Public Comment

The akathisia comes and goes. It is at its worst two to three hours after taking antipsychotics. But sometimes, the episodes of unbearable "motor restlessness" (as one psychiatrist termed it) have been hard to predict. Akathisia has been my acquired normal since 1984, the first year that I was consistently medicated. To describe it: It is a feeling that I want to jump out of my skin or jump out of my seat and do a crazy dance. It is an agonizing and unusual type of physical suffering. For many years I was able to eliminate this sensation through mindfulness. But in the past ten years mindfulness hasn't worked, and I've gone down a notch or two, into just tolerating it and waiting for it to wear off. It seems unavoidable and it is the normal consequence of antipsychotic medication. But the alternative is worse. 

When I am by myself, I can flail my arms wildly and get a little bit of relief. If I'm in private and no one is looking at me to call me a crazy person, it won't do me a bit of harm to flail my arms, unless I do this too hard and throw out a shoulder. 

As far as I'm concerned, taking psychiatric drugs is a non-negotiable must. But it also sucks. 

Unchecked psychosis is the outcome of medication noncompliance. And that's absolutely not acceptable. Medication is the primary treatment and it's an utter necessity. I am sixty years old, and I've had a psychotic disorder my entire adult life. By learning the hard way, I have learned about what does not work. 

I am not "a psychotic", I am a human being who suffers from psychosis, and I am an actual person with feelings. I'm capable of suffering, of fear, and of outrage. And I'm capable of love. And love heals, and it sustains a person through life. 

And referring to a mentally ill person in degrading terms, such as "a psychotic", or "whacked", or "a Prozac" is offensive and should not be socially acceptable. President Trump, when he campaigned, referred to us as "the crazies", and this is offensive. And now he's our President, which makes me apprehensive about bringing his attention to mentally ill people if he reads this. But life goes on, regardless of who we have as President, and we must work with anything that currently exists. 

Off medication, delusions ultimately take over the helm of your consciousness. A psychotic episode is like being in the path of a tsunami. By this I mean that my mind would be subject to overwhelming forces that are far more powerful than any mental exercise or any cognitive attainment. If you seek Buddhist-type attainment, you should know that attainment rests on functioning mind as its foundation. You could become enlightened and then stop medication, and then you would nonetheless become severely ill. And then when you are back on medication, the attainment is erased. 

The psychotic condition itself is out of this world, not in a good way. The mind accepts unusual beliefs, beliefs that have no sense of reality. You lose the ability to discern nonsense thoughts from accurate, useful thoughts. You start to live in an internally generated, fabricated world, and consciousness is connected to the unreal and not to the real. Psychotic people may barely be connected to the five senses. One's thinking, which has become inaccurate, takes the main stage in the auditorium of consciousness. 

Is a mentally ill person dangerous? They can potentially be dangerous if the symptoms go untreated. Active psychosis not kept in check by medication causes a person to have the potential for harm, whether through violence or through incorrect perceptions brought about by delusions. That's why the standard for an involuntary hold in California is where you are a danger to yourself or others, or if you are so bad off you can't care for yourself, "gravely disabled." 

The solution, which is that of getting a mentally ill person to accept medication, is mostly within the hands of the mentally ill person, and this can mean a huge obstacle to recovery and to salvaging one's life. 

Mental health activism at one time consisted of making mental health treatment voluntary and giving patients choices concerning being medicated. Many mentally ill young people in the past, had the tendency to make mistakes that affected others, leaving an innocent bystander in a position of cleaning up the outcome of the psychotic person's chaos. This could affect parents, if the patients' parents were still living. It could also affect people's businesses. That's probably a reason that laws have become increasingly restrictive. 

Mentally ill people, especially those of us with psychosis, need to have the illnesses addressed, and this is done with medication, like it or not. Conservatorship is one method of forcing a patient to go into treatment. This is and should be a last resort. Yet, we must not have innocent bystanders losing their lives because of a person with untreated psychosis. Being in treatment is no fun, but we have to live with it. 

Life with bipolar or psychosis is hard, no matter who you are. If you live in poverty and in a situation of being told what to do, this adds to the displeasure. I advise doing anything you want to do to better your circumstances or even to comfort yourself, so long as it's not illegal and doesn't involve abuse of oneself or others. Reading on a Sunday afternoon, any reading you want, would be one answer. 

Jack Bragen is author of "JACK BRAGEN'S MID 2025 SCIENCE FICTION COLLECTION, FOR KINDLE", and lives in the East Bay.