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The clarity of some of your posts amazes me. It's nice to see another grounded forum member. I would have posted this exact thing. Thanks!
Originally posted by glee
The voices thing is common with schizophrenia. Thing is, he probably really does hear a voice inside his head. To him, it is real. But it is an indication that his current treatment isn't working like it should. He may not be taking his meds. That's a common problem. If I were you, I'd check in with his family or his doc, and let them know. You may be saving him and everyone he knows from a lot of pain and sorrow.
MEDICATION: THE FOUNDATION OF RECOVERY
by Edward G. Francell, Jr.
Ed Francell suffers from manic-depression and is a member of the Board of Directors of the Treatment Advocacy Center.
In traveling the long road from ignorance to knowledge about medication, I found that medication issues break down to about five categories. The main issues as: (1) compliance, (2) coercion, (3) rehabilitation (4) education and support, and (5) medication response.
When I got anxious and paranoid a few months before graduating from high school, I did not even know that psychiatric patients took medication. I kept looking for the couch in the psychiatrist's office, but I found out quickly you had to sit up and eyeball the doctor. I moved in and out of the hospital from about age 18 to 22, and "field tested" about 10 drugs in the process, until a second opinion found me a stabilizing medication. It was then that the slow process of recovery actually began.
I have been seen as paranoid schizophrenic, bipolar, and major depressive. I am currently diagnosed with bipolar disorder and panic disorder with agoraphobia, a diagnosis combination one consumer has described as, "Depressed maniac with the heebie geebies."
I once knew a consumer with schizophrenia who had a lot of restlessness, or a side effect called akathisia, who made the greatest statement about side effects I have ever heard. He said, "When I look good, I feel bad. When I look bad, I feel good."
Although I have experienced many side effects from psychotrophic medication, two effects stand out as particularly troubling: dystonia and akathisia. Dystonia is a drug reaction that can be very subjectively unpleasant, where the throat muscles become rigid, like a powerful invisible force grabbing you by the neck and holding you off the ground. Dystonia scared the hell out of me, and made me feel helpless, rather like falling into quicksand. Akathisia is to psychiatric patients what nausea is to cancer patients--it is the worst side effect I experienced. I remember having to get up from the dinner table one night and running three miles as fast as I could just to try to get rid of it. The more severe it becomes, the more you cannot feel the positive effect of the drug, and sometimes it can make a bigger impression on you than the symptoms of the illness.
Both of these side effects are controllable and not life threatening, but they can happen without warning and can feel worse than the illness itself (Van Putten, 1974; Awad, 1992; Kahn et al., 1992). Tardive dyskinesia, on the other hand, is sometimes irreversible and can cause concern among consumers and families.
On the other hand, medications do have positive effects. Antipsychotics reduce or eliminate hallucinations or delusions, and mood stabilizers and anti-depressants can allow persons to live essentially normal lives. I have been helped by drugs in all classes, but overall we should be able to do better. Some effective medications now in use, including chlorpromazine, imipramine and lithium, started out as accidental discoveries.
A successful response to medication can be an important point in recovery--it often marks the point at which the process of recovery begins. Indeed, the beginning of my recovery began when I found a medication that finally worked. Although the primary disability was controlled, I had to deal with secondary disabilities, namely, the years lost to the illness, the loss of friends, societal stigma, and the pain of being ill itself. These disabilities can be more heart-wrenching than the illness itself. A consumer once wrote, "Even if medication can free the . . . patient from some of his torment, the scars of emotional confusion remain, felt perhaps more deeply by a greater sensitivity and vulnerability." (Anonymous, 1986).
It has been observed that if a person stays on medication after a first psychotic episode, a chronic course may be less likely to develop, particularly in the psychotic disorders (Talan, 1993). Each psychotic episode may weaken the effect of medication. It is speculated that some people who stop lithium no longer respond when restarted on it (Post, et al., 1992). Therefore, long-term compliance may become more important than ever.
A neurobiological disorder can be like perpetual childhood, a kind of roller coaster ride that suppresses maturity. Although my family supported me greatly (and still does), at times when I was symptomatic I occasionally heard the phrase, "It's like living with a five year old." I cannot really blame them for that--or myself for that matter. Sometimes interpersonal deficits resulting from the illness make consumers appear selfish or manipulative, but instead of blame, consumers should receive help in these areas (Diamond & Factor, 1994). A psychiatrist said that when clozapine patients respond, "The long-standing immature personality that had been struggling to be healthy, but could not because it kept going crazy--is freed. They start to grow up." (Kotulak, 1993).
Recovery does not mean getting rid of the illness, or becoming fully independent, or getting back to the way you functioned before the illness. Its real meaning is not any of those things. What it really means is gaining back a sense of control, a sense of purpose in life, and that means getting up in the morning and accomplishing something every day. Psychotropic medication can play a key role in attaining this stability. The most important quality in facing neurobiological disorder is a persistent belief that things will be better in the future--it is this hope that drives recovery, and better services, including medication, can provide this hope.
Whether we are consumers, family members, providers, advocates, or a combination of those, it is important to keep in mind that many obstacles exist on each individual's road to recovery. It takes persistence from the consumer and those around him or her to succeed at this process, just as it takes persistence to manage any illness. Abraham Lincoln's life illustrates the kind of persistence and faith that is needed in this endeavor; it is the story of a person whose sense of purpose helped him to overcome many obstacles in his way:
He lost his job in 1832. He was defeated for the legislature in 1832. He failed in business in 1833. He was elected to the legislature in 1834, but he lost his fiance to death in 1835. He had a breakdown in 1836. There were no hospitals then and no treatment. He was defeated for speaker in 1836. Then he was defeated for his bid for Congress in 1843. He was elected to Congress in 1846, but then lost the nomination bid for Congress in 1848. He was rejected for land officer in 1849. He was defeated for the Senate in 1854. He lost the nomination for the Vice-Presidency in 1856, and was again defeated for the Senate in 1858. But in 1860, he was elected President of the United States. They did not call him "mentally ill," they called him "Mr. President."
Lincoln once wrote, "Always bear in mind that your own resolution to succeed is more important than any other one thing." Our resolution to succeed will make more recoveries possible. Those who have recovered or witnessed recovery from neurobiological disorder can forge their vision of recovery into a living reality for others. With better medications, services, and lessened stigma, the recovery vision we share will transform darkness into light, pain into joy, and despair into hope. We will all be better because of it.