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In my first months of taking antipsychotic medication, in 1982, the side effects made me incredibly miserable. I took Stelazine and then Prolixin. The dosages at the time were not huge, yet, it was bad enough that it resembled a chemical straitjacket. 

How can I describe the side effects? Functioning to do even simple tasks, things that nearly everyone takes for granted, required massive effort, if they were doable at all. The simple act of reading was painful. It was difficult to brush my teeth. Carrying on a conversation was painful. It was miserable to live within my own body. 

Compounding this, I had post-psychotic depression. A mental health worker told me of this, when I was an inpatient. When you've just had a psychotic episode, there are numerous reasons that you can come out of that depressed. There are brain-related reasons, and there are the circumstances in which a patient finds oneself. Circumstances are different for everyone, however, many of us have just been informed that our diagnosis is Schizophrenia. 

Psychiatrists don't paint a rosy picture for the future of patients given the above diagnosis. They may believe that a patient will be limited. There is no encouragement to try going to college to obtain a degree. Instead, their suggestion is to try jobs that don't involve much thinking. 

When I got hired as a janitor following my first psychotic episode, it was the same kind of work that I'd done before I became ill. I was surprised when my outpatient psychiatrist had suggested that I do the same kind of work that I'd done before. 

I'd expected that I'd be advised to do something completely different, since it seemed to me that it was partly the jobs that had made me become ill. Yet, the psychiatrist believed I became ill strictly because of a brain malfunction. He believed that I should do what I'd already done because it would be more within my grasp. 

Trying to make my body function as a janitor while taking antipsychotic meds was agonizing. I was depressed and the side effects impacted freedom of movement. I became noncompliant with medication after a few months on the job. I worked at my job and asked for more hours. I rented a room so that parents would not be able to insist that I take medication; it had caused me to be miserable and interfered with work. I relapsed a year later, at age nineteen. 

Then, I was back on antipsychotic medication, and my situation had been set up such that I did not have a choice about it. Eventually, the side effects were less, because my body adjusted. 

By age 21, I didn't notice the side effects as much from the fluphenazine I was prescribed. By then, I'd gone to electronics training and I was employed in television repair. It was more respectable work than pushing a floor-polishing machine. 

(Not that I knock janitors--it is genuine, honest work, and it is a necessary service.) 

(In my present life, people seem to remember me more as a former janitor as opposed to my career repairing electronics. I would do electronics now, except that my skills are at least thirty years behind the current technology, and you must continually go back to school. If I did electronics now, I'd have to be fully into it. My current circumstances and needs don't permit that.) 

In recent years, my medication side effects have again increased. It comes at a time that I'm trying to taper off the nicotine use. Maybe the nicotine masked side effects. I've read somewhere that if mentally ill and quitting smoking, it is appropriate to have the meds adjusted. 

I know that antipsychotics affect ability to concentrate some of the time. At other times, it is painful to carry on a conversation. The sensations in my body are physical stiffness, and a numbed out, yet painful sensation. I believe that the supply of neurotransmitters gets used up, and frequent breaks are needed when attempting activities that use certain brain capacities. 

I will say that the suffering induced by antipsychotics is a hundred-fold less severe than the suffering of being psychotic. That makes it a worthwhile tradeoff. 

Side effects of medication are high on the list as causes of medication noncompliance among mental health consumers. The medication is like using a sledgehammer to kill a fly. Unfortunately, not enough research has been done to find a better set of medications. 

People should not assume that a mentally ill person can't do tasks that require brainpower. The collective assumption that mentally ill people are unaware in comparison to normal adults has a bad effect on us. The medications introduce limits. Yet, some of us have found ways to maneuver around these limits. The brain condition, whether it is paranoia, bipolar, depression, or other, often does not indicate absence of awareness or intelligence. A mental illness does affect how these faculties manifest. And that is why treatment is usually a non-negotiable necessity.