I’m fifty-seven and have worked with my mental health for forty years. Over that time, both therapy and medication have benefited and harmed me. Even though we know more now, the system of mental health care is much less generous, and much less open to different modalities, than it was when I first entered it. I received a much higher standard of care than I now see patients receiving. I was fortunate to experience my first challenges in the 1970s, before the dollar was the bottom line.
I’ve come to understand that a single-minded focus on either therapy or medication can do great, if unintended, harm. I’m sharing this brief history of my journey, with both my good and bad decisions, to illustrate the importance of conscious care, and of maintaining the ability to change course.
I had my first psychotic break at eighteen, in college.
My parents made a really helpful decision to keep me at home, rather than sending me for the year of hospitalization that was prescribed. On the other hand, I was put on Thorazine for six months, which was not helpful. The Thorazine didn’t take away my suffering; it fogged my thinking and made it impossible to be productive. Once a week I would try to bake cookies, and it would take the entire week to make one batch that weren’t burnt. That was the limit of my functioning on Thorazine. Something that is not helping is probably doing harm, even if you can’t appreciate the harm it is doing while it is happening.
I went to a local psychiatrist who cared for me during this crisis. Both my family and this doctor were generous with their time and care. Although my mental health was not restored, I was encouraged to stay alive and keep trying.
When I reached a plateau, my parents looked for and found a better doctor. They chose a Jungian analyst who saved my life. His skill as a doctor led me to learn that I had a self and was a valuable part of life. Life was mysterious, full of light and dark. He saw me as often as I needed, sometimes three times a week. Each hour with him helped me hang on through many excruciatingly dark times. Because of my experience with Thorazine I steadfastly resisted any medications.
Choosing home over hospital, no medicine over Thorazine, searching for and choosing a more skillful physician – all these choices added to my continued progress. If we had stopped making these new choices anywhere along the line, I believe I would have stopped progressing.
Eventually it became clear that although I had grown, matured, and dealt with childhood issues, I was constantly haunted by dark visions and suicide. I was committed to a hospital after ten years of learning, struggle and suffering. When my doctor suggested I “check out” the hospital, I vividly remember the feeling of the door locking behind me before the next door opened. I had been tricked into going. What I had pictured was a rolling green lawn, pillows, and a cup of tea with someone sitting beside me. Instead, I entered an ugly, sterile space, and was locked in a room with no furniture and no control over anything, not even a light switch. When I was allowed to be with others they were too drugged to connect with. Everyone just sat around. The food was terrible. It was not the healing environment that I had longed for, but it did provide quiet and a shutting-out of the world. Being locked up was a much-needed rest for my mind. Not dealing with the outside world, I was able to gather myself, take stock and see that I had come a long way: I was married, and a mother of three.
But I still had my daily struggle with darkness. I had my warm outer life with family, friends and art. And simultaneously I had constant visions of blood, mayhem and destruction. There was a continual pressure that came to feel like acid burning in my brain, a pressure to destroy myself, to destroy my world. It was incapacitating and exhausting.
After the hospital I went to a psychopharmacologist who prescribed a small dose of Stelazine. I clearly remember the day I began it: I was washing dishes at the kitchen sink, and the world suddenly got quieter. I was not feeling strongly about anything. Everything was just OK. “This is what normal feels like,” I thought.
I had a really good couple of years, until the side effects of Stelazine caught up with me. I became sluggish and poisoned. I couldn’t remember much. Couldn’t drive. Couldn’t function. Still, the gift of my time on Stelazine was that it showed my brain how it might feel to be at rest.
Around that time, I moved and was without my support system. I was hospitalized again – this time it was more like being warehoused. I was shuffled on the hospital’s schedule from room to group meeting to some unknown doctor. I didn’t get to spend enough time with anyone for them to get any sense of my problems or really evaluate me. There was not warmth or care. Many drugs were thrown at me, layer upon layer. Those drug cocktails made everything worse – it turned out antidepressants were terrible for me. When I left I determined I would never go back, and I started looking for alternatives.
Homoeopathy was my first ray of hope. The regimen really helped, though I was never as steady as I had been on Stelazine. Every step along the way something improved, but life has a way of upping the ante. I would reach a plateau, and be managing well, and then the stress level would increase and the balance would be lost. At one such moment a dear friend rescued me by taking me to hear Julia Ross, the founder of the Nutritional Therapy Institute Clinic, whose approach to treatment looks for alternatives to drugs through a combination of nutritional therapy and traditional counseling. There I learned about diet and supplements that could help me return to balance. It was another reprieve, and yet the old darkness always returned, with a vengeance.
Finally, at fifty, I felt that I could not struggle any more. I had tried everything that came my way, but the pain in my mind was more than I could bear. Another good friend made me promise to see one more doctor before I killed myself. She put me on lithium, and I felt better immediately. Lithium made it impossible for me to think of suicide and despair. It was my miracle.
Of course, down the road it, too, became a challenge to my body. But, carefully titrated, it remains a crucial part of my mental health.
There was no quick fix for me. Care and patience were crucial to my healing. Great psychiatrists who really listened were crucial. Medication was crucial. And I was willing to accept help even if I was unsure of its benefits, maybe because I had some good in my life, or maybe because I’d seen family members with mental health struggles reject aid, and in so doing increase their own suffering and that of everyone around them.
I believe because we know so little about the mind that care, patience, excellent doctors and advisors are critically important. I know that this is not simple to find. But I believe it is worth trying. I love my life, my family and the work that I do. I add to my community. It was worth my suffering through it and my community generously standing by.
In the future we may have the key to healing the mind. But until we do, conscious care is worth the effort.