Surviving Psychiatry’s ‘Help’

When I was 25, and the world still seemed full of promise for me, a very unfortunate thing happened. I went ‘crazy’. Or, at least, I fully believed I was losing my mind, that I had inherited a dreadful and debilitating illness, which was beginning to manifest itself, and which would steadily progress until it ultimately robbed me of all the positive attributes I possessed: intelligence, creativity and musical talent, athleticism, and even my ability to simply function autonomously as a healthy, independent human being.

The reason I felt the clock ticking was primarily because my older sister had suffered a very significant mental breakdown at roughly the same age, and had been heavily medicated ever since, never regaining her pre-crisis personality and abilities. So I had always secretly wondered, and feared, was the same horrible fate in store for me?

And now, on the verge of a tumultuous breakup with a partner who I loved deeply, I feared that the answer was a resounding ‘YES’. I was becoming increasingly convinced that the extreme levels of anxiety I was experiencing, combined with insomnia, decreased appetite, and most frighteningly, a noticeable deterioration in my ability to process information, were manifestations of a condition that would soon extinguish the life and person I had always been. I felt I was experiencing the equivalent of a psychological cancer, a malignant and rapidly accelerating condition that was disintegrating my very personality, my identity, from the inside, and from which there would be no returning. It was, in my mind, unstoppable.

Quite apart from any underlying depression or acute anxiety I was actually suffering from at the time, my conviction that this impending psychological apocalypse was inevitable resulted in a level of fear, stress and sadness that I had never before experienced. I have described it to people I know as a waking nightmare, the unfiltered and primal scream of the reptilian brain devoid of any self-soothing or other placating mechanisms. Little did I know, nor could I have believed, that things were about to get several orders of magnitude worse, thanks to my fateful decision to visit the emergency department of my local hospital out of fear that I might otherwise take my own life.

My local hospital had a ‘prestigious’ psych unit, one of the best in the country according to its reputation, I would later discover. Unfortunately for me and my soon-to-be fellow inmates in the acute psych ward, this reputation would not translate into anything resembling a sense of care, or competence, let alone efficacy of treatment.

I want to be fair here before I continue: when people are presenting at hospitals because they are experiencing extreme psychological distress (regardless of the particulars involved, such as delusions, hallucinations, cognitive impairment, etc), one might expect their ‘stay’ at a hospital to be a stressful and generally unpleasant experience. However, what I witnessed, and the ‘treatment’ I personally received during my three months in that facility’s acute ward, have left permanent and completely unnecessary scars on my psyche and soul.

The first thing that concerned me, which I noticed upon my admission and which became a running theme over the ensuing months, was the reluctance of staff, particularly the higher-ups (the psychiatrists and psychologists), to simply BELIEVE anything I had to say: about my condition, my past, anything. There was an immediate skepticism, overtly expressed, and a reluctance to accept what I said at face value. Even in my heightened state of anxiety and impaired cognitive function, I found this extremely odd and perplexing. Here I was, voluntarily presenting to a mental health clinic because I was afraid I would self-harm, here I was actively seeking help and being as open and transparent as possible, and I was immediately hit with a wall of distrust and cynicism by the very doctors I was trusting to help me. This did not bode well.

It turned out, and I would later learn that this is unfortunately endemic to the field as a whole, that the lack of trust I perceived was representative of a general and broader disdain and disrespect with which doctors, and to a lesser extent staff, viewed and treated patients in the ward. The subtext seemed to be: “You’re crazy, we’re sane, and much smarter than you, so don’t expect to be treated as one of us, because you’re not!” It should go without saying that acute ward patients constitute a population suffering some of the most extreme levels of mental anguish possible, thus these people need and deserve to be treated with the utmost respect and care. It was therefore astonishing to me to see, and experience, the callousness with which staff treated some of the most fragile people in society.

This ranged from open displays of anger and impatience, to mocking and laughing at patients. I recall one incident where an aggressive patient had been locked in an isolation room and was violently pounding on the door to be let out, and a clearly frightened patient asked one of the nurses, “What should I DO?” To which the nurse glared at the patient and replied in a deliberately cold and sadistic manner, “There’s nothing you CAN do.” There was no offer to help or comfort the patient, simply a harsh rebuff, and the patient began to cry. Such indignities were a constant, and the power divide within the ward felt both oppressive and dehumanizing.

Another thing that was disturbing about the ‘culture’ in the ward was the lack of oversight and control that the staff on duty exercised over it. For example, I remember that on the first day I was admitted, a woman who I shared a room with (all the rooms were co-ed) took a liking to me and began making overtly sexual advances towards me. I was extremely uncomfortable about this, and mentioned it to one of the staff on duty. He responded by snickering and then ignoring the issue entirely. The situation became further complicated when I discovered that one of the male patients had a crush on this particular woman, so there was immediate conflict and tension within the first day of my admission. And this was indicative of the chaotic and unsupervised nature of the ward. Given the number of unstable and heavily drugged people in that small space, the environment was often hostile and tense, and certainly not conducive to recovery.

I recall one of the most upsetting side effects of being institutionalized, and I’m not sure how much of this was the result of the medication versus simply the experience of being locked up day after day. But most people, myself included, developed the habit of pacing. And we would just pace and walk back and forth in the small spaces that existed there. It was a kind of torture, but preferable to being still. It’s like you had this abundance of nervous energy, with no outlet, you couldn’t do puzzles or play games because you didn’t have the cognitive ability to focus, you couldn’t sit still because it was excruciating not just mentally but physically. And so, you paced.

I had befriended a fellow patient and he and I would make requests to be able to go out for short walks, and we would walk through the local shops and streets, not conversing, just walking robotically, nervously. I’ll never forget how foreign I felt in my own body during those times. I didn’t recognize what I was doing or why, I acted out of a compulsion that I didn’t understand and it was horrifying. I can never visit a zoo again after my experience in the acute ward. I could never watch an animal pace back and forth.

Far worse, and more lasting, however, was the critical aspect of diagnosing and medically treating my ‘condition’. To say that I was administered an inconsistent and illogical cocktail of psychotropics would be like saying the use of thalidomide by pregnant women in the 1950s was a little “ill-advised.” Rather than admit that they did not understand what I was suffering from or how to treat it, the standard psychiatric playbook of ‘prescribe now, prescribe more later’ was quickly adopted. By the time I left the ward, I was on a combination of antipsychotics such as Clozapine (even though I never experienced a single psychotic episode), strong sedatives such as Lorazepam, and Lithium because hey, why not. It took more than half a year for a psychiatrist I saw post-hospital to wean me off ALL the medications I had been on, and start me on a dose of Prozac (a story for another time, perhaps). He was stunned at the combination of psych drugs I had been on, calling it an example of “very bad medicine.”

Similarly “very bad” was just how inept my ‘diagnosis’ and corresponding prognosis were. The fact is, I never received a definitive diagnosis at all (or if I did, no one ever told me what it was). I was left to basically infer what my condition was based on the ridiculous combination of drugs I was given. The main thing I wanted when I presented at hospital was reassurance that someone could figure out what was wrong with me. That to me was just as important as the “cure,” if such a thing even existed.

It became terrifyingly clear soon after I was admitted that all my assumptions about the field of psychiatry had been misplaced. Like so many people, I had assumed that psychiatry was akin to other areas of medical science; that it had been founded on rigorous studies, which resulted in a neat, and of course valid, list of illnesses, each with a discreet set of symptoms, and corresponding medications to ‘treat’ said illnesses. All that was required was for a competent doctor to diagnose me by ticking ‘X’ number of boxes in some symptoms catalogue and presto, I would be given some pills and feel better. Except, no. It turns out none of that is true.

In reality, there are significant issues at every junction of that hypothetical treatment map, starting with the constructs of the illnesses themselves. Rather than being discreet and easily measurable and identifiable pathologies, many of the ‘disorders’ are so nebulously defined and/or poorly researched that their very existence is entirely uncertain. Many of the criteria and symptoms are similarly unreliable and/or arbitrary. And needless to say, if the illnesses themselves are less than valid, it is not surprising that there is a high level of discordant diagnoses (i.e., where the same individual can receive entirely different diagnoses from different doctors), and, in turn, a slew of inappropriate medications being prescribed and taken by unsuspecting patients.

Returning to my own frustrating story, even after spending three months being ‘observed and studied’ as it were, I was no closer to understanding what was wrong with me than the day I entered the hospital, and clearly, neither were the doctors. I was on medications that suggested I suffered from everything from bipolar disorder to schizophrenia, as well as major cognitive/affective disorders. It was a complete farce. I distinctly recall the head doctor of the ward having a meeting with my girlfriend (who had, miraculously, stuck with me throughout this ordeal) at my request, and confidently telling me that there was a “90% chance that you will be readmitted to hospital within the next two years.” That was more than three decades ago, so, I’m okay with those odds.

Needless to say, the fears I had at the time that I was on the brink of a devastating breakdown that would permanently alter my sanity and cognitive abilities were totally unfounded. I experienced a depressive episode with heightened anxiety (largely BASED on the false expectation I had that ‘the end was nigh’). As relatively mild as my underlying condition may have been, my stay in hospital resulted in SIGNIFICANT iatrogenic harm, from the institutionalization, the misdiagnoses and the self-fullfilling prophecy that ensues from such labelling (for years afterwards, I lived in the shadow of fear that it was “only a matter of time” before I would wind up back in the horrific confines of an acute ward), to the ‘dirty’ drugs I had been prescribed there, NONE of which addressed what I was experiencing, and ALL of which caused unwanted side effects ranging from the unpleasant to the debilitating.

One of the things I found most disturbing about my experience being hospitalized was the lack of informed consent about the many drugs that were shoved down my throat. In particular, the side effects of some of the stronger antipsychotic drugs were devastating to me, both physically and mentally. I will never forget the day they took us out to play basketball in the courtyard. I’ve been an avid basketball player all my life, and when I went to take a free throw, not only could I not make a single one, I couldn’t make the 15 ft distance to the hoop. I tried with all my strength and the ball traveled maybe 8 to 10 ft. It was an extremely traumatic moment, and obviously completely unexpected since no one had explained to me that this was a ‘normal’ side effect of the Clozapine.

Again, all someone, anyone, had to do was explain to me that my motor skills and strength were going to be significantly impacted by the combination of medications I was on. I wouldn’t have liked that, of course, but at least I wouldn’t have been terrified to see and experience these effects without any forewarning. Like the depression and anxiety weren’t bad enough, now suddenly I can’t MOVE MY ARMS normally!? It was sickening.

It took many years for me to recover; not from whatever was actually ailing me, but from the very experiences I had in that institution. I left there significantly more harmed than when I entered. I am not exaggerating when I say I literally had to learn how to function again in even the most rudimentary ways.

Consider my story a word of caution. I would strongly encourage anyone reading it to carefully weigh the risks and do your own research before seeking ‘help’ at any psych clinic or hospital. Depending on the severity and nature of what you’re experiencing, there is a good chance that avoiding such institutions altogether would be the safer, smarter choice. I can say with absolute certainty that, had I known then what I know now, I would never have set foot in that place.