I had never believed in evil until I met my psychiatric nurse.
By evil, I do not mean malevolent, or sociopathic. We have all been evil at one or various points in our lives. Evil, to me, simply means one is wrong, and in a way that, through their actions, is causing harm. When this happens, the responsibility of others is needed. People with a greater awareness have to step in, or somehow promote healthy alternatives, because the person is not going to change on their own.
What I seek is to is make a contribution to that larger awareness of psychiatry, growing in the world, by telling my story the way I see it.
I was 17 when I had my first psychotic episode. Since then, I have been in several different clinics, and on various antipsychotic drugs, for the past six and a half years.
In 2018, I had my second psychotic episode. I became psychotic after cutting myself off from a drug called risperidone in a matter of days. My second psychosis was worse than the first one. My psychiatric nurse told me that they had taken my desire to be creative into consideration and put me on Abilify, which would maintain that part of myself for the most part. The 300 mg per month injection of Abilify was given to me with my psychiatric nurse’s statement that it was a “light,” dose. Four hundred was average, or even 500, for many people.
My nurse and others talked about giving me a lighter than usual treatment as if it was a strain for them to adjust their perspective. “We want you to be as close as possible to yourself,” said my nurse. In my experience, close enough for them was very far away.
The new medication, Abilify, started giving me digestive problems. I threw up my breakfast in the mornings, sometimes more than once. I would be unable to eat for long periods of time, and starve for the majority of the day. It was interfering with my life on a daily basis. I couldn’t read because I was hungry all the time. I couldn’t draw sometimes, because it made my hands feel funny from the amount of energy I was using up. I was filled with constant fatigue that made me have to rest for hours, and I went to bed hungry.
My psychiatric nurse looked at me, as I sat in the chair in her office as I did every month. She explained how we had tried to implement an eating plan; specific times I could eat, with specific meals prepared. “I know eating has been really a challenge for you,” she said.
I was legally bound to the medication for a period of six months. I was on a form. If I didn’t show up to my appointments or refused the injection, or didn’t show up at the correct time, police officers, given my address by the hospital, would come to my house and escort me. “They’ll ask you why you don’t want to go to your appointment and you might end up back in the hospital,” my nurse told me. Luckily I understood the importance of being rational with these people. I wasn’t going to get my way by even voicing my opinion, let alone freaking out and smashing things and yelling at them, which was what I deeply wanted to do.
My psychiatric nurse was the one who handed me a program with the headline along the lines of “Studies Show Those Suffering from Schizophrenia Experience 15-20 Year Lower Life Expectancy.” When I saw it, my stomach churned. The article in its neat print highlighted how cardiovascular disease was very prominent for some unknown, unspecified reason in people with schizophrenia. It’s the medication, obviously. It slows down the immune system and kind of wrecks it. People gain so much weight, they literally don’t recognize themselves anymore.
It was my psychiatric nurse who saw me wanting to take a year off school to focus on my mental health as a problem. It was my psychiatric nurse who said I should know better than to confess my love to someone. And it was she who said she was listening to her gut instinct, which told her for safety reasons, because she didn’t want my life to fall apart, they should raise my dose to a 400 mg injection a month. “I don’t want you…to walk out of here after three years thinking you could have done better,” she told me, which I thought was a weird answer as to why I should be more medicated. She said I was still having “some turmoil.”
I was 20, living on my own in a basement apartment for the first time. In the winter, a friend of mine commit suicide after tapering on her own from antipsychotics, and I was assaulted by a stranger several days later. My so-called turmoil was a genuine reaction to things I was facing.
I thought back, at the mention of turmoil, to the peace I experienced when left alone as a teenager, when I had the chance to really get to know and work through all my negative day-to-day experiences. Things like sorrow and stress and even fear were sacred to me. They were generally needed responses to very real conflict. They gave me insight about why and how I was responding to certain things in my life that were not OK, and I could create good quality art and writing from them. I’d draw for hours in this macabre Tim Burton style.
I owned and made the best of “my turmoil.” It was my intuition. It was my voice, and when I followed it, beautiful things took place and I was able to feel better in the long-run. By working from and with my darker sides, I gained insight, strength, and a balanced life.
The emotional blunting caused by antipsychotics is what has fueled, more than anything else, my sense that my treatment is immoral and inhumane. I have never been compliant in my heart.
To give those unfamiliar with this experience a better picture, imagine the rest of your life being nothing more than a boring video game, a simulation of real life. One where you can’t feel truly emotionally invested on any satisfactory level. One where, most of the time, you learn to forget and to tune out the vicious part of you saying this is all wrong, because your experience is 24/7 and there is literally nothing you can do to get out of it, besides try to taper off. That’s what taking medication is like.
I told my psychiatric nurse, sitting in her office again after receiving my injection, that my entire life felt like the equivalent of being in a waiting room, eating a sandwich. She smiled and laughed, for a second. Then she said, “Well. Some people do live their entire lives that way. Maybe, taking into account your life now and everything that you’ve been through, I’m going to say, Ruby…maybe that’s as good as it gets.” She told me her father had naturally been one of those people and she said, “And you know what, they’re content.”
I felt like a joke.
My life has to have meaning. In my experience, psychiatric drugs are able to take that away. I talked to my psychiatric team (the nurse and a psychiatrist) constantly about this, in the beginning. I asked if I could be put on a lower dose. They were very, very fearful of me getting sick, even though I was taking their prescribed dose. They said lower doses were impossible, even though the product monograph describes a lower dose method. They claimed I had to be on 300 mg or the drug wouldn’t be effective.
Eventually, I just stopped talking in an honest way to my psychiatric team. I stopped communicating any kind of open statements about how I felt, and was able to smile and chit-chat and make polite conversation. I told them nothing was wrong. “Oh yeah, everything’s going well. I get a bit stressed, but I know I have to manage that.”
For a fleeting moment, I was entertaining the possibility of someday working as a peer support worker. I asked a question about what kind of person they looked for. My nurse said the kind of person they look for in a peer support worker is someone who’s accepting of treatment and the kind of life they have to live. That killed it for me.
My psychiatric nurse was so polite and friendly, saying things in an uplifting way that made me feel crestfallen. It got to the point where I was constantly thinking there was something wrong with me because my inner voice wasn’t nice to her in return. I lacked confidence in myself for a long time. Because I couldn’t trust my own perspective, I felt she was a positive contribution to my life. I felt guilty for thinking otherwise. I couldn’t listen to my own instincts, and I assumed her judgment was better.
In that environment of the out-patient mental health clinic, professionals take note of anything except exclusive rationality; everything the least bit quirky or just authentic to a specific individual is viewed with skepticism, if not as a symptom.
The last winter I was at that clinic, we had a meeting. I had been voicing my continued desire to wean off the medication, or at least try a lower dose. For the meeting, both my parents were in the room, as well as an occupational therapist, my psychiatrist, and my psychiatric nurse. I felt crowded out by them all being there at once. I felt overpowered before anyone even said anything.
I came in that day with the hopes that I’d make some half-hearted attempt to tell them how I was suicidal every three months, how this suffering caused by no emotional fulfillment in life was something I just couldn’t deal with. But the presence of all of them quietly sitting there made me feel I had to lie, to protect myself rather than argue my case.
“I get suicidal from the emotional blunting,” I said. I probably had a desperate look on my face. “But sometimes I can try to read and focus on things I like. And if I really try, it feels…a little bit better.”
One of them sighed with relief. They were all so happy to hear it. They concluded the meeting was done, and that it was a success. They needed no further reassurance that everything was fine. They needed no solutions.
My dad told me later that I had folded. I had let myself be weakened, like a mouse. “If someone is suicidal every three months, there’s a real problem,” he said.
I did ask. Every so often. About weaning off or being on less. I did try.
Now, I’ve been able to live on a slightly reduced dose. I am working towards getting off altogether.
Things are more workable in general in my life, though not satisfactory by any means. I have some minor solutions that make the side-effects less dominant than they would be otherwise. For the past year I’ve been taking supplements, some of which increase dopamine, which the medication is designed to block, and some that boost cognitive functioning in general. These include Gaba, Empower Plus, L Tyrosine, and several others. They do not completely give me a feeling of concrete normalcy, but I have more energy and feel strong on some days.
I am in a full-time university creative writing program, taking five online lecture courses during the pandemic. I am getting a lot out of it. I sometimes like where I am, in this position: working myself out of a situation where the only other option was to accept the terrible fate others had already accepted for me. I knew for a while, and now believe on a deeper level, there are other options.
In reality, the anger is a painful thing I have to censor myself from. When I think about the lack of clear paths out of this, the need for some sort of justice, and a real justice, consumes me to the point where it’s unbearable. The only thing I can think about that keeps me going, is that yes, I am now on a lower dose, and functioning better than before as a result. That means there is hope for weaning off completely, which is my goal over the next year or so.
My psychiatric nurse and numerous other workers in the system took my life, when I was in pieces, the first time I had a psychotic episode, and rather than help, they made it so I maybe could never be properly redeemed.
Yes, I had my initial psychosis, when I was a teenager, coming back from boarding school. I broke down sobbing, due to external events that were cataclysmic in my life. I was mourning something. And yes, there was mania, and yes, there were things abnormal about it that I couldn’t control.
But compared to how the last six years of my life have been, compared to how intense the drugs are and how grueling the side-effects, let alone when I tried to come off medication on my own and crashed, my first psychosis at 17, I admit, was honestly not that bad.
I am convinced that if I had been given maybe a year or two off school, to live with my aunt and uncle in their nice, big house close to the woods, I would have sorted myself out and been able to recover to a much higher level than I am right now.
If I had maybe gone for walks every day, if I had maybe been given a productive form of therapy by someone who could really appreciate the depths of suffering and what they can turn a person into. If I had started taking high doses of supplements back then, made a lot of time for myself and endured rigorous daily exercise. I think I could have been out of the illness after a short enough span of time.
I think that was what needed to happen, and could have, if others and myself included had just taken a breath, and been in the right frame of mind to really assess where we were headed, not just where we were right then.
The view of psychiatrists, in my experience, does not take healing into account. Professionals who put anyone, but especially young people, on these drugs and expect them to take them for life, without taking responsibility for things like side effects and lower quality of experience, are just not in a compassionate place. They are causing harm to society.
I believe psychiatry is no more ultimately about being sane than it is about treating people with empathy, understanding and respect. My psychiatric nurse was by far the worst person I’ve encountered, though most people who have ever been involved with my care caused me to feel greatly misunderstood.
I think real evil, according to its nature, is never open about the fact that it’s evil. It masquerades as the solution. It masquerades as something no one should have a choice about because it’s just that morally good. And I think people who are evil genuinely believe that they are doing good. That’s what makes them so difficult to reason with, in the end. They can say no to you a hundred times. Everything you ask for, they can tell you, you don’t have a right to. But you can’t say no to them.
For anyone reading this who is on psychiatric drugs, I hope you can find your own personal courage and be able to recognize what sits right with you and what doesn’t. Believe in yourself and your perspective. Keep searching for people who can acknowledge your situation when you say it doesn’t work for you. You deserve a happy life, and you deserve support from those rare few who are educated and grounded enough to support you.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.