The Pharmaceutical Journal
Vol 268 No 7192 p476
6 April 2002

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Living with mental illness: a growing up and developing experience

Pharmacists, who are also patients, describe in their own words what it is like to have to take a medicine for life

Living with mental illness: a growing up and developing experience

Back in 1995, when I was a clinical pharmacist in charge of two psychiatric wards, little did I think that one day I would be a patient on one. It was the combination of a stressful post in a busy, understaffed, low-morale pharmacy, being a new wife and a superwoman who considered 99 per cent achievement a failure that led to the gradual, but horrific collapse of my world. Through my experience I have accepted that I may need medication for the rest of my life coupled with visits to psychiatrists and community mental health nurses and blood tests. Bit I am also able to understand issues such as alcohol abuse, anorexia, self-harm, seizures, depression and unstable mood.

It all began in March 1995 with my first trip to an accident and emergency department with angioedema. In July 1995 the asthma started, waking me at night. I was wheezing and coughing and relying on inhalers and steroids. But it was in September 1995 that the nightmare really began — the pseudoseizures. My husband (now ex) found me fitting on the floor. It was serious: an ambulance and an admission to hospital. Having the fit meant that I could not drive so I could not go to work. I was given a sick note and sent home — home to a long day with no close friends or family, boredom and an ever-increasing desire to be the perfect wife. Winter was approaching and the more depressed I became the more alcohol I abused. I stopped eating so my weight plummeted. I had regular seizures or I overdosed. I became a regular at the local A&E department.

I had many investigations done to rule out epilepsy, meningitis (the lumbar puncture gave me the worst ever headache), or brain tumour. Eventually everyone thought I was faking the grand mal seizures. I was having seven fits a day at one stage. How could you possibly fake that number? Fits leave you exhausted. Before the fits I would have "butterflies" or an aura. I was able to delay but not stop the jerks or the collapse. During some fits I could hear people around me and it was devastating to hear, "Oh ignore her. she's putting them on for attention." However, my prolactin level increased during seizures, an indicator for pseudoseizures.

After a big overdose of tricyclic antidepressant which ended up with me on a heart monitor for a day, the inevitable occurred: admission to an acute psychiatric ward. My husband cried when he was told. He thought I was going into a lunatic asylum.

Challenge

Surviving on an acute psychiatric ward is a challenge because it can be a frightening place. You feel vulnerable, there are a lot of very sick people sharing living space with you, and there is little privacy and not much to do except watch television in a smoky environment. You are doped up with medication — in my day it was Melleril. Many patients do not know what their medication is or what its side effects are. Having a medical background, it made it a learning experience watching others and diagnosing illness. I found it fascinating at medicine time to look in the trolley and see what drugs were being dished out to whom — confidentially of course. However, I kept the fact that I was a pharmacist quiet, at first, because I found people would ask me awkward questions which they should have asked their doctors. I soon discovered that patients knew little about certain types of medication like mood stabilisers but knew loads about "moggies" (Mogadon) and Valium.

In February 1997, after a spell on suicide watch, I was looked after 24 hours a day by my mother. I finally met a caring, understanding, compassionate psychiatrist who sorted out my polypharmacy. My mother had to construct a day-by-day chart of reducing and increasing medication. I found Antabuse worked very well. It is an excellent deterrent in some people. I was prescribed a selective serotonin reuptake inhibitor and felt very well.

Too well in fact. In September 1997 I was sectioned with mania and put in seclusion to protect myself and everyone else. It was the worst night of my life. I was scared and out of control. But a injection of Clopixol brought much needed sleep and carbamazepine controlled the seizures. To this day I take Clopixol in tablet form. It has become my wonder drug. I may take it for the rest of my life but I can control the dose. When I feel good I reduce it slowly and when I hit a crisis I increase it rapidly. It makes me feel in control if I can dictate what dose I require. After all, psychiatrists cannot feel how you are feeling.

In February 1998, depression returned and I was diagnosed with mixed affective disorder with a degree of seasonal affective disorder. Since I was banned from antidepressants because of mania and overdoses, I began light therapy, which worked well. I still use a light visor for an hour during winter months. After a year in rehabilitation homes , divorcing my husband, taking Clopixol regularly and controlling my drinking I am back on course to start community pharmacy again soon, with a lot of help and support.

My nightmare has ended. I feel in control of my life and I feel happy and can cope with stress a lot better. It has been a growing up and a developing experience. I know a lot about mental health and hope, in a service users' group, to extend this knowledge to help people who are starting this journey.