ON MENTAL ILLNESS: Being a Proactive Participant in Treatment

By Jack Bragen
Thursday August 08, 2013 - 06:20:00 PM

Antipsychotic medication is used to treat psychotic illnesses and sometimes bipolar. It is a very imperfect treatment for serious illnesses that might otherwise create enormous amounts of suffering. Medication causes suffering through its side effects. However, untreated mental illness can cause a far greater amount of suffering. 

Antipsychotic medication turns up the relative volume of the external environment in consciousness. This reduces the tendency to focus on internal stimuli. On medication, it is harder to ignore one's environment, and people may "get through" your "defenses" a bit more. Others may be able to influence you more easily. This is not necessarily a bad thing. 

If the alternative is to live in a world of gross illusion, which psychiatrists term as being "delusional," it is worthwhile to take the medication and not worry so much about one's independence. With maturity can come less difficulty accepting some of the situations that seem unfair. 

Some say that antipsychotic medication blocks the higher functions of the human mind. I don't agree. If delusions are in charge, that will block the higher functions immeasurably more than will medication. 

I have noticed far more blockage of consciousness when I was taking an "older" antidepressant called Trazodone. There is no right or wrong to medication--it just is. There is no intrinsic rule that says a medication blocks or doesn't block consciousness. 

(Different people react differently to various medications. A medication that helps one person with mental illness may be bad for another.) 

Cooperation with treatment despite the fact that it may seem unfair is the only way I know for a person with severe mental illness to overcome an otherwise unworkable situation. People against psychiatry are often extremely polarized, and many don't believe mental illness even exists. (Mental illness does exist--its existence is not an hallucination. Mental illnesses are medical conditions.) 

On the other end of the spectrum are those who do not believe persons with mental illness have life potential, who believe that we must always be under supervision, who believe that we can never be responsible for our own destinies, and who believe we are a nuisance and a threat to the rest of society. (None of this is true--persons with mental illness have worth and potential. And we do not deserve to live under oppressive conditions.) 

My position is somewhere in the middle of these two extremes. I believe that mental illnesses exist and are caused at least in part by a brain malfunction. However, as a person who has mental illness, I am aware of the abuses of power perpetrated by treatment "professionals" supposedly in the name of making the person well. 

Imagine becoming ill and then being punished for it. Such treatment is one reason why many persons who have been in mental hospitals would like to do away completely with the profession of psychiatry. 

If a person has found a psychiatrist who treats them with respect, with empathy, and with a good "bedside manner," it is worthwhile to give him or her one's cooperation. This entails, among many other things, not keeping secrets. 

Sometimes delusions are difficult to articulate, especially when the delusions are paranoid, or when the delusional thoughts have not been recognized as delusions. However, the more you can express to a good psychiatrist precisely what is going on for you, the better equipped the psychiatrist is to give you the correct treatment. Lack of communication can mean that symptoms are not adequately addressed. 

Playing an active role in one's treatment can include asking for what you want. If you think you are overmedicated, ask to be on less medication. If your symptoms are getting to you, ask for medication to help alleviate that. 

Working hard as a recipient of psychotherapy (not to be confused with psychiatry) may pay off in the long term. There is much value of talk therapy in addition to medication. Talk therapy in no way implies that you are a sick person. Many psychotherapists themselves see a therapist. Getting one's troubles aired out through talking about them may prevent emotional wounds from festering. 

Being a proactive recipient of treatment among other things includes trusting your own judgment when stabilized, and realizing that while you are not always right, you are not wrong about everything. This means among other things that you can disagree with the opinions of mental health professionals.