Psychiatric Drugs “Help” By Causing Brain Dysfunction

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What do the following have in common: antidepressants, steroids, antipsychotics, opioids, electroshock, lobotomies, leucotomies, power washing and belting for patients in the “insane asylum,” and inducing malaria to cure schizophrenia?

They all impair brain functioning—and it might be the reason for their “success.”

There are currently ten classes of prescription medications that impair brain function, including both psychiatric and non-psychiatric drugs. A number of non-drug “treatments” do the same.

3d illustration of a brain with one end red and shattering

And it’s not just psychiatric drugs. Some patients receiving chemotherapy complain of “brain fog” and problems of memory. For decades this topic has been one of heated controversy, with some oncologists saying the impairment arises from the patient’s depression and others that the impairment arises from the chemotherapy. There are many other sources of brain dysfunction, such as some major surgeries with general anesthetics, pollution, ingested metals, herbicides, and of course several dozens of neurological disorders, both reversible and irreversible, such as Alzheimer’s disease and other progressive brain diseases.

Some of these brain-impairments are reversible, perhaps when the substance is tapered and the person’s brain is restored to its pre-intervention state. On the other hand, if continued long enough, these impairments may result in permanent damage to the brain.

And psychiatric drugs are a key factor, given their proliferation and the fact that they may be used to ostensibly treat the cognitive impairment that arises with depression or schizophrenia, for instance.

Consider a happily married woman who becomes quite distressed after her husband of 40 years confesses that he had a one-night stand many years ago. She cannot shake her obsessive thoughts about this distressing event, as well as her down mood that affects all of her waking hours. She can’t get it out of her mind, she has no appetite, and she has difficulty sleeping.

If her emotional distress lasts for two weeks or more, her doctor might diagnose her with Major Depressive Disorder (MDD), a “disease” according to psychiatrists. In fact, even if it hasn’t been two weeks, she could receive a preliminary diagnosis or a diagnosis of depression “not otherwise specified.”

Her doctor, knowing what he has been told by psychiatry and the pharmaceutical industry, would likely prescribe his patient an antidepressant based on a belief that a neurobiological “imbalance” is to blame for her “depression.”

Let’s say the woman returns to her doctor six weeks later and says that she does feel somewhat better. But why is she better? Her doctor says the antidepressant is beginning to restore her chemical imbalance, but what about some other possibilities to explain her partial improvement?

There are many situational reasons that she might have improved, such as reconnecting with her husband, social support from friends or family, or even just having the time to process her feelings about what happened.

But perhaps the antidepressant drugs did have an effect, too. We know that these drugs have a number of adverse side effects, including impairing brain function. Our patient’s brain was already impaired in response to her husband’s confession, and now her brain dysfunction is substantially increased by the antidepressant.

One of the many consequences of brain dysfunction is difficulty maintaining one’s attention or mental focus. Is the woman a little better because the brain impairment is disrupting her ability to maintain her focus on what she has been obsessing about, her husband’s one night stand?

When their patient is not improving substantially on an antidepressant, doctors will add an antipsychotic drug to the mixture (have you ever seen the ads for “Abilify”?). Both drugs impair brain function, but antipsychotics are more mentally impairing than antidepressants. Now we have a patient with brain-impairing effects from the distressing news, additional impairing effects from the antidepressant drug, and increased impairing effects from the antipsychotic drug!

Imagine a face-to-face comparison of antidepressant and antipsychotic drugs for our patient. I am quite sure the antipsychotic drug would win hands down (setting aside the other adverse side effects the patient must contend with) because it impairs the brain substantially more than the antidepressant drug. Although very little actual research exists on this subject, one study showed the antipsychotic to be superior to the antidepressant in the first week because it affected the participants faster.

Instead of an antidepressant or antipsychotic, what if the doctor had given our patient another brain-impairing drug, such as an opioid? Would this drug disrupt our patient’s ability to focus on what is distressing her? I am quite sure it would.

Of the 10 classes of brain-impairing drugs, how many of those drugs address the health problem directly, and how many disrupt the patient’s cognitive focus and thereby give the patient perceived relief? Moreover, some of these brain-impairing drugs, such as opioids, are “feel good” drugs, much like the alcohol in “snake oil.”

Now, imagine that our patient’s husband kept his mouth shut about his one-night stand, but we find that our patient has very severe back pain instead! Again, significant pain from any source causes mental impairment, but the impairment is not severe enough to distract our woman from being aware of the distressing pain. However, bring on the brain-impairing and feel-good opioid, and the pain is lessened. Often even that is not enough, and the dosage of the opioid must be increased.

I will end our patient’s story here, but if it went on it could certainly end in a serious addiction to the opioid and perhaps an overdose death, especially if the doctor increased the opioid dose and added another feel-good drug!

What about the non-drug brain-impairing treatments throughout history, many of which are still in use, such as electroshock therapy (ECT), lobotomies (destroying parts of the frontal lobe), leucotomies (surgically removing parts of the frontal lobe), and giving hospitalized patients malaria to “treat” schizophrenia?

Inducing malaria in hospitalized schizophrenic patients earned one physician the Noble Prize, even though the induced malaria caused several deaths of patients. There was one patient on the unit, diagnosed with schizophrenia, who had not “responded” to a number of psychiatric drugs. However, this patient came down with cancer (certainly a brain-impairing diagnosis) and his schizophrenia disappeared permanently! In this case one disease (cancer) cured another “disease” (schizophrenia)!

One more example of a brain impairing “treatment” that seemed to improve a serious mental disorder: Prior to the 19th century, in the insane asylums, most of the treatment centered around physical abuse and outright torture—for instance, power washing and belting of patients. This “treatment” may have initially come about because these bizarre illnesses were thought to come from the devil and the treatment was to drive out the devil from these patients.

But how can we explain why punishment and physical abuse lasted for centuries? Were all of the asylum staff sadists? Or are there possible explanations other than sadism to explain the torture? The pain from torture certainly induces serious brain dysfunction in the individual, which may distract the patient from being able to focus on and maintain a delusional or hallucinatory state. If so, some of the asylum staff may have believed the physical punishment was an act of healing, since some of their patients seemed to improve in response to the abuse!

It is my opinion that modern antipsychotic drugs and their many adverse side effects, particularly sedation and cognitive impairment, also tend to disrupt the psychotic process in the short term. After all, if you’re too tired to get out of bed, you might be too tired to get worked up about delusions, too.

Does all of the above mean that medical care and the rest of us just have to live with drug and non-drug induced brain impairment because these health problems cannot be effectively treated otherwise? No. There are other ways to accomplish the same end without damaging a person’s brain.

For one, psychological therapies, such as CBT and interpersonal therapy (IPT), have been shown to be just as effective (if not more so) than drugs for most psychological issues, including depression. Additionally, many mild episodes of depression resolve on their own, over time, and it is possible that treatment with drugs actually harms, rather than helps.

Rather than just continuing on with business as usual in medical care, we need to pay attention to the research. Medical care in many areas has focused too much on treating the organic factors involved in a variety of health problems. It is time to begin treating the non-organic, psychological factors in many health problems as well!

How do we deal with the cognitive impairment pandemic?

In 2013, 16.7% of the US population was taking at least one psychiatric drug. If that number still holds true, that’s about 55 million people being exposed to the potential cognitive impacts. And when non-drug therapies and non-psychiatric drugs like chemotherapy are also factored in, the number only grows.

Unlike the Covid-19 pandemic, the pandemic of cognitive impairment (CI) has been largely invisible to the general public and the healthcare system, including most physicians. Often, when patients complain of possible CI problems, these complaints are explained away by attributing the cause to another source, a favorite one being depression—and perhaps the physician prescribes an antidepressant to “treat” the patient’s complaint of mental impairment!

When CI is not identified, or when its cause is misdiagnosed, treatment may be inappropriate, potentially harmful to the patient, and wasteful of healthcare resources. For instance, if the cause is misidentified as “depression,” then the “treatment” may be exacerbating the problem rather than helping.

One might say the various forms of cognitive and brain impairment are our number one health problem. Unlike many other health problems, this one exists largely under the radar and typically remains untreated.

Medical care’s focus has been directed toward diagnosing structural brain damage such as brain injuries, strokes, progressive brain diseases, seizure disorders, and others, but there has been almost no attention directed toward cases of reversible brain impairment from some of the causes mentioned above, and particularly from psychiatric drugs. These causes compromise the quality of life of several hundred thousand or more persons in the U.S. annually.

Because of this, I suggest that CI assessment of the patient needs to be done both prior to and following initiation of a psychiatric drug. This enables the prescriber to see the patient’s initial, baseline cognitive functioning and then to compare that with the patient’s brain function after they have been prescribed psychiatric drugs. This will make it more difficult for the provider to claim that the CI is due to underlying depression, for example, since they will have a record of the patient’s functioning with depression alone and another record of the patient’s functioning with depression plus a drug.

If the doctor finds that the patient’s cognitive functioning is decreasing once they’ve been prescribed a drug, the doctor then has enough evidence to begin the withdrawal process. The doctor should then continue assessing the patient to determine if their cognitive functioning returns to baseline, bearing in mind the possibility that withdrawal symptoms could also cause further CI.

This may also help with research. For instance, it could help determine whether, and how much, drug-induced CI is reversible, and how long patients can expect before they return to normal functioning if it is. It could also help determine if some drugs cause more CI than others. These are vital research questions that, so far, have not been studied.

One way to assess patient’s cognitive functioning is with the Ruthven Impairment Assessment (RIA), which I developed and tested. The RIA is a brief, inexpensive, computer-delivered performance measure used to identify cases of CI.

The test takes about 15 minutes to complete and can be self-administered (for instance, delivered through an online program so that people can take it from their own homes). It consists of five tasks. The first three are reaction time tests (a measure of speed of mental processing). Task 4 measures sequential attention/memory. Task 5 measures more complex processing, and is likely the most sensitive to persons with structural or permanent brain damage.

A real-life example will help illuminate the utility of the RIA. We administered the RIA to a patient complaining of memory difficulties. Her overall score was mostly in the normal range, but her performance on Task 4 was very low—consistent with her report of memory problems. I reviewed her medical history, and found that she was on 50 mg daily of the antidepressant drug Celexa (citalopram). I recommended to her doctor that he help her discontinue this drug.

Once she had fully withdrawn from Celexa, the patient’s memory returned to normal.

Based on my research and clinical experience using the RIA, I believe that if the RIA profile demonstrates CI but Task 5 performance is in the non-impaired range, the brain impairment is likely to be reversible. If Task 5 is impaired as well, it may be a case of structural and static or progressive and irreversible brain damage.

I want to emphasize that the RIA is a screening assessment, and thus should not be used as the sole evidence for any specific diagnosis. Instead, those who have potential CI based on their performance need to be referred to experts in CI care for diagnosis and treatment.

The RIA should be given before and after any intervention that might have an impact on cognitive functioning, including psychiatric drugs, non-drug treatments, opioids for pain, chemotherapy, and surgery with anesthetic.

Overall, the RIA—or other measures like it—can provide vital information to doctors about the cognitive effects of the drugs they prescribe. If given both before and after a new treatment, doctors can actually see the cognitive effects it has, and intervene quickly to prevent progressive brain damage.

 

Notice to qualified health researchers connected to university psychology departments, school psychology departments in public schools, hospitals, and medical schools: You may obtain the RIA and its procedures for research purposes without cost by contacting Dr. Ruthven.

Dr. Ruthven’s website is http://www.ruthvenassessments.com/ and he can be reached by email at [email protected]. His recent book on healthcare can be found here.

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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.

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25 COMMENTS

  1. Thank You Dr Les,

    Yes, that’s what ‘antipsychotics’ do – they switch a person off.

    What a person might do if they’re very anxious – is to sit with their uncomfortable feelings, until their feelings eventually calm down. From this State Of Mind – they will KNOW what to do.

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  2. This article is well-written and could prevent this crazy maintenance drug concept that causes the patient to be prescribed years upon years anti-depressants, anti-psychotics, lithium, benzos, even anti-seizure drugs like depakote and tegretol and others. In the article the author discusses an imaginary patient who does possibly get prescribed an anti-depressant and then if that doesn’t work, an anti-psychotic is added. But, unfortunately, what really happens is the psychiatrist begins with one or two drugs, complains they don’t work, and they add and add on even stronger drugs like anti-psychotics. Many patients are on perhaps six or more even up to twelve and thirteen of all these drugs for years and years. What really happens here to the brain and the body in this situation? What are not only the short-term effects, but the long-term effects even after all these drugs have ceased being used by the patient? In my case, my brain and body rebelled from this regimen. I went into a semi-comatose sleep state, could not be awaken, and was considered that my future would be as a “vegetable” or only slightly better, probably needing 24 hour long term care. However, eleven days later, I did leave the hospital without needing any such type of additional care. However, it took another two years before I got off the last drug, which was lithium In the meantime, they tried several different anti-psychotics, etc. that never worked. But, now, I, probably live a strange life compared to some. I am allergic to many foods, probably all drugs and who knows what else. And, I still don’t have a “sleep schedule” but I am no longer “batting myself on the head” about it. There are other changes in some of my skills, abilities, concentration ability, etc. I guess I could write a book, but, then I don’t have the “where with all” or the patience. I know there are others out there like me. We are an emergency warning system, but, will anyone listen to us? Thank you.

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  3. Psychiatric Drugs Harm By Causing Brain Dysfunction, too.

    I do agree cognitive impairment should be tested prior to, and after, each change of psych drug. But that’s 100% the opposite of what my psychiatrists did. Willy nilly poly pharmacy would better describe my psychiatrists’ prescribing habits.

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  4. Thanks Les.

    First of all we have to establish what impaired function is. The first thing a doctor does is send victims to either a neurologist or psychiatrist.
    Neither of them knows the problem, and most often a neuro will just pass his clients on to a shrink anyway.
    The lack of knowledge within science is where psychiatry benefits and so do all other systems.
    It’s a sham and a shame.

    I’m not sure what to make of people who would score high on any test, showing cognitive ability exists, but those same people sit in chairs and write prescriptions and nonsense gobblygook labels all day long.

    Really, we have no assessments that show that shrinks are capable of looking after humans.
    Psychiatry proved that. One of the most unsafe babysitters.

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  5. When psychiatrists turned to the concept of mental health conditions as brain diseases that was a recipe for poly pharmacy and for non-psychiatric physicians to become the largest group of mental health professionals in the country, the latter having had a 6-week rotation in psychiatry during the internship. MIA published another article of mine partially on data I obtained on psychiatric drug prescribing (80% by non-psychiatric physicians); many patients were one two and sometime three classes of psychiatric drugs and one patient was on 5 different antidepressant drugs. Rather than looking at the patient’s behavior (psychiatrists and psychologists used to do that in the 1960s) psychiatrists now seem to be most concerned with various neurotransmitters and manipulating them. Forgive me but I don’t think this approach is working, which Robert Whitaker discovered years ago.

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    • Katel, akathesia is a very severe adverse side effect which is clear evidence of severe brain impairment, which may or not be reversible. Actually we don’t know because drug companies do not test drugs for impairment of the brain. They should.

      You are right that a cognitive test (such as the Ruthven Impairment Assessment) should be taken before and after ECT. It has been known for many years that ECT causes memory problems but we do not know if the memory (or other brain impairment) is reversible or not. Is is time to get the answer.

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      • AKATHESIA: THE ELEPHANT IN THE LIVING ROOM

        There’s a continuing Epidemic of Homicide, Familicide (and Suicide) in Ireland among the “Normal Population” – taking Psychiatric drugs for ‘Lifestyle Problems’.

        Everybody in Ireland is extremely concerned about the situation. But there’s NO mention of the Obvious Cause:- A K A T H E S I A.

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        • Fiachra, this is scary. I think all we can do — “we” meaning the small segment of the population who actually know what akathisia is, what it looks like, what it feels like, what causes it — is keep educating people about it. It’s so frustrating but what else can we do, since it’s not something that will show up on blood tests or MRIs. It’s hard, maybe impossible, to prove, so people who are invested in the idea that psychiatry is basically good and psychiatric drugs are basically good and needed…these people are going to reach for other explanations for the violence happening. Of course, many people seem to love the explanation:. “The person had (undiagnosed) mental illness. That made them violent.” It’s definitely an uphill battle.
          I recently had an email conversation with an acquaintance who has had a bipolar diagnosis for at least 20 years. I mentioned akathisia to her, and she said she had never heard of it. After I described it to her and sent her a couple of links with information about it, she quickly realized that she had suffered from it when she was taking risperdal. This is a very smart, well-educated woman. I guess she trusted her doctors to let her know about the risks of the drugs they were prescribing and didn’t research them on her own. That’s a mistake that I made for a long time also.
          I’m glad for the MISSD organization. They have some very informative, though heartbreaking, videos. I just wish the mainstream media would pick up on this, but I won’t hold my breath.

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  6. The best thing to do is for these doctors to quit prescribing these drugs. Even better would be for the patient to say no to these drugs when the doctor tries to prescribe them. But, I know it is very difficult. We have given our doctors and others in the medical, including the psychiatric industry too much power. It is almost as if we have given them a “god-like” power and authority and many seem to enjoy this and abuse this power and authority. If we want to be free of this “mumbo-jumbo” we need to take our lives back and be our own authorities. We know our body and brain better than they do. We know what is best for us better than they do. And if you do believe in God, it is important to not put “god-like” power and authority onto another mere human. All of this is important. And, it is not easy, but very necessary if we want to survive as a species. Thank you.

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  7. When I was first diagnosed with borderline personality disorder following ECT treatments — about 15 years ago — the prevailing “wisdom” among mental health treatment providers was that there is no drug to treat borderline. However, the argument went on: There *are* drugs to treat the symptoms. So, an antidepressant for the depression, an antipsychotic for the I don’t know what…in my case it was the rage. A mood stabilizer, to stabilize the mood. Depending on the prescriber, the following could be added to the mix: a benzodiazepine, an ADHD drug, a drug for sleep (Ambien or the like).
    In my case over the course of over a decade with this diagnosis and probably 20 different prescribers, at least, I was put on and taken off of drugs in all of these categories. Drugs started, drugs stopped, drugs changed (switching from generic to non generic, as when Latuda came out I was put on that at the insistence of the prescriber, and taken off Abilify).
    To realize the truth behind all this drugging, and in fact the truth behind the diagnosis itself, after all this time and all this loss is definitely, well, a hard pill to swallow.

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    • Katel, I don’t think it matters what diagnosis they give you. They just use the diagnosis as justification for all the psych pills. They did similar stuff to me until my body and brain rebelled and I became semi-comatose and could not be awakened. Before that happened, they could not figure out what was wrong with me. What was wrong with me was all those evil drugs they were giving and I, although I wasn’t aware of it, was giving out signals that my body and brain were done with the drugs. Of course, they ignored it until that nearly comatose incident which put me in the hospital and they still denied what was happening. Of course, it still took me two more years until I finally got to the point that I could no longer swallow any pills. Still, they tried, but I left them for good. My desire to live was much stronger than their evil drugs and therapies. I just wish others would listen to stories like mine and not be swept in psych world’s propaganda which has seeped too much into the mainstream. I saw a tshirt on tv that said, “Fight the Stigma.” I would like to see a tshirt that says something like, “Stigma Saves Your Life. Embrace the Stigma!” Thank you.

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        • Yes, you are right; but there are more involved in this deceptive hyprocrisy than just psychiatrists.. Let’s see: There’s Big Pharma, Mainstream Media, Government and Legal Sources, the psychiatrist little helpers, therapists, in some areas, health prescribers, health insurance, blah, blah, blah, etc. etc. etc. It’s going to take a super large shirt to list all who are involved. There are a lot of people out there doing the “stigmatizing.” Oh and I forgot groups like “NAMI” and others. Evil is as Evil does. I am open to a good tshirt message that makes people think before they make that appointment at their local mental health clinic or before they take that next pill. Thank you.

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          • I agree. The news and entertainment media are also a HUGE part of why “everyone believes” in chemical imbalances, while even the most cynical psychiatrists nowadays have to admit it’s kind of a crock of horseshit. The message is out there in many forms, and I think a lot of people get their “Truth” from movies and TV shows. It is a lot to battle!

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      • rebel,
        I think you’re right about that. Whatever the diagnosis, the psychiatrists just drug, drug and drug some more. It’s so sad that you had to go through what you went through. It’s also inspiring though. It shows your body’s innate wisdom and your will to survive. I too wish that more people would listen to your story and the many stories on this website of people who have gone through harrowing experiences in the name of help. Since I discovered this website two or three years ago, I talk to anyone who will listen about it and I am always sending them links to the personal stories and the articles that back up what I’m always telling them about psychiatry and the mental health system. A lot of times I get replies suggesting that maybe I should start thinking about other things, start thinking happy thoughts, get over it, etc. Or sometimes I just get silence, and when I’m speaking to a person face to face telling them about the latest article or story I read on MIA, I get this sense that they wish I would just stop talking about it.
        You’re right, too, that if the stigma keeps people away from psychiatry it keeps them safe from psychiatry. Also, who created this stigma? I think Psychiatry and the mental health system in general plays a big part in perpetuating stigma. They need to convince the general public that there are people with a thing called mental illness and that those people need treatment although they probably don’t know it because they’re too mentally ill to realize they need treatment so it’s everyone’s job to make sure these people get treatment and get the help they need. It’s all part of their big gaslighting money making evil plot.
        I did overhear one time, while I was still in treatment, another person who had a borderline diagnosis, who had used the statement, “there is no drug that treats borderline” to convince doctors not to drug her. I remember thinking, I wish I had done that. I wish I’d done more to protect myself. But, lessons learned.

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        • Katel, It’s good that you get to talk to people about your experience. I live in silence about what happened to me. My mother, of course, knows, but I am not sure that she understands. She admits my mind is clearer than it was when I was on the “psych drugs, etc.” But, otherwise, she somewhat doesn’t listen, especially, when I tell her that where she gets her news, etc. has been brought to her and others by the same people that almost killed me. So many people have been brainwashed that they don’t believe you. Once, I thought I had a friend, but, then she told me that she was sorry that she had not emailed me in about six weeks because she was having trouble with her “psych drugs” and she said she had a bipolar diagnosis. I deleted her from my email listings and never responded. I felt that no matter what I said, she would probably not listen. Now, when something happens to a celebrity or athlete, it is due to being honest about their “mental health” and they are celebrated and congratulated. This type of thinking is so dangerous because it obscures the truth and it makes people think that if they cry “mental health” they can avoid their responsibilities. Sometimes, we do need a break from life. Sometimes, we do need to change course. Sometimes, we do need time for self-examination or whatever. However, using mental health and mental illness is an excuse for solving life’s problems is a “cop-out” and a very, dangerous and harmful one, too. Thank you.

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          • rebel, I’ve actually had the same experience of either being cut off by people who are sick of hearing me talk about what I went through or I stopped talking to them because they buy into everything they read and hear in mainstream media. My family abandoned me years ago because in their eyes I was severely mentally ill and needed to work harder and treatment or whatever I don’t even know they all moved 3,000 miles away from me and I haven’t seen any of them since. I haven’t spoken to my mother and like 6 months and now she’s blocked my phone but that’s fine because the last time we spoke she just kept insisting that I’m mentally ill.
            I mostly send email links to people that haven’t blocked me yet but pretty much everyone has by now.

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    • Psychiatrists are still using mood stabilizers, etc., etc., to treat borderline personality disorder and after 25 or more years of failure it is still going strong. Yours is an example of off-label prescribing which is endemic in healthcare today and needs to be stopped. There is simple no proof for an FDA approved drug that is use off-label.

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  8. Katel, Actually, my mother and I live in the same town. I probably speak with her a million times a day. She just doesn’t quite understand what I have been through. She is 86 and my father (her husband) passed away back in 2013. She helps me in some ways, but, we don’t discuss politics, the governor, covid or the evil mainstream media which she believes as gospel. She also doesn’t understand that I am upset with the church she goes to because I feel they are denying God, in favor of the mainstream media and governmental pronouncements, etc. I am not sure if it is only mainstream media, etc. that influences her or not. She is a good woman but since I am her child, although I might be an adult, it makes what I say or think not really worth considering. This is about some things. She will take my advice on how to cook chicken in the crock pot; which is funny. I am allergic to all poultry products. And, even more so after the psych drug years, but still I do love her and worry about her. And when I lost my cable, tv and phone for several hours after bad storm last week, I called her in the middle of the night (when it came back on!) just to hear her voice. However, my mother will deny this; but she does have a tendency to prefer to talk to her friends rather than me. Oh, she doesn’t think I’m mentally ill anymore, but if I have a very bad day sometimes, she ask me if I want to talk to someone like the lady preacher at her church. I say no! politely. I told her that talking to someone like that any one is likely to lead me in to the drug world place I was in and I am not going back. I say, do you remember how I couldn’t sign a check? Then, she shuts up. At her age, it’s dangerous, if I can’t sign my name. Thank you

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