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What I Wish I Knew Before My Daughter's Psychotic Break

Posted: 10/08/2012 7:54 am

Now that Mental Illness Awareness Week (MIAW) is over for another year, how many of you learned about the early warning signs of schizophrenia and bipolar disorder?

Or the Early Psychosis Intervention programs that offer the best help? Since over 3 per cent of the population will develop these disorders, usually in adolescence or young adulthood, it's useful information.

It's not an oversight that you probably didn't receive this basic education about psychotic illnesses. The Canadian Alliance on Mental Illness and Mental Health (CAMIMH), the sponsor of MIAW, has clearly been guided by social scientists interested in de-medicalizing mental illness in its public education campaign.

Their 2008 National Integrated Framework for Enhancing Mental Health Literacy in Canada (p.7) reveals the dubious notions that are now influencing how we are supposed to think about mental illness literacy:

There is a tendency among professionals to assume the mental health literacy of the public will increase as it aligns with professional thinking, but there are many reasons for caution about adopting this approach...


The Framework then warns about this approach, because "its emphasis on medical perspectives...can be associated with disempowerment, pessimism, and increased stigma."

Since these particular illnesses are now considered to be medical disorders by the medical community, it would make sense for a public education campaign to let us know what "professional thinking" is about these brain disorders. Limiting the dissemination of medical information on psychotic disorders actually leads to the "disempowerment, pessimism, and increased stigma" from which we're presumably being protected.

Parents who don't understand the strange behaviours that accompany psychosis are completely disempowered. Delays in getting treatment do lead to poorer outcomes, so there's reason to be pessimistic when trends in social science dominate the distribution of knowledge about medical illnesses. And the more the public witnesses the disturbing behaviours of people with untreated psychosis, the more stigma they will have about all people suffering from mental illnesses.

Currently, the strongest component of Mental Illness Awareness Week is its Faces of Mental Illness program, which profiles five Canadians who have battled a variety of mental illnesses and gone on to build very productive lives.

One of those people profiled this year is Vancouver author and artist, Sandra Yuen MacKay. Sandra has worked for years with the B.C. Schizophrenia Society to educate people about psychotic disorders. Her memoir, My Schizophrenic Life, The Road to Recovery from Mental Illness, provides an informative account of the frightening intrusion of this illness into her teenage years. Fortunately, Sandra's parents eventually were able to get her into a local hospital where her illness was diagnosed.

In a recent conversation, Sandra mentioned that if education about psychosis and if Early Psychosis Intervention programs had existed when she became ill, she might have received appropriate treatment much sooner.

Last year Sandra participated in a workshop I gave for the B.C. School Counsellors Association on how to better support students who develop psychotic illnesses. In discussions with these counsellors, it was clear that they really wanted to understand these disorders, which they hadn't learned about in their previous training. Although many were working in schools in and around Vancouver, where good Early Psychosis Intervention programs have existed for over 10 years, few knew about them.

It's not surprising that many school counsellors haven't heard about these programs. Even though in B.C., we have an excellent plan describing how EPI programs should operate, appropriate funding hasn't been allocated. At the same time that this plan was being unveiled, for instance, Vancouver's Early Psychosis Intervention program lost funding for its EPI Educator position.

This outreach worker went into the community including secondary schools where she taught counsellors how to recognize the early signs of psychosis. Counsellors also learned how to easily connect students to EPI for psychiatric assessments that are otherwise very difficult to obtain.

One of the many beneficiaries of Vancouver's EPI program is Tracy Windsor, a very articulate young woman. As Tracy says, "EPI has been the backbone of my recovery from bipolar disorder. Without the staff at EPI, I believe I would have fallen years behind in my recovery."

Tracy now shares her story through the Mood Disorders Association of B.C.'s Lowdown program. As well, she supports students with mental illnesses by coordinating the Kaleidoscope program at the University of British Columbia.

Students struggling with psychotic illnesses they don't yet understand are fortunate if they connect with a group like Tracy's. They might instead wander into a workshop like the ones offered recently by the Mad Student Society at the University of Toronto and at York University on Resisting Mentalism: Becoming an Ally to Mad People and the Consumer/Survivor Community.

Informed by contemporary social science theories, this group wants to help students who "have been labeled with 'mental illness' diagnoses," a process the Society refers to as mentalism or saneism, to challenge "the medical model understandings of madness."

I wish public education about the "medical model" perspective on psychotic disorders had been much better 14 years ago when our younger daughter began showing signs of what developed into a severe schizoaffective disorder. Our ignorance led us to choose a therapist who has a MA in Counselling Psychology. She trained in a program at a major Canadian university that neither offered nor required curriculum on psychotic disorders. This crucial mistake on our part led to circumstances that meant our daughter unnecessarily experienced a two-year psychotic episode.

One of the sad benefits of writing a memoir about these experiences has been to receive messages from other families who are continuing to make the same mistakes we made. The one national public education campaign that we have about mental illnesses isn't helping. Early Psychosis Intervention isn't even a topic listed on CAMIMH's website.

 
 
 
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08:50 AM on 10/13/2012
I am grateful for this discussion. I am mother of a 31 yr old. She is now living in a group home. I hear
the word recovery. However, my impression is that no drug, no therapy, no community is going to fix her broken brain. I do believe it is heretitary. She had "issues" from the beginning and all along the way. I could write a book on each of the ages. I too wish I had had more information about schitzophrenia and where this path was leading. It was as if no one knew or wanted to share this with me. One of her 20 something counselors tried to give me a 'tip" when she was 17. She suggested we get her into the hospital right away, but did not inform me why. She was trying to lead Heather to a disability check before she was 18. What she went through in the following 9 years before she had that is shameful. She was homeless, she was missing for 3 months, etc.
etc. etc. Though the SS check is small, it does with the systems in place, pay for her basic needs.
Her delusions are constant. Nothing she thinks has anything to do with reality. She is now safe
and cared for and my tramua is all but over. I have accepted what is and can move on with my life.
07:45 PM on 10/10/2012
Thank you Leanne MacKenzie, Novabird, Juniper1, MaggieDog99, Wellreadandresearched, Willy327, and hphoenix for being willing to share your personal stories; I think the public really needs to understand what people with severe mental illnesses and the families who help them are experiencing.

I wish there were a way to know if people are discussing situations in the US or Canada, and, if in Canada, which province's mental health system is being described. I hope you each continue to speak out about what did and did not work in regaining mental stability.

I admire your stamina.

Susan
01:15 PM on 10/09/2012
Thank you SO MUCH for telling us about the Mad Student Society. I had never heard of them, but will now spread the word. What a great resource for young people struggling with extreme emotional states that get labeled as mental “illness.” Yet another great resource for young people “navigating the space between brilliance and madness” is the Icarus Project in the U.S. http://theicarusproject.net/ and Mad Pride Toronto http://www.madprideto.com/

Of course, the best all around resource on truth about psychiatric drug treatment can be found at Robert Whitaker's Mad In America website.
01:22 AM on 10/09/2012
I have extensively researched the topic of trauma, especially childhood trauma and it has become quite clear that the associated conditions are of a "spiritual" nature first and foremost. When a traumatic experience occurs, one finds a way to protect themselves by dissociating or shutting down their emotions. Often one becomes overly cautious and hyper-vigilant (due to a fight,flight or freeze response gone wrong), They have difficulty to trust anyone because they are unable to find their way back to a balanced state (more importantly in the endocrine system). Most mental conditions are epigenetics in nature and doctors are usually ignorant of the causes. They just look at symptoms and are only concerned about the danger to the person or to others. In therapy, the only real hope is to find the root cause and to help the person make sense of what is going on. However, trauma severely tempers with gene expression. This needs to be corrected or re-established. You can do it the long way with therapy or you can take a short cut and use plant medicines e.g. Ayahuasca, Ibogaine. These work well for all addictions as well as many PTSD symptoms (incl. milder cases of schizophrenia, OCD, bipolar, borderline, eating disorders, paranoia, anxiety, depression, etc). Prescribed drugs NEVER address the source of the shattered/fragmented personality. For the most part, fear, shame and guilt are the real issues and how one copes with these feelings are as varied as the people themselves.
04:20 PM on 10/08/2012
I am a substance addictions counselor and an author in the field (Tao of Sobriety). I have been a social worker and counselor working with youth and families at risk for about 40 years. I had a severe addiction myself and suffered from deep emotional problems since the age of 2, until about the age of 35. I am 65 now. My wife of 45 years is a clinical manager of addictions for a large health organization. About 85% of the folks my colleagues and I see with serious substance dependencies suffered miserable, dark, childhoods. Addictions are self medication for the resulting post traumatic stress. Many clients we see have been diagnosed with a mental illness as well as an addiction. It is very rare indeed to come upon a client whose social environment, principally family and school, did not contribute (mightily) to their stress load, triggering their addictions issues as well as their "mental" issues. If we really really want to eliminate most addictions, criminality, and even mental illness, as a community we need to put our money where our mouth is when we say "kid's first." It is not my intention to blame familes and schools. It is my intention to SHOUT OUT! how vital family and school are to a child's mental health. Yes, most addictions and criminality would be eliminated if kids came first in our communitees. And, rates of mental illness would fall dramticaly, as well.
04:02 PM on 10/08/2012
This is such an important topic. Psychotic disorders are medical disorders. They are diseases of the brain. They are not moral failings or willful misconduct. People suffering from psychotic disorders cannot just "snap out of it". They need medical intervention to manage the biochemistry of their disease and psychological counseling to teach them how to live with their disease. Bipolar disorder with psychotic features, schizophrenia, depression with psychotic features, and schizoaffective disorder are chronic medical diseases just like diabetes or rheumatoid arthritis. The faster society accepts this reality the sooner people will feel safe to get help for themselves or their loved ones.
11:50 AM on 10/08/2012
While perfect tenses have all but disappeared from public discourse in The United States, let us not follow our American friends in impovrishing the English langauge. The title of this piece should read "What I wish I had known..."
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HUFFPOST SUPER USER
Leanne McKenzie
You can't make this sh*t up.
10:44 AM on 10/08/2012
Can't continue in comments...

She had a complete and total psychotic break just before she was 22. She broke into our house and threw paint around in an effort to see the invisible man who was stalking her. The police took her to the hospital and the hospital let her out that same night. She had lied to them about the situation and they "could not do anything".

She lived in her apartment, staying in one room. She refused to eat because she could see 'them' poisoning her food. She attempted suicide and was in a coma for a few days. When she revived, they sent her to the detox unit where she talked the doctor into letting her out days later.

I confronted the nurse and asked - what does it take? The bottom line is it is up to the patient who is a consenting adult. They kept her for an extra week, but that was all.

She has reached the age of 25 and stopped all non prescribed drug, and diagnosed with schizoid-affective disorder. She still hallucinates but has learned to differentiate them from reality.

Now she is a big part of her daughter's life with regular visitation and participation.

It is a very scary world for people who have psychotic breaks and it is very scary for those who love them. If you haven't seen mental illness at work, it is very hard to imagine.
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novabird
Lover of Life, Radical Centrist
11:23 AM on 10/08/2012
I agree!
In my opinion a big part of the problem is that many, many people have experienced various forms of mild mental illness (mild depression, mild anxiety, etc) and they often assume that what worked for them will work for everyone.
Most of those folks have never experienced severe mental illness and the devastating damage it does. My own daughter has schizophrenia and she literally lost everything before I went to a judge and he issued a court order to force the local hospital to give my daughter the proper medical treatment that I believe saved her life.
03:37 AM on 10/09/2012
Our son had his first (we think) psychotic episode (break ?) when he was just over 22 yo. He also took drugs on lots of occasions, but we were told that drugs do not cause this, but often "reveal" schizophrenia. We don't know if he had hallucinations, but he certainly had delusions and feelings of persecution. Everything else you describe seems similar. But to get help, our son needs to accept help.

Thanks
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Leanne McKenzie
You can't make this sh*t up.
10:03 AM on 10/09/2012
That is very true. We have an advantage in that our daughter wants to see her daughter and she knows that she has to be clean and capable to see her. It took her 3 years to get there, but she finally did.

People with mental disorders usually self medicate. The drugs prevent treatment because they confuse the issue. As well, the human brain doesn't actually stop changing until the age of 25, so that makes diagnosis hard too.
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HUFFPOST SUPER USER
Leanne McKenzie
You can't make this sh*t up.
10:42 AM on 10/08/2012
My daughter was always a strong willed child with no sense of responsibility. When she was a teenager she ran away multiple times. We saw counsellors, the whole family went but the moment she had to follow up on all her agreements, she declined. She started taking drugs, stealing from us and lying about it.

Then she had a baby when she was 20 years old. We tried as hard as we could to look after the baby while not assisting her bad behaviours. She finally confessed that she need to go to detox and we looked after the baby for her. She didn't finish the program but we had talked to children's services and followed their advice which included the process of applying for guardianship.

continued in comments.
11:54 AM on 10/09/2012
Im sorry but, something about your' story speaks to an element of deception or not full disclosure... I've read both your comments and there are parts of your story that do not add up to facts of mental illness etc.

It's not possible for a person with schizoid-affective disorder to separate reality from delusion, that is the basis of the diagnosis. Im not sure what your' deal is but, your' story is not adding up.
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Leanne McKenzie
You can't make this sh*t up.
07:06 PM on 10/09/2012
Believe me - I have no idea if it adds up. All I have is the information I've been given because my experience is on the other side of the coin - dealign with the laws and the problems when someone is mentally ill. When the drs first diagnosed her with bi-polar - I argued that point. Hallucinations are not part of bi-polar. I knew that from having bi-polar friends. After a few years they changed it to schizoid affective. It does encompass hallucinations, but apparently not to the extent that my daughter still has them. When she was taken to the hospital by police for breaking into our house and throwing paint around to "see" the invisible guy who was stalking her, the doctor sent her home. He'd never seen anyone with that type of disorder before and thought she was lying. He has since seen her and apologized. Again, this is what I have been told.
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HUFFPOST SUPER USER
Leanne McKenzie
You can't make this sh*t up.
07:10 PM on 10/09/2012
BTW - I'm not sure what deal I could possibly have either, but to me this proves one thing, Not only is mental illness not understood, but it is highly personalized. I imagine that no two people ever have the exact same symptoms, reactions, medications or diagnosis because the diagnosis is spread rather widely.
10:35 AM on 10/08/2012
There are so few people who understand any form of mental illness and it seems even fewer who try. My child has severe anxiety and the high school never considered this in any way. Now this child is not in school and may never return
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wellreadandresearched
Other than frustrated, I don't know what I am
09:00 AM on 10/08/2012
It wasn't until I was diagnosed in my mid-thirties that I started getting help. I now live a productive life, but still maintain a prescription routine and counseling. Growing up, all the signs were there, but since I grew up in the 70's and early 80's, my family knew something was wrong but couldn't put there hand on it until I was arrested. Then everything came together, and the help I received was minimal until I was arrested a second time. That's when I decided, enough is enough, and demanded the best help available. I am now in my mid-forties and doing well. I am very fortunate that I have a loving and supportive family, friends of the family and my own friends, that I can go to when necessary.
Having someone to talk to and get it out of my system, is usually great medicine and reduces my likely hood of going into relapse.
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HUFFPOST SUPER USER
LGC1953
Be careful what you ask for, you might get it
05:29 AM on 10/08/2012
I can see where taking a child to someone who is not even a doctor might have been a problem!
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novabird
Lover of Life, Radical Centrist
10:03 AM on 10/08/2012
There are hundreds of thousands of medical professionals who are not medical doctors, my friend.
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Pondering panda
04:44 PM on 10/08/2012
true and many times overworked doctors just medicate instead of "treat"
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HUFFPOST SUPER USER
LGC1953
Be careful what you ask for, you might get it
10:38 PM on 10/08/2012
I would not recommend taking a child with psychotic problems to anyone who is not trained in such - someone with an MA in Psychology is not qualified to deal with those problems!
04:30 AM on 10/08/2012
Our son has just been diagnosed with schizophrenia / borderline disorder ... at 22 yo. Needless to say, many appointments and interviews with numerous doctors, psychiatrists, psychologists and various mental health professionals and 4 hospital stays lates, due to our son being diagnosed so late, treatment is now very difficult, and it might even prove impossible. These pas 5 years - full of failures and problems with the law, broken promises and friendships - have been absolutely devastating for him, for us (his family) and his entourage, and picking up the pieces is like trying to make a smooth mirror out of a smashed one that has been thrown in the bin. Doctors always told his he suffered from depression (of which there are many kinds), and never until now was there ANY mention of schizophrenia or bordeline disorder. He is now in a state where he thinks there is no coming back, is now set in his bad habits (his way of coping with his mixed up thoughts) and is not accepting treatment properly, and recently ran away from the hospital, as they did not take into account our account of the last 5 years. We now wonder if our once wonderful and normal son will ever be able to get help.

He has not been seen nor heard from for 10 days now. Is this the answer ? Isn't it better to treat before such disorders wring everything out of one's life ?
09:54 AM on 10/08/2012
The same thing happened to my brother. I am so sorry this is happeneing to you, truly, you are in my thoughts
03:29 AM on 10/09/2012
Thanks - I now realize there are many aching families out there like ours -
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novabird
Lover of Life, Radical Centrist
10:01 AM on 10/08/2012
I have lived this my friend. My daughter has schizophrenia and in the course of a few years of non-treatment by the local hospital (the police would take her to the emergency department and the doctors would assess her and release her) she got sicker and sicker, losing everything and she ended up living on the streets and in trouble with the law.

At that point I went to a judge and he issued a court order to force the hospital to provide proper medical treatment to my daughter. When she finally got the anti-psychotic medications that she so desperately needed she was able to start getting better. She is now in her own apartment and working on her recovery, and she takes anti-psychotic medications.

One helpful resource for family members is the family support group offered by the provincial chapters of the Schizophrenia Society of Canada. This amazing support groups/educational program provides support to family members of people who have schizophrenia, bipolar and schizoaffective disorder. You can find further information by going to the website of the Schizophrenia Society of Canada.
03:20 AM on 10/09/2012
Thank you for your comment - I describe the situation in France, but from what I can see going on in other countries, it can be the same. Indeed, the most helpful site I have found to date is the Canadian one. (I am of Canadian origin). Thanks for you help, but I have a bad feeling that the worst is yet to come. I can only hope that he will turn up and we will be able to somehow legally bind him to treatment ... but will it help at this late date ?
12:42 AM on 10/08/2012
The very worst thing that happened when my 12 year old bipolar daughter overdosed was that the hospital informed her of her rights, and she invoked the right to privacy and to determine her own treatment. There seems to be no way around this rule which prevented her from getting the treatment she needed at that age. Now, at age 30, her life is a shambles and her bipolar disorder still not treated. We have spent years trying to get her help, all without a positive outcome. The line I get from the professionals is "it's not against the law to make bad decisions." Not helpful when you consider why those decisions are bad. As it is, my very bright girl is living a dreadful life and there's nothing much I can do to help.