Finding a path to recovery

In the second part of our series on mental health, Jennifer Hough meets a young woman who found a way to stop the voices in her head

MICHELLE DALTON first began hearing voices when she was about 12 years old. At first she thought it was normal, and tried to ignore them, but as she got older it became more and more difficult to push them to the back of her mind.

“It was not unusual to me that I heard voices so I didn’t tell anyone, but I was very self destructive — I had bad mood swings and finally after years not wanting to admit something was wrong, I erupted and realised I really needed to do something about it.”

At 17, Michelle began confiding in a friend who advised her to seek help. Her experience was far from positive.

“I went to a counsellor because I really didn’t want to end up on medication or in hospital. After about five minutes, I was told I was bipolar and extremely suicidal. I found it very condescending and unhelpful. The counsellor sent me to a GP who wasn’t very nice either.

“I was a brick wall at the time and couldn’t answer any questions and was told I was being an over-dramatic teenager.

“The same day I was referred up to Cork University Hospital. I was up there for five hours waiting for a doctor and saw a trainee because the main consultant was not on at night. I had never spoken about it all before so I found the questions very intimidating and again, I was told I was making it all up.”

Eventually, Michelle was referred to a consultant psychiatrist.

“I didn’t want to go at all, it was very intimidating, but she was actually the first one who really listened to me.”

After six months, just 17, Michelle was told she had schizophrenia and was put on powerful anti-psychotic medication.

She finally told her parents what had been going on, but didn’t tell them about her diagnosis.

“I didn’t have a clue what it was myself and it was a big shock. So I didn’t want to tell my parents ‘I have schizophrenia’ without knowing what it was and hearing other people’s stories and really understanding it, because it is a really horrible label to have. It’s like a black cloud hanging over you,” she said.

“I was put on Zyprexa [olanzapine], and I was out of it. I found it very strong, it made me bloated, and I was in bed a lot of the time.

“It was the year of my Leaving Cert and I was falling asleep in class, the voices became ever more intense and it was like having loads of people shouting at you incomprehensibly.”

Summer trip

Despite all this, Michelle managed to pass her Leaving Certificate and once the exams were over, she was much improved and went on a summer trip to Italy.

“I had a great summer and everything was okay and I thought there was nothing at all wrong with me. I even came back with a present for my psychiatrist saying ‘thanks for all your help I don’t have schizophrenia, I am fine’.”

It was about a week later that the most intense voices began instructing Michelle to go to Galway and take an overdose.

“The voices were screaming and shouting in my head all night long, saying pack your bags, go to Galway, find an abandoned house, take an overdose. They were very clear directions.”

Michelle went back to her doctor who said she needed to go to hospital straight away. “I was very wary and afraid about going into a psychiatric unit at 18. You are supposed to starting out in life — not ending up in a psychiatric ward.”

Although hesitant, Michelle was admitted to hospital and it was only then her parents found out about her diagnosis.

“I got my doctor to tell them and, when I came back into the room, they were both bawling crying. I felt so guilty, like I had done something wrong.

“I was terrified at first in hospital, but after a while, when I started talking to the other patients, I realised they were such nice and genuine people.”

That admission was the first of many for Michelle, but she says, often, there isn’t much to do in hospital, and it’s more a place of containment.

“There is a regime — you are up at 8, lunch at 12, dinner at 5, and there is not much to do after that. There is art therapy and news of the day, but you fill up your day by talking to other patients.

“There was a smoking area and we had great craic, it’s really strange, because you think it must be all doom and gloom, but it can be good fun. There is something about being in hospital with others — there is an element of comfort.”

When she came out of hospital, Michelle was still hearing voices very intensely and eventually confided in her doctor about how bad things were.

“I was happy to get out of hospital, but I was also scared, because I was wondering what people thought and I felt alone, very depressed. People can have very negative viewpoints, and I have had terrible things said to me.

“The medication numbed it, but that’s all, and it is all trial and error. I had some terrible side effects from the medications, I had awful nightmares, facial twitches and, one time, my eyes strained upwards for eight hours.”

When her grandfather passed away, it triggered a manic episode which lasted for six months.

“It’s hard to explain, it’s like a person on ecstasy or speed. You have so much energy and can stay up all night. Eventually you burn yourself out, because you are not eating or sleeping. But I was painting and very creative, I could get up and paint at 6am and then go out that night and come back and paint again. You have this non-existent energy, like you are connected to electricity, battery charged. Eventually, I did crash and then went through a long period of depression. I had to face up to the fact that my grandfather was dead and it was a huge comedown. I was crying non-stop, I was in hospital — it was my fifth of sixth admission at this stage — and it was a very, very bad depression.”

Positive thinking

Michelle found herself focusing on all the bad things in life and in her past, but through Cognitive Behavioural Therapy (CBT) has learned how to control her thoughts and think positively.

An artist and musician, she has been working hard to address the voices in her head in order to get rid of them — and has succeeded.

She explained how the therapy worked for her: “It is like being in a concert hall full of people and you are in the middle and everyone screaming and shouting at you. The CBT was me moving through that room facing everyone and then finding the door out.

“It took two-and-a-half years and was tough but I don’t hear voices anymore. My doctor said to me: ‘You are the first person I’ve seen who has done this’.

“It was a compliment in a way, but a shock as well because that’s so sad. I think a lot of people fall back on medication and that’s what the model of care is. I am so lucky I had a psychiatrist who believed in alternatives to medication.

“A lot of doctors say to patients — don’t look up side effects of medication, don’t do this or that. A lot of times I would talk to patients and tell them about the drugs they are on, because people just don’t know.

“The attitude is that the doctor is always right and the medication will cure, but it doesn’t. It sustains you and is helpful in the short term, but therapy is the only way in the long term.”

Under control

Now 22, Michelle is philosophical about her illness and finally feels she is getting it under control.

She firmly believes, however, that labelling people as “being” bipolar or schizophrenic is wrong and that it leads to further stigmatisation.

“These are labels you are giving people for life. When I was first told I was schizophrenic I thought my life was over — I was doomed. But I do not accept labels, and do not define myself as schizophrenic, because that ends up defining you as whole and that’s all people see.

“I have a mental health problem and I experience extreme states of emotional distress.”

Michelle says being diagnosed was like a shadow over her whole life but says she is proof that people really can get better.

“People are drilled into this idea, that it is going to be like this forever, but it’s not. Yes, you have to work very hard and it’s especially difficult for people who have been on medications long term and are maybe damaged by them, but it can be done.”

At the moment, Michelle is in the process of withdrawing from the psychiatric services, because she feels the focus is too much on medication.

“I am on medications at the moment and they are working okay, but I don’t want to stay on them long term. You are like a guinea pig, and sometimes one drug can work at one time and then not again.”

Michelle feels very lucky to have a psychiatrist who is understanding and supportive.

“I know others are not so lucky and their doctors won’t let them come off medication. They are trapped in the system which tells us our problems come from a ‘chemical imbalance’.

“There is no chemical test proving that so it is sad that because people believe it, and that medication will cure them.

“There are people who have been on drugs for 20 years and it still doesn’t click that it’s not working — and in fact people are getting worse, how can that be called treatment?”

New approach

PUTTING diagnostic labels on a mental health problem does little to help people who feel stigmatised and marginalised by a psychiatric diagnosis which feels like a loss of “citizenship”, a campaigning professor of psychiatry argues.

Dr Sami Timimi, founder of the International Critical Psychiatry Network, believes the “illness like any other illness” approach is likely to contribute to a worse prognosis for those diagnosed, not better.

In a paper to campaign for the abolition of psychiatric diagnostic systems, Dr Timimi, who is set to speak in UCC later this year, maintains one problem with medical model diagnostic approaches is many of the diagnoses, such as schizophrenia, bipolar disorder, ADHD, OCD, are believed to be genetic and lifelong with little chance of making a complete recovery.

He argues that because people are told the best they can hope for is gaining some control over symptoms, through, for example, life-long use of medications, this makes them despair over their so-called chronic conditions.

Dr Timimi, a consultant child and adolescent psychiatrist, maintains the prognosis for those with mental disorders is also further hampered by the stigma associated with the medical model.

“In studies where members of the public are given a psychosocial explanation for the sufferer’s symptoms — such as serious life events, loss, trauma etc — they are much less likely to give negative attributions. Yet again, the medical model diagnostic approach has a significantly negative impact, causing an increase in stigma rather than a reduction,” he says.

According to Dr Timimi studies show that accepting you are “mentally ill” and need medical treatment impacts negatively on emotional well-being, economic satisfaction and vocational status.

Picture: Artist and musician Michelle Dalton with some of her own artwork



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