Public Comment

I am Jack, I'm a 59-year-old man, and I have suffered from a psychotic-type psychiatric condition my entire adult life.

A major psychiatric condition has the potential to ruin your life if you let it. And you should not let that happen. Despite the massive hardships that come with mental illness, you are better off not giving in to it, and you are better off getting what you can still get. And part of not letting this condition do away with your happiness is to adapt. And there is a lot of adapting you must do.

A psychotic condition may be the most severe category of mental illness and the worst in terms of affecting your present and future life. If you are new to psychosis, whether you are the patient or a family member, there is a lot to learn, and there may be a lot of unpleasant surprises. How do you manage psychotic symptoms? Is the medication truly necessary? What can I expect? What will be my son's or daughter's capabilities, and what will be the limitations? 

To begin: Almost universally, if a young person suffers from psychotic symptoms, he or she must have medication. There is no getting around it. 

In 1982, at the age of eighteen, I first became ill with paranoid schizophrenia. I had an extremely bad episode of psychosis that rocked my family and from which I was lucky to get out of alive. I was put on medication, and it made all the difference. Had medications not yet been invented, I would have been fully out of luck. 

Antipsychotics are a relatively recent discovery that began with Thorazine. In 1952, scientists discovered Thorazine to have a dramatic effect on psychotic patients. 

But it is a natural consequence of being treated with antipsychotics for patients to try to become noncompliant, even while these are drugs may be the only things that stand in the way of total disaster. The side effects of Thorazine, Stelazine, Haldol, and many more drugs produce a great deal of physical and mental suffering. To get the patient on board with taking antipsychotics, it is up to the patient to gain the necessary insight. When we fully realize the consequences of going noncompliant, most of us will choose to take our medication rather than let our lives be ruined by a neurobiological condition. 

The lifetime decision of compliance that I made did not come quickly or easily. I had several episodes of noncompliance and resultant psychotic illness. At age 30, I was smart enough to realize what I was up against. I also knew that my parents were getting too old to deal with me as a psychotic person. Additionally, I needed to have a life. And this was only achievable through medication compliance. 

But in 1982, this was not yet the case. 

Despite the urging of doctors, family members, and my better judgment, I stopped medication after five months. I had a job cleaning and polishing supermarket floors in the East Bay. I was able to move out of my family's home and live in shared rental across town. 

A year later, the disease caught up with me and I was fully ill once again, but this time I was not violent. I was picked up while trying to steal gasoline from a gas station. The debt for the gas was resolvable. However, I needed a much greater level of care in the months that ensued, because my brain condition had been harmed by the time off of medication. 

Taking psychiatric medications is generally not the most fun thing we can do. And if the meds are antipsychotics, the side effects can be very unpleasant and sometimes disconcerting. 

In addition to being medicated, there is more that we need to do to get well. It helps to be in contact with other human beings. Getting employment that is isolating could have a harmful effect. Old school psychiatry might not acknowledge what I just said. Old school psychiatry, in my feeling, is wrong about a lot of things. 

The diagnosis they gave me was seemingly fully correct. Yet the prognosis was wrong, and the prognosis didn't do me any favors. 

When I reached my early twenties and was back at work, it was a period in which I could regard myself as "normal," and I didn't define myself as a mentally ill person. I was a young man, I had semiprofessional employment in video repair, and I had girlfriends. 

When I reached age 25, I started to experience more setbacks. A man decided he wanted to have a fistfight with me. He may have been a drug dealer, or he may have just been irate. Being knocked to the ground and hit in the face was not the favorite experience of my life. 

When I was in my mid-twenties, things had become difficult enough that I decided to apply for Social Security. It was a last resort, because I truly didn't want to give up on working. 

In my quest to become successful, many people and circumstances have invariably come out of the woodwork to interfere. 

Finally, I am approaching age 60, and success is in my scope. I have a professional activity that I'm good at. Many people acknowledge me as a good person. And I can shrug off, ignore, or deflect further attempts at knocking me down. Or so I hope. Please wish me luck.