This post tells more about my experience of withdrawal from the antidepressant, Effexor, and my less than positive experiences in the mental health system.
A quick recap first. At this point in my story I am in severe Effexor withdrawal – I was psychotic, manic, physically ill and volatile. In the space of a few hours I had taken a little sojourn up my local high street in the nude; burst into a community hall of unsuspecting meeting attendees (still naked), scared off an ambulance (partially naked) and been escorted by her majesty’s boys in blue to the local station (fully clothed) only to be told by the doctor that I was fine. Last but by no means least – later that day I physically attacked a dear friend of mine while he lay sleeping.
If you would like to read about how I got to this point, then see my earlier blogs:
Entry into the mental health system – how I came to a point where I needed help from the mental health system and why I first started to take anti-depressants
Induction into mental health system – My first experience of help from the mental health system and how my condition deteriorated as I continued to take anti-depressants.
Sabbatical and re-entry into the mental health system – My time away from psychiatry and the things I tried to improve my quality of life. How and why things went wrong for me and how a severe withdrawal reaction from antidepressants saw me propelled back into the mental health system.
Explosion back into the mental health system – How quickly I became acutely psychotic and manic when withdrawing from my antidepressant – Effexor.
The alternative title for this blog is ‘For goodness sake, will somebody lock her up!’. I will attempt to explain how difficult it was to get me sectioned and the all-consuming devastation that Effexor withdrawal brought about in my mind, body and life. This is also a story about how difficult it was for my family and friends to go through, as we all struggled to accept and understand what was happening to me. I was confused and confusing…
The morning after I smashed my fist into my friends face, was spent with me whizzing around the house – trying to burn most of my possessions, but keeping those items that were imbued with mystical energies. The world was being destroyed, we had messed up and ruined Planet Earth, and humans were now reaping what we’d sown so arrogantly, selfishly and hatefully.
But the good news was that I had an important role to play and some humans were to survive and we were all going to meet up. I had a lot of work to do and not much time, as I needed to turn my home into a sorta good vibe energy magnet defense complex.
Meanwhile, back on the reality channel, my friend was having a rather stressful morning. He was tired and in shock and needed help. He had managed to make a few phone calls, Beener was on her way over and a GP was coming to do a home visit, but their arrivals were a few hours away. It would be a few days before the ‘Community Mental Health Team’ and Rapid Response Team rode into town. And you know what they say ‘things will get worse before they get better’….
My friend tried to encourage me to eat, to relax in the bath, to stop making fires and burning my things. So I sat in the bath, purifying myself with flower petals and magic water – which was actually mass-produced, cheap, gaudy pink, pot porri that I must have found at the back of a cupboard somewhere when ransacking the house. Perhaps it was at this point that my friend managed to reconnect up the various TV wires that I had removed to stop the Freemasons and other ‘bad’ humans from beaming into my house. I was on to them – they were evil and scary and hurt people and did mean things- they had no place on ‘new earth’.
My friends recall now that at first they thought that I had been brain-washed by an online cult. I was saying such strange things and was obsessed with the computer. I had been on the net in the last few months reading about ‘spirituality’ and yogic philosophies. Now, my friends aren’t daft, but to them that seemed more logical than believing that I had somehow just got mental and flipped.
My friend sat me down to watch TV. I sat captivated watching a steam engine program, telling me all about energy lines that had been involved in the time-line that had brought earth to its destruction. How clever of the ‘good’ guys to make a program for me that would explain exactly what’s going. By this point I believed that my friend was somebody else and he was there to help me. This is known as Capgras delusion.
The GP came round and the TV went off. I don’t really remember what he said to me – but I recall that apart from the fact that he looked real strange, he also looked a bit frightened and wary of me. I don’t think he stayed very long, it really didn’t take much time for him to agree with my friend – yep she’s crazy. He left medication with my friend for me.
I was reluctant to take the medication and when my friend did get me to take some it had absolutely no effect. Beener and my friend stayed with me, keeping watch over me and trying to get me to just ‘chill out!!!!’ Nothing I said was making any sense to them and I was having violent mood swings from one minute to the next. I would be sobbing my brains out and then threatening them or trying to attack them in the next breath. No pattern, no warnings. I had super human strength at this time.
I was completely unrecognizable as me, my voice, my facial expressions and my body language. I was scared and scaring people. I threatened Beener with some golf clubs at one point, pacing the room, swinging them around randomly, with a disturbingly ‘evil’ look on my face. A lot of the time all Beener could do was sit absolutely still, as she realised that even a slight movement could be perceived by me as threatening.
The point about all this un-gratuitous description of violence is that it was so out of character. I could sloppily and lazily categorise myself as a lefty social worker type, who does not believe it is right to raise your voice to someone, let alone whack ‘em round the head with a golf club. I was underweight at the time (although I possessed super-human strength during this period) and had a history of being ‘bullied’. I was not known as a particularly assertive person.
My friends were in bits – tired, scared, worried, confused and outta options. The emergency GP was rang again. He hid from me in the kitchen, talking to me as I paced the lounge (there is a hatch between my lounge and kitchen).. He looked a bit scared too, but he was kind and it seemed like he wanted to help me, so I agreed that I would go to the hospital in the car with my friends. I questioned him furiously about this so-called local hospital – I’ve never heard of it, is it real etc. My friends were told to take me to the local hospital emergency department immediately. It was suggested and agreed that an ambulance would take too long. My friends were given a letter and were told that the mental health team were waiting to assess me.
We whizzed down the motorway, me realizing that I was transmitting my thoughts out to the whole world and that everyone could hear them, my friends in stunned silence, hoping I didn’t freak out in the car and not wanting to trigger anything off.
I was seen pretty quick and taken to this room where I was seen by a psychiatrist and a social worker. It didn’t go too well because unfortunately I didn’t like the look of them and found their questions irritating and pathetic. The delusional context was that I had to keep all of my secrets about armageddon so that they would give us some ransom money so that we could go to Maderia and live in the mountains.
They began to ‘assess’ me. First off the Psychiatrist – one of the opening question ‘do you believe that the television communicates with you”. It was all I could do not to laugh – this was gonna be easy peasy! His questions continued and he irritated more and more. I guess I began to smirk at him and later on I was told that I was displaying ‘inappropriate laughter’.
They brought up the Effexor – no, nope, incorrect, I’m not thick I didn’t just stop cold turkey – I withdrew properly – I was already starting to feel very heavily that I was being spoken to like I was a moron and I felt extremely offended by this. At that point I didn’t believe that Effexor could/did cause it – more’s the pity. My friends continued to state (in private chats with the doctors) that it must be that, Beener had been researching withdrawal from Effexor – besides it was inconceivable that I had suddenly gone ‘mental’.
Next up – Mr social worker – talked about my job as a mental health service manager for a bit, discussed my life with me, looking for stressors and problems in my life and my ‘history’. But there were none that would readily explain this, except for the cessation of Effexor. As he spoke to me I noticed his red, sallow face and noted to myself that he was a drinker. I triumphantly told him that I had stopped drinking some years ago and that in fact I was managing my depression and anxiety very well thank you very much (thinking to myself unlike you – you cheeky bugger)!
And so it went on. I smirked at them, they sniffed about for a problem and my friends sat with tears in their eyes thinking she’ll slip up soon and say something or do something gooky. But I didn’t – I guess because I had been trained and worked in the system it didn’t require too much concentration on my part to pull the wool over their eyes. Also I was as far as I as concerned fighting for my life – I couldn’t afford to slip up on my quest.
The upshot of the assessment to my friends disbelief and amazement was that yes I was a bit ‘high, but are you sure it’s not ‘behavioural’. In other words was ‘I acting up’. My friends desperately told them that I was normally a very polite, well-mannered person and not the obnoxious, arrogant creature they had seen. My friends said they couldn’t cope and couldn’t keep me or themselves safe. We were sent away with some medication.
Besides “there are no beds anyway”.
It seems that the treatment that I was being offered, the drugs, were steadily getting stronger. Eventually I was given Largactil, an old medication first used in the 1950s, with a knock out punch effect. Chemically, it is classed as a phenothiazine; experientially and to the observer it is classed as a chemical strait jacket. It produces an effect commonly known as the Largactil shuffle. This is an extremely controversial drug, with many side effects and huge potential for long-term damage to mental and physical health. I was given this drug steadily over the next 24 hours . I am not arguing here that something didn’t need to be done, it clearly did. But that’s where the horror, the frustration and the disgust at the mental health system comes in.
I have several conclusions, observations and realisations about this nightmare scenario:
1) The most obvious and anger-inducing thing is why didn’t any medical people realise that I was going through Effexor withdrawal. If I had started back on the Effexor then, rather than three months down the line, I would have been right as rain (ish) in a couple of days. They had my medical history and I’m told a lot now ‘oh yeah everyone knows Effexor/SSRIs can do that psychosis/mania/bi-polar thing’. Grrrr! lol
2) I continued to race around my little home and garden, preparing for armageddon, despite the Largactil. Over time my body and mind started to slow down – I took 400mg in 24 hours but I was still flying and racing. I was very thin, with no prior experience of tranquillisers – so no habituation or tolerance. Bet you didn’t think Effexor could do that now did ya!?!
3) The fact that I was being given a major tranquiliser without my consent or knowledge. This was largely because I was unable to understand what was going on, although I had also clearly stated that I did not want to take ‘tablets to help me sleep’. My reaction to the mediation was not being closely monitored, like I said it is heavy duty. This was an intolerable situation for all involved. I should have been placed under the provisions of the Mental Health Act immediately. My friend was administering the drugs to me and I was very vulnerable – the potential for abuse was massive…
My mum also came down and was shocked to see the state I was in, again inconceivable to her that this was happening. She is a trained nurse with years of experience of supporting people with mental health problems and administering psychotropic medication. She was horrified at the levels of drugs being chucked down my neck without adequate medical support and monitoring. She was not going to allow this to continue.
I felt safer when she was around – but I was so worried about her – she really didn’t look right – sorta upset, so I carried out healings on her and randomly spoke about things from my childhood to console her, she was upset that I was going to Madeira but I had already decided to take her with me. But in the blink of an eye I was demanding that she go back to her own house – what was she doing here on a week-day morning anyway for goodness sake – maybe she’s betraying me to the Freemasons…
More phone calls…
Eventually, the mental health squad team arrived. They introduced themselves – an approved social worker, a psychiatrist, the GP and a Community Support Worker. I am not entirely sure how the conversation went. I guess I spent the whole time smirking at them, disbelieving that they really where who they said they were – more tricks! I was not acting rationally, I was pacing and raging at them. In my own home I found it impossible to hide my insanity. I don’t suppose it was a difficult assessment to make – insane -tick; dangerous -tick. The decision was made and various little looks and nods went on between them – by the way not a good idea when in the presence of someone who is paranoid. The psychiatrist then looks at me with a faux-concerned voice and face and said ‘what can we do to help you right now’. Her disingenuousness was apparent and clear even through the muddle of psychosis and Largactil – I remember that much and feeling an intense level of irritation, as they all sat there gawping at me, looking edgy. Apparently, I walked over to her, picked up her bag and thrust it at her and told her she could get out of my house. I then frog marched her off the property. Its a shame the Community Support Worker left too, she had made me feel at ease when I looked at her, she had smiled at me..
They hadn’t gone far, just outside the house. There were still murmurings amongst the mental health mob that I was ‘acting out’. That I knew that I was psychotic but was being ‘arsey’ – lol. The psychiatrist, who is apparently an expert on early intervention in psychosis said to Beener that I was very rude! The information from my family and friends about my ‘premorbid’ personality completely ignored. Comments like that did not ease the distress of my mum and friends.
Incidentally, whilst they were licking their percieved wounds, they were missing a vital clue – a complete personality change has often been reported by loved ones of those experiencing severe withdrawal from anti-depressants.
Anyways to me – they were gone – problem solved, I had successfully defended myself from more ‘baddies’, from more bad energy.
Now they had to find a bed and arrange transportation for someone who had clearly stated that she ain’t going nowhere.
A bit more Largactil was thought to be in order there, as there was no-where for me to go. I eventually ran out of steam as I hadn’t really slept for a number of days – ZZZZZZzzzzzzzzzz
A number of hours passed and mental health people sat outside my house waitin… I was sleeping like a baby…
The ironic thing is that just as I was in the middle of this much needed sleep that had eluded me for 7 days, the transport arrived to whisk me off to the looney bin. A large vehicle turned up with 4 escorts and a driver. It was a contract firm, who clearly hired most of their staff on the basis of brawn, rather than being skilled or highly trained in supporting people in emotional distress.
They marched into the house and went up to Beener, leant over her and said (as she recalls) in the most pathetically, nauseatingly patronising voice ‘hello ####, how are you?’
I just wanna say – people who are psychotic/loopy whatever have not suddenly become stupid/deaf etc etc. Just because they’re saying/thinking stoopid/crazy stuff it doesn’t mean they don’t know when they’re being talked down to. If someone is in a florid phase of psychosis, or to put it more clearly if they’re proper crazy and distracted and confused, the best thing to do is to say their name loudly and clearly to capture their attention/divert them from harm or doing a bit of harm. That’s not shouting or aggressively – believe you me, some people do need the basics pointed out! lol. Its an ingrained response from an early age to respond to your name being called – it grabs your attention, a beacon in the fog of muddled thoughts, feelings, voices, visions. It worked on me loads. Also you need to be aware of your body language. Like I say, basics. Dr Iain Bourne is a great trainer in this field and his site has got oodles of research and guidelines for mental health workers when dealing with what he describes as Difficult, Disturbing & Dangerous Behaviour. His definition gives a refreshing emphasis, it is not that the nutter is disturbed so much, rather the focus is on how workers react and interpret things – how they become ‘disturbed’ and react in unhelpful ways. His approach ultimately urges practitioners to understand the perspective of the patient and to work in ways that keep both workers and patients safe.
Anyways, sermon over. The ‘Rapid Response Team’ do exactly what it says on their black people carrier with the black tinted windows and what it says on their lovely coordinated uniforms- there’s a load of ’em and they don’t wanna hang about! The imagery of their company was very reminiscent of the hollywood smash hit film ‘Men in Black’ – the MIBs. But I digress…
I was woken up and told it was time to go. Where I was going, I hadn’t a clue. The social work squad team was a distant memory, a vague mirage. So I hopped in the van. It felt ok because my friend was with me. The radio was on, so I could sing along to the songs in my head and communicate with my dad via telepathy. I watched out the window, as thousands of people were flooding out of the cities of the United Kingdom, aliens had landed and they were fleeing in panic. The ‘baddies’ were all going in the wrong direction. I was being taken to a secret safe place, there’s going to be a party, everyone I know will be there, because I am the saviour of the world. Hang on a minute – how embarrassing! And, I don’t like parties and I’m scared. Luckily the vehicle registration plates had coded messages in them that I understood.
The strangeness of the situation kept me quiet and relatively content except for brief confused conversations: “Yes I want a cigarette, no I don’t want a cigarette, yes. no”. My friend and the ‘Rapid Response Team’ advised me to sleep. But there was no way I was sleeping I wanna see where they’re taking me, besides I’m not tired….
Two hours later, I arrived at a private clinic in London – apparently intensive care for acutely disturbed female ‘clients’, including from within the criminal justice system. At first I thought it was a hotel we were gonna stay in for the night. It certainly cost my local health trust a fair whack of cash, but it took less than an hour for me to realise that this ain’t no hotel…..