The recent words of the new RCP president telling us that psychiatric diagnoses are scientific and necessary reminds me of the old childhood saying ‘Pull the other leg, it’s got bells on’. If he was only saying that some people believe it is helpful to understand their problems in terms of a diagnosis, I wouldn’t refute that. We each have to decide what’s right for ourselves.
But scientific? Necessary? People who challenge such views often get accused of presenting unbalanced arguments, which seems ironic to me given the often ‘unbalanced’ views of the professionals supporting the validity of psychiatric diagnosis.
Many years ago, in my other life, I was given a mental illness diagnosis. I thought my diagnosis was depression, and it wasn’t until many years later I read my case notes and found I’d been written off with a diagnosis of Chronic Schizophrenia. Perhaps I was fortunate in that I didn’t know my diagnosis until long after I’d left the mental health system to lead a full, productive life.
I didn’t know during years of feeling awake and alive again on no medication that I needed to remain on medication for life to prevent ‘relapses’.
I didn’t know during years of happy marriage, and while sharing many precious times with close friends, that I had an incurable illness which brings about social isolation.
I didn’t know when I returned to study and got a first-class degree that I’d got an irreversible brain disease leading to severe cognitive deterioration.
I didn’t know, until I looked it up in psychiatric textbooks, that people with the form of schizophrenia I’d been diagnosed with (simplex) are likely to end up as vagrants. (Well, I suppose there’s still time for that. I’d better not push my luck too much).
The Great Yorkshire Vegan Festival in Leeds today was fantastic. When I read a promo leaflet which said the event would attract thousands of people from all over the UK, I couldn’t help wondering if such a turn-out may be wishful thinking. I was wrong. The crowd was enormous.
The woman in the red cardigan in the above pic is me looking for my husband Ian who, it turned out, was on an upper level taking this photo.
There were over 100 stalls offering a wide range of vegan products, including food, cosmetics, bags and clothing. (I can’t wait to wear my stripey luxury eco-friendly bamboo socks!).
I’ve been thinking, talking and writing a lot lately about mental health and perhaps that’s why the picture and caption on a postcard immediately caught my eye, with its grim reminder of how captive animals in zoos often show signs of mental illness because of the psychological distress they are subjected to in their restricted environment. (www.captiveanimals.org). So let’s remember the animals, too.
Voluntary workers from various animal welfare charities manned stalls to tell us about the work of various local and international organisations and to provide leaflets alerting us to why it’s so important to adopt a cruelty-free lifestyle.
I’m concerned about the medicalisation of life; over-prescribing and how sometimes normal difficult emotions are (mis)diagnosed as an illness requiring medication. I expressed this view on twitter and said how I think Dr Joanna Moncrieff does make some valid points. Immediately I was accused of pill shaming, lack of empathy and insulting people who suffer from real deep depression.
Here is the article in the Telegraph which triggered the twitter responses to me after the psychiatrist Dr Alex Langford had put up a link to a similar article – his blog about this topic is here. The media is often insensitive in its choice of language. I can see why ‘happy pills’ would annoy some people. This wasn’t my choice of words so I won’t try to defend a phrase I don’t use. ‘Happy Pills’ or ‘antidepressants? Call them what you will. They didn’t make me happy and they increased my depression. But adopting a critical approach to psychiatric medication does not automatically amount to criticising those who take pills. Isn’t the valid point being made in the Telegraph articles that there is over-prescribing, and sometimes the (mis)diagnosing of human experience for a ‘depressive illness’? The increase in prescriptions for depression gives rise to genuine concern and I think Joanna Moncrieff is right to point this out. I struggle to see how expressing my agreement with this makes me a pill shamer.
So what does pill shaming mean? ‘Pill shamers’, I am told, don’t understand what ‘real’ depression is and think it’s just a sad mood that can easily lift. But I do know, only too well, that suffering and despair is very real. It can be a devastating, gut-wrenching experience whether it’s a normal reaction (as in the normal grief process, to use just one example) or goes beyond our perception of what is ‘normal’. Pill shaming, I am told, means demeaning people who seek help and take pills for depression. Shaming and demeaning anyone for taking pills is something I would never do. (After all, I took pills, for depression and heaven knows what else, for five years). Maybe meds helps some people and not others. There is no shame in taking them or in not taking them (though hopefully both through informed decisions). But let’s not forget, too, that people choosing to come off pills are often told they’re ‘ill’ and have long been made to feel they are doing something wrong, dangerous or shameful in making that choice. More support and understanding is needed for people who do want to try a no meds approach.
I would have liked to engage in constructive debate about this important topic but found I couldn’t get beyond trying to defend my views against the strongly felt accusations of pill shaming. This has happened to others before, and often it silences people and hinders much needed discussion, as expressed in this blog here. I’m aware that speaking out against the use of medication and the medical model in psychiatry upsets and angers a lot of people, not only some psychiatrists but people undergoing psychiatric treatment. It is the latter group with whom I empathise and I hope I do always remain sensitive to their feelings in the ways in which I express my views. But I MUST speak out. People have been, and are being, harmed by the medicalisation of their problems. A rigid application of the medical model almost destroyed me. I’m not antipsychiatry, I’m anti-bullshit – and psychiatry did throw a lot of that at me.
Tuesday 25th March was a big day (or rather evening) for me. I gave a talk at Oxfam Bookshop (as part of the Headingley Literature Festival) about my experiences in High Royds Hospital, as told in my memoir ‘The Dark Threads’. Of course, remembering how things had gone well on other similar occasions helped a lot, but I did still did have some pre-event nerves. Throughout the day my mind kept going into collywobble mode and throwing up a lot of scary ‘What ifs..?’
What if I lose my vision in the middle of it? This wasn’t as daft as it sounds. Every now and then I get ophthalmic migraines which come on without warning and they severely affect my eyesight for a while. Sometimes I go a long time without having them, but once I get one they often come in clusters a couple of days apart and I’d had one two days earlier. Other ‘What ifs?’ were What if in the middle of my talk I urgently need the loo? feel sick? go dizzy? lose track of what I’m trying to say mid-sentence and dry up? What if the audience gets bored and start leaving? What if nobody turns up and I’m staring out at empty seats? Or what if too many people come and there’s not enough room for them? What if..? What if…? What if…?
Fortunately my ‘What ifs?’ proved unfounded, except for one. Over forty people turned up. This meant some of the audience had to stand, and a few had to stand round a corner barely within earshot of me, but it was manageable. In fact, I’ll be bold enough to say it was more than just manageable. The evening was a success.
I spoke for about fifty minutes, followed by a question and answer session. The evening was then rounded off with coffee and biscuits. I’d tried to plan a ‘balanced’ talk – a mixture of grim parts and humour. Most of the extracts I read from ‘The Dark Threads’ were fairly light-hearted, though some with an undertone of black humour. I didn’t want to downplay the horrors of the mental institution experiences for myself or anyone else but neither did I want to make everyone feel depressed rather than inspired. I wanted to get across what I feel are important things to say about psychiatry, relating both to the past and now, but at the same time I didn’t want to be ‘preachy’. After all, this was part of a literature festival and I wasn’t speaking to a roomful of psychiatrists!
The second part of my talk was about the writing process and getting published. It included topics such as how writing for therapy and writing for publication are two different things (though there can be some overlap), the importance of truth in memoir but having to accept the fallibility of memory and the need to protect peoples’ privacy by changing names and perhaps physical descriptions of people, how I got published and how I became confident enough (ahem) to give talks. Actually, as has happened often before, I did feel confident enough to enjoy doing the talk once I began. The audience seemed wonderfully attentive and asked me lots of questions afterwards.
During the coffee and biscuit time, I sold lots of books, and chatted to many interesting people. I do hope that everyone else enjoyed the evening as much as I did. It does seem so, because feedback has been wonderful. When I get my next pre-event nerves I’ll remember this and reassure myself that, yes, I can do this. Despite all the problems I’ve had in the past with shyness/social anxiety, I CAN talk.
Perhaps we all can do more than we think we can if only we believe this is so.
Tuesday 25 March
The Dark Threads Partnership Event
Jean Davison will read from her memoir The Dark Threads and talk about her experiences as a patient at High Royds psychiatric hospital in the 1970s. Electric Shock Treatment and drugs reduced her to a zombie-like state for five years, before she managed to turn her life around. The talk will also include her experiences of writing the book and getting published. A question/discussion session will follow, and then the evening will be rounded off with tea/coffee and biscuits.
7.00pm Oxfam Bookshop, 13-15 Otley Road, Headingley, Leeds LS6 3AA (next to Skyrack pub)
Free. Donations invited
It’s World Book Day so I thought I’d write a post about books. I love books, but when asked about my favourite authors I don’t know what to say. I’ve got an eclectic taste in books and I have favourite books rather than favourite authors. Often I read a book I love, only to feel disappointed when I get another book by the same author. I enjoy a diverse range of fiction and non-fiction.
I have a friend who says she never reads novels because she feels there is nothing to be learnt from them. As they are ‘not true’ she feels she would be wasting her time with them. I so-o-o-o much disagree with this, but it would take a much longer blog post than I’ve got time to write today to defend reading fiction.
The latest novel I’ve read is ‘The Goldfinch’ by Donna Tartt. I thought it was like the curate’s egg – good in parts. I was drawn into the opening chapters and really felt for the narrator, Theo, whose mother dies when he is only thirteen, leaving him alone in New York. His grief is very movingly expressed. As he grows up, he loses his way, often in a haze of alcohol and drugs. Things go from bad to worse for him when he gets drawn into the criminal underworld. I thought some of the plot points were unbelievable and the main plot shoots off into too many tangents with long-winded descriptions. Having said this, some of the writing is brilliant, and the themes thought-provoking. At 771 pages I felt the book was too long, though of course this is subjective. Myself, I think editing it down to lose about 200 pages would have made a better book. Hey, but who am I to criticise? Donna Tart writes far better than I can.
Now, this is strange. I’ve got a half-finished mug of tea somewhere and I can’t find where I’ve put it down! Must go find it before it goes cold.