Wednesday, October 22, 2008
"Lost"
There is a place in the darkest alleys
lost and abandoned centuries ago,
where it twists and turns and winds so deeply
there’s no hope of finding one’s way to go
Within this unfamiliar Babylon,
this gateway of passages intertwined
if escape should evade you ere the dawn
the urban scape you knew you’ll never find
For once here, when you should turn around
you’ll find your residence far from the city
in a terrene which has yet to be found
by cartographers or those who seek it
To find this place one must be so far lost
that every way to go’s an equal toss
Some have reached this place through labyrinth or forest
others through turbulent storm and rapacious sea
Those who seek this place will have no rest
if they hold knowledge of where they be
Yet search they still for the notorious bridge
which all those lost are said to’ve crossed before,
An arch across neither river nor gorge
whose vanity urges to be explored
On our side of this bridge shall we begin
with the aid of all but dear Urania,
for all leave her might find their way within
the starless land of Reven Erehwè
So Urania, fair muse, be on your way.
In you I invoke neglect for Lost’s prey.
Canto I
It was a day at the cusp of winter
sapped of life and grey with overcast skies.
Late in noon when the cool mist grew thicker,
and the clouds veiling the sun lost their light.
The streets of London had thinned of their crowds
and the alleys left all but abandoned,
Only pigeons still flooded the city in bounds
save a soul present as a wisp of air; disturbing no one
He wore clothes of the darkest shades; heavy
and loose, with a coat reaching past his knees
and fingerless gloves worn frayed and dirty
from countless days of rugged wandering.
His face and build betrayed a man yet young,
though his ageless eyes told a different tale;
so dark with witness to a world of wrongs,
the yellow-green within could not rebel.
This pair gazed far beyond reality,
on a place he’d vowed to never return.
A place where peace is short-lived fantasy
between long years of struggle undeserved.
Lost’s cherished land of broken wings
In his heart he felt her calling him through
dreams lost, and lives lost, of loss in all things
His home forever, an unwelcome truth
But why after years of untroubled thoughts
had his mind once again fallen to dreams?
After all this time condemned and forgot
so ill an omen was the worst of things
These thoughts churned through his mind uneasily
though his step felt nothing of this heaviness
His walk and smile still came naturally
like a commander used to such distress
and to liken him to such might not be
so far off as one might first imagine
for there isn’t much of peace in the stories
of Reven, one known to all in that land
Reven forced his harrowing thoughts from mind
and took a moment to breathe it all in.
Then released it, letting his tightened chest untwine
as he started home where Lost awaited him.
Yet even there was no sanctuary
for she was of the land of Erehwè
and though of her land she recalled nothing
His thoughts were uncured by her amnesia
Only a greater burden did it rest
on a mind already struggling with weight
for how could he tell her of their dark past
and keep her where he knew she would be safe?
Yet how could he lie to her loving face
when she asked him of how things once were?
Struggling to remember that special place
that had only been a shared dream in war?
And how many times could she be convinced
by explanations that could never be?
How should he explain that their home exists
yet hasn’t since the nineteenth century?
How should he explain why she gets no mail?
or phonecalls or visits from friends?
That her parents are in the depths of hell,
with tombstones of fine dust; so long since dead
Best to start before she was known as Lost
but even then she’d known only her name
Seraya Alexandris Aizenghast
the first of Erehwè, or so they say
He’d told her her name, but had said no more
to protect her life he would damn the rest
but as his hand reached for the door
He nailed the cause of his mind’s unrest.
Fury of the Spirits [Novel Excerpt]
Rekia’s lightning blue eyes glared at him through the stray locks of black hair that partially hid her face. Her lips were tightly crushed into a grimace that openly displayed her agitated boredom at the ignorant prattling she had been forced to endure for several minutes longer than she could stand. “You keep dwelling on the simplest point as if everything else will fall into place perfectly just because you wish it. If Akordin or you had the sense to stage this anywhere else, then that might be my only concern. But as it stands what you’re asking me to do is impossible.” Her hands had a white-knuckled grip on the back of the chair across from his desk as she tried desperately to channel her elevating aggravation and keep her voice calm. Her very presence threatened to light the whole office on fire. “I can’t get within arms reach of an ambassador at an invitations-only dinner catered by personal servants. There’s no way for me to be seen there without being immediately plucked out as an uninvited guest. And there’s no way not to be seen by that many people while still managing to get close enough to put this in his chest.” She motioned with the knife she had been given. “Let alone escape alive after killing him in plain sight of everyone there! Do you even know how many guards he has? Thirty-eight. I know. I counted them myself.” Rekia’s brow lowered. “Or is this merely the Circle’s way of retiring me without getting its own hands dirty? Because if I find out that’s the case, I’m coming after you first.”
Neirus’ eyes sparkled with menacing humor as he spoke. “Even if it were, it changes nothing. Your empty threats mean nothing.” He cradled his chin in one hand as if appraising her as the fingers of his other methodically drummed on his mahogany desk. “Or have you finally freed yourself of your stake in this, Circle’s Child?”
Rekia had been in a dark mood before, but mention of that coiled all her helpless fury deep in her breast until its poison nauseated her. The ire in her defiant glower could have set his hair to ashes, but she remained silent. She would have liked nothing more than to cut out his mouth and use it to spit in his face. She hated with a passion how he, or any other among the Circle’s officers could so easily bring her to rein with so simple a threat. If there was one thing she didn’t need to be reminded of, it was her stake in this. The cost of failure - to her - was far worse than death. And it was a threat that would have her serving the Circle’s every whim for the rest of her life.
Neirus, after a show of waiting for her reply, seized the last word like a trophy as he triumphantly rose and walked past her out of the office. As he passed, she caught the subtle scent of flowers effusing from the dark lengths of his well-kempt hair. Whatever flower it was, he had ruined it for her for life.
Rekia relished in a small fantasy of turning the tables on Neirus with her knife until he screamed for his mother before finally releasing her vice-like grip on the chair and exhaling deeply. She would have done nearly anything to escape the Circle’s grip on her. Nearly. Unfortunately, the Circle knew the one thing she would not do.
And here she was.
Rekia turned to leave when something caught her eye. Neirus had left his keys. She wasn’t sure why that had caused her to hesitate. She wasn’t a thief, and she had no particular interest in anything that belonged to that man. Even so, she felt compelled to take them, if for no other reason then to foil him for being such an ass. She couldn’t help but smirk at how reminiscently childish it was as she picked them up and twirled them around her finger.
Monday, April 14, 2008
Pay Off or Pay Out: What Pharma Corps Will Do to Sell You Drugs
Comment: "Drug Research: To Test or to Tout?"
First I would like to thank you for drawing the public eye to the questionable ethics of pharmaceutical corporations such as Eli Lilly. After having done extensive research on the effectiveness of atypical antipsychotics and their predecessors, it comes as no surprise to me that these new drugs are no more effective and pharmaceutical companies are doing everything they can to cash in on them anyway. Although this article does not address the greater issue of the severe negative effects of antipsychotics in general, giving consumers a reason to question their prescriptions and begin researching these drugs themselves is the ultimate goal, and this is definitely the type of provocative post that could cause such a phenomenon. It is important that patients realize that they can not rely solely on FDA approval as evidence that medications are safe and effective; that much of what the FDA approves is influenced by biased research conducted by these corporations, and that even those that the FDA attempts to restrain manage to spearhead through direct marketing to practicing physicians. In criticism, however, I would like to mention that many sources and studies are alluded to, but no direct references or links to references are given besides the link to the St. Petersburg Times. When confronting an issue of such a purely scientific nature with so much contention in the research field, linking to authoritative electronic resources is truly a necessity in order to drive home the point. Although a minor issue, I also believe this post could have been improved upon by use of graphics or visual media, as these elements are essential in harnessing a would-be reader’s attention. I only offer these suggestions because I truly believe in what your blog is doing. I am an avid reader of Atypical Antipsychotics and look forward to many more insightful posts in the future.
Comment: "Pharma Pursues its Wet Dream Legal Phantasy, Gets Paxil and Zoloft Suicide Lawsuits Denied"
Philip:I’d like to start by thanking you for attacking the growing issue of pharmaceutical companies in an argumentative fashion that demands attention. I too believe that the growing power of the already colossal Big Pharma within the legal and research spheres is a frightening problem. However, I would like to contest your comment that “We all know that pharma companies dream about little but money and will go to damn near any length to create a market, hide problems with their drugs from the public and regulators, and manipulate their way to the latest blockbuster.” It is my belief that an epidemic of patient ignorance is the only thing truly responsible for these drugs becoming “the latest blockbuster.” If people understood that their marketing, their labels, and the doctors who prescribe them are not to be trusted, I would hope that sales would be on the decrease instead of the rise. Just from my personal experience with individuals on anti-depressants and anti-psychotic medications, I can say that there are still too many people who trust their drugs more than they trust themselves to cope with a problem. I agree with your response to the third circuit court’s ruling and I have little doubt that the reason for this ruling is checks being written on both sides of the table – in fact I just commented on another blog that addressed this issue in particular. The bigger pharmaceutical corporations get, the less chance anyone has of tackling them through the court system. This is why I believe our primary goal should be raising the awareness of consumers about the ineffective and destructive nature of antipsychotic and anti-depressant drugs. Your indirect approach to this matter is quite effective. If people start asking why Big Pharma would hide the suicide risk on drug labels, maybe they’ll start asking why doctors are prescribing them, and why they don’t seem to be getting any better. I appreciate your post and hope to see more like it in the future.
Monday, April 7, 2008
No Easy Way Out: The Depressing Reality of Anti-Depressants
Whether or not antidepressants treat the cause, however, they will remain titans within the pharmaceutical market for the treatment of depression’s symptoms due to their heavily marketed effectiveness; for, as my previous posts have shown, the majority of psychiatrists and patients in the United States are already more concerned with alleviating the symptoms of mental illnesses rather than finding ways to cope with them. The majority of patients just want to feel better, whether their problems get solved or not. However, unlike anti-psychotics, an overwhelming amount of evidence suggests that antidepressants fail to treat even the symptoms of depression at a significantly higher rate than placebos. One of the largest studies ever done on anti-depressant drugs has concluded that they have “no clinically significant effect.” In this study, researchers conducted an analysis of the 47 published and unpublished clinical trials submitted to the Food and Drug Administration in the US made in support of the best known antidepressant drugs, including: Prozac, Seroxat and Efexor. The results proved the drugs ineffective in all but a very small portion of the most severely depressed.
It is of such importance for patients to be aware of what antidepressants do not do because of what they have been proven to be capable of. Long term doses of anti-depressants can actually lead to the patient becoming more depressed. This is because many of the side effects of antidepressants such as weight gain, sexual dysfunction and anxiety can cause a depressed state in people or make their depression more severe. Since depression is often if not always the result of life problems, adding more difficulties and stress on to those that drove the patient to take the medication in the first place can only cause the psychological state of the individual to worsen. Not only this, but according to Peter Breggin, M.D., the methods by which antidepressants reach–or attempt to reach–their desired effect inhibits the brain’s function and can lead to permanent, irreparable brain damage. There are also several published research studies which suggest that antidepressants increase a patient’s likelihood of attempting suicide–especially in the case of adolescents. These results can be especially problematic due to the deceiving nature of antidepressant withdrawal symptoms such as crying spells, irritability, anxiety and agitation. These symptoms can lead a patient to believe their depression has actually worsened and further medication is needed when such is not the case.
Although it is puzzling that antidepressant medications remain so widely trusted, believed in, and consumed in light of all the research that suggest their relative ineffectiveness, even more confounding is the use of off-label anti-psychotic drugs to treat depression. Currently twenty-one percent of anti-psychotics are prescribed for symptoms not indicated on the label and one of the few other disorders for which they are prescribed is depression. Considering several studies have shown, with little opposition, that anti-psychotics have absolutely no positive effect on depression, one need only read my prior posts on the negative effects of anti-psychotic pharmaceuticals to understand how grave an issue this is.
Why are antidepressants being prescribed when their effectiveness has such limited value and their side effects are so severe? Why are anti-psychotics being prescribed for something they do nothing about? For the same reasons that children younger than five are being prescribed them before they can say “I’m sad” and 67% of pharmaceutical companies negative research results remained unpublished (see chart). The majority of researchers involved in data collection are being sponsored by - or hold shares in - the very corporations producing the drugs, the doctors are getting paid to prescribe them, and the patients demand expensive placebos that make them feel better about the situations they don’t want to cope with.
Saturday, March 29, 2008
10 Ways to Stay Informed: Sites Dedicated to Mental Health
DB’s Medical Rants, for one, is a blog covering a wide range of topics on health and pharmaceuticals. The blog, being posted by a very prestigious doctor, contains a great deal of authority and receives fresh posts on a daily basis, currently containing over 3000 posts. Unfortunately, “DB” does not make use of visual aids or graphics of any kind. “Atypical Antipsychotics”, another blog, shares this deficit. However, it makes up for this by being updated several times daily and providing recent information on harmful drugs in mental health and the negative effects of irresponsible prescriptions. Unlike these blogs, “The Last Psychiatrist” contains a humorous and entertaining twist to an otherwise grave topic, and manages to do so in a way that remains informative and insightful. Although the authority behind the author of “The Last Psychiatrist” is questionable, his sources are reliable. Stepping out of the blogosphere, I’d like to direct interested parties to “Psychiatric Services” and “Advances in Psychiatric Treatment”, two websites which feature online databases of medical journal PDFs in the psychiatric field; two sites most commendable on their levels of concrete and referenceable data and most lacking in their ease of direct navigation. If filtering through a massive selection of PDFs is too cumbersome, ScienceDaily or Pharmacy Choice might be better websites to visit. Both feature extensive and up-to-date news coverage on the latest in medical and pharmaceutical news but unfortunately lack the use of large, visually appealing graphics and multimedia. The Citizens Commission on Human Rights, being an organization dedicated to the investigation and exposure of human rights violations, is something all-together different. CCHR uses concrete evidence to reveal treatments harmful to patients, and offers healthy and beneficial alternatives. Following a similar field of interest is PsychRights, a law firm targeting these violations in the field of mental health. The site, although drab in its choice of colors and lacking visual quality, contains some very useful information relevant to the mistreatment of the mentally ill in psychiatry today. PsychSearch, a site which indexes case reports of such malpractice, is a very professional, model example of a page which makes proper use of colors and graphics while remaining easily navigable and with fast load times. As previously, all of these websites can be found in my linkroll posted on the right.
Monday, March 10, 2008
“Macha”: An Anti-Psychotic Community
Macha had always been unapproachable
Not just by her classmates and peers
but her teachers, her parents
felt powerless to relate with her
she wasn't unfriendly
nor her demeanor unpleasant
She was, simply put, an enigma
impossible to define
impossible to predict
Her style was not normal
nor was it rebellious
Her choice of music was unnerving
Celtic lullabies to death metal
There was no label
nothing relatable
The school counselor was suspicious
any child who didn't get along
didn't communicate
anyone undefinable
unpredictable
wasn't necessarily dangerous
but definately had something wrong
Were the parents abusive?
No cigarette burns to tell
No bruises, no cuts
Nothing at all
She seemed happiest alone, though
and there was crime in that
there were rumors too
of other things
unusual things
that she spoke to empty chairs
giggled at the oddest times
"spaced out" a bit too much in class
smiled at phantoms
and spent three days
walking a dead cat.
How much of this was true
was certainly questionable
She denied everything
As did her best friend
whose pleading was hopeless
considering her lack of substance
When they were alone,
Macha would explain that others
couldn't perceive her
because she wasn't real
but her friend simply couldn't understand
She knew that Macha wasn't crazy.
And only crazy people saw things others didn't
After several tests, Macha was defined.
Predicted.
Labeled.
Schizophrenic.
A single word that meant nothing
yet explained it all
A few weeks in the hospital
and a regular dose of antipsychotics
coupled with antidepressants
to relieve unpleasant side effects
And she should be Perfectly
normal
in no time.
The binding on her wrists were tight, because they knew she would fight it.
She had dislocated her thumb three times in the past week trying to escape
She went for the gag first every time. It was remarkable.
The binds were as padded as could be without being escapable,
yet somehow, she had managed to make her wrists bleed again
she would make anything she could bleed when she got the chance
they had had to clip her nails uncomfortably short
so she wouldn't attempt to scratch her captors to death
or failing at that, gouge her way into her own throat
Fortunately the medications kept her mouth dry
or they would have had to swab out her spit
to keep her from choking on it.
They had to keep something in her mouth at all times
lest she bite off her own tongue
She was a difficult one to manage
with eyes that glowered with ire and defiance.
It had started with refusal to take meds.
Then institutionalization,
Now this.
Most of the staff refused to be anywhere within her general vicinity.
one member had even offered a letter of resignation.
When it was apparent that her behavior would not cease
They locked in a medicated stupor
tranquilized at the slightest upset
A drugged, unwilling surrender.
My purpose in creating the fictional “Macha,” as well as my artistic renditions of the work, is to address the typically unquestioned authority of antipsychotic medication as the first and last solution to mental disorders such as schizophrenia. The use of such drugs as exclusive treatment is a current and growing trend in the
I created Macha to be an example of what happens when medication is considered before alternative, less detrimental and more productive methods of treatment have been exhausted. As in Macha's case, there is a high probability that the popularity of medication is due to its instant gratification, a deficiency in information, lack of required effort, and the dearth of tolerance and patience for mental illness. Antipsychotic treatments, as they function currently, aren’t designed for patients so much as for the short-term suppression of the unnerving characteristics of psychosis. The alternative–facing the unsettling nature of this disease, understanding it, and supporting those who experience it– should be the goal of not only patients’ guardians, but their communities, and society as a whole.
A common misconception is that medication is required for the recovery of individuals with mental disorders such as schizophrenia. However, schizophrenia reverses naturally in the majority of its victims, and the highest rate of recovery has been observed in non-industrial countries where antipsychotics are not used. A fifteen-year multifollow-up study published by The Journal of Nervous and Mental Disease supports this claim, documenting the extreme disparity in recovery between schizophrenic patients who took antipsychotic medication and those who remained without it. According to their study, at the end of the fifteen-year period, twelve out of sixty-four patients were in a period of recovery. Of the sixty-four, twenty were not on any form of medication and eight of those twenty (fourty percent) were in a state of recovery; two of the thirty-nine patients on antipsychotics (five-percent) were recovering; and two out of five patients on medications but not antipsychotics were recovering. This article is not alone in its conclusion. One need only begin to browse the vast number of references it cites for further evidence. For even more authoritative research backing this conclusion, browse this index of authoritative articles dedicated to the subject.
M.D. Matt Irwin offers an explanation for why this lack of recovery in patients might occur. According to his extensive research, the physiology of people who have been exposed to antipsychotics and other drugs naturally adapt through “alterations in receptor number and function.” This "creates a physiological dependency which reinforces psychological dependency." The current emphasis of psychiatrists on drug treatment might also cause issues of social, psychological and spiritual nature to go unaddressed. A combination of these factors could worsen the outcomes, especially since tolerance of severe adverse effects of antipsychotics among patients is low and many choose not to take them unless forced to do so.
Obviously, the difference in recovery between patients on and off antipsychotic medications is not marginal. Even so, it can not be denied that there are plenty of cases of schizophrenia that are too severe to simply “cope with” and “tough out”. In such situations, antipsychotics might be necessary for short to mid-term therapy but should never be used as a primary or sole form of treatment. This is why anyone with a mental disorder or the guardian of anyone with a mental disorder–be it schizophrenia or otherwise–absolutely must educate themselves on evidence-based, alternative methods of treatment–treatment which offers permanent recovery benefits whether or not the individual requires a term of medication. A method that has been proven effective in multiple cases is cognitive behavior therapy (CBT). This system uses mental techniques such as developing alternative explanations for symptoms, and altering thought processes to “reduce the severity of, or distress from, the symptom regardless of whether the patient accepts a diagnostic label.” One of the greatest advantages of cognitive behavior therapy is that it does not rely on the patient accepting his or her symptoms as a function of a mental illness in order to be effective.
One example of such an examination is an piece studying cognitive behavioral therapy in schizophrenics with command auditory hallucinations, which found that patients undergoing this form of therapy had fewer episodes, complied to auditory hallucinations less, and generally acted in less ways to appease them. Although the hallucinations did not cease, they became less of a hindrance and burden on the lives of patients. Conductors of another, similar study discovered that after one year, patients who had undergone cognitive behavioral therapy, starting at the time of hospitalization and while acutely psychotic, benefited greatly over those who did not receive this therapy. They noted that the benefits extended to both the positive and negative symptoms of schizophrenia as well as overall social interaction.
Even though the severity of schizophrenic symptoms may require temporary treatment with antipsychotics, this represents a minority of cases. Those who wish to undergo such treatment, and guardians who are considering putting their children on antipsychotics should be fully aware of the long-term consequences, increased relapse rates, drug withdrawal symptoms, decreased probability of recovery and side-effects. They should also be relieved of any disillusions that these pharmaceuticals are a completely safe and effective form of treatment, because there is plenty of evidence to suggest otherwise. The greatest offense a guardian, or the community responsible for an individual’s care can commit, is medicating a person with a mental disorder out of sheer convenience. Antipsychotics are quick, easy and deceptively effective at suppressing symptoms, but their aid ends there. In and of themselves they are not, and should not be considered a healthy, productive form of treatment.
Monday, March 3, 2008
Mental Links: A Guide to the Authorities on Mental Health
Wednesday, February 20, 2008
Over-Medicated, Under-Treated: The Reality of Antipsychotic Pharmaceuticals
.
As Dr. Peter Breggin illustrates in his post “Brain Disabling Treatments in Psychiatry: Drugs, Electroshock and the Psychopharmaceutical Complex”, there is no “wonder” in anti-psychotic drugs. Medication for mental disorders do not “cure”, but merely hinder cognitive ability to “suppress” symptoms. They are misleading both in their initial effects and in their withdrawal symptoms. While on the drug, the patient will inevitably be perceived as doing better, when in fact, not only are the side-effects destroying the victim’s body, but the brain is doing worse. When off the drugs, the withdrawal symptoms can cause misleading psychotic episodes which could lead parents to believe their child is actually worse than before and seek more, possibly stronger medication. Instead of passing anti-psychotic drugs to force on unwilling patients in an effort to suppress symptoms, we should be researching alternative, healthy methods of helping victims of this disorder cope with their illness without destroying their minds, their bodies and inevitably their lives. However, before this can ever become a reality, the proliferation of nonconstructive, misleading information in the media about the disease and its treatments needs to be addressed.
I have offered my comments on the injectable Zyprexa drug as well as Dr. Breggin’s views on medication for mental disorder below:
“Injectable Longer Lasting Zyprexa May Be Approved”
Through the tone of your post, I can at once gather a sense of apprehension concerning the release of this new, injectable form of the Zyprexa and I am appreciative that you are revealing medications such as this for what they are rather than allowing them to remain naively considered “wonder drugs”. Your article is truly informative, and reveals several things about the Zyprexa drug that I was not aware of upon entering the post. I knew that Zyprexa could have devastating side effects, such as heavy weight gain, diabetes and sedation, but I was unaware that Zyprexa had actually made an effort to restrain information about these side effects to patients prescribed this medication. I find this to be revealing of Eli Lilly’s intentions in the pharmaceutical industry and something which patients or their guardians should be aware of before considering the drug. I also find it amazing that doctors prescribe this drug off-the label for anxiety and depression considering its side-effects. I suppose they never take into consideration that considerable weight gain and diabetes can cause even greater anxiety and depression than the disorder itself, not to mention that drugs such as these often fail to address feelings of hopelessness despite their effectiveness at ridding other symptoms. What I find most alarming about your post is that this drug is being considered for use on children and adolescents. Unlike adult patients, who can often at least have some control over their forms of treatment, children are completely dependent on their parents’ decisions; and I believe that many parents would decide to have a “fat, stable child” as opposed to an “unwell, skinny one” without ever consulting the child. And unfortunately, Zyprexa’s misleading marketing campaigns coupled with the vast amounts of negative media related to schizophrenics in general will have parents deciding on it before exhausting alternative forms of treatment that could potentially lead to a completely healthy, stable child. The 250% increase of antipsychotics in
In the sea of misinformation about the nature of mental disorders and their treatments, I found your blog post to be a breath of fresh air. Given the rise in popularity of antipsychotic drugs such as Zyprexa both on and off the label, a truly informative post such as yours, which reveals the true nature of antipsychotic drugs, is long overdue. The brain disabling function of antipsychotic medications as a means to suppress symptoms is certainly something that a patient or guardian should be aware of before accepting these drugs over alternative forms of treatment. I also somehow doubt that the withdrawal symptoms of these medications are being addressed, and that most patients are even aware of them. Considering the emulation of psychotic episodes that these withdrawal symptoms have, I don’t find it hard to believe that patients would be perceived as worse when off the medication when their condition might actually be improving. Bearing in mind that many mental disorders often improve over time, this could definitely have severe consequences for the unwitting patient. Although I understand that this is a mere summation of points expounded upon in greater detail in your book, I think it would be beneficial both to your post and to the community, to elaborate on some of the alternative methods of treatment that patients with mental disorders could consider besides medication. Currently it seems that pharmaceutical treatment has complete domination as the end-all be-all legitimate form of treatment for patients with mental disorder, and this absolutely should not be the case. But until other effective forms of treatment start to take a foothold both on the information highway and in the media, awareness levels will remain too low for medication to ever be challenged.
Monday, February 11, 2008
Elissa: A Case of Schizophrenia
The first time she saw it, she was mortified.
A freakishly self-mutilating clown
tearing at its face as it laughed
It giggled like a girl
but that was the only girlish thing about it
Looking at it, watching it, she felt her flesh crawl
the hair at the back of her neck stood on end
this thing wasn’t right
No one else seemed to notice but her
It was obvious they were conspiring.
They paid this clown to scare her.
On the playground they were always laughing
the other kids
but there was never anything funny
She was the joke.
She knew it.
They never looked at her.
They didn’t have to.
There was nothing else to laugh at
Giggling, giggling
Just like the clown
They giggled just like it
All around her, giggling
Mutilating laughter.
The clown stepped closer
she wanted to run
her feet were frozen solid
tried to slap it away
with arms that defiantly hung
limp at her sides
closer
closer
She couldn’t see
Tasted like vomit
Where was she?
Tried to open her eye-lids
but she could only roll
her eyes up into her skull
She couldn’t remember how to open her eyes
It felt like hours passed
before the sickeningly bright light spilled in
Rolled her tongue in her mouth.
Spat out bitter, acidic flecks.
"Are you Okay?"
"Are you Okay?"
"Give her some room. I think she passed out."
"Probably the sun, she should be fine now."
The world swam with faces
colors, lights
Sounds…people talking, asking questions
"I’m Okay." She heard herself say. "Is it gone?"
"Is what gone?"
"The clown."
Confused voices. "What…clown?"
She felt breath on the side of her face
warm, rancid breath
it smelled like vomit.
She rolled her head to the left
That clown.
She wanted to scream but she couldn't
she couldn't force her voice out of her throat
her mouth worked at the words she wanted to say
no voice came
She looked the other way
Still there.
Again.
Still there.
She couldn't move the rest of her body
Couldn't hold her head straight
the clown was making a point.
And then she heard it
A voice like nails
clawing furiously at a chalkboard
There were no words but she understood the meaning
Don't be afraid. I'm on your team.
Elissa blacked out for the second time that day.
She wasn't sure where she was
Her chest tensed as she strained her eyes
trying to force her eyes to adjust
Her eyes darted about but it looked the same everywhere
Was it there?
Despite her fear, she felt comfortable, soft
Familiar
As her eyes adjusted she recognized
the blades of her overhead fan
the unique shape and color of her ceiling
Her room
The tense feeling that had gripped her
immediately vanished
She was safe here
Her neck muscles loosened
sinking her head back down into her pillow.
As the minutes passed, she felt them again
those eyes staring back at her
her nails dug deep into her palms
trying to hold back her panic
I changed sides, I’m on your team now.
The clown squealed in its raspy, wordless voice
Why? She asked shakily
She didn’t want to talk to it
She also didn’t want to make it angry
Because I’m just like you.
No you’re not.
Everyone hired me to fuck with your head.
You shouldn’t say bad words like that!
Fuck fuck fuck fuck fuck fuck fuck fuck
Stop it!
They want you put in the crazy plaaaace
Why!? Why does everyone hate me!?
‘Cause you’re lunie ‘lissa, lunie ‘lissa
No I’m not! I’m not lunie ‘lissa! Elissa cried
They want you all locked up so they can stab you with needles til’ you die.
Elissa stared at him in shock.
She couldn't believe it. Who?
Everyone.
Everyone?
Everyone.
At the playground?
In the world.
Everyone in the world?
In the world.
Even mama?
Even mama.
You’re a liar.
Even mama.
I’m not listening to you anymore! You’re still on their team!
even mama even mama even mama
He started yelling it over and over. Elissa screamed.
The clown giggled his girlish giggle when her mother came inside
What’s wrong honey? I heard screaming.
Mama was out of breath.
Get it away get it away! get it away from me! Elissa screamed
Get what away? Honey, there’s nothing here.
The clown hissed Even mama
Elissa’s eyes were wide
the shock of betrayal clawed at her heart
You want me to go away too mama? Even you?
Elissa baby what are you talking about? Come on, you can sleep in mama’s room tonight. You’ll be safe from the boogey man in there.
There was no boogey man. Everyone knew that.
This was proof.
Only a crazy person would believe in the boogey man
Mama was in on it too.
Elissa froze. She understood everything now.
They hired the clown to make her crazy
pretending it wasn’t real
But Elissa was smart
If she pretended the clown wasn’t real
when they were around
they would be the ones who went crazy
Epilogue: Making Elissa Convincing
While replicating the schizophrenic condition in a fictional character with unerring precision might be considered a task far from reasonable, with adequate research as a foundation it is possible to develop a convincing sketch of the condition within such a character, as I sought to do with Elissa.
Next, unfortunately for Elissa, came application. During Elissa’s schizophrenic episodes, she consistently suffers from visual hallucinations of a frightening, clown-like figure coupled with auditory hallucinations similar to those of nails on a chalkboard. Another curious element to her illness that isn’t uncommon to paranoid schizophrenics is that she suffers from delusions of reference. That is, she sometimes believes that events, objects, the behaviors of others, and other stimuli have a particular and unusual significance to herself. There are two definite instances in which Elissa suffers from this. She believes that because children are laughing, and she doesn’t know what they are laughing about, they must be laughing at her. She also perceives special meaning from the sound of nails on chalkboard. Although this is an auditory hallucination, she is still deriving special meaning from it which simply is not there. Elissa also suffers from two other symptoms of paranoid schizophrenia which, in her case, go hand in hand: delusions of grandeur and irrational fear. Elissa believes that, for whatever reason, it is on the agenda of “the entire world” to drive her insane through a clown that “they” hired, after which “they” will proceed to lock her up and stab her with needles until she dies. The symptom which makes Elissa’s “type” of schizophrenia undifferentiated rather than paranoid is her body’s motor functions are prone to shut down – a symptom of catatonia. During her initial episode, she is unable to lift her arms and then loses consciousness completely. After she regains consciousness, she begins moving her head in a repetitive manner – another common trait of catatonic schizophrenics. Aside from this, she speaks irrationally, suffers from social withdrawal, and is beginning to experience deterioration in her personal relationship with her mother. These are secondary traits caused from the primary symptoms, but nonetheless they are characteristics taken into account when making a diagnosis so they are important to be aware of when considering the actions of the character in question.
“Elissa” is a depiction of what it might be like for an undifferentiated schizophrenic child suffering from symptoms of catatonia and paranoia in the early and most frightening stages of the disorder. However convincing Elissa’s symptoms might appear, they are the result of research on both scientific studies and victims’ personal experiences with the disorder.