Tuesday, May 19, 2009

The benefit of institutions

Chris is out of the psychiatric hospital after three months and 10 days. This time around it was a different experience than when he was last hospitalized in the same institution for three months in the summer of 2004.

This time around I had warm fuzzies for the psychiatrist and staff. The atmosphere felt "homey". Chris and his fellow inmates appeared much more functional to me than was the case before. We were moving up the food chain.

Although he is back on medications for the foreseeable future, I am no longer as uptight about the damage they are supposed to inflict. I have worked with a holistic psychiatrist for three years and I experienced how the other side of the drugs versus no drugs debate can be played out. It can be every bit as exhausting, demoralizing and propagandistic in its own way as what I experienced worrying about the damage that the drugs were doing. (See: The tyranny of vitamins - April 17, 2009.) At the same time, holistic/orthomolecular interventions take into account the personal history and biochemistry of the individual. For this reason alone, they are infinitely superior to meds. My position on the meds versus vitamins front now looks quite schizophrenic. In my own way I have become quite schizophrenic since schizophrenia befell Chris.

In the exit interview, Chris's psychiatrist spoke warmly about Chris. He expressed a clear belief that Chris was evolving and that Chris will continue to evolve. I agree that Chris's general future direction looks good, but not wanting to be a party pooper, I kept quiet about the niggling fear that Chris had merely gone underground for a while. No doubt the psychiatrist was also putting the best polish on the situation. Chris had been there long enough. There was nowhere to go but out. We discussed Chris taking life one baby step at a time in order to move onto the next level. We discussed letting him make his own decisions. During his worst periods Ian and I assumed that unwanted role. Chris has expressed an interest, in no particular order, in Buddhism and cooking classes. I was pleased to see that he pulled out an agenda during the exit interview and wrote down all his upcoming appointments.

The dreaded R words to the anti-meds folks are relapse and re-hospitalization. Re-hospitalization is seen as a sign of failure (relapse) and falling into the clutches of the drug lobby. I am now somewhat open to working with medications because (a) my husband is threatening to divorce me if I don't support them (the gun to the head approach) and (b) because Chris has made progress over the past few years. I attribute this to the vigorous holistic interventions that he underwent during this period and the fact that we didn't give up on him. The holistic interventions will continue, but I have "bought" the psychiatrist's point that if, from time to time Chris needs a respite, the door is always open for shorter hospitalizations or overnight care on the road to good health. He suggested that this strategy shouldn't be seen as a failure, but is more often a need for a sort of "regrouping". The staff can offer help in this way. I nodded enthusiastically at the mention of short overnight stays. Although I fervently hope and pray that it doesn't deteriorate to that point again, the idea of a little R & R away from Chris is very appealing.

First day back home, he was fine. Second day back, I wondered what Chris had been doing for three months in the hospital. He was acting pretty weird, possibly the voices, maybe not. The behavior always shakes me. This time around I promised myself that Chris was not going to get to me. I went to my room and closed the door, no longer wanting to be "helpful". Let Chris come to me if he needs something or just wants to talk. At the end of the day, I broke my vow and instigated a little chat. Since Chris had still not filled the prescription that was about to run out, I asked him what exactly he was told at the hospital about the repercussions of not taking his meds. "Well, they just told me that I am supposed to take them every day," he claimed. "And, what happens if you skip them or "forget" about them?" I prodded. He didn't know. "I'm surprised that the doctors didn't detail for you the physical consequences of not taking the meds as prescribed," says I. "Being told to just take them every day is not as informative as spelling out the gut-wrenching head-clanging experience that you get by "forgetting" to take them." I'm prepared to let Chris learn experientially on this one.

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