My present psychiatric diagnosis, is schizophrenia (due to hearing voices and so-called social withdrawal) with occasional depression. This diagnosis is somewhat incomplete, as I also sometimes suffer from mania, where I get very elated, have racing thoughts, and occasionally can't sleep for a whole night. Very occasionally, I don't sleep for two whole nights and days, and on these occasions, I get a burn-out effect of severe depression causing anxiety, and where the anxiety and stress again prevents me from sleeping. Then the severe depression and anxiety, co-exist alongside each other, with one exasperating the other, and thus making me more depressed and more manic or anxious.
On these occasions, I am both very mentally alert and anxious, and yet very tired at the same time, as the severe depression and anxiety, overlap at different times, although the mania or anxiety still seems to be the overall overriding factor. As a result of all of this, psychosis can arise, as the mental alertness and anxiety resides in my sleep, and the sleep or dream-state of mind, starts to manifest itself in my waking consciousness. It is on these occasions, that I find it very hard to sleep much at all, and it is then, that I sometimes experience negative and intrusive hearing voices, and some delusions.
On these occasions, when I am very depressed and anxious at the same time, I need to get short durations of rest or sleep during the day, and gradually increase the durations, and then go to sleep fairly early at night, and sleep more or less right the way through until the morning. I need to get an hour to three hours sleep during the day, to make up for some of the lost sleep at night. I have had manic-depressive, schizophrenic, or schizo-affective psychotic breakdowns before, in 1991, and in 2000, when on both occasions I was first admitted, and then went freely into psychiatric hospital, roughly for a few weeks on each occasion. I have also seen another patient, in 2000, in psychiatric hospital, who was going through very similar experiences to me, and who I tried to help.
The second time I had a breakdown and was hospitalised, I was sedated by 10 mg of Olanzapine, and which decreased the mania, anxiety, stress, and negative and intrusive hearing voices, and which also helped me sleep, but the first time I was in psychiatric hospital, I was not sedated, as I was just on a fairly low dose of 8 mg of Stelazine, and which wasn't a very strong sedative. As a result of this, and as a result of being made to stay awake all day, I had to undergo a lot of unnecessary suffering, and which could very easily have been prevented and avoided, if I was treated more effectively, appropriately, and humanely.
Psychiatrists need to realise, that people who are suffering from a manic-depressive, schizophrenic, or schizo-affective psychotic breakdown, are in great pain, distress, anxiety, and stress, and need an anti-psychotic drug which also sedates them, or a sedative along with their anti-psychotic medication. Psychiatrists also need to realise that these patients, very much need short and increased durations, of rest and sleep during the day, in order to reverse the manic-depressive, schizophrenic, or schizo-affective psychosis - to make up for lost sleep - and to ease their way back into a sound and well-balanced sleep pattern. Most psychiatrists and psychiatric nurses, now realise this, when a patient is admitted to psychiatric hospital, for the first few days, but sometimes these patients are prevented from short durations of rest or sleep during the day, and from the moment they arrive, and which slows down the recovery process and good sleep patterning, and which also prolongs the psychosis. .
My present psychiatric medication is 3 mg of Risperdal a day for hearing voices. Risperdal is fine for hearing voices, but in any dosage, it is not an effective sedative for the mania or anxiety I sometimes experience. I was taking Olanzapine before I was changed onto Risperdal, and which did sedate the occasional mania, anxiety, or stress, and help me sleep, as it is a strong sedative, but I had to come off of Olanzapine, because it can cause or increase diabetes and weight gain.
I very much need my psychiatrist, to make a prescription for me, for a sedative, so I can take it when the need arises, and to arrange this with my GP, to be added onto my regular prescription, so I can put a tick next to it, and collect it from the chemist as the need arises. I have requested this twice before, but all that has happened is that my Risperdal dosage was increased, as it was still believed by two separate psychiatrists, that I was experiencing stress and anxiety due to schizophrenia. This also means, that the psychiatrists need to add to my current diagnosis, from schizophrenia with some depression, to schizo-affective, and so I am treated and medicated humanely and properly.
I saw my psychiatrist recently, and gave him a letter explaining the main points of all of this. His first response, was to say that I was not schizo-affective or experiencing mania, and that he had seen no signs of these symptoms in me. I commented that when I am manic, he isn't there with me to see me, and that he would have to live with me, or experience what I do, to see signs or symptoms of mania. He said that I wasn't manic, because mania has three main aspects to it: 1. Motor movement symptoms, 2. Mood symptoms, and 3. Thought symptoms. I explained to him that I did have racing thoughts, elation, and restlessness when I am manic, and when I can't sleep for a whole night or nights, but he said that I don't have manic motor movements, and that the racing thoughts, elation, and restlessness were caused by the Risperdal that I take, and that I still didn't have all three components to mania.
My psychiatrist then said, that I suffer from neither classic manic depression disorder nor classic schizophrenia, because I had a lot of insight into my mental health problems, and that most manic-depressives and schizophrenics have no insight into their own mental health problems. He said that I was suffering from a mental illness because I hear voices, and that I also suffer from stress, and from the side-effects of the Risperdal anti-psychotic medication that I take. In response to my request, he has now prescribed me a sedative (1 mg of Lorazepam), to be added onto my repeat prescription, and to be used as the need arises, and he suggested that he doubled the strength of my sleeping tablets, and which I have agreed to.
So it is the case that me and my psychiatrist, have a fundamental disagreement about my diagnosis. I say I sometimes suffer from mania, and he says that I don't, but that I suffer from a mental illness and stress. One criticism I have of some of what he said, is that he is taking a very textbook, extreme, black and white thinking view, of what is mania and what isn't, because there are various degrees of it, but I think that I do get the occasional manic episodes or cycles. I am prepared to admit that I could be wrong, or that the mania is actually something different, like stress, as he suggests, but he never says that he doesn't know, or that he could be wrong. He is a bit of a know-all, and always thinks that he is right. He can also never seem to agree to differ with me, but instead seems to militate against what I say, if it is different from his own opinions and explanations.
The other main criticism I have, of some of what my psychiatrist said, in our latest session, is that I don't have classic manic-depression or schizophrenia, because I have a lot of insight into my own mental health problems. I agree with him, that I have a lot of insight into my own mental health problems, but it is not just insight about my own mental health problems, but also based upon my observations and interactions with other psychiatric-diagnosed people. I am also able to be receptive, to the mental health problems of others, and internalise their thinking-patterns or similar experiences, so I can learn about this, teach others about it, and understand and help them.
The other point, is that there are reasons why most psychiatric-diagnosed people do not have insight into their own mental health problems, as they are discouraged from doing so by most psychiatry, social work, and the mental health system. The rule of confidentiality, is often misused to prevent people from seeking the causes or influences to their mental health problems, and for finding solutions, and from sharing their experiences, and learning and teaching with others. Most psychiatric-diagnosed people, are encouraged to be very selfish about their mental health problems, and to remain very ignorant and secretive about it, including many of those diagnosed people, who see themselves as outspoken users of services, or psychiatric survivors.