Lionel sat in his dark brown Lazy Boy and took comforting puffs off his pipe. He began to think about his son, Garry. He hated to admit it to himself, but, at times, he tried to forget that Garry even existed.
Garry had just turned twenty-eight. He had often lived with his parents for brief periods of time. Garry would leave the home, temporarily, when he decided he wanted the freedom of living in his own apartment. At other times, living with his family would become too stressful.
Things would usually become intolerable when Garry decided that either there was nothing wrong with him, or that he thought he was cured from his schizophrenia. The positive symptoms of schizophrenia such as hallucinations and delusions would start to manifest in a few days after Garry stopped taking his medications. As these symptoms exacerbated Garry would frequently experience a complete psychotic break.
During his last psychotic break Garry went running up and down the stairs screaming that he knew that both his parents were reptilian creatures from outer space and that he could see them changing from their human forms into their reptilian forms. He would then try to place phone calls to the CIA and FBI to inform them that two aliens were living in his house.
The last time this happened Garry went outside the house to the street. He stopped cars to warn them that his parents are aliens and even knocked on their neighbors doors to deliver the same message. One of the neighbors became very afraid and called the police.
In a few minutes the police arrived at the Hardy’s door. Garry had walked a short distance, a little further down the street, and was still trying to stop cars and warn the neighbors about his parents. Two police constables arrived at the family home and spoke with Lionel and Edith Hardy for a few minutes.
“Our son, Garry is very ill with schizophrenia. He must have stopped taking his medications and is experiencing a complete break from reality,” Edith explained.
“That’s right,” Lionel interjected. He is having hallucinations and delusions that are telling him that my wife and I are reptilians from another planet.”
“Thank you,” the female constable said. Constable Myers and I will restrain Garry, as gently as possible, and take him to the hospital so that he can be promptly treated.”
Garry was medically stabilized at the hospital and would be ready for release in about five days. This situation created a moral dilemma for Lionel and Edith Hardy. They were both in their sixties and had to deal with the stress of Garry’s medical condition for approximately ten years. The cycle had repeated itself too many times. Garry would experience a psychotic break and would be released by the hospital into their care. Garry would be compliant with his treatment plan for a couple of months and would take all his prescribed medications as directed by his psychiatrist. The positive symptoms of his schizophrenia would either not manifest or be greatly reduced in intensity. The negative symptoms of the disease, however, would still be prevalent. Garry would have very little energy and would sleep until the late afternoon.
Garry would be very lethargic and not be motivated to do much but sleep, smoke cigarettes and drink coffee. During these times Garry’s parents found that they were still able to manage living with him.
Then after a few months Garry would decide that he no longer needed to take his medications. He would lie to Lionel and Edith and would tell them that he was still taking his pills. After a few days off his meds, Garry’s positive symptoms of schizophrenia would manifest once again and he would suffer another psychotic break. This crisis situation would necessitate another trip to the hospital to have Garry’s medical condition stabilized.
Lionel and Edith talked the recent incident over and came to the conclusion that they could no longer tolerate Garry’s residing with them. Lionel called the hospital to set up an appointment with a social worker to discuss alternative housing options for Garry when he was released from the hospital this time.
Chapter Twenty- Four:
Dr. Lionel Phelge had just got out of bed on a Thursday morning. As usual he was feeling groggy due to drinking a couple of shots of Southern Comfort along with taking the zopiclone medication that his doctor had prescribed to help Lionel sleep as he went through his grieving process over his loss of Edith.
For the first half hour upon awakening Lionel felt like he was trying to navigate a ship through some heavy fog. In a robot like fashion Lionel got the coffee maker set up and poured himself a large glass of water. It was time for Lionel to take his morning medications. The older that Lionel got the more meds got added to his list. He took Proscar for his enlarged prostate. He had an uncle who died from prostate cancer. He also took enalapril and a water pill for his high blood pressure. For the painful arthritis in both his knees and his back, the professor took Tylenol 3 three times daily.
He was also prescribed a cocktail of antidepressants by his psychiatrist. These included cymbalta, prozac and amitryptiline. The amitryptiline also helped with his back pain and his trouble falling asleep at night. As Lionel did not respond as well as expected by his current regimen of antidepressants, his psychiatrist added the anti -psychotic med, Abilify as an adjunct. Likely due to the large number of pills that Lionel took he found himself feeling excessively sleepy during the day time. A few months ago he went for a sleep study at the hospital. Lionel’s sleep was monitored all night while he was hooked up with electrodes. During the next day he was asked to take short naps every hour to check for other possible sleep disorders.
Approximately, a week after the sleep study Lionel had another appointment to meet with a sleep disorder specialist. The sleep doctor informed Lionel that he definitely had the condition known as sleep apnea. This was to be expected as Lionel was about eighty pounds overweight. The doctor also told Lionel that the daytime sleep study showed inconclusive results but that she could not rule out the possibility of narcolepsy. The appropriate treatment plan that the doctor selected was that Lionel use a CPAP machine when he went to bed at night. She also prescribed the stimulant medication Ritalin for use during Lionel’s waking hours. Lionel now had so many medications to take that he put all his medications in a little blue travel bag.
After Lionel Phelge had taken his morning medications, he went to his kitchen to make himself some toast. After the toast popped his coffee was ready to pour. Lionel took a knife out of the drawer and spread marmalade on his two pieces of toast. He then walked the short distance to his easy chair in the living room. As well as being a voracious reader, Lionel was an avid fan of audiobooks. He was sixty years old now and found that his eyes became tired after about a half hour of reading. To satisfy his hunger for reading material that would not over work his eyes, Lionel discovered audiobooks. He found that he could add at least an hour or two more reading to his daily routine if he listened to audio books. He was presently listening to the audiobook version of The Two Towers from Tolkien’s Lord of the Rings Trilogy.
Lionel had just finished packing his pipe with Borkum Riff tobacco when the phone rang. Lionel picked up the receiver.
“Hello, could I speak to Lionel Phelge?” asked the caller.
“Sir, this is Rick Jennings, the supervisor at The House of Hope Community Rehabilitation Center. Your son, Garry went missing yesterday evening. Is he, by any chance with you?”
“No, I haven’t seen or heard from Garry in about a year. The last time I talked to him on the phone was when I told him that his mother had cancer. I’ve haven’t heard from him since,” answered Lionel.
“I’m sorry to hear that sir, but if he happens to call you or drops in at your home could you let us know? We’ve already reported Garry to the police as a vulnerable missing person.”
“I certainly will, Mr. Jennings. I have your phone number on a business card. You’ve now got me very concerned,” said Lionel.
Lionel sat down and lit up his pipe. He made the circling motion with his fingers as he held the match to the tobacco. He had to admit that he hadn’t given his son, Garry, much thought during the last few months. Garry has been diagnosed with schizophrenia and had been residing at The House of Hope for about a year now. Lionel had tried to contact Garry with the news of his mother’s passing. Lionel left a phone message for Garry at The House of Hope, but Garry had not returned his father’s phone call. As Lionel puffed on his pipe he now realized that he had more things to think about than just coming up with a sabbatical research project for Dean Sanderson.
As it was already Saturday morning, and next week’s bubble packs of medications had already arrived. Rick could remove the appropriate pills from Bret’s new bubble pack and place them in this week’s bubble pack. Rick quickly went to
work making the necessary changes. Later in the morning he would call the pharmacy and tell them that he needed a packet of replacement meds as a
staff had accidentally dropped the originals on the floor. The pills would have to be replaced in case they had become contaminated by falling to the floor. With great relief Rick thought this cover up just might work. He valued his position too highly to allow one mistake to ruin his career.
Just then Rick could see Holly, the weekend day shift RCW through the office window. She was here to start her weekend day shift. It was 6:45 AM the time that they normally did shift change. Rick let Holly into the office.
Holly was a twenty-two year old punk rocker. She played in a local punk band and looked the part. This morning her hair was blue with some gold streaks thrown in. She wore a Sid Vicious tee shirt and light blue stone washed jeans. She was petite, with an abundance of body art visible on her arms. Holly had the inevitable pin through her nose. She had been a residential care worker for three years now. Previously she had worked in a home for seniors and once in a facility for the mentally handicapped.
“What’s going down, Rick? Why are you here anyway?” Holly had rarely seen Rick at work on the weekend unless there was some kind of emergency.
“It’s not good,” Rick answered. “One of our residents passed away during the night.”
“What?! Who was it?” asked Holly.
“How did he die?”
“That has been determined yet. They found him unconscious in the stairwell. Look, Holly, I’m going to need you to give the guys their morning meds and try to calm them down. They will be asking us a lot of questions and they’re bound to be upset. Meanwhile, I’m going to call the executive supervisor at home and ask if she can give us some extra staffing for today.”
“No problem Rick. I’ll see what I can do to settle the boys down.”
“What do you think Drake? What do you want to do?”
“I’m not sure Dr. Stein. I don’t think I have the health and stamina to return to full time teaching,” said Drake.
“Then let’s explore some alternatives. I’ll give you a couple of psychological tests to do. I’ll score and analyze them for you and then we’ll talk some more.”
“Sounds good to me,” said Drake.
“Are you planning on applying for long term disability benefits?”
“Yes, I am.”
“Then ask your doctor to refer you to a psychiatrist. The insurance companies require the assessment of a psychiatrist for these stress related claims. I know this for a fact. I’ve worked with several teachers and other professionals in your position. As for any career transition issues I will be the best one to help you. It’s probably going to take awhile for your life to stabilize and you’re going to need a source of income during this time. That’s what long term disability benefits are for,” said Dr. Stein.
“You mean I’ll have to see a psychiatrist. Do you think I’m crazy?” asked Drake.
“Not at all,” laughed Dr. Stein. “ But it’s very likely that you are depressed and that’s an accepted medical condition. That’s what your insurance company will be looking for, a recognized medical condition.”
“And they need a psychiatrist to determine this?”
“That’s the way the game works, Drake. It’s the insurance companies that make up the rules. But let’s cross that bridge when we come to it. Are you ready to start your written tests?” asked Dr. Stein.
“Yeah, let’s get at it,” answered Drake.
Drake looked at the papers that Dr. Stein handed to him. One test was known as a Strong-Campbell Interest Inventory. This test was designed to determine what kind of occupations Drake might be interested in pursuing. The other test was the Myers -Briggs Personality Tests. Drake had done both these tests when he had seen a university counselor but that was several years ago. Dr. Stein also had Drake do a couple of psychological tests that Drake was not familiar with. Fortunately, Drake enjoyed doing these types of tests and was interested in how Dr. Stein would interpret his test results when he was finished. In a little over an hour Drake had finished his tests and called Dr. Stein to come back to his study.
When Drake went to see his doctor he did not get a clear bill of health. His doctor told Drake that he had a form of mononucleosis that could lie dormant for awhile but cause later flare ups. He could not guarantee Drake that he would ever get his premorbid energy level back. The doctor suggested that Drake seriously consider a less challenging occupation that would not excessively tax his energy level.
“What am I going to do?” asked Drake. “I have been a teacher for most of my adult life and I have a family to support.”
“I know that this is not what you wanted to hear Drake, but I’m obligated to give you my best professional assessment and recommendation. I’ll tell you what I can do for you. I know an industrial psychologist that counsels people in your situation all the time. This guy is good and I know he gets results. I have already referred a few of my patients to him. You will likely be able to keep your health insurance for a few months yet so seeing the psychologist shouldn’t cost you anything.”
Drake knew that he could trust his doctor and that he would only refer him to another professional who is very competent in their field of expertise. When Drake returned home he reported the details of his doctor’s appointment with his wife, Judy. Drake was very emotional and started to weep when he told Judy that he shouldn’t return to full time teaching. He also told her about the referral to the industrial psychologist.
“ I know it doesn’t feel that way but I think that this will work out for the best, Drake. You’ve been working much too hard and you no longer have the stamina that you had before you got sick with mono. Your principal and your doctor both care about you and want what’s best for you, and so do I. To tell you the truth I was very concerned about your return to teaching but I didn’t want to discourage you. I think that you should definitely make an appointment with the psychologist that your doctor recommended. You are a very talented man, Drake, and I’m sure that the psychologist will show you many other career options that you can pursue,” said Judy.
“I’m sure blessed to have you for a wife, Judy. Most wives in your position would tell their husbands just to tough it out and go back to teaching,” said Drake as he moved towards Judy to give her a hug.
“Why was Brett so well thought of?”asked Detective Barnes.
“ Mostly because he was what is known in residential care as a high functioning client. He was one of our clients that I had predicted would probably have a good chance of living on his own in six months to a year,” said Rick.
“What was preventing Brett from living on his own?”
“Brett needed to reassess who he choses as friends. While he was in high school he got in with the wrong crowd. In grade eleven he took an auto technology course and ended up befriending some guys who were into dealing drugs and stealing cars. As Brett got more involved with these guys he managed to get himself a criminal record. At his hearing the judge declared Brett to be NCR.”
“NCR? Not criminally responsible?”
“Yes,” answered Rick.
“Why do you think his peers at the center liked him so much?” inquired the detective.
“Brett had excellent people skills. His two parents are very educated people. They are both university professors in the United States. Brett was also a leader and was level headed. He’s very patient with the other guys. He’s not a push over, but he’s usually willing to help the other guys out. It probably doesn’t hurt that he’s physically fit and has a strong build as well.”
“He sounds more functional than a lot of people walking the streets right now,” concluded the detective. “ So if he could learn to stay away from his sleazy friends on the outside, he would probably be good to go.”
“We would have to be reasonably sure that he would take his meds too when he was released from our program. From what I’ve read in his files, Brett is a much different guy when he’s off his meds.”
“In other words he could be a danger to himself or others.”
“Rick, you said that the majority of the residents liked Brett. Which ones didn’t?” asked Detective Barnes.
“There are two guys on the floor that resent Rick,”
“Who are they? Simon Kent and Matthew Richards,” answered Rick.
“Why do they resent Bret?” asked Barnes.
“They resent him because they can’t control him. He is not intimidated by them and he won’t play their game,” Rick explained.
“What’s their game?”
“Controlling the others residents in the facility. Simon is the leader and Matthew is just his follower. I think that Matthew felt he would be a lot safer if he became a friend to Simon,” added Rick. “Of course, there is a price to pay for being Simon’s friend. If you’re his friend you must never criticize or question him and you must always do what he says.”
“In other words surrender your individuality to Simon.”
“For the most part, yes,” answered Rick. You see a mental health treatment facility is much like a prison in some ways. The residents often feel like inmates. Our counselors and residential care workers often function like guards in a penal institution. They regulate the schedules and lives of their clients for the most part. There are set times for several of the resident daily agendas. Meals are always at the same time, medications are given out at a certain time. There are set times for life skills classes and recreation periods. And we can’t forget curfews.”
Detective Barnes shook his head. “ A structured routine is part of the the treatment plan.
The Symptoms of Depression
Depression is the common cold of mental illness. It can be very debilitating and one may never know that they suffer with this condition. Here are some of the symptoms of this mood disorder:
1) a persistent feeling of sadness that you can’t seem to shake.
2) Having trouble sleeping on most nights.
3) Finding that you are sleeping excessively but do not wake up feeling rested.
4) Having trouble concentrating and remembering details.
5) Having very low energy. Feeling exhausted for a good portion of your day.
6) Thinking excessively pessimistic thoughts about the future.
7) Often thinking, “What’s the Use?”
8) Finding your work to be drudgery even if you recall enjoying it in the past.
9) Starting to lose confidence in your own skills, talents and abilities.
10) Having a low opinion of yourself and others.
11) Feeling very slowed down and thinking that the world is moving too fast for you.
12) Losing interest in sex.
13) Losing interest in your hobbies.
14) Isolating yourself.
15) Turning to alcohol or drugs for relief.
16) Experiencing more aches and pains in your body. than usual.
17) Feeling very stressed out and anxious.
These are but some of the common symptoms of depression. In future blogs I will be writing more about the experience of depression and ways of dealing with it.