As a long standing carer for a son with schizophrenia, I have seen him emerge from frightening hallucinations and delusions with the help of anti-psychotics, and for the last 8 years, on the one which suits him best, I've seen him become able to take part in conversation again, to look forward to things and now even to volunteer for a couple of hours a week in a charity shop. During this period, I'm very pleased that he has never needed to be readmitted to the psychiatric unit where he had spent so much time before.
On the down side, he has steadily put on weight since he started on anti-psychotics and this tendency has increased while he's been on his current one, so that he now weighs about double what he should. We both know that this morbid obesity can lead to diabetes which in turn can cause dangerous blood circulation problems. The medication is not the full story, of course, but it certainly contributes - by stimulating the appetite - to the problems caused by an inactive life and poor self care.
It needn't be like this and in some places it isn't. I've heard of programmes which have been developed and evaluated in which psychosis is treated as a problem of both physical and mental health right from the outset. So the illness and its treatments are thoroughly explained to the service user and help with diet and exercise is provided, all as part of an early intervention programme. The results of this approach in terms of improved physical health have apparently been impressive.
So one would expect this now to be the accepted way of doing things throughout the country but the findings of Rethink Mental Illness' recent medications survey suggest that this is still far from the case. The majority of the respondents hadn't had the benefits and risks of anti-psychotic medication explained to them and they hadn't discussed physical health symptoms with their health professional, which suggests that their problems are still being put into a narrow mental health pigeon hole. I wonder if a similarly blinkered view is taken by cancer specialists when explaining treatments such as chemotherapy which can also have bad side effects alongside their great benefits. My guess is that it's not.
The survey paints a gloomy picture but let's not be totally downhearted. I asked my son what he thought were the lessons from his 20 years of experience and he said: "Things are better now because it's a bit more inclusive and you feel more part of it all." Something has recently happened which suggests that he's right. His psychiatrist is currently investigating whether cognitive behaviour therapy could be available for him to help change his attitude to food so that he doesn't approach every eating opportunity as if he was starving to death. So change seems to be happening but, in order to extend the lives of our loved ones, please let it be sped up.
For more information about anti-psychotic medication, read Rethink Mental Illness' factsheet. You can also find further information about medications and prescribing on the Rethink Mental Illness website.
For further information or advice, call the Rethink Mental Illness advice service on 0300 5000 927 (lines open Monday to Friday 09:30am-4pm and calls charged at local rate).
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