I was first put on an antipsychotic medication (Thorazine) in 1964 in Middletown State Mental Hospital in lower New York State . We didn’t used that term in those days. I thought i was on a tranquillizer. I thought it helped me to get much needed sleep which helped my nervous system which had been completely wired during my psychotic episode to relax and start recovering.
Actually I hadn’t yet heard the term “psychotic episode.” I thought I had had a nervous breakdown caused probably by excessive worrying and an inability to properly relax. But I was dubious about Thorazine’s effectiveness and hated it. I hated it primarily for two reasons. It represented a need I was trying so hard to deny. I was ashamed of my weakness and wouldn’t admit to needing help insofar as I possibly could. Also I was a junior in high school who had played on his school varsity football, basketball and baseball teams. I was pretty good and hoped an athletic scholarship to college would be my ticket to a better life. I couldn’t be taking a tranquillizer that would slow me down and hinder my athleticism.
For years I doubted the efficacy of the medicine. I had had a series of electric shock treatments. They had done the trick. How did I know the trouble wouldn’t have gone away in about the same amount of time without any meds?
After my release from the hospital I had to see a psychiatrist on a regular basis. I soon learned that the first thing he would ask me each session was whether or not I was taking my hated pills. Because of my upbringing, I was very uncomfortable lying about it and no reason for not taking them seemed convincing, so I took them pretty regularly.
In a couple of years despite the thorizine I had another episode bad enough to result in hospitalization. After my release I just slowly quit seeing anybody or taking anything. Because I’m one of the very lucky ones and my life went fairly smoothly for a while I went a number of years without an episode. But eventually, now living in Tucson, the madness returned. My wife called home and my uncle came out to help. He and my wife were able to get me to see a professional who suggested medication. I told him I wouldn’t take Thorazine so he put me on Stellazine.
Though still in denial it was easier to take the pills than fight with my wife about it. I would have recurring episodes for a period of time of nearly 25 years. On the meds I had tried so far an episode would start anyway and I would soon be so rapped up in my mania, delusions and fantasies that I just would never remember to take a pill. This no doubt made things worse.
I went through a number of stages with regard to my disease. The first and longest was denial. Every time I recovered from an episode, I invented a new reason to hope it would never happen again. After many years I was able to accept that I had something chronic that needed to be dealt with. My social worker and I identified precursors. There would be a period of time when an episode began where I wasn’t so lost in delusion that I knew trouble was brewing. I had doubts about a medicine that really wasn’t that effective and wondered about the value of talking. But these were the only weapons I had. If there was any chance they might work, I had to try them. On the advice of my social worker and out of desperation I would double the medication dosage and see the social worker much more often. I was actually on a couple of occasions able to ward off episodes before they got me in trouble.
I decided that although the medicine didn’t prevent occasional episodes on my maintenance dose, it was of some value.
Along with acceptance came greater effort to learn more about my disease. When fighting something, nothing is more useful than knowledge after all. All I had heard with regard to causes so far was the Freudian bad parenting nonsense that dominated the field during much of the twentieth century. I had little access to information but read what I could find. I came to the correct conclusion that nobody really knew anything with any certainty.
With the advent of the internet and access to it came the ability to get a lot more information a lot easier. When I discovered that Neuroscience had discovered psychical differences in the brains of people with serous mental illnesses, I had two simultaneous, immediate reactions.
One was despair. If my brain was physically different what could I do to prevent relapses? No change in behaviour or manor of looking at things or approaching life would help.
The other reaction was profound liberation. It wasn’t my fault! It wasn’t the fault of my upbringing! It wasn’t a reflection on my character, mental strength or decision making! Their was no need for feeling guilt!
If it was a medical disease it could be treated with medicine like many diseases.
During a voluntary stay in a psych ward I became convinced that I was being poisoned by white powders. My pills were white so I tried to fake taking them. The nurse who caught me went to my Doctor who proposed putting me on Haldohl. Because these pills were green, I agreed to take them.
The Haldohl has been undeniably effective for me. I had some trouble when I quit smoking. The other time was when a psychiatrist put me on a second generation med. When I went back on haldohl, the trouble quickly left.
For me most medications help and haldohl is the right one for me. I have found that I can maintain on a low enough dose so that tardive disconesia is not an issue. My side effects are manageable. All antisychotics have side effects-some very bad. But I have to say that in most cases the cure is better than the disease.
I have come across research suggesting that the use of these medicines causes changes in the brain including some reduction in grey matter. To me it’s still a no brainer. If taking a pill takes me from psychotic to lucid and keeps me that way, I’ll live with brain structural changes including reduced grey matter.
None of that has the effect on cognition that a psychotic episode has.
I have worried that long term use might shorten my life, but nothing shortens life expectancy quite like madness.