Is there a pill for every ill or is it the case, as the Verve would say, that the drugs don’t work? This piece in the Irish Times Weekend makes interesting reading. The sheer amount of pills being popped to combat mental illness is mind-numbing (non Xanax induced, presumably). Are we being over-prescribed or is it, as the IT piece mentions, a product of a more effective diagnosis of mental illness?
Almost 20 years ago, I checked into St. Vincent’s Psychiatric Hospital as an in-patient. Already looking at life through the fog of depression and depersonalisation I didn’t want to lose any further touch with reality and refused to be put under any drug regime. Surprisingly enough, I wasn’t strapped into coat with buttons on the back and my therapy mainly consisted of talking which – for anyone that knows me – was excruciating. Word association games became the opening gambit of most of my sessions – but I got bored easily and these disintegrated into a sort of Two Ronnies sketch. But there were times when I was swimming in some deep emotional pools that I even wished for a dose of Prozac just to numb the pain. There were other times when I was asked to present my case to a class of student doctors and, looking back now, I realise that doing something so public at that stage was not a good thing, at least for me. My psychiatrist tended to treated me as a person but most of the students saw me either as a footnote in a series of case histories or, even worse, as someone with a particularly contagious disease – it’s a bit unnerving to see 20 pairs of eyes all staring at the floor.
What really kept me from disappearing any further into my own private cloud were two occupational therapists on their first assignment. I know that a psychiatric ward wasn’t the first choice for either of them but their sheer energy, enthusiasm and desire to make a difference meant that they saw us as individuals and not cases to be treated. They were able to drag us all down to the therapy room, even the most catatonic and, believe me, there were some patients that would make the Easter Island statues look manic. The therapy room was designed as a space to keep your hands busy and your mind calm – bit like a monastery. We made things – there was weaving and I probably know more about macramé than I ought. We had relaxation therapy, to this day the sound of the sea makes me both want to nod off and to kick a hippy and if I hear any more whale songs I’m joining the Japanese fleet. But the most useful part, not just for me, was the group sessions. Unlike the anally-retentive students, most of the patients shared their pain – from the manic, tourettes induced, expletive-ridden shouts to the mumbling, stumbling, half-whispers and grunts (mostly me).
And then there were the group outings. It wasn’t quite a McMurphy hijacking in One Flew Over The Cuckoo’s Nest but the number 7 bus into town on a Wednesday afternoon became our own version of the Great Escape, although I’m not sure how comfortable the other passengers were with getting up close and personal with this sort of care in the community. I remember we saw Ghostbusters in the Savoy after a show of hands in group therapy, “who wants to sit in the dark and laugh at Bill Murray telling dick jokes?” The more neurotic of us huddled down in our seats, cowering at the overacting and when the Marshmellow Man appeared there were shouts for mammy (probably mostly from me). Although, there was the time that a couple of us led a breakout after tea one evening, crossing the Merrion Road to the M1 pub like some scene from a Woody Allen sketch. It didn’t take long for the staff to find us, mainly because the bar staff spotted our hospital wrist bands, that and the fact that one of our more paranoid members locked himself in the bathroom (not me this time). Funnily enough, it was shortly after this that a few of us were released back into the wild and only had to turn up on day release. And, thanks to the caring staff, I left there with an ability to cope and two hand-made stools.
There are no easy answers when it comes to treating mental illness with drugs. I don’t use them and don’t think I need to but I saw some seriously disturbed people who wouldn’t have been able to get out of bed without some sort of medicinal intervention. But I also saw people who were given the totally wrong drugs that made them infinitely worse and set back their recovery in a big way. I think, in general, that we are over-prescribed drugs (and I know a couple of people in the pharmaceutical industry, so apologies for trying to reduce your profits) and sometimes it’s a bit too easy for doctors to issue a script for a pill. That said, the Irish Times piece is timely and hopefully will contribute to a broader debate on how we should treat people with mental problems. The first thing we need to do is treat them like people.