March 10, 2004

Seven p-docs in eight years

My daughter till now has been treated by seven psychiatrists in the last eight years. Three of them were from the Military hospital. The hospital is located in the Cantonment area of Delhi. It is an oasis of greenery where peacocks strut with peahens on the slippery, asbestos roofs of some wards. My daughter was born in one of those rooms. Twenty years later, while my husband drove past the place where she was born, taking her for her first visit to the Psychiatric Section, I remember thinking how unjust it was for someone so innocent, so good, so kind, so wise and so loving like her to suffer so much. Who could I rant against? Fate ?

The first visit led to her diagnosis and treatment and recovery. So was it a kind of being reborn in the same place? I wonder. A different life thereafter, a difficult path to tread on, an unconventional way of looking at life's challenges where small achievements were equated with a great deal of hope.

Since my husband was in the Indian Air Force, stability in treatment and environment was so difficult! Either the doctors were transferred or we were. The first p-doc at the Military Hospital was good and competent. Another one was condescending and cruel. I recall telling this p-doc about her reluctance to take her medication because she had put on so much of weight and his reply 'let her not take it. Let her suffer. She will come to her senses and then start taking them.' When refusal to take medication is one of the symptoms of the illness, how could he have ever said something so bizarre? There was no place where we could air our grievances because psychiatric patients and their relatives were not taken seriously. A patronising tone was used with the patients. There was a beautiful garden in front of the p-doc's room where some of the patients tended to the plants. On the grass lay sprawled tired families who had come a long way from other towns because few hospitals had psychiatrists. I recollect a painting of a house from which led a winding path, hanging on one of the walls. Underneath which was written 'Home is where they have to take you in when you have nowhere else to go'. I had read these very words somewhere, sometime, I don't remember ...a long time ago. They didn't tug at my heart then but now they do.

We took her to the same place after her first relapse and came to know what the word 'remission' meant. She was put back on Haloperidol. Her recovery took longer and we moved our home to a town in Central India because my husband was transferred there. The town had a Military hospital but no psychiatrist. Fortunately a good friend lived in the same town and they told us about a 'good p-doc' in private practice. A week after we moved, my daughter started relapsing. So we rushed her to this doctor. He had his rooms in a huge building where doctors of different specialities practised. He was our sixth p-doc in three years. We stayed in that town for two years and we found him quite understanding and easy to communicate with. He looked so weary - most of the time. He used to start treating patients from nine in the morning till late in the night. His charges were affordable and one had to come a couple of hours early to meet him. We spent a lot of time in the waiting room. His patients were so varied, the rich, the poor and the middle class all awaited their turn. The waiting room was comfortable but it had a television set showing sometimes violent movies.

My daughter later told me that she used to sometimes feel guilty talking about her feelings of depression to the p-doc especially after seeing some really poor peasants who came in with dust- encrusted feet, nut brown faces etched with lines of toil and clothes crumpled after a long journey from some far-flung village. Generally there is so much of superstition regarding mental illnesses in the villages, but I found a lot of people from the villages in that room. Talking to
some of them, I was amazed by their attitude. They said that they were not well, so they couldn't work, hence they had come for treatment to get well to earn something or to look after their families. No formal education but so much of awareness! Some of the patients or families whispered to each other but most of them kept quiet while a few read. This p-doc prescribed SSRIs alongwith Haloperidol to ease some of the symptoms. He was the first p-doc to tell us never to take the threat of suicide lightly. So we used to lock up all the knives, scissors..and take turns sleeping on a mattress on the floor next to her bed whenever she felt very depressed or was very ill.

Although she recovered, she remained unhappy about the weight she had gained. The p-doc changed her medication to Loxapine. She relapsed again. Later she told us what a frightening period it had been. Her mind
being constantly bombarded by unhappy memories of unkind people criticising her and remarking unpleasantly about her appearance or abilities. It was like a deluge, she said. The p-doc put her back on Haloperidol and she recovered.

She recovered so well that she took charge of the home while I went to hospital for yet another operation. I returned home and there were so many restrictions that I had to take a lot of rest. It was amazing the way she went about doing the chores and cooking the most delicious meals. My husband used to help her out occasionally. In the evenings she would go to work. I will always feel indebted to her and remember that time with gratitude. It could have been a terrible time but it turned out to be such a happy one!

By then the Internet had come to India and to this sleepy town and so much of information was available. We discovered this wonderful site and found a great deal of comfort when we knew that we were not alone in this battle with this illness. We remained in that town for two years and then had to move home yet again because my husband was transferred, this time to Delhi. Shall write about that later...

Thank you for your comments.
Dear Moeder, you speak with so much of wisdom. How true that we cannot take away this illness from our daughters...we can only help. Thank you especially for telling me to be good to myself. I just did. Yesterday was Women's day so I went out with a friend for a movie, and had my favourite icecream. You too take care dear mother.

Dear Nick, yes a lot of loving and caring does help. Thank you for your response.

Dear Monica, My daughter was also diagnosed when she was twenty years old. She was on 600 mg of Quetiapine (200mg in the morning and 400mg in the evening) and 2.5mg of Haloperidol till last week. About two weeks ago, since she told the p-doc that she felt drowsy during the day the dosage was adjusted (100mg in the morning and 500mg in the evening). She started relapsing and although she went back to the previous (200mg morning, 400mg evening) she didn't get better. Apparently the action of Quetiapine does not last for more than seven hours for some people. So now the p-doc has stepped up her medications. She is now on Quetiapine (300 mg in the morning 400mg in the evening) and 5mg of Haloperidol since yesterday. She is improving. Do talk to your p-doc for adjustment of dosage for your son if he is still troubled by the symptoms. Dosages do need to be adjusted from time to time. Thank you for your response and do take care of yourself dear mother.

Posted by survivor at March 10, 2004 12:15 AM


ohhhh it is so sensitive......but I am very sure that she should be better now, could U tell me how long she is on QUITIPINE......the main precautions for it is right dosage, some weight gain & drowsiness. I pray god she should be better soon................

Posted by: Nick at March 10, 2004 03:01 PM

i'm not doing well enough to read the whole thing...all i want to say is that my prayers are there for you and your family. (((((((((hugs))))))))

Posted by: puzli at March 10, 2004 10:24 PM

Hi there,

Im just a college student in the US. I was working on my research paper on schizohprenia last week and i found this wonderful website along with your journal about your daughter. All i can say is I'm really encouraged by your strong will and love for your daughter. Im a third year Human Development major and though i learn all these knowledge about mental disorders in lectures, it is yet different to hear what schizophrenia (And other disorders) is all about from a personal perspective. Thank you so much for sharing your story with us. Im definitely taking my life for granted yet i should always remember how blessed I am.

I pray that God will continue to give you strength, and remember, everything happens for a reason. And mayb you can tell your daughter that no matter how much weight she gains, she's still a beautiful woman in God's eyes, and that's what beauty is all about.

God bless,
helen :)

Posted by: Helen at March 12, 2004 05:50 AM

This is not only in india but all over the world..that psychiatric patients and their relatives are not taken seriously at most of the places. I am with pharma company,Even today when we talk about p-hospital, it is something very crazy & not serious...but i feel internally what it is......and it is useless to explain people beacuse I tried a lot but when a p-doc doesn't understand it.......we shouldn't expect from a normal person. I also saw very rich & poor peasants with dust- encrusted feet, nut brown faces ...coming to delhi from as far as 200 - 300 km away. I recall...I used to drive about 1 hour 20 min to see p-doc and there was patient with family who also reached same time, I just told him that I am from so far away, he told it is Ok, but if distance is considered they came from 300 km and it took 7 hours for them to come to that doctor.REALLY I HAD NO WORDS and just bowed to them, they were also quit poor, 50 yr old mother
with his 25 yr old son. but there was so gaceness in her wrikled face, which only i could judge... .. she talked a lot with me and always smiled with shyness...

Posted by: Nick at March 12, 2004 03:32 PM

My wife till now has been treated by four psychiatrists during last 2 and year , she has taken Olinzapine, pecitone, Aripiprazole, Quitipine and Resperidone etc.. prescribed by different P-Dr. There is no change in her thinking (She talikng with dead men) In feb 2004 she recovred some while taking ARIP-MT10 1-0-1, Pecitone 2 1-0-1 and Quitipine 50 0-0-1,

May I start again .

With kind regards

D-26, NDRI
KARNAL - 132001

Posted by: A.S. GHAI at August 13, 2005 07:41 AM

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