Wednesday, January 22, 2014

Tales from the schizophrenia ward - Part III: Haldol - Part 2/2

Once I got to the schizophrenia ward with my fancy new "paranoid schizophrenia" diagnosis things started to get really weird. The medications I had taken to this point were all designed to combat an anxiety spectrum disorder, which obsessive-compulsive disorder is. (Prior to OCD I was diagnosed with generalized anxiety disorder, some of the meds from that time were carried over.) Took a bit of mirtazapine (known by the brand name Remeron in the United States, Remergil in Germany), an antidepressant and downer supposed to calm you down, a bit of fluoxetine (Prozac), another antidepressant that's supposed to help with OCD, a bit of olanzapine (Zyprexa), an antipsychotic with strong sedative properties, for the same purpose as the mirtazapine, and a bit of pregabaline (Lyrica), an anticonvulsant which in Europe is indicated as an anxiolytic. None of that really felt to have any effect, mind you, but I'm trying to illustrate here that before the whole schizophrenia nonsense started, doctors had me pretty clearly tuned to an anxiety disorder.

So I meet the head doctor for the first time, he looks at my new diagnosis with his trademark "why do I have to deal with this vermin?"-look, looked at my then-currennt regiment of medications and basically told me that I shouldn't take all that stuff because I have paranoid schizophrenia, and that I should take stronger antipsychotics instead. Okay, at the time I didn't put up much fight, as you could read in part 1/2 I was in a pretty wrecked state of mind at the time, so I agreed to his recommendation, after all, he's a doctor, right? The first few weeks I was supposed to phase out all the medications I took at the time since they were all claimed to be totally wrong for me, then start a new medication called Fluanxol (flupenthixol), sounded reasonable enough at the time.

Many weeks passed phasing out all that stuff I had been taking. First the antidepressants, which went quickly since you could basically take them out rather abruptly, then many weeks phasing out the pregabaline, which was physically addictive, so you had to go small step by small step to avoid major withdrawal. It was about a month-and-a-half, but finally I was down to only the olanzapine. I may have been ready to bash my skull into the wall out of utter boredom, but after a long wait it seemed like I was nearing the end.  So I went to see the head doctor again, and was ready to begin my switch to that Fluanxol stuff, which didn't seem all that bad from what I had heard from other patients. So friendly Doctor "god, will someone please euthanise this filth?" looked at me, looked at my file, and his words were something along the lines of "Well, we said we were going to try Fluanxol. We will have to try to see if you respond to potent antipsychotics at all. So I recommend you start taking Haldol."

Wait, what? Time-out for a second here. You are going to test if I will respond to the Fluanxol by giving me Haldol? What about testing if I will respond to the Fluanxol by giving me Fluanxol? Wouldn't that make a little more sense? No?

Naive questions aside, "doctor knows best", I suppose, and he made it pretty clear that I would be sent home with nothing if I didn't agree to his recommendations. So I started taking Haldol. If you have read part II of this series, I have already begun to get a bit into what that medication is and what that medication does in there, but I'll recap for those who haven't read it. Haldol, essentially, is the off-switch to your humanity. On Haldol, you are not human anymore. You are a shell of a human, a sort of breathing mannequin with no thoughts, no emotions and no capacity for understanding the world around you or for the world around you to understand you. There really is nothing for you to understand, though, because not only can't you process what little impressions you get, you don't care that you can't, either. And there certainly is nothing for the world around you to understand, because there is nothing inside you. Someone picked up a remote and switched you off. You're in standby mode, now. Nothing is happening.

I knew this, and I didn't resist. Because my thought process at the time was that if I took the Haldol, which I didn't want, the mere thought of which I hated, and proved to the doctor that I'm not psychotic anymore after taking it (assuming I ever was), then he'd switch me to the Fluanxol and I could be sent on my way with maybe a better medication than I had when I entered the clinic. So basically a clear-cut case of taking one for the team, with the team being my misfiring neurons in this case. Suffice to say I was scared shitless before taking the first dose that evening, and had one perpetual panic attack from the time I took the pill to the time it started working.

Once it did work, and I was at a very low starting dosage, I knew instantly that this was not what I wanted. Everything felt so wrong in every possible way, and my previous train of thought of "taking one for the team" as I put it above to score the Fluanxol afterwards (which may not have been any better) became invalid, I just wanted it to stop before it got any worse. The next day I complained to the nurses about the Haldol and that I didn't want to take it again, but they left me no choice (blackmail, again), and instead advised me to take a medication called Akineton (biperiden) in addition. It's an anti-Parkinson's medication that supposedly decreases the side-effects of potent antipsychotics. It didn't do anything. What I did manage to convince the staff of was to at least give me a milligram of lorazepam, a benzodiazepine (sedative) to somehow keep my shit together, because I was extremely stressed out by what felt like my brain dissolving and liquefying. It needed to stop, and I did not know any way out other than to put on a smile and lie to the doctors that I felt much better, because otherwise they would not have let me go, and would most likely have increased my dosage.

So I lied, and they bought it, and I was sent home, and the Haldol experience quickly ended.  It was short, and I was on a low dosage, so I got off easily. What stuck with me were two things: 1.) Just how readily they give that horrifying poison, and 2.) As I witnessed from other patients in the ward, that most of the time, they don't stick to a dosage as low as mine and don't let people go as easily as me. As I'm writing this, I know for a fact that on the ward I was at, right now, there are most certainly a number of patients on a high dose of Haldol. In the entire clinic, there most certainly are dozens (about 500 beds in the clinic if I recall correctly.) In clinics across Germany? Thousands. And does anyone in society give a damn? Not even the doctors have any scruples about it, neither do the nurses, and they actually see the results. How would society care if they have never seen the results? Ninety-nine percent of them do not even know that this is happening, or what Haldol even is.

Or that one day, this may be done to them, or their loved ones.

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