Medication: Is It Enough?

When I first entered the psychiatric system in earnest (not counting a few previous flirtations) I was told that the drugs would make me well. My new psychiatrist seemed very positive and reassuring - telling me that I needed to come into hospital where they could start giving me this miraculous medication. My parents and I (being scared and confused by what was happening inside my head) deferred to his greater knowledge and so I was admitted. I remember being very put out that it was two days before Christmas.

Medication, though, wasn't quite the cure we imagined. It was a slow process. I tried a number of medications (neuroleptics) for my psychosis. As each one began to work we were hopeful - only for something to go wrong. It was a confusing time, made more so as I wasn't all that sure what normal was. Each changeover between meds was especially traumatic - especially when I'd achieved some degree of stability beforehand.

Not that it was all bad. There were major improvements - I was able to drink out of a can of pop (not fearing too much what was inside), the voices dissipated, I was allowed out for walks. It was slow though - painfully slow.

Much of the hospital environment is focussed on medication, in one way or the other. The doctors prescribe it, alter it and combine it with others. The main point being that it's the medication that will get you better and get you out of there. The nurses often suggest it when you are distressed, anxious, angry or need to calm down. Yes, some nurses do try to encourage you to relax (read: go and lie down on your bed) or distract yourself (read: go and make a cup of coffee). Things are such that, without proper support, we often begin to resent this and go along the 'give me the damn drugs' line instead. It's easier for them and it's easier for us. Or so it seems at the time.

The alternatives? Very costly. Mental health workers could spend more time supporting, talking to and listening to their patients. Not just handing out clichéd advice but tailoring it to the individual. Helping them through stuff by being there with them, not hiding in the office. By treating each patient as an individual, as a human being, therapeutic relationships are made which aid recovery.

It is now widely accepted that life events, coping techniques and circumstances contribute to a person's mental health (ill or otherwise). I would go further and say that, in many cases, these factors are at least on an equal footing with chemical imbalances etc. Without having therapists/counsellors on the ward it is difficult to resolve these issues. Having contact with a therapist might provide an opportunity to move forward, or at least better understand the problem. In acute ward settings this would be short term - but if it's supportive it could be extended after discharge (maybe handed on to a post discharge care team).

After leaving hospital many peoples only support from the health service is their medication. No Care Plan. No therapy. No CPN. No Day Service. A follow-up appointment with the doctor in, say 3 months time. It's not that difficult to see how people slip through the gaps. The fact that many people don't know what support is available to them (from within the services and from other agencies) compounds the problem.

I know that I need my medication. Without it I can't function - I get depressed, I get psychotic. I also need understanding, empathic support from the services. I need quicker access to counselling services and more of a say in what treatment I receive. Happily I am now being supported by a non-statutory housing support scheme with a positive outlook. They are always available for a chat and I feel see me as a whole person. I'm even involved with some outpatient activities that are also positive. Other people are not always so lucky.

Medication? Useful as it sometimes is, it can't listen to you and it doesn't try to understand.

Rachel Waddingham © 2002