The magic bullet

In Hindi the word for a pill is “goli”. Funnily enough, this is also the word for a bullet from a gun. The quickest way to get the help that you need. Rapid delivery of one could save your life, the other could kill you. Medication was my lifesaver.

My first and only admission to an inpatient environment on a section 2 under the mental health act (1983) meant that I was there for assessment and treatment. If I refused treatment this meant that it could forcibly be given to me if deemed necessary for my health and wellbeing. I was there for 28 days until my section was allowed to lapse.

I don’t think I ever really knew where the clinical room was where they dished out the medication. No one had shown me, so I didn’t know. I was lost in my own thoughts. My family told me it was fed back to them that I was refusing to have my medication.

A mental health nurse must have explained my rights to me as a patient under legal detention and mentioned how I could appeal the decision. I became fixated on the appeal process, that if I appealed within a certain timeframe I would be able to take the people who were against me and who were hiding important knowledge about the government to court. I clearly did not have the mental capacity to understand what the appeal process meant and that it was actually about appealing my legal status as a detained patient. Every piece of paperwork I had to complete for the nurses fed into my delusional beliefs. I definitely needed to be in hospital, even if I didn’t think so at the time.

One day I was walking through the ward that was made up of a day area, TV room, dining room and doors to patient rooms. On each door in the top right corner there were numbers. These numbers were a code that I had to break to get out of hospital. I would figure it out. It seemed like a game and that I had been put in hospital by people because I knew too much about the outside world and this was to be the cage in which I was confined.

My mind was racing. They were all against me. They would keep me here forever. I would end up in a vegetative state if they gave me the medication the other patients were on, who were all so slow, lethargic and over medicated.

I suddenly threw the papers on the table up in the air and started screaming and shouting and rushing around. In the next five minutes there was an influx of staff onto the ward. They were all around me and I was ushered to my bedroom. I was struggling, I didn’t know why they were there or what they were going to do. I felt like everyone was watching me like a zoo animal. I felt caged and unsafe. One of the nurses injected me with an intramuscular injection (rapid tranquiliser) and I immediately drifted into a deep sleep.

Over the next few days things would dramatically improve. The magic of medication is undeniable. It works fast and thought to reduce the level of dopamine, a neurotransmitter that transmits signals within the brain that may be responsible for psychosis.

Psychotropic drugs have a global effect, according to psychiatrist, Moncrief. They do not specifically target the dysfunction in the brain chemistry thought to be responsible for the disorder, despite what the pharmaceutical companies say. They do a whole lot more than that. This means that although we think of drugs as only having their intended therapeutic effect they also have other effects, which are labelled “side effects”, but these are a part of what that drug does and not separate from it.

My paranoia and delusional beliefs became less easy to access without realising and my head felt lighter as though a huge weight had been lifted off my shoulders.

The medication also affected certain pathways in my brain that made me sleep better, which I hadn’t done for a week now. Sleep is important for a stable mental state so this was much needed. I was also less hyper-vigilant, less on edge and less alert. The medication also increased my appetite, so I ate properly which was also good for my health as I was malnourished having eaten poorly in Thailand.

I think generic psychiatric nursing notes on me towards the end of my stay would have read as:

“Calm and settled with less evidence of psychosis, no delusional thought content, more insight and no impulsive behaviour. Coherent in speech content and normal rate, tone and volume. Appropriate engagements with staff and peers. No suicidal ideations, plans or intent. No risk to self or others. Compliant with medication and eating/drinking and sleeping well“.

The ideal scenario for discharge.

Medication was the magic bullet I needed to propel me onto my journey to recovery. Before this state I would have been happy to put a “goli” in my head but instead medication had helped save my life.