Tuesday, May 5, 2009

Existential concerns

Chris will soon be released from the hospital after three months. I am concerned that we will be right back to the situation that prompted his hospitalization in the first place. He knows that he needs to get out, he is bored out of his mind, and yet he is not looking like he can blend in with quote unquote "normal people". He arrived home for the week-end on Saturday morning, attended to his e-mails and fixed a few computer problems. He talked to me very thoughtfully on Saturday evening. Sunday was a different story. We invited him to join us for a lecture and lunch. We went for a walk on the grounds of the lecture hall before lunch. He was in existential despair. He didn't want to spend his day with "old people". I can't fault him there. He said he didn't know what was real anymore - was I real? Was this scenery real? Was the day going to end and the sun go down? He claimed he didn't know. I asked him if he wanted to resume his Alexander Technique lessons when he came home. "No, I have learned everything I need to know", he answered.

The hospital fussed with his medication, introducing a second antipsychotic over my objections. I maintain that despite the elaborate, weird behavior that got Chris committed, his problem cannot be fixed with medication. It is looking likely that I am correct. The doctor is not satisfied with the addition of the second antipsychotic, noting that Chris seemed overall better just after they introduced it in a low dose. So, now they are tapering it back but not discontinuing it. Discontinuing it would be admitting they were wrong. Nobody, not my husband, not the hospital psychiatrist, not Chris's regular psychiatrist nor anybody having seen Chris in his pre-committal state, understands my objection to the medication. It is they who just "don't get it". Chris has problems that persist whether he is on medication or not.

What I think has taken the edge off the situation while Chris has been hospitalized is not the medication but the fact that Chris got away from us, from living in claustrophobically close quarters every day and being treated like the two year old he was becoming. The doctors acknowledge this reality, but medicate anyway. When I object to the fact that this latest med was the fifth antipsychotic Chris has been on, and shouldn't we conclude that antipsychotics don't work for Chris, the clear message I receive in return in that it is foolhardy not to use antipsychotics as one treatment modality. My husband is almost threatening to divorce me if I undermine in any way Chris's staying on medication. He reminds me of the lead-up to the hospitalization. Yes, I am painfully aware of all that but I also know that Chris has exhibited extremely weird behaviour while on medication, beginning with his first antipsychotic. His mind is more powerful than any drug or vitamin. Until he resolves his existential problems, we will continue to weather the storm.

1 comment:

  1. Hi Rossa,
    I understand your dilemma and we agree on the limited value of antipsychotic medication. My son was offered a diagnosis of schizophrenia a couple of years ago and has several major psychotic breaks. I have taken a treatment approach with him with psychotherapy as the foundation. I provided the therapy myself after failing to locate a competent therapist who is capable of dealing with the problem. Adam is currently on no medication, has no symptoms, has been depressed, but I believe is headed toward full recovery and will overcome. We were down the road with vitamins and supplements a year ago and this had limited benefits. I would caution you that withdrawal from antipsychotic drugs can be very tricky and that not done right can result in tardive psychosis. There is really no evidence that anyone should be on more than one antipsychotic drug at a time. I think that psychiatrists keep adding because the drugs are not having the desired effect. Does your son have any substance problems? I would be happy to share my insights with you if you wish. Email me at taillorville@hotmail.com if you want to talk.
    Al

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