this mean that people with Dyslexia don’t commit murder? Of course not, but we wouldn’t dare stigmatise these people in such a way.

It is admirable that Great Ormond Street is responding to this need of information by adding a new section to their website Children First, dealing with mental health issues; but just as with this blog, I fear that only those who have an interest in mental health issues will access that area of the site, and believe it or not, there are still some children without internet access or the privacy to read information on such a sensitive issue.

Young people are often influenced by the attitudes of their parents and teachers before they reach their teens, and prejudices can already be ingrained by then. There needs to be more education for the general public and especially for parents and those who work with young people – firstly to avoid passing on such prejudices, and secondly because mental illness often first develops in adolescence and needs to be recognised for what it is. Mr Mans illness remained undetected throughout his teens, as his depressive behaviour was dismissed as being “normal teenage” behaviour.

No, there is no surprise at the lack of knowledge about mental illness by young people. Ignorance breeds stigma and further ignorance. Only knowledge breeds understanding and acceptance.

Wednesday, August 20, 2008


September 2003

If you have been following our story in order this is quite a jump forward in time, but the subject of having a loved one detained under a section of the Mental Health Act is one that has been discussed recently, but not in depth. This was our experience.

It was a Sunday morning. I awoke earlier than usual, not having slept very well after being woken during the night by Mr Man repeatedly banging his head on the pillow in an attempt to get the voices to stop. He had been discharged from hospital five months earlier, but the medication he was taking seemed to have less and less effect on his symptoms as time went on. It had been decided some months previously that Mr Man would be admitted into hospital to start treatment of Clozaril, but he was still on the waiting list for “the Clozaril bed”.

Despite a growing history of self harm, suicide attempts, and psychosis, Mr Man still had no Care Plan in place, no CPN, and no Care Co-ordinator. We “coped” alone. Earlier that week the strain had become too much for me and I had resorted to alcohol, just to experience one night without the worry and the emotional pain of watching Mr Man suffer. Not being a regular drinker, when I wanted to repeat the experience two days later I realised I wasn’t coping.

Without a support system in place, when I realised how bad the voices were getting I didn’t know what else to do except call the usual “out of hours” Doctors surgery. I explained that Mr Man was waiting to be admitted for treatment with Clozaril, but that in the mean time his condition was deteriorating quite badly. The Doctor agreed that I should bring him in to be seen.

The problem was that although Mr Man had previously agreed to go into hospital to start his treatment of Clozaril, whilst waiting to be admitted his symptoms had deteriorated to the point that now he was confused as to whether he was really ill or not. Mr Man refused to get up. To begin with I thought this was merely part of the ongoing problem I had with getting Mr Man to do anything, because of the negative symptoms of his Schizophrenia. I called the surgery to explain. I was sure that the Doctor wouldn’t understand and would think I was wasting his time; after all, that was the response I was used to from Psychiatrists and Psychiatric Nurses, so I didn’t expect much from a GP, but he suggested I try again. Mr Man still wouldn’t get up, but this time it became clear to me that it was because he didn’t want to be seen by a Doctor, rather than just not wanting to get up. This worried me even more because I knew from experience that once Mr Man had lost the insight that he was ill his delusions would take hold and there would be no reasoning with him. I called the surgery again to cancel the appointment. I was embarrassed that I had called the surgery for an appointment and now Mr Man was refusing to go, and I felt so helpless. The Doctor must have discerned the anxiety in my voice and he threw me a line.

“Are you saying he is refusing to be seen by a Doctor?” Something in the tone of his voice told me what he was thinking.
“Yes” I replied.
“Are you concerned that he could be a danger to himself?” he asked.
“Yes” I replied, and I went on to explain that that was why I was so worried; because the voices were worsening and they often tell him to harm himself.

I was so relieved and so grateful when he said he would arrange a home visit for Mr Man to be assessed. Mr Man was a bit sulky with me about that, but once the Doctor arrived he agreed to go down stairs to be seen by him. After discussing his symptoms with him, the Doctor asked Mr Man if he would go into hospital voluntarily, but he refused. The Doctor asked me if I agreed that Mr Man needed to go into hospital, and I did, so arrangements were made for a Psychiatrist and a Social Worker to attend.

Mr Mans mother visited us that day, which had been pre-arranged earlier in the week. She was obviously confused by the presence of strangers in our home, so I took her into the kitchen and explained what was happening. She was overcome with emotion at the thought of her son being taken into hospital against his will, but for me – as someone who had needed to hide knives and blades, and constantly reassure Mr Man that he doesn’t have to slice himself open when the voices tell him to, and that no harm will come to him or me for not doing it – having him “sectioned” seemed far less traumatic than the thought of his condition deteriorating further.

The lesser of two evils?

"Sectioned Lady" by Philippa King

The whole process was very drawn out with much waiting around, firstly for the appropriate people to attend and then for an ambulance to take Mr Man to the hospital, which wasn’t really necessary but apparently required by law. From the time I called the surgery to the time Mr Man was finally admitted took about 12 hours. During that time Mr Man was anxious but quiet. He didn’t argue, and he didn’t struggle. He was resolute that he didn’t want to go to hospital, but he seemed to have resigned himself to the fact that he would have to. The Social Worker was very chatty and friendly, and even managed to get a smile out of Mr Man a couple of times. There was no drama, and apart from that edgy feeling of expectation when you’re waiting for something to happen, the day was quite boring. I was relieved when the day was over and Mr Man was safely on the ward, although leaving him on the ward was never easy for me. I could never quite decide which was the lesser of the two evils.

I’m not sure if I had Mr Man admitted for his own safety or my own sanity, but it prevented him from having to wait many more months before starting his treatment of Clozaril – the first medication to really make a marked improvement on his symptoms.

Friday, July 18, 2008


Thank you to everyone who has asked how Mr Man is doing. I’m sorry to have kept everyone waiting so long for an update; since the weekend I seem to have swung from being mentally very alert and hardly sleeping, to feeling like a zombie and sleeping at every available opportunity. I expect this is a normal reaction to stress, and my sleep patterns seem to be governed by the perceived level of need from Mr Man – now that he is sleeping more soundly, I am too.

Dr Hillary was able to go back into work on Monday afternoon, and she obviously felt that seeing Mr Man was more of an emergency than whoever had spoken to the receptionist that morning, as she called to say that she would come for a home visit after 5pm that day.

It was important for her to establish why Mr Man had stopped taking his medication, as this would have a bearing on which direction her care would take. She was happy to find that it wasn’t due to any loss of insight, or command hallucinations, but because Mr Man had simply had enough of the side effects (I will write more about this soon). She was also concerned that Mr Man could be suffering from rebound psychosis after stopping his Clozaril so abruptly, but again, was happy to note that this didn’t seem to be the case.

Actually, I have been very surprised that Mr Man’s symptoms have not deteriorated as much as they have in the past. I suspect that the Abilify he takes has helped him far more than anyone realised. About four years ago Mr Man skipped some Clozaril, hoping to control some of his side effects, and at that time he became very ill, very quickly. He was careful not to skip more than one dose at a time so that he wouldn’t have to be reintroduced to the drug (which is when the side effects are at their worst), but within days he was sitting right up close to the TV, with a note pad and pen in hand, insisting he had to write down “codes” from the commercials for “the company”.

At that time he was also taking Risperidone, but the worsening of his symptoms without the Clozaril was dramatic. This could lead some to conclude that maybe the Risperidone wasn’t really up to the task, but it’s interesting to note that when the Risperidone was reduced before the introduction of Abilify, there was a marked deterioration in his symptoms then as well, even though he was still taking Clozaril. This is why I say that the Abilify has obviously helped Mr Man more than anyone realised, as it really seems to have kept him afloat this time. I can’t help wondering if some of Mr Mans current psychosis is in fact rebound from stopping the Clozaril abruptly, and I wonder if he would have managed on Abilify alone if the Clozaril was reduced gradually and the Abilify increased slightly. Perhaps we’ll never know.

Of course, from Mr Man's point of view he's not doing very well at all - the voices have worsened, his anxiety is worse, and he is struggling to "hold it together" as he put it. I've no doubt of the internal struggle he is having to remind himself of what is real and what is not, and I know that when the voices worsen it becomes very distressing for him, but he hasn't lost his insight and become completely delusional so from my point of view he is doing very well. He even spent some time in his studio this evening. I still keep running up the stairs every time I think I can hear him in the bathroom though, so deep down I know the potential for further deterioration in his symptoms is there.

Dr Hillary praised my good sense (her words) to increase Mr Mans Abilify over the weekend and has decided to keep the dose at the increased level of 15mg instead of 10mg. She didn’t want Mr Man to continue relying on Diazepam for sleep though, because of its addictive nature, so after also noting Mr Mans heightened anxiety (he was shaking from head to toe), she prescribed him Quetiapine, also known as Seroquel. Quetiapine has a sedative effect and is sometimes used for the treatment of sleep and anxiety disorders, although it is primarily an anti-psychotic medication. So hopefully it will cure everything! So far it seems to have had the desired effect – we’re both sleeping better and I’m not even the one taking it!

On a Lighter Note

After researching Quetiapine on the internet I discovered that it is highly sought after by inmates in US prisons, referred to as “Suzie Q”. I told Mr Man that if he decides to cut out his medication again to give these ones to me instead of throwing them away – I might be able to sell 'em!

And Hannah, from Coloured Mind and Scattered Thoughts, raised an interesting point in the comments section about crisis teams and early intervention. Dr Hillary mentioned this during her visit. She said if we wanted to be referred to the crisis team we should let her know before Thursday. It seems one actually has to be referred to a crisis intervention team before they can intervene, which really isn’t any use if you’re suddenly having a crisis out of the blue, is it?

Monday, July 14, 2008

The Question of Emergency

I called our local Community Mental Health Team this morning to book an emergency appointment with Dr Hillary. Unfortunately she wasn’t at work today as she was having an emergency of her own, and Mr Man was refusing to see anyone else. Additionally, Mr Man has decided that he doesn’t want to start taking Clozaril again (which I will write about later). His Care Co-ordinator is on holiday, so the receptionist put us on hold while she spoke to a nurse.

She came back and explained that there “isn’t a real emergency” so Mr Man could come in and see Dr Hillary on Wednesday.

I accept that there are unavoidable circumstances which mean that Dr Hillary can’t be magically brought into work in a puff of smoke, but it’s that phrase “isn’t a real emergency” that bothers me – as if I’m being accused of overreacting again. I suppose she’s right; Mr Man hasn’t chopped his own head off and he hasn’t been running up and down the street naked screaming blue murder (subject to change). But really, those are the kind of emergencies where I would be looking for an immediate assessment to have him admitted into hospital, and it wouldn’t matter which doctor he saw. This situation is an emergency to us because we want to avoid a hospital admission.

Admittedly, Mr Man’s symptoms haven’t deteriorated as quickly as they have in the past when he has skipped some medication, although I suspect he is keeping much of it to himself and he is sleeping most of it away with the aid of Diazepam. If they had, I would be much more worried about him than I am. Still, I won’t be leaving him at home alone any time soon, to avoid any real emergencies.

Sunday, July 13, 2008

Best Laid Plans

Mr Man saw his psychiatrist, Dr Hillary, recently. We discussed the worsening of the voices, and also an interesting symptom which he has not admitted to previously – his auditory hallucinations actually include hearing music. Obviously this is not a symptom that is bothersome to him, and the music that he composes is a recreation of what he hears. This takes us back to the subject of psychosis and creativity, and raises the important question of how or how much of these symptoms need to be controlled.

For the most part Mr Man has been coping very well with the level of symptoms he currently experiences. It’s probably not what most people would call a “normal” life, as there are still many areas that cause him problems, but compared to just a couple of years ago his quality of life has improved dramatically. He regularly plays table tennis and has been able to interact with other players and form new friendships, albeit not close ones. He also composes music, writes computer programs, and designs websites.

Obviously increasing medication would greatly impact on his ability to carry out these activities due to the side effects of drowsiness and lack of concentration. As Mr Man said himself “I don’t want the music to stop”, and yet some of his symptoms are still distressing to him. For this reason it was decided that now would be a good time to refer Mr Man to a psychologist who specialises in psychosis, so that he can help Mr Man to learn how to “talk back” to the voices. I feel this is an important step, and now would be the ideal time; Mr Man has good insight into his illness, and has been progressing steadily.

However, I fear these plans are about to be put on hold for a while – Saturday evening I discovered that Mr Man has not been taking his medication.

I had noticed over the last few days that Mr Man’s anxiety had been increasing. By Saturday afternoon he didn’t really know what to do with himself. He was fidgety and felt clammy. He’d sit on the door step and then come in again 10 seconds later. He was feeling hot then cold. He also had this very strange look in his eyes that I had not seen before. His eyes were wide with a “crazed” look – I’m sure to others it would have seemed quite scary. I put it down to the anxiety. Thankfully we still had some Diazepam left from when he was prescribed it previously. It settled him for a while, but later that evening he became very negative about life and everything in it.

As I gave him a reassuring cuddle I asked him: “How come you’ve been feeling so poorly just lately? Have you missed some of your tablets?” He avoided eye contact but nodded to confirm that he had.

At a time like this, establishing and maintaining open and honest communication is essential. A person suffering from psychosis will already be feeling confused and anxious because of the voices, so no matter how scary or shocking, I always try to be supportive and never react emotionally to anything that Mr Man tells me, as this would only raise his anxiety further and possibly make him feel that he can’t confide in me. I say this, not to make myself sound amazing, but because it is an important factor when dealing with someone who is suffering from psychosis, and yet one that is easily neglected.

“Ok, which ones have you missed” I asked him calmly, still cuddling him. Mr Man started to panic:
“I’m not going back into hospital”
“No, that’s ok; I don’t want you to go into hospital either, but I need to know which tablets you have missed”

He told me it was his Clozaril, also known as Clozapine. I needed to know how many doses he had missed. He kept repeating that he wasn’t going into hospital, and now I realise why he was panicking so much – he had missed too many doses to be able to just go back on to his usual dose. *Please see footnote.

"Missing Clozapine" by Philippa King

We talked for a while and I reassured him that I wouldn’t let anyone take him back into hospital. We made a deal. I promised to keep him out of hospital, but in return he has to be completely honest with me about how he is feeling – I can’t keep him safe unless I know how he is feeling, and if I can’t keep him safe then I can’t keep him out of hospital. We have to work together. He promised, and we shook on it. I know I will have to remind him a few times because his memory will worsen as the voices become more intrusive, but so far I feel confident that we can overcome this together.

In saying that, I had a sleepless night on Saturday night wondering if I really will be able to keep my promise. I couldn’t have done this before, but his symptoms are not new to me anymore. In fact, I think I would cope less if he ended up in hospital again. I’m actually more worried about the side effects of starting his Clozaril again than the worsening of his symptoms. I really don’t think that hospital would help him at the moment, as none of his usual distractions would be available to him. He can’t concentrate on much at the moment, but we are watching an enormous amount of Star Trek and Babylon 5 to help keep his mind occupied!

I called the out of hours doctors surgery on Saturday evening, and they put me in touch with the on-call Psychiatrist. I was keen to start Mr Man back on the Clozaril as soon as possible, but there was no way of being able to get hold of any low dose tablets. He told me I would have to wait until Monday morning and contact Mr Mans usual Psychiatrist. That means another two nights without medication. In the mean time he said I could increase the Abilify that Mr Man takes in the morning, and give him Diazepam for his increased anxiety.

So now we wait until Monday morning. But what makes a person stop taking their medication in the first place? This will be the topic of a post in the near future.

*The problem with Clozaril is that there are some very serious side effects, and so guidelines are very strict. It cannot be prescribed by a GP and high street pharmacies do not stock it. Previously it was licensed solely for the treatment of “treatment resistant Schizophrenia”, although I have read recently that it can also be used for psychosis associated with Parkinson’s Disease.

Patients on Clozaril have to be monitored very closely as it can lower a person’s white blood cell count dramatically, leaving them defenceless against life threatening infections. Due to this and other serious side effects a person is usually admitted into hospital when starting treatment, not to mention the fact that they will probably already be very ill with the symptoms of psychosis. When a person first starts treatment of Clozaril their WBC is tested once a week for six months, and the person is only given one weeks supply of medication at a time. After six months the patients WBC will be tested every two weeks for a further six months, and then every month for the duration that they take the drug.

A starting dose of 12.5mg is gradually increased to a therapeutic dose of between 350 and 600mg. At one time Mr Man was taking 800mg a day, but after a certain level the therapeutic benefits fail to increase whilst the side effects continue to worsen. The correct therapeutic dose will be different for everyone, and can be affected by other medications that are taken. A blood test can be taken to establish the correct dose for each patient. Currently Mr Man has been taking 300mg daily.

The starting dose is exceptionally low as there are other complications associated with taking Clozaril. Suddenly starting on a larger dose can result in coma or cardiac arrest. For this and other reasons, once a person has missed two consecutive doses of Clozaril they have to be reintroduced to the drug with the starting dose of 12.5mg.

Tuesday, July 08, 2008

Over protective

End September 2002 - beginning October 2002

As previously mentioned, the voices have worsened again for Mr Man recently, telling him to cut himself. So far he has managed to resist carrying out their demands, but it’s funny how the fear that he will follow through never completely leaves me.

Most of the knives in our house aren’t very sharp but I do own a craft knife from years ago when I went through a phase of card making, and I keep this well hidden. I needed to use the knife recently and I had to wrack my brain to try to remember where I had hidden it. Mr Man walked in on me as I retrieved it, and it made me jump like a naughty school girl trying to hide a secret. It was still stained with Mr Man’s dried blood from 2002. It was the only time he had ever cut himself at home, and yet I still fear it could happen again.

Mr Man had been in hospital for about 4 months. He was still an inpatient at the Psychiatric hospital but he was at home with me for the evening on home leave. I’ve discussed previously why it was difficult for me to have Mr Man at home on home leave, but equally as difficult to refuse.* Things were really starting to come to a head; I could see that Mr Man’s condition was deteriorating, but the only member of staff who recognised this fact was his primary nurse, who unfortunately didn’t seem to be at work that often, or was working nights. The other staff, including the consultant, was under the illusion that Mr Man wasn’t suffering from psychosis at all and never had, and that he wasn’t a risk to himself either, despite recently having been through several assessments which indicated otherwise.*

Mr Man had cut his arm whilst on the ward two weeks earlier, with razor blades. The poor lad that found him had only just been moved from the Psychiatric Intensive Care Unit to the Acute ward, and had to be taken back to PICU because of the shock. Mr Man was assessed and found to be suffering high levels of psychosis, and was a high suicide risk.* He was placed on level 3 observations, which meant he was checked every 15 minutes – as if it takes longer than 15 minutes to seriously harm yourself. These observations never lasted long anyway; maybe a day or two, and the following week Mr Man’s consultant suggested that Mr Man go home over night for some leave. This caused a huge row between the consultant and Mr Man’s primary nurse, who was the one that carried out the assessments and seemed to be the only person who took Mr Man’s symptoms seriously; not to mention my own ability to cope. She overrode the consultant’s decision, and told Mr Man that for the time being he was only to have a couple of hours home leave at a time, and no overnight stays.*

During those hours I followed him everywhere. I tried not to make it obvious, but whenever he needed the toilet I would find something that I needed to do upstairs. I told the staff I was doing this, in an attempt to get them to understand how worried I was about Mr Man's safety. They told me I was being over protective and that I needed to allow Mr Man to take responsibility for himself. They said I was "hindering his recovery". So on Tuesday 1st October when Mr Man was at home for a couple of hours, I followed their advice and allowed him to go to the toilet alone. I knew it was wrong. It felt wrong. There was something in his face that told me it was wrong. I patiently waited down stairs. When I heard the floorboards creaking I knew he wasn’t sitting on the toilet, so I went upstairs. And that’s when I found him.

He had cut the inside of his forearm lengthways with the craft knife, and was prodding around inside with his fingers. “What are you doing?” I shrieked, as I took the knife out of his hand. He was clearly very distressed. “Please don’t be upset with me, I had to do it. They told me I had to get the aerial out”. It was difficult for me to be a calming influence when inwardly I was panicking. I know now from reading medical blogs that I probably didn’t need to panic quite so much as there was no arterial spurt, but at the time the cuts looked deep, and finding him in such a state was traumatic.

"Cut Out" by Philippa King

I didn’t know what else to do except take him back to the ward. He really didn’t want to go, but I managed to persuade him by explaining that I didn’t know how to dress his wounds and that the nurses would know what to do. I wrapped his arm in a clean tea towel and we made our way back to the ward. The cuts were worse than last time, but he wasn’t monitored under any level of observation this time.

The next two weeks were probably the worst two weeks for both of us, as Mr Man’s symptoms continued to deteriorate, and the staff continued to ignore it, but I will write about that another time.

So when Mr Man says that the voices are telling him to cut himself, I know that the danger is real, although I also know that Mr Man is learning to cope better and resist their demands. I don’t follow him around like I used to, but I still make sure that temptation is hidden out of his way. I don’t hide every knife in the house, and if he really wanted to he could find a way to cut himself, such as with razor blades as he has before. But when just a momentary lapse in his resolve could result in such traumatic circumstances I don’t see the point in unnecessarily leaving very sharp knives in view. I don’t think that is being over protective, do you?

*These points have been discussed previously in the post "Patient rights verses patient safety"

Thursday, July 03, 2008


I just came across this video on Post Secret. Having come so close to losing Mr Man through suicide, it touched me deeply, and I wanted to share it.

The button below can be used to save and/or share the Hopeline website in your favourites.


Friday, June 27, 2008


Some of this post has been deleted

Some time during the winter months Mr Man’s CPN, Mark, had a job change, so now Mr Man has a new Care Co-ordinator; an Occupational Therapist who we will call Sandy.

Being an Occupation Therapist, she wanted to do something practical to help Mr Man with his anxiety. Since he has already been on every anxiety management course imaginable with little or no success, it was decided that she would go for a walk with Mr Man every two weeks to gradually build up his exposure, and to talk him through how he was feeling during the walk. This seemed like a reasonable plan, and she turned up the following week without an appointment as planned; prior notice would have given Mr Man time to worry about it. That was 3 months ago. This could have been a great opportunity for her to establish a relationship with Mr Man, if she had followed through, but since then she has only come to see Mr Man once, with a trainee in tow.

I think the plan was supposed to be that I was to carry on what she had started, as after the first walk she said “Maybe Mrs Man could go out for a walk with you next week?” and since then there has been no mention of her taking another walk with him. This irritates me because on one hand they are very fond of telling me to step back and that Mr Man has to learn not to be so dependant on me alone, and yet on the other hand they expect me to be the one to support him in all of their wonderful plans for him; not to mention the fact that I don’t always have the physical or emotional energy to undertake these endeavours due to my own health problems.

How do I stop the darkness from rolling in, for Mr Man or myself?

"The Darkness Rolling In" by Philippa King

Mr Man would like to start running regularly, to try to lose some of his medication weight, but this is going to be difficult to put into practice. Obviously he doesn’t feel able to run alone, and I really don’t have the health to support him in that way. It would be nice if someone from the Community Mental Health Team could take half an hour out of their day to run with him, but these people don’t want to give you the practical help that you actually need; they prefer to hold “Well Being” classes to just tell you what you should and shouldn’t be doing – if you can overcome your anxiety to get there in the first place of course. I wonder if this is partly due to wanting to maintain a certain amount of professionalism and emotional detachment, or whether they just don’t care enough to do anything even remotely outside their job description.

More recently Mr Man has been experiencing some fluctuations in his symptoms. We expect this from time to time, but when the symptoms are particularly bad there is usually a trigger, such as a stressful situation. No such situation springs to mind, but the voices have been telling Mr Man to cut himself again. More about that in my next post.

Friday, June 20, 2008

Questions From Readers

In January I received some questions from a reader, prompted by a post I had written in November 2006. The post was entitled “Blip”, and at that time Mr Man’s medication had been changed, causing a temporary fluctuation in his symptoms. This had led to him believing that many of our friends were spies, and that even his Psychiatrist was “in on it”. You can read the full post here. Below is a portion of my correspondence with the reader, for the benefit of those who may be in a similar situation.

"How do you handle it when Mr Man says things like “she’s in on it”? And how do you handle living with someone who always believes that people are spies? I have fears about when my hubby comes home – how am I going to feel with him always thinking that people are after him? I have a hard time when he thinks I am against him. I don't know how I will react if he is going to say stuff like that throughout the years."

I understand your fears at present. When I first realised that Mr Man was suffering from Schizophrenia I didn't think he would be well ever again. But in time, and usually with medication, things do get better. It can seem slow at times, but then other times you look back and you suddenly realise how far he has come. The key is not to compare to what he was like when he was well, but to compare to what he was like at his worst.

At the time of writing this “blip” post, I didn't actually challenge Mr Mans beliefs too strongly. I think I said something like "Do you remember telling me that you realise these beliefs are part of an illness? When your meds get into your system you won't feel like this anymore" But he didn't remember it, and it seemed to confuse him, so I chose not to challenge it anymore, only reassure him and distract him from those thoughts as much as I could. Dwelling on them definitely doesn't help.

I was aware that I would have to keep a closer eye on him and I made sure he took his medication. Apart from that I tried to carry on as normal. It really did turn out to be just a blip and he didn't need to see his doctor after all. If the symptoms had persisted or had got much worse I would obviously have had to contact his doctor against his will.

Mr Man isn't like this all the time though. Once a person is relatively stable on medication the fluctuations in symptoms aren't usually severe. Also, you do learn to adjust and accept certain things in time.

"His social worker said that if I took over his care, not only will I be the wife but I will have to be the one responsible for him taking his medication, and if he doesn't then I will be the one forcing him into the hospital. So it could strain our marriage. Do you have any experience with this?"

Yes, I have had to make sure that Mr Man takes his medication, and I have also had to have him detained under a section of the Mental Health Act before. Even now, I get Mr Mans medication ready for him, but that's mostly because he would probably forget to take them otherwise! I don't usually have to watch him take them these days, but if he becomes unwell, like in this "blip" post, then I have to watch him take them to make sure he has had them. It's when he starts to doubt that he is ill that he is likely to skip medication, but most of the time he understands that he is ill and needs the tablets. They call this "insight".

We have had problems with this in the past, but communication was the key for us. I always tried to give Mr Man lots of reassurance that I loved him. I knew he didn't believe that he needed the medication but I had to ask him to trust me and I would try to reassure him that I would never make him take anything that would harm him. At times he only took the tablets for me, but at least he took them.

"Trust Me" by Philippa King

It was painful sometimes when I sensed that he was suspicious of me, but I had to remind myself that it was temporary and that as soon as he started to improve he would understand.

For a while it wasn't uncommon for him to ask what each tablet was called and what it was for. Understanding his fear helped me to be patient with him and explain about each medication time and time again. He would especially ask these questions if the chemist had used a different manufacturer that month and the packaging was different or the tablet was a different colour or shape. They really should think of these things shouldn't they?

The day he was admitted under a section of the Mental Health Act was a strange day. Although he had refused to go to the Doctors with me, when the Doctor came to our home he didn't become argumentative at all. He refused to go into hospital voluntarily, but he seemed to just accept the situation when they enforced the section. He didn't seem angry at me either. This was his third admission, and each hospital stay had been a lengthy one. I suppose he knew by that point that I was going to support him as much as I could, just as I had done on both previous occasions. It's different for everyone though.

Hopefully it will never come to that point with you and your husband. It really depends on how much insight he manages to gain through his medication. One thing I would say though (and I'm not suggesting that you would do this) is never lie about anything, even if you think it will protect him. I have always been completely honest with Mr Man about his medication and everything. When our home was broken into he was still in hospital. It would have been easier to not tell him about it, as he thought the burglars were spies, but I knew if I didn't tell him he would lose trust in me when he eventually found out. Maintaining trust is vital.

Sunday, May 04, 2008

Austria cellar man 'mentally ill'

Stories such as this one infuriate me. Once again we have a lawyer who is paid far too much money to try to find a way of reducing the punishment of a man who has undeniably committed a heinous crime, and the best he can come up with is “he couldn’t help it; he’s mentally ill”.

There’s no getting away from it; some people are just bad and do bad things. People can’t always be excused for what they do. Continually using mental illness as an excuse means that bad people are not being punished adequately for the crimes they commit; the sincerity of those who do commit crime due to mental illness is called into question; and people with mental illness in general are wrongly viewed as people to be feared and avoided, as it appears that there are more people with mental illness committing crime than there actually is.

This has to stop.

Are we going to get to the stage where no crime is punishable? Will every crime be attributed to mental illness? Will all murderers, rapists, and paedophiles be regarded as victims of illness rather than bad people? Where does it end?

Saturday, April 19, 2008

New Blog - Bipolar Speaks

I received this comment from Bipolar Speaks in the comments section, and thought it was such a wonderful idea that I wanted to make sure that everyone got to read it.

Most of you know me as “Dreamwriter.” I recently launched a new blog called, “Bipolar Speaks.” One day something came over me as I was reading websites called “Post Secret” and also a blog who had a post where they had quotes from other Bloggers with mental illness about how they felt. It occurred to me that WE need an escape to let out our feelings and frustrations. I know that a lot of Bloggers say what they feel within their own blogs, but you are welcome to share your thoughts, opinions, and feelings.

You are welcome to help raise awareness and put a stop to the Stigma that lies within mental illness. We can change the world - one story at a time. I thought it would be interesting to design a “Safe Haven” for those who battle with a Mental Illness; and allow them to come and let out their most darkest, painful, and emotional feelings. This would be a great way to spread awareness by letting society know what is REAL about mental illness.

If you are interested, you can submit a story or short piece as an “Anonymous” contributor, or if you don‘t care about what others think, then feel free to reveal your blogger identity; its purely up to you. I tried this several times and the “Anonymous” button works and ends up in my email as an “Anonymous” comment.

The rules and regulations are in the blog within a post. Take the time to read them thoroughly and I hope that you become a constant contributor. Remember, we all have things on our chest to let out and we all truly don’t want others to know. But now is an opportunity for YOU to speak up, speak out, and be heard! I know that I have a lot of feelings and issues that I don’t want my husband, friends, or family to know about… this is my chance to get it off my chest and I WILL be a constant contributor. Depending on the issue, I might submit the story under both “Anonymous” and my name.

Go to “Bipolar Speaks” and look around, don’t forget to display the Bipolar Speaks button on your blog and link it back to us.

By the way, I still have my other blog, so don’t forget about me over there, too. :)

Friday, March 07, 2008

“Care” in the Community

I’m aware that Mental Health workers sometimes read this blog, and some have previously commented that it helps them to see things from a different perspective. So this is a message to all those who provide “Care in the Community”.

Don’t get shirty when a “service user” who can’t even remember to change his underpants doesn’t return your calls. And if he has a spouse who usually takes care of these things for him, take a minute to think about why she might be letting those things slip at the moment.

Sometimes there are more important issues in life than your appointment schedule running at 100% efficiency.

Edit: After making such a fuss last week, she failed to turn up for a scheduled appointment with Mr Man today, and she didn't even call to cancel. Maybe life has taught her a lesson in "more important issues"?

Wednesday, February 27, 2008

Update on the Respite Saga

Head Meets Brick Wall

It’s been a long time since I wrote an update in the Respite Saga. The problems continue, with the addition of brainless staff at the helm, upholding pointless rules.

The local MP was little or no help to me whatsoever. After the helpful MP we had previously I foolishly concluded that all MP’s would want to care for their own constituents. In reality the only thing he did was to forward my letter on to the Chairman of the local NHS Trust and Patricia Hewitt, the then Minister of Health.

Of course Patricia was far too important and busy to look into the matter and respond to my letter, so she then forwarded my complaints on to someone else. Someone else, like most politicians I suspect, was caught up in her own fantasy world of statistics and figures and wrote me a long letter to explain how many millions of pounds our wonderful government had invested in mental health services – which didn’t actually address the problem of the cut backs in our area which I was referring to.

It was April last year when I sent my second letter of complaint to the Chairman of our local NHS Trust, regarding the cutbacks in respite beds. It took the Chairman four months to reply. In part he wrote:

“Although in the past [the respite home] provided respite on a limited basis our strategy in the future will be to provide a wider and, I hope, more convenient range of respite opportunities such as direct payments for home support, holiday respite and respite relief from home in other settings similar to [the respite home]. Until these arrangements are in place [the respite home] will continue its current arrangements.”

In other words “Stop writing to me because it will make no difference whatsoever – the changes will stay as they are”. What of these “other arrangements”? It appears to me that care services are being reduced in favour of direct payments, knowing that many people, including us, won’t even qualify. Those who do qualify are so ill that they could clearly do with both services. Alas, when you’re dealing with the NHS it’s one or the other – or neither – not both. I have no idea what “holiday respite” is – unless the government are planning on paying for holidays for everyone (yeah right), and “respite relief from home in other settings similar to [the respite home which we have just reduced the number of respite beds in] – what exactly is the point of that? Why would they open up another home similar to the one they have just “reconfigured” services in? Are these simply more lies designed to pacify me?

Not long after receiving this letter I became more depressed, although it took me a little while to recognise it. But we still had our three breaks a year, right?

Several things happened at the respite home over the following months, which provided varying degrees of irritation, but as usual, nothing to actually endear the staff to me. There were the stupid rules which prevented respite for Mr Man being booked by anyone other than his key worker, who of course wasn’t there, despite the fact that they all have access to the same diary for the same bed. Then of course there was the day when Mr Man was left caring for the emotional needs of a lady who was staying at the home as a form of “crisis intervention”, because the staff who were intervening in her moments of crisis didn’t actually notice that she was upset, or didn’t care. And of course there was the wasteful booking by staff members of the respite bed for Mr Man on a night he wasn’t even going to be there, because they insist on booking Monday to Friday / Friday to Monday, even if the person won't be staying for that full length of time, which left me wondering if the staff actually realise that they are there to provide a service, or do they believe that this home remains open simply to provide them all with employment?

Nothing could have quite prepared me for what happened when I called to book our third break for 2007 and a couple of breaks for 2008 though. Following my bout of depression, it was December before I felt able to face the thought of going away from home and trying to be happy, let alone dealing with those people at the respite home. I never look forward to calling and speaking to Jim, and actually it was Mr Man who kept prompting me to ring this time. When I did, I suppose I shouldn’t have been surprised to learn that the bed was fully booked for the rest of the month, and naturally the home was closed over Christmas and New Year, because no one needs respite or rehabilitation at that time of year do they? The bed was already booked by someone else for the dates we wanted in March, and due to the stupid “Monday to Friday / Friday to Monday” rule with the booking of the bed we couldn’t have the dates we wanted in July either. So I'd called to book three breaks, and couldn't book any of them. It seemed like a bit of a pointless service really. Probably to try to calm me down, Jim came up with the suggestion of booking a break in early January, and he said that would still count as one of our 2007 breaks. He seemed pretty sure of this – until I asked for confirmation in writing. It’s a good job I did really because once he had checked with his ever-so-helpful manager it became apparent that respite breaks cannot be carried over from one year to the next, even if it is booked early in January because the rest of the previous year is fully booked.

Hang on a minute, I thought the ever-so-helpful manager had told me what a flexible service this was, and that actually, I could possibly have more than three breaks a year if I wanted to because they would rather see the bed in use than go empty (which is obviously why they booked the bed for Mr Man for an additional night in October, knowing that he wouldn’t be there) and all I had to do was ask? Well now I’m asking, and we’re not even allowed our third break, let alone any extra. How flexible is that?

Once I had received the letter explaining this, I called Jim to cancel the break in January and to tell him what a liar his manager is. All he could say was “I’m sorry you feel that way”. Yes, I do. After all of my fighting last year with the Chairman, I actually felt that the manager was on our side, when in reality she was also lying to pacify me, only she was better at it than the Chairman.

These lies have left me feeling so angry that I’ve wanted to kill people. I can’t bear the thought of going to that place or speaking to anyone from there ever again. Several people have tried to help sort out the problem with the July booking by speaking to the manager at the respite home, including Mr Mans Care Co-ordinator, and the Carer Support Worker, but it’s pointless. She won’t even budge on such a small issue by allowing me to book Thursday to Sunday instead of Friday to Monday. Mr Mans Psychiatrist has said that she will now call the respite home, but I’m not holding my breath.

I haven’t replied to our good friend the Chairman. I haven’t had the emotional strength to do so. There are only so many times one can bang their head on a wall before it causes serious injury. Interestingly Jim claimed that other respite users appear happy with the arrangements. How does he know that? How does he know if these people are happy or if they simply do not have the strength to go through a pointless complaints procedure as I have?

Edit: I have now been informed that the bed has been booked by someone else for the Thursday in July, but of course I have no way of knowing if the person actually intends on staying on the Thursday night, or if the staff have just booked it anyway like they do with Mr Man. So there is a possibility that this bed that we need will remain empty on that night. Now you see why I get so angry when they insist on booking Mr Man in from Friday to Monday when they know full well that he will be going home on the Sunday morning.

Thursday, January 10, 2008

Violence and Schizophrenia – Comments from Readers

I would like to thank all those who commented recently on my posts “Violence and Schizophrenia”. Often I find that the comments left by readers are more interesting and informative than the posts I have written! Some of the explanations of what it is like to suffer violent intrusive thoughts were too valuable to leave unread by the majority in the comments section.

“The thoughts are like movies you can't shut off... no matter how horrible it is I can't press stop… I'm forced to "watch" the whole thing until it is done.”
- Minnesnowta

“I've struggled with these thoughts for a long, long time. I thought they made me a horrible person and I have done very silly things to try and erase them from my mind. I could not even write them down for fear that they would become more real.”
– Anonymous

“They cause great distress, and I wonder why my head does this to me? I don’t like swatting wasps, let alone harming a person; it’s just not me at all.”
- Slurry

I also sometimes receive comments which raise very interesting questions and points of view. No doubt these points of view will be shared by others, and so I would like to reply in full in a blog post. I have recently received the following comment from an Anonymous reader, regarding my posts on Violence and Schizophrenia.

“I have been reading your journal with interest and after some time have decided to post a reply to this thread.

On the topic of intrusive thoughts my guess is that we all have these and from time to time they can be elaborate, explicit and violent but a filter or whatever prevents us from taking these fantasies and enacting them in the real world. If this were not close to the mark I fail to understand the attraction that violent films and latterly computer games have for a large proportion of the population. In fact, children may re-enact what they have seen but as play rather than through real aggression.

I am reluctant to continue this post as I believe it will be unpopular with the non sufferers of schizophrenia and those with the illness who read this blog. However my opinion is as valid as anyone else’s and deserves to be considered.

A small percentage of people with serious mental illness are capable of the most appalling violence. I know of no way to differentiate those who will go on to kill and those who will not. I believe that by claiming that there are far worse dangers out there you are bordering on denial. There are many dangers out there, far more people are killed by the sane than the mentally ill but a percentage of schizophrenics will go on to kill.

Even a small percentage is significant, I personally know of no one who has been killed by a seriously mentally ill person. I have however been stabbed over a prolonged period by one and am lucky not to be one of the statistics I feel some would rather ignore.”

Anonymous, thank you for taking the time to respond to my posts “Violence and Schizophrenia”. Firstly I would like to say how sorry I am that you have been a victim of violence over a period of time. As you so rightly point out, your opinion deserves as much consideration as anyone else’s.

You begin your comments by stating:
“On the topic of intrusive thoughts my guess is that we all have these and from time to time they can be elaborate, explicit and violent but a filter or whatever prevents us from taking these fantasies and enacting them in the real world.”

I personally don’t believe that I have ever experienced intrusive thoughts. In rage I have experienced very violent thoughts, but as I endeavoured to explain in my previous post on the subject, intrusive thoughts are unrelated to the person’s emotional state and additionally are “intrusive” – unwanted, unwelcome, distressing, and difficult to be distracted from. Far from being a fantasy, they are more like a waking nightmare for those who experience them, especially as they can be accompanied by visual hallucinations. See the comments above by those who have experienced them.

You continue:
“If this were not close to the mark I fail to understand the attraction that violent films and latterly computer games have for a large proportion of the population.”

This is an interesting point. For Mr Man, the intrusive thoughts and hallucinations that he has endured means that there is rarely a violent scene in films that he finds more distressing than what he has already witnessed. However, this doesn’t mean that he finds violent films entertaining.

For most people who are entertained by such, I suspect that it is more than simply a case of desensitization. Over the years films have not only become increasingly violent, but the violence has been glorified by being acted out by the most popular actors delivering “cool” one liners. In addition, age restrictions have been reduced and the video games often allow the gamer to become the hero of the film. Violence then has become synonymous with many desired traits such as popularity, admiration, and sex appeal, to name but a few, and I feel it is this that has increased its popularity.

Like you, I fail to understand the attraction of such violent “entertainment”, but the result of which for many is an impaired conscience, which I believe you alluded to when you said “a filter or whatever prevents us from taking these fantasies and enacting them”. For some, the filter stops working. Despite suffering from intrusive thoughts, the conscience of a person with mental illness is no more likely to become impaired than anyone else’s. As Mr Ian, a psychiatric nurse for many years, said in the comments section:

“Most people with psychoses harm themselves before other people as they still maintain their moral reasoning that it is wrong to hurt others. Those that do harm others, only do so because they feel they are severely threatened, regard it as the best/only option for their dilemma, or they have a delusional belief that such behaviour is 'ok' (I once nursed a guy who stabbed a horse guardsman in the leg because [he believed] it was an act of mutual bonding and honour that the guardsman would have understood).”

You continue:
“A small percentage of people with serious mental illness are capable of the most appalling violence.”

I agree, just as a percentage of those without mental illness are capable of equally appalling violence.

“I know of no way to differentiate those who will go on to kill and those who will not.”

Again, I agree, just as I have no way of knowing which of those without mental illness will go on to kill and which ones will not.

"On Balance" by Philippa King

“I believe that by claiming that there are far worse dangers out there you are bordering on denial.”

I never claimed that there were far worse dangers, only that a person has as much chance of being killed by a person without mental illness as with. What I do question is whether a person’s mental illness is truly the cause of their violent acts in all cases. In many cases I think it is used as an excuse; on the other hand, for those who clearly were affected by mental illness at the time of committing a violent crime, support was obviously lacking as there are always warning signs before hand. Consider this comment by Mr Ian:

“In regard the myth of the "snap" theory, I agree. It never comes unannounced. It frequently goes unnoticed or unattended though. I have worked with violent mentally disordered offenders for several years now. What you say is true and accurate from my perspective also; that the true cause of the violent act being purely in psychotic reasoning is pretty rare. Often it is increased in probability by prior personality, intellectual or environmental influences; or is more to do with those predisposing/predictive factors and not psychoses at all.”

You continue:
“There are many dangers out there, far more people are killed by the sane than the mentally ill but a percentage of schizophrenics will go on to kill.

Even a small percentage is significant”

I agree that although the percentage of those killed by people with mental illness is small, those victims are not insignificant. However, I think it is unfair for the media to wrongly give the impression that these murders are more frequent than they actually are, or that everyone with a mental illness is violent. Rather than trying to ignore statistics, I am asking people to be balanced in their view of people with mental health problems.

I understand that your experience has not been a good one. You don’t say what your relationship is to the individual who has stabbed you, but I would recommend seeking outside help and advice from a GP or a Community Mental Health Team. If this person is persistently violent towards you he/she should either be arrested or detained in a secure unit under a section of the mental health act.

Thank you again for your comment, and to all who have commented on this subject.

Related Posts: Violence and Schizophrenia - Part One, Violence and Schizophrenia - Part two

Related Posts on Mental Nurse: The Will To Do No Wrong, The Will To Do No Wrong Part 2