Mental Hero

Last year after my son’s major psychotic break started and went on and on for six months, he actually lost weight… I guess about thirty pounds or so. The weight loss was a good thing because he was a little overweight to begin with, therefore the weight loss made him look to be at a healthy weight again… not too thin and not overweight.

photo by greggoconnell

Now as the severity of his mental illness symptoms has abated DS has started putting on weight again. I would say in three months he has put it all back and more. I went with my son to one of his psychiatric appointments and the doctor, after making a visual observation, decided to change one of his medications.

This is interesting how no weight scale is used. If I go to my regular doctor for anything at all, they make me step on the scale. I have never seen a scale in a psychiatrist’s office.  I have read that this is becoming a matter of debate. The majority of medications for treating mental illness cause weight gain. Obesity is becoming a major contributor in the USA for many serious health problems, such as heart disease, stroke, diabetes, etc. and any doctor should be concerned about this side of their patient’s health.

Then again, where mental illness is concerned, medication compliance is a serious issue. It is a common thing to hear of a person going off their medications and having relapses. I wonder if psychiatrists do not want to draw attention to a person’s weight gain because it will cause only more reluctance to take the medication. Psychiatrists and their patients have to walk a very fine line. This is something very hard to do where the science is so inexact, and the medications leave a great deal to be desired for being effective without serious side effects.

So, how do my son’s medications cause his weight gain? From what I have read they interfere with his body’s ability to recognize fullness after eating. He can eat and eat and eat (and he does) and never know when he has had enough. For the last couple of months I have tried talking to DS about this problem and let him know that he cannot trust his body’s ability to signal fullness. Also with him being a young man and not having much experience with dieting or counting calories or all that, I have tried suggesting to DS that he merely look at his plate, put a reasonable amount of food on it, eat, and be done.

I have also talked to CA (the woman who takes care of him in her personal care home) about creating fewer opportunities to overeat by cooking less at a time to begin with or putting away the extra food in the refrigerator after putting portions on their plates. She says, he always asks for more and it is hard for her to say “no.” I can understand this. I don’t always like facing his angry moods either, and I am always treading softly. (Yes, I am a wimp.) CA also made me aware that DS is buying cookies and sugary drinks in large quantity at the grocery store when they go together. He takes them to his room and eats them there, so there is no hope of her being able to regulate it. I agree this is a big problem also, so I have told her I will try to discourage him from taking as much money from his checking account, talking to him about having a plan for how he will spend his money.

This weekend when he was home for his visit, I tried to enlist him in talking about behavior modification to prevent overeating, using myself as an example. Yes, I could lose a little weight also. Last year while DS was losing thirty pounds, I was putting on thirty pounds. I had my pad of paper and pen and was writing down ideas and trying to elicit suggestions from DS. I then tried to get DS to do the same for himself. He was not interested. He knows he has a weight problem, but he says he is sure he can exercise it off. I expressed skepticism about that, but when I could tell I was not going to change his mind, I suggested we make a trial of it. We then talked about his exercise goals, and before his dad took him back to CA’s, I spoke with her by telephone within DS’s hearing about his new exercise goals. She wanted to argue with me about the futility of the program without controlling eating, and I had to say, “I agree, but we are making a trial of this, it’s a first step, and hopefully we can make adjustments in the future if we need to.”

Before DS left, all three of us, Dad, DS and I, took our turns stepping on the scale and we recorded our weights on the calendar. I am trying to make this weight loss program a supportive thing and hopefully not a competitive one. I never can get myself to lose weight for external reasons; I have to be ready to do it for myself, so I don’t know if I will be able to lose weight right now while I am dealing with some other stresses and goals in my life.   I have found weight loss to be rather difficult when I cannot make it my number one priority all day long.

From the way I see it, my son has just the opposite problem. He has very little to do all day long, so I can see that eating and sleeping may be his escape from boredom. Also I still wonder how much his schizoaffective disorder has affected his ability to focus on a goal or any task for that matter. While his delusions do not appear to be as severe as they were last year, he sometimes does not seem to be “all there.” This falls in line some with what I learned in my NAMI Family-to-Family class. Mental illness has positive and negative symptoms, meaning it adds things (like delusions) that were not in a person’s life before and takes away things also.

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I was going through my stack of papers and found this one. I intended to mail it to Governor Sonny Perdue of Georgia, the lieutenant governor, the Cobb County Community Service Board, and a few other individuals that I could locate on the mental health section of the Georgia state government website. I do not know why I did not mail it, other than from a feeling of hopelessness that it would do any good.

My overstuffed folder of papers pertaining to DS’s illness last year.

September 5, 2007

Dear Governor Perdue,

My son DS is mentally ill with schizoaffective disorder and living in a personal care home at _________________ Road, Marietta, Georgia, in Cobb County.

After some type of state inspection of the PCH last week, we were informed that DS needed to be attending a day program. He needs the therapy to prevent a relapse that could cause him to be re-hospitalized. (He has had three hospitalizations since June 1st, 2007) Also, the personal care home will lose its license if he is not involved in a day program, we were informed. If he does not attend a program, he will have no place to live but the streets. We were given two weeks to resolve the matter.

DS did attempt the program at OCS (the Hope Program?) off Windy Hill Road in Marietta. Unfortunately because of his mental illness, he is having fearful delusions about that place and is adamant about staying away from it.

We have been attempting to contact the Cobb County Community Service Board to find out about other day programs or solutions to his residential problem. My first attempt was shrugged off because I am not the client. When I put my son DS on the telephone, he first dialed ____________ and was directed to dial ____________. After dialing that number, he was directed to call the first number! When he informed the person on the line that we tried that number already, his call was redirected to a voice mailbox. (I do not know whose.) We have waited for a reply to the message left there 24 hours ago and have received none.

I am asking for some help in finding a day program for DS in Cobb County. His only resource to pay for one is Medicaid. (For out-of-county letters: I am willing to look at other residential arrangements in other counties, if that is what it takes to have DS in a residential arrangement and a day program.)

If HIPAA (privacy issues) make it difficult for you to communicate with me, DS would probably sign a release to discuss matters with me.

Sincerely,
(my contact info and DS’s picture)

I had forgotten about driving down to my son’s PCH and putting him on the telephone. I also remember another example of my level of desperation at this time. I took DS to the local homeless shelter (MUST Ministries in Marietta, GA) to try to find some volunteer who might be able to steer us in the direction of finding some alternate housing or programs for DS. As it turns out, it was Labor Day, and there was no one there we could talk to. We did see the homeless people loitering in the parking lot. It upset DS and he said, “you are trying to scare me.” I am not proud to say it was true. I was hoping to scare him sufficiently about the prospect of joining the homeless that he would return to the OCS program. Didn’t work.

One more note about the Governor Sonny Perdue. My mother said to me the other day that she had heard that the governor was proposing more money for mental health in Georgia. I usually avoid discussing anything remotely political with her because of our differences, but I replied, “Yes, more money would be good, but I think we need some new ideas, too.”

Here is another of my Recollections posts, where I am trying to catch-up the story of my son’s diagnosis of schizoaffective disorder in 2007. 

Fom my son’s first hospitalization, the social workers’ I spoke with reminded me that an outpatient program would be available for my son, if transportation could be arranged.
 
The program they were talking about was called “OCS” or sometimes even the “Hope Program” and it is another offering of the Wellstar Health System. It is located off Windy Hill Road in Marietta, Georgia. The address is 2000 South Park Place, Atlanta, Georgia. I only know a little of what happened in the few days my son went there.
 
While my son was attending OCS, he told me the chairs and floors were coated in drugs and one of the other patients threw his drugs at him. Since this falls right in line with the delusions my son had been having all summer long, it can be assumed that he was still very ill. (I did have a social worker that told me she could believe the latter about drugs being thrown at him, because she had heard of just about everything in her line of work. To me, that stretches credulity just a bit too far.) My son DS also mentioned that he had seen Dr. K., while at OCS. I thought this was a good thing… you know, doctor supervision.
 
Whether because of the delusions or something else, in just a few days after his third hospitalization, DS got to the point where he vehemently refused to go. I telephoned the program to speak with someone about DS’s situation and to ask whether there was something they or I could do to help him to want to return to the program. I received a very flat refusal to discuss anything about my son because of patient privacy laws or in other words, “Mighty HIPAA.” (Let us all now kowtow.) That was the end of my son’s attendance at OCS.

Months later, I found a folder about the OCS program in my son’s room that he let me have since he wanted nothing to do with the program. Here are some quotes from the Orientation Handbook.

Quote from page 3:

The objective of OCS is to help our clients reduce or elimate symptoms and make positive lifestyle changes while focusing on a holistic approach. At OCS, we work with individuals who are experiencing marked distress due to depression, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, bipolar disorder, schizophrenia, addiction etc. Through a multidisciplinary approach, our staff assesses symptom severity, determines the appropriate level of care for each individual, and assists him/her with the development and attainment of appropriate treatment objectives. When appropriate we use release of information to help us create a holistic treatment involving clients’ supportive social network (e.g. family) and multi-disciplinary doctors in order to provide an effective continuity of care.

In our case, obviously, the lack of “release of information” may have contributed to my son’s lack of “continuity of care.”

Quote from page 12:

Family members and/or close friends of clients are encouraged to attend each week. Mental health disorders and substance abuse/dependency are disorders that typically affect the family unit as a whole, Educating and treating the client, and the family, on Disorders increase the likelihood of the client maintaining a long-term lifestyle of recovery…. Family members and significant others are encouraged to utilize this opportunity to get support for themselves while continuing to support the client.

It is too bad no one told me I could attend with my son. After DS came from a mental hospital setting where visiting hours and information were extremely restricted, I do not know why anyone would think I could make that leap of thought.

From reading the OCS Orientation Handbook, I have come to the conclusion that the program’s strength lies in treating substance abuse. There seems to be an emphasis on that, including requiring patients to attend two 12-step meetings per week, obtaining the AA book and an AA meditation book. I seriously doubt this program has any benefits for a person like my son, coming off a serious psychotic episode, and probably needing rest and a low stress environment more than anything, as I have since learned.

After my son DS refused to attend OCS last August, a state inspector of some type visited the personal care home (PCH), and according to the manager, MG, my son was required to attend a day program or the PCH would lose its license. I took that to mean that DS had to attend a day program or be homeless, because I did not think the PCH would allow itself to lose its license.

“between a rock and hard place” photo by judepics 

I tried to find out why DS was singled out for this requirement when there were other people in the home with a mental diagnosis not attending day programs. Was it his relatively young age of 27? The unofficial word I got from another staff member at the PCH was that is was the severity of DS’s symptoms that made him stand out, particularly the pacing and spending time alone in his room.

I assumed they were right… he must need a day program because his symptoms were severe, and he would get treatment or therapy or something there. (Wrong, I figured out later.)

I started calling around trying to find day programs. First, I tried the Cobb County Community Service Board. From what I have read on the Georgia government website these county community service boards are supposed to be very helpful for the mentally ill. I tried to make an intake appointment on my son’s behalf. The first question I was asked was, “why is your son not making his own appointment?” Thinking his mental illness alone might not be a good enough answer (because of previous problems I have had making psychiatrists’ appointments on my son’s behalf), I said he had autism (Asperger’s) and that makes it difficult for him. I received a firm reply, “we don’t provide services to the autistic.” When I tried to explain he had schizoaffective disorder too, the person did not listen at all, but she continued to deny us an appointment. I decided to call back the next day without mentioning the autism. As it turns out the day program that the service board administers was not accepting new patients anyway, but they did refer me to a program at “Walton Nursing” in Austell, Georgia.

This post is already too long. I will tell the sad story of what happened with Walton Nursing later. For right now, let me leave a couple of words of advice to anyone dealing with a similar situation for their loved one:

1.  Always visit a day program with a family member. Visit for a whole day or session, if that is what your family member will be doing in the program.
2. Speak with the state inspector of the personal care home, when they are making difficult demands on your loved one. Perhaps the PCH exaggerated the seriousness of the situation? (i.e. losing their license versus eviction of my son?)
3. Day programs are not for the severely ill.

There is a question of whether it is healthy for mentally ill people to isolate themselves by their own choice.

My son was diagnosed with Asperger’s syndrome (a type of autism) years before he became ill with schizoaffective disorder. He has always liked his privacy, and he has always spent hours at a time in his room.

photo by loufi

After he had his major breakdown last year, he went to live in a personal care home. It has come up twice in the past five months from the people that take care of my son, that his preference for being alone in his room is not healthy, i.e. it gives him nothing to do but listen to the voices for one thing. At one point we were pressured to put him in an adult day program with rather disastrous results. (This story will come in a later post.)

I am now enrolled in a class offered by NAMI called the Family-to-Family program. Like a breath of fresh air, I found support and explanation for my son’s desire for solitude. In short, the class taught that the three predictable features of a person in the post-psychotic stage of mental illness are exhaustion, depression, and delayed stabilization. People in this phase are in need of rest and recuperation because they have undergone major trauma and stress, physically, mentally and emotionally. One evidence of trauma I believe in my son’s case is that he lost thirty pounds with no conscious effort. He has not been in any condition to plan and execute a program of any type, even for weight loss, for months.

Here I have been trying to go to the “experts” about what to do to help my son… the people in charge of the programs. Now I find out that they do not really know what they are about.

I quote from NAMI materials (page 4.37):

This extended period of vulnerability routinely goes unrecognized by professionals as well as families. Although many professionals may now agree that biology causes the illness, they often assume that recovery is solely a function of ‘psychological will.’ Consequently many programs involve ambitious psychosocial treatments and full-day scheduled activities during the early recovery period when the individual is least able to participate.

This vulnerability period may last from months to years. Stress can cause additional relapses. The demand that he be around other people does not serve his need to heal, but I believe serves the needs of those who watch him to be able to actually see him… even when their solicitousness is probably doing him harm.

Understanding is coming very slowly to me.

This post falls under my Recollections posts of my experiences with my son DS in 2007, who has been diagnosed with schizoaffective disorder. As I began to explain in my Third Hospital Admittance post, my son was hospitalized for third time in three months last summer on August 1st, 2007.

My husband and I and DS’s two youngest siblings were in Florida at the time he was taken to the emergency room. We were returning to our home in Georgia the next day when I received a call from DS on my cell phone. He was very anxious and fearful about the delusions and hallucinations he was having. He begged me to get him out of the hospital. “Begging” is actually too mild a word. I have never had anyone ask me (over and over again) for something with such fervor and earnestness. If it was in my power to to do anything, I think it would have been very difficult for me to do nothing. The power to release him from the hospital was in the hands of a doctor, as I told him again and again. I was extremely upset by our “conversation” if you could call it that.

DS was in the hospital until August 15th. In the interim, I made and rescheduled three optometrist appointments for DS. I was told by MG at the AM personal care home that DS had broken his glasses. I asked if it was just the lenses that broke or whether the frames were also broken. She did not know. She was only telling me what another resident had told her: he saw DS break his glasses. Apparently no one knew what became of the broken glasses. I remembered DS telling me earlier that there were microphones in his eyeglass frames that “they” were using to spy on him. I knew from the strength of DS’s prescription he would be rather uncomfortable from not being able to see as well. On the telephone, he complained of bumping into walls in the hospital because he could not see. I think to him it was more evidence of how he was being affected by the illicit “drugs” (narcotics, meth) that “they” were trying to kill him with. I felt horrible about him not being able to see, so I kept on rescheduling appointments at the eye doctor’s office. I did not have a clue when he would be discharged, and I wanted his appointment to be as soon as possible. I felt bad every time I talked to the receptionist about changing the appointment.

She never asked a reason and I never gave one, and I silently thanked her for that. Through this whole experience I have learned to try to be less critical of people. I do not know what it is going on with their life and if they do not tell, it may be that it is too painful to tell. On the other hand, I remember, too, the critical librarian who ran my preschool children and I out of her quiet sanctuary the day we needed some refuge from DS, following his first hospitalization. It still hurts; I do not think I have been back to that library branch since.

Now I will tell you about the “creative hospital discharging.” DS was not happy with AM, the personal care home. He did not want to go back there when he was discharged; he wanted to come home. I reminded him that he felt no more safer at home than he felt at AM. I knew DS was still going to be too much of a handful for me and his five-year sister and three-year old brother to live with. I knew I had to stand firm. He could not come back to our house. On the 14th of August, I learned DS was being discharged. I asked JC the social worker, “How are we going to do this? DS says he refuses to go back to AM.” He said, “Don’t say anything about where you are going. Just pick him up and drive him to AM.” I did not think it would work, and I told him so. DS and I had had many conversations before that day, and DS knew where I stood on the matter.

So I show up at the mental hospital, Wellstar Behavior Health, in Austell, Georgia to pick up my son, DS. My five-year old was at kindergarten, but I had my three-year old with me, who was tired because it was his nap time. He clung to me the whole time we waited for them to bring DS out to the lobby. It seemed to be taking a very long time. When DS came out he was walking between two male staff members. This is the only time I have seen this. (On one of his previous discharges he came out with one female nurse who gushed, “we just love having DS, he is so sweet.”) I had the feeling that just before DS came through the door they were physically forcing him to move. The first thing DS says to me is “Mom, I can’t believe you are doing this.” Then he changes his tact and starts saying, “this is not my mother, I am not going with her.” DS had been saying the “you are not my mother” thing a few days before and earlier that summer. I am not certain if it was a delusion, or a way of trying to hurt me. I think he knew that he could hurt me worse by saying “I hate you, you are an idiot,” which he did, and still does on some occasions. A piece of me thinks the “you are not my mother” was a delusion he fell upon when I was not doing what he expected I would do and disturbing his reality.

Anyway, after discussing it for a while, it was obvious DS was not going with me. He was also saying things like “I would rather be homeless than go back to AM.” DS is standing there between these two guys the whole time, and one of them picks up the telephone and calls a RN nurse to come out. She came out and looked at me without a word with one of the coldest expressions I have ever seen in the healthcare profession, or to be less critical of her, maybe she had already had her fill of DS’s behavior for the day. (Why do they think people who are this unreasonable are ready to be discharged?) I surprised myself with my own strength when I said to her in a very calm voice, “He is delusional, he says I am not his mother and he would rather be homeless than go with me. He is a danger to himself.” She says, “ok,” and back through the door they all go. I carry my sleepy three-year old back out to the car for the fifty minute drive home. For a change, I think I do not shed a tear.

The next day, I am determined I will not answer the telephone if the caller identification says it is the hospital. JC calls once and leaves a voicemail that DS will be discharged that day even if it means discharging him to a homeless shelter. I start formulating a plan for how I will help DS if they discharge him to the homeless shelter. I figure I can show up in the evening when he is standing in line for his slot and give him his medication. I can give him food and some money for food. But I will not bring him home. This is a really brutal thing that is happening to DS. He has never lived away from home before that month, always dependent on us his parents. It was a waiting game all day. Later, JC calls and leaves a message that Dr. K. says DS will not be discharged to the homeless shelter, and JC will work on finding him another personal care home.) A sigh of relief for a brief reprieve.

The next morning I realize I have another voicemail from the day before. I do not know why I missed hearing the telephone ring. It was a call from MG at AM, the personal care home. (Sorry about all the acronyms.) DS had just shown up in a taxi on their doorstep in the evening and he did not have his discharge papers. It is one of the regulations; she needs the discharge papers. I call the hospital and request they fax me the papers. (The fax machine to the rescue again. I am telling you, if you have a mentally ill person in your family you need a fax machine.) I believe I call MG back first with apologies for not returning her call sooner; I am incredulous. DS appeared in a taxi? Who paid the taxi? It was prepaid. Did the hospital call you first to let you know he was coming? No.

When I visit DS, he is very subdued and despondent. I have never seen such a picture of abject misery. I see him still in my mind’s eye with his head in his hands as I ended our visit. I cry bucket loads of tears for him on my ride home. I guess for all of his talk about preferring homelessness he realizes he is better off to stay at AM because he could get up and walk out the door anytime if he wanted to. A couple of days later, when I get the courage, I ask him how he ended up in the taxi. He said they told him he was going home. I did not know, and I still do not know, whether I should be angry that they lied to him, or glad that he did not end up homeless in the street. I was so angry and confused I knew I could not discuss it with anyone at Wellstar. I am sure someone very smart could defend their actions by saying “we said he was going home and AM was his home.” I am sure they knew full well that DS would not understand it that way. I am still wondering who orchestrated the whole thing: the doctors, the nurses, the social workers, or all of them.

Well, how about you, my readers? Have you ever been lied to like that when you were in the hospital? Do you think I should be angry about the lie or glad that my son ended up where he would probably be safer? (I am not even sure what I mean by the last part of the last question: safer than being in a hospital that lies to you or safer than being homeless?)

This story makes me sick to my stomach. A couple nights ago, I watched American Experience: The Lobotomist on Public Television. The procedure itself has a great deal of ick factor, but even more alarming is how Dr. Freeman was able to invent and then cavalierly practice his procedure without scientific method, or peer review, or even a surgeon’s license. From now through January 25th, 2008, you can ask questions in an online forum of people who appeared in the program, including Dr. Freeman’s sons, and the daughter of a woman who was apparently cured of her depression by lobotomy. Don’t let this opportunity get away!

photo by jylcat

Beginning with his private practice, Dr. Walter Freeman eventually performed lobotomy on thousands of mentally ill people in hospitals across the US without permission of the patients or consultation with their families. He performed his procedure on more than a dozen children, including one as young as four-years old. For ten years or more in the 1940’s or 50’s he was lauded by the press as having invented a cure for mental illness. A few patients experienced a miraculous recovery, but for many others it was trade-off. They became docile, emotionless and child-like, but there was no relief of their illness or restoration of their mental health. Some patients even died during lobotomy.

I guess what really made me sick to watch this television program was to realize that with the level of desperation I have experienced since my son has become severely ill with schizoaffective disorder, I would have absolutely gone along with a treatment like this one for my son, if I had been promised by “a man in a white coat” all that lobotomy was once touted to be.

PsychCentral.com has this article about a teen who was given electrical shock against his treatment plan. I identified with the observation about immigrant workers. I have always wondered why it is that immigrants dominate staffing and ownership of the personal care homes in this area.

I felt it was time to fix up my blogroll a little more. Here are some blogs I added today.

For Better, For Worse, In Sickness, In Health
is the blog of the wife of a man with schizophrenia or schizoaffective disorder. I was very moved by her post about her lil’man, their three-year old son. Having a son that age, I can sympathize. Fortunately, in our case, his older brother’s illness has not affected my three-year old as profoundly.

Quodrophenia
 is the blog of a 25-year old schizophrenic. In the post Masterful Domains I was reminded that the fear of psychosis is absolutely real to the person experiencing it.

A Broken Mind
is an informational blog about schizophrenia with one of the prettier WordPress themes I think I have seen. It is an article style blog with useful, factual information. I would be curious to know a little more about the blogger’s life and what motivated them to start this blog. We all must give what we can when we can.

The Bipolar Diaries
is Danielle’s blog and she also happens to be a great amateur photographer.

A Long Walk to Forever
is Catherine’s blog. I am not sure whether she has bipolar or depression or something else, but she is recently dropping one of her medications, Geodon. I love the little poetic quips at the end of some of the posts.

Robert Wilkens Home Page
There is very little to be seen in Rob’s blog about mental health right now. I very much appreciate that reminder that people are not their diagnosis, and many people are able to get on with their lives in a very functional way. I thank Rob again for the insights he gave me into schizoaffective disorder in his comment he made here on my blog.

So there you have it. I am open to any suggestions of other blogs to add to my blogroll. Your comments are welcome below.

Today I spoke with CA, the woman who takes care of my son, DS, in her home, which is also a personal care home. She was asking again about the possibility of finding some day program for DS because she has no time to do things by herself. Apparently it is a state regulation that she cannot leave him in her home by himself. When she leaves to go to the store or anywhere, she takes him with her.

I can sympathize with her complaint. I really do not know what to say. DS had a bad experience with a previous day program. I just cannot imagine him agreeing to go to another one. CA suggested that if DS could come home for one day a week, it would be a help. I need to think about that one. Right now I need to have my husband present when DS is around because my nerves are rather shot by the verbal abuse he is inclined to heap on me when we are alone. I figure that is why he did so well during the holidays… lots of extended family around. 

The alternative will be getting CA to the burned-out point where she will probably ask that DS move to another home. I am heartsick about both possibilities.

Totally changing the subject, DS called me today to let me know that Bobby Fisher died. DS has long enjoyed chess, so I am not surprised he would want to call me with the news. He said, “Isn’t it interesting that Bobby Fisher died at the age of 64 and there are 64 squares on a chessboard.” I wonder if he thought that one up himself or if he read it somewhere.

On the lighter side, we had snow here in Georgia yesterday. My five-year old daughter and I built a one-foot tall snowman. Here are the before and after shots of the snowman yesterday and today.

It can be interesting to read the statistics of this blog and look at those keywords that have brought visitors here from the search engines. Two keyword phrases that have brought visitors are “people with mental illness talk in foreign accents” and “mental illness british accent.”

photo by Phinias H

That caught my interest. I have not actually said anything about my son, DS, having an accent, but it is true that most people notice that my son has an interesting way of speaking. This was true for most of his life and long before his diagnosis of schizoaffective disorder. He was born and raised here in Georgia, in the USA, but he does not have an American southern accent. Sometimes when meeting amiable people for the first time they will ask him where he is from. It is kind of funny to watch their reactions when he answers, “I’m from Atlanta.” My son’s way of speaking comes from his Asperger’s syndrome. Asperger’s is considered by some people to be a form of autism or pervasive developmental disorder and is a developmental disability… DS can speak, has vocabulary, etc., but it has affected communication in him in number of ways. The only way I can think to describe his speech is to say that it is precise. Sometimes he overemphasizes certain consonants and changes or softens certain vowels. It is really his own accent.

The only mention I have made of accents on this blog is in the people who have been caretakers for my son in personal care homes. It seems in this area that most personal care homes are owned and run by people with foreign language accents. The PCH my son entered last August was managed by a woman with a British accent. I believe that CA, the woman who takes care of my son today, is from Jamaica, since she mentioned something once about making a telephone call to a relative there.

Speaking of British accents, today this blog ranks about fourteenth of so in Google search for the phrase “mental illness british accent,” and nearly all the previous results are about a certain celebrity whose mental health is in question because of her recent behavior… including (supposedly) recently acquiring a British accent. I do not have any particular interest in following celebrity news, but if she were to announce some mental illness diagnosis, it would capture my attention and perhaps garner her a mention here by name.

Having my curiousity aroused I did a little of my own searching and found this academic article here: Characteristics of Psychotic Patients With Foreign Accent Syndrome.

The authors describe three patients with foreign accent syndrome during psychotic episodes which resolve with improvement of psychotic symptoms. Psychotic symptoms were worse during the times patients had foreign accents, suggesting a relationship between the presence of the accent and the severity of the psychosis.

Unfortunately you have to pay $15 to read the full article. I thought I would give it a mention for the benefit of anyone else who stumbles upon this blog looking for that connection.

The brain is certainly a mysterious thing.