the long view

Working in social services, dealing with a psychotic ex, seeing people fall apart. The mantra of the industrty is “Treatment Works.” But we all knew that for some people (or even most people, some of the time) it abolutely doesn’t. Or maybe “Works” is a little too vague. Getting rid of command hallucinations, yes, is important, but there are other factors that impact quality of life, public safety, ability to maintain employment.

I understand why people refuse medication. They can feel that long term damage being done. The numbness, weight gain, blood sugar problems, digestive problems, tardive diskenesia. Drooling. Diminished capacities and diminished life span. And although we keep saying “Treatment Works” we also insist that treatment should never be manditory. Coercive treatment traumatizes.

What it really means is that treatment CAN work, but people are rightfully afraid of it too. Drugs have changed over the past few decades, but that means we haven’t studied the full long-term impact either. And we can’t learn more about other options if we keep insisting that what we have is working. Instead of partnering with friends and family members who could help monitor symptoms on a day to day basis, we actually drive them away by denying the problem, denying the need for help, refusing to talk about the reality of living with medication.

I undersand the arguments, but I would NEVER argue against medication where safety is concerned. The man who talks about killing my daughter periodically refuses medication because he’s self conscious about his weight. Every single time he’s been unmedicated he’s ended up being arrested, hospitalized, etc. Even medicated he’s unable to mantain employment or relationships. He’s still dangerous. But his story is not typical of others with his diagnosis. He’s a bad person with or without psychosis, with or without hallucinations. For some people choosing recommended medications really is a lose-lose situation. But no one wants to talk about that. We just smile quiety and insist that “Treatment Works.”


Lost to Bipolar

This just about made me cry. And almost made me jump up and down.
Someone else gets it!
This could be my family.
Except when my baby daddy said he could hear the baby talking to him, it was followed immediately by “I don’t like the way she sounds. I think she’s a threat.”   And every time I insisted that an unborn baby talking was a symptom, he insisted that he would take his meds if the voices were in his head. But they’re not. They’re in the baby. Let’s get rid of that baby. And every time I went to the police, they said they couldn’t do anything about it. Every time I tried to leave him, he escalated.
And I, too, took way too long to realize that a generally unhealthy relationship was actually part of the paranoia. Not letting me out of his sight. Wanting to see everything and control everything. Hanging on my every word because he thought there was some deeper hidden meaning. I saw it as annoying rather than dangerous. Without even realizing it, I gave into his whims to avoid confrontations. I was walking on eggshells without seeing it for what it was. In hindsight, it was psychosis, abuse.
Even when he takes his medication, the symptoms are there, he’s just more careful about not discussing them with doctors or law enforcement. He checks himself out of the hospital every time. The medications are for bipolar, but his symtoms are classic paranoid schizophrenia.
The responses to this article are intensely split. And in a way so am I. I had the same decision to make, but I know I did what was best for me and my child. Some day I will have to explain to my daughter why daddy’s not around. And I worry, too, that she might have the same illness some day. I struggle to integrate what I know about mental illness – that it’s treatable, that people recover, that it’s not linked to violence – with lived reality – treatment hasn’t worked, he isn’t recovering, he is dangerous.
I keep hoping some day he will get better. A new medication, a break through. Court ordered medication compliance. Or one of these days he’ll end up hospitalized, or locked up, or living on the streets. Or maybe he’ll end up making newspaper headlines when he finally does one of the horrible things he talks about.
A part of me wants to track this woman down. I  want to hug her, cry with her. I want to know that 12 years from now everything will be okay. That her daughter is safe and happy and loved; and mine will be too. I want her to know she made the right choice. She’s not alone.