Society's Lowest Caste: the Mentally Ill

The following is a true story, one of many, about how the mental health care system ignores, rejects, and hates the mentally ill. I am schizo-affective, a member of the lowest caste in society; the Untouchable. The following story takes place in a city in California about 4 years ago. I have no criminal record. I don't even have a speeding ticket. And no, I would never hurt anyone who isn't physically in the process of beating me up or assaulting me. I am well-behaved. I am schizo-affective. I am an Untouchable of this society.

4 years ago------

"I need medicine," I told the woman behind the plate glass barrier.

"Talk to your doctor," she said, turning away.

"I missed my last doctor's appointment and they used that excuse to kick me out of the county program."

"Talk to your case worker," she said.

"I have no case worker. I have no doctor. I have no money because nobody will hire me. I am too manic to work, been manic for a while, no sleep the whole week. Please let me in, this is the only way I can get medicine," I pleaded.

"There's no room," she said.

Mind you, she is behind a plate glass barrier in a psychiatric triage room. I am on the Outside, two feet away from the door to a barren world that despises me and makes me feel that my persecution delusions are not delusions at all but reality. 

Behind her, a male nurse shook his head. 

"I know her. She just needs her doctor. She's fine," he said. Turning to me he said, "GO TAKE YOUR MEDS."

"What meds? I haven't had meds in months. They won't see me, they won't give me treatment and the pharmacy won't give me the pills either because I have no insurance and doctors always prescribe the 700 dollars a month anti-psychotics," I told him. I then began to jabber on about what the voices were telling me. I told them all the horrible names they called me, the fact that I believed I was going to be renditioned, tortured, killed, brought back to life, tortured, killed, my whole family would be tortured and killed, the entire constitution had been overwritten, there was a mass conspiracy to psychically drive me into committing hara kiri....I told them that I was going to kill myself by slitting my wrist with a knife I bought for the purpose of slitting my wrist.

"Jesus Christ just TALK TO YOUR DOCTOR," the male nurse shouted. I walked out into the World, unmedicated, floridly psychotic, suicidal, and abandoned by the medical system and by doctors and nurses who vowed to uphold the Hippocratic oath. 

Later that week, I was still psychotic. I went to the outpatient treatment center that had previously been treating me. They sent me to a county mental health crisis center. The mental health crisis center was humorously located behind a "WALK INS ONLY" sign. I walked in. 

"We don't take walk ins."

"How do you get an appointment," I asked, apparently an idiot, as the women behind the counter were rolling their eyes.

"You walk in," she said. I was starting to feel like I was in backwards land.

"Okay. I'm a walk-in. I need to see a doctor."

"We can't take walk ins now." I was biting my lip. I was dealing with voices, visual hallucinations, thugs on the streets who were very aware that I was vulnerable and probably wouldn't be believed by cops if they robbed or assaulted me....here I was, I could see that jerk doctor in his room, shuffling papers, his Rx pad only feet away....these women were part of the Evil System. I began to realize that the only people getting treatment were the ones who walked outside naked to get their coffee from the corner store. Seeing as how I preferred to get my coffee fully clothed, I chose the next best option. I went back to the outpatient center.

At the outpatient center they attempted to turn me away, again. I decided to die. In fact, while I was killing myself, why not do it like that Buddhist monk who set himself ablaze in front of cameras as a form of protest to an unjust system?

"I am going to kill myself if you do not put me on anti-psychotics right now," I said. The woman grimaced, shut the little window, reopened the little window, and said, "You have to go through the county crisis center."

"Okay, I just wanted you to know that I am going to be slitting my wrist right here now." I was in an empty waiting room. The nurses were all behind glass barricades and doors with alarms. I didn't want to hurt anybody except myself because I was tired of the Catch-22 that is the Evil System. So I started to slit my wrist. My intent was to get to the bone and be done with this life, with this hateful Evil System...with everything. I just wanted the staff (SAFE behind the barricades, mind you) to remember the day they turned away that schizo patient who then lopped off her hand right in front of them and died a terrible death. It would be my hara kiri. My way of setting myself ablaze. I had actually thought of self-immolation but I was afraid the fire might get out of control and damage the building. So, I opted for wrist slitting.

They watched. They finally called an ambulance once the blood started to appear. I put the little cutting utensil through the slot below the window and watched it slide into the staff's side. Most times, a pen or a paper is slipped below the window. Today  it was my life.

The ambulance guys then came, tied me up to the gurney, and complained that REAL sick people had to go to the hospital and that all I needed was to see the DOCTOR who was right in that same building. They looked at me with scorn, derision, and barely concealed hatred. Whatever, I thought. I am Untouchable. I am a disgrace. I am a sore on society. So be it. As they drove me to the psychiatric facility, still talking about what a waste of an ambulance trip it had been, I started giggling. They shook their heads with unspeakable disgust.

"WHAT?"

"You wouldn't understand," I said, trying really hard not to laugh hysterically. To this day, I will not say what made me laugh. 

Believe me, reader, if I could go to the moon and start a colony with my schizophrenic and bipolar brethren, I would. I do not like being an unnecessary burden to you or the rest of society. I did not go into my own DNA strand as a fetus and make my own DNA defective, nor did I commit any felonies. I was just born with DNA that causes my brain to perceive what is not there for the rest of you.

I suggest that society either make jobs for the nutcases so they can afford their pills or craft a gigantic spaceship to send us all into outerspace so we can start a planet of our own, because obviously affordable health care will never be a reality, at least not in the next 75 years. No, euthanasia is not an option.

******************************************************************

4 years after the previous story:

I get medicine

I get therapy

I complete my Bachelor's degree

I volunteer places

I get a little book of erotica published

I get a boyfriend

I get a 3.6 my first semester in my Master's program

I get ready to move to Sweden as an emigre if worse comes to worse. Why Sweden? They seem sensible, which ironically, the current state does not appear to be.

I get a little blog up and running where I can leave my cyber footprint for everyone to see. This is my biography. This is my graffiti markings. This is my ultimate retribution---I can be disgraced but my soul is intact. Plus, I have a plasma TV. That is more than a lot of people have. I earned my plasma TV by studying so hard I was honored with merit-based financial aid. 

Now if you will excuse me, I will now watch PBS on my Plasma TV and devise strategies to make a living and donate half my earnings to NAMI. Tata.

On weight, anti-psychotics, suicide, and metabolism

I have found an interesting and entertaining documentary concerning the existence of obesity. I hope that you already know why so many people are obese: the obesity gene began as a way of our early ancestors to survive through periods of famine without dying. A thin person would simply die, but an obese person would be able to live off all of their stored-up fat and still be able to bear children. This kept the human species alive for hundreds, if not thousands of years. Then, with the advent of food and medical technology, being obese was no longer an evolutionary advantage. Being thin became an advantage, especially a social advantage.

This documentary is available for free streaming on top documentary films dot com, and you can also find it on youtube. It's called "Why are thin people not fat?" Here is the link:
http://topdocumentaryfilms.com/why-are-thin-people-not-fat/
In this film the audience follows a group of naturally below-average-weight individuals who are put onto a daily caloric diet more than twice their previous diet. You may have heard of a previous experiment like this one. Prior to this film, there was a 1960's prison experiment where prisoners were allowed to leave prison early if they could get fat--some ate up to 10,000 calories a day (versus the 2,000 recommended caloric intake for males), and to the researchers' surprise, some failed to get fat.
The researchers in this documentary are looking into why some people can get fat and others can't. It's a very interesting watch, and I, as a thick woman, feel a little vindicated to finally see media that says people are genetically different, not just their genes but their metabolic rates as well (metabolism=how fast you burn calories, be it through exercise or transformation of calories into heat).

For myself I know what makes me fat: 1) hypothyroidism, which is a slowing down of my metabolic rate combined with low body temperature. This means that I can't burn off fat by converting it into heat because my body remains at a cool temperature. Also, the ability to burn off those calories through exercise is difficult, due to my slow metabolism.
At the moment, I'm not on synthroid, though I was in the past, due to the fact that health care in America is a murky swamp of paperwork and employment through which one must wade into to get the health care you need. Being unemployed, this makes health care impossible. Free clinics get booked so quickly that there is a 6 month wait period to see a doctor in the Central Valley of California where I live, with no guarantee that you're getting adequate health care. Now that I'm a student, I plan on making a trip to the campus physician to get my long-postponed prescription to treat my hypothyroidism.
2) Anti-psychotic medications, which I need to treat my schizo-affective disorder . Yes, I'm mentally ill, but you wouldn't be able to tell unless I'm acutely psychotic, which isn't that often off medication and doesn't happen at all on medication, so don't stigmatize me---I'm not a psychopath who goes berserk on innocent people. I also don't wander around town shouting obscenities; that's a different disorder. Nor do I accost random people to spout conspiracy theories, curse at them, or whatever preconception you have of mentally ill people. I just have different perceptions which scare me. But back to the topic: zyprexa pills are much like snicker's bars in that you will pack on weight if you eat one every day. I was on zyprexa for about a year, so imagine that. Hence, how I went from a moderate size 5 to a size 16 in less than five years. There is still research being done on why anti-psychotics cause extreme weight gain, some of which I believe (my opinion here) that some of the findings are being kept in the dark due to pressure and financing from major pharmaceutical companies. If you think that sounds like a paranoid talking (and, well, I am) then you should google Zoloft  and suicide risk and read the studies that were withheld until the relatives of suicides came forward and sued the pharmaceutical company for not disclosing that Zoloft increases the risk of suicidal behavior, especially in the initial period when medication is first taken.

Having just lost a cousin to suicide, I was not surprised to hear he was starting medication for depression. Frankly, I think the doctor and pharmaceutical company are liable for my cousin's death, but it's not my call at the moment. Plus, I'm still in mourning and I don't feel like thinking about who is to blame for the suicide of a 24 year old male with no history of suicide attempts (most suicides have a history of botched attempted suicide, they usually don't just kill themselves out of the blue). But now

I'm getting angry, so I'll change the subject: anti-psychotic medications made me gain weight. No, it wasn't lack of self-discipline or lack of exercise. I ate what I ate before. I admit, I liked pizza before and after my new medication, but I had never packed on more than 5 pounds for this indulgence. So I ate what I ate before, did my usual running before work, walked for miles during the day, and boom! 50 pounds settled on my short frame rapidly. Suspiciously rapidly. I had never had a problem with my weight before Zyprexa and all the other drugs I've been on (Geodon, Zoloft, Seroquel, Paxil, Zyprexa, Risperdal, Abilify, Zoloft-generics, and a host of others whose names I've forgotten). The moment I started taking the pills I began to plump up so quickly I began to think of myself as a puffer fish, you know, that one fish that expands into a balloon when you frighten it. ( image:http://www.google.com/search?q=puffer+fish&hl=en&biw=1280&bih=576&prmd=ivns&tbm=isch&tbo=u&source=univ&sa=X&ei=BLEjTq-NPIHkiALCuLzOAw&sqi=2&ved=0CCsQsAQ)

Now, having been on heavy anti-psychotics off and on from the age of 23-24 to my current age of 28, I have found that every time I get OFF my medication I immediately begin to slim down. Several years ago I went off my medication, lost 15-20 pounds in a matter of months, got a little zealous, began a starvation diet, lost another 15 pounds, then, unsurprisingly, went mad, got quarantined in a psychiatric facility,  was forced to take weight-gaining anti-psychotic medications, along with having my diet monitored to the point where I was not allowed to leave the cafeteria without eating a certain percentage of my plate, and gained all my weight back again. I was so close to weighing 125! So close. But then I would have been a slim nutcase and the county psychiatrist thought that would be a liability.

So I learned that I must have some sort of borderline diet crazed mentality in order to reduce my pudgy body to a moderately overweight frame if I plan on being compliant with psychiatric treatment. Being both hypothyroid and on a steady diet of multiple psychotropic medications, I am competing with a natural propensity towards obesity, so the best I can do without developing a severe eating disorder is to be slightly overweight---and even that requires a minimalist, sugar-free diet mixed with excessive exercise and the high-end anti-psychotics that claim to have less side effects.

Here's an example of a typical diet day:
no breakfast.
If I eat breakfast it's always half a cup of yogurt. I then drink about 3-4 cups of coffee to keep me energized until lunch.
Lunch=small plate of zucchini with lots of spices to trick my taste buds into believing I'm eating something delicious, + 1-2 cups of chai (tea with milk). Snack=nothing.
Dinner=small portion of whatever I want. This can be more zucchini, but usually it's something a little greasier like a handful of home-made cumin fries with a salad or veggie burger with a piece of buttery garlic bread. I then drink 3 cups of tea to trick my body into feeling totally stuffed, and into bed I go. I wake up, weigh myself, and spend the rest of the day going to class, caring for my grandmother, doing my homework, and hunting down either a salad or a cup of coffee to chase away the hunger.

If you're wondering why I eat fries, the answer is simple: they taste good, they're everywhere, and I will cave in and binge eat if I abstain from eating comfort foods for more than a month. Sugar I don't like, and I rarely eat cake or ice cream unless it's my birthday or my relative's birthday, but butter---that's my achille's heel. So I eat it in moderation and not every day, or week for that matter. But when I do eat it, I feel guilty. Right now, there's a box of garlic bread in the freezer that is singing siren songs to me, but I already ate dinner so I must boil 4 cups of tea and drink until I feel full. Yes, this vegetarian, chai diet actually works: I've lost somewhere between 12-20 pounds since I started it this April. I can't be exactly sure since I didn't buy a new weighing scale until May something, and the initial weight loss occurs very quickly at the beginning (and then slows down...), but I do know that a month ago I weighed 179 and my weight this morning read 169. I can now fit into a size 14, but just barely. Oh yeah, on top of the diet, I walk to and from the bus stop (30 minutes each way) all week long, plus one hour of continuous power walking every day, plus 20 minutes on a rowing machine three times a week, plus 10-15 minutes of using a 10 pound weight one to two times a week. All this...and still on the borderline between overweight and obese. On the plus size, my internal organs will be in great shape in time for the beginning of my new judo class this fall semester, even though I can't wear a bathing suit because I'll still be too fat.