Columns

Congratulations! You’ve successfully treated your psychiatric problems and you have attained psychological wellness!

It is bitterly ironic that many psychiatric illnesses go into remission when we are older, and we become able to think more clearly and function better and with more ease; yet, by then, our bodies are decimated, and we don't have much time left. People who live with chronic psychiatric illness typically have substantially shortened lifespans, for numerous reasons.

(In my case, the thinking is far better, but I am not as able to drive long distance, to travel, and/or to work at a job. Things that require a high level of mental energy--and physical energy--are much harder, and I get tired more easily. Yet, I am a lot wiser and cleverer. But wise and clever don't do much for you if you can't leave the house.) 

When a mentally ill patient sees a medical doctor (a psychiatrist is also a medical doctor but specializes in mental illness) and when we present to a "medical doctor" that we are sick or have a medical problem that needs attention, often our lives are not considered valuable, and our nonpsychiatric illnesses and the treatment of them are more readily sidelined. 

Also, mentally ill people like me do not have much tolerance for things like surgery, and could be fearful of this, and may postpone or altogether refuse necessary procedures and surgeries. You can force us to be psychiatrically compliant, but you generally can't force us to be medically compliant. 

The COVID vaccines approved on an emergency basis by the FDA, in my view, represent medical science at its best. These three vaccines rival in the importance of the Polio and Rabies Vaccines. The beauty of a vaccine is it usually come in a shot, and usually stops a disease before it starts. Other categories of medicine are far messier, and some of them cause a lot of suffering and/or unintended consequences. 

Mental illnesses do not have vaccines, but in the distant future, they could. This is only in the circumstance that a viral infection of the nervous system is found to cause some types of mental illness. (Some theorists have put forward that idea.) This, admittedly, is a longshot. 

Mental health treatment, however, is much better than it was before the discovery of Thorazine in 1950, and it is better still following the discovery of Clozaril. Yet, the reader should realize that psychiatric conditions are medical conditions, even though most usage of the English language doesn't reflect this. Medication to treat mental illness, as it is used today, may seem barbaric in the future. In the future, much better medications will be discovered. Or perhaps future doctors will be able to do procedures in which faulty neural routes in the brain are changed. 

(A note concerning patients' rights: The Mental Health Consumer Movement is responsible for legally forcing those in the treating professions to treat us with some level of gentleness and respect. We must not only look at means of treatment, but also at how this is carried out. The past treatment of mental health consumers is shameful, but I don't have space here to discuss that topic.) 

Here's a fact of life for you: People get sick. And when we get older, people get sick more often and with worse things. I know lots of people who have incorporated doctor visits into their normal routine. They might average one or two doctor visits per week. When you get older, your body begins to fall apart. There are different responses you could have to this. You could be medically noncompliant and decide you're not seeing a doctor, or you could cooperate with doctors' advice and see them more often. Neither of these is ideal. 

I don't like doctors and I don't like seeing them. I want to live my life. I am forced to be compliant with psychiatric treatment by life circumstances and by the illness. No one can force me to do more. On the other hand, I do see medical doctors for some problems--I do not completely evade medical doctors. 

Pandemic? Immunizations? Of course, you must do that. Other doctor visits? Many of them make a lot of sense. But it is always good to ask questions. 

I knew a woman, an acquaintance, who was multitalented, who passed the California BAR, and who did high level administrative work. She was happy to at least live into her mid-sixties because she had a history of taking lithium for bipolar. Lithium is a mineral, and it is the old treatment that was used before the new mood stabilizers came about. Lithium, as a rule, damages the kidneys. She had kidney issues, and for specific reasons could not tolerate dialysis or a transplant. Before her death, she said she was getting her affairs in order. She'd wanted to be a published author, and it was something that had evaded her all her life. I recall telling her that it is all done electronically, and she didn't seem to warm up to this very much. Her lifetime accomplishments dwarfed mine in all other areas. 

What does it take to give mentally ill people long lives and maybe even happy ones? If I knew I'd tell you. The psych medications, that we are mandated to take, have side effects, some of which include harm to the body's systems. I don't know any chronically mentally ill people who've made it to their eighties or nineties. And in recent years, I've bumped into an attitude of those who run the mental health treatment system, expressed through inaction and other unspoken means, that I am expected to go defunct. (More about this in a later column.) 

When we get older, we face a predicament. I wish I could tell you otherwise. If you can treat a medical problem, and if doing that doesn't ruin your quality of life, you should go for it.