André - Interview 13

Age at interview: 29

Age at diagnosis: 23

Brief Outline: André describes a 'normal' life doing his university degree but then having a 'nervous breakdown'. He has had three admissions to hospital but is now reducing his medication and looking forward to further education in the future.

Background: André works as a volunteer, and is currently single with no children. Ethnic background: White British.

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André describes his life before diagnosis as ‘pretty normal’. He went to university, did a Masters and had a scholarship to train as a barrister. However he remembers being ‘very stressed’ with his exams, and had a ‘nervous breakdown’. He remembers feeling ‘fuzzy’ and ‘light-headed’ and was shaking, so he contacted his sister. At that time he failed his exams and his girlfriend split up with him. Subsequently he spent a fortnight in hospital; he was diagnosed with paranoid schizophrenia and was prescribed Olanzapine. He had three admissions in total, the first to a private institution, the second to an acute, single-sex ward in London, and the third to the initial institution under a Section 3. André says that he was relatively fine until ‘he ran into the NHS’, after he couldn’t afford the consistently high fees. Now he receives medication free on the NHS and also fish oil, called EPA.
 

André describes the community mental health team as quite good, although they are reluctant to reduce his medication. He receives CBT and ACT but would like to investigate psychoanalysis further. He would like to reduce his medication and find the long-term use of anti-psychotics not a ‘cure’ but a ‘tranquiliser’. He continues to have auditory hallucinations which are like a ‘running commentary’ ‘pretty much constantly’. When he is with friends he doesn’t hear voices so much, but he does hear them when he is on his own. They are the voices of the police, his father, or the security services, and yet he also says he has excellent hearing. He describes himself as having ‘persecution mania’. He says it’s sometimes difficult as a lot of people do actually get persecuted and it’s hard to tell the difference.

 

André has been on a range of anti-psychotics for a period of time and this it has affected his weight. He is currently on clozapine which has ‘terrible side effects’ including ‘chronic constipation’, and also experiences effects on the nervous system and sedation. He describes being sleepy yet not well-rested.

 

André has disability living allowance and income support, and also has access to free transport which he finds invaluable in getting around. He was relieved when he had the diagnosis of paranoid schizophrenia, even though he now hasn’t been called ‘paranoid’ for a long time. He thinks that diagnosis is important as there are different communities to get in contact with. Religion played an important role in his life and he has understood that religion ‘tests’ you as most people’s lives are hard.

André will think about doing a degree at a local university, and then thinks in about 3-4 years’ time the job market will have improved and he will be able to start work in the financial sector. He thinks recovery is about improved relationships, and considers possibly having a partner and children. 

André says that the voices are like a commentary and he is not sure whether they are real or not.

Yes, you hear voices in third person, and that feels from a male. And you believe that, not inside your head, outside your head. They don’t control you, and you don’t control them. They don’t tell you to do things. Don’t give you orders. And they are there constantly, when I’m sitting here with you, I’m distracted, but as soon as you leave I will hear them. Or on the bus I will hear them. And it’s generally like just a form of commentary. Sometimes it’s positive, sometimes it’s negative. Sometimes it pejorative, sometimes not so. And, yes, pretty much constantly really.

 

And what are the voices talking about?

 

Usually a running commentary on what I’m doing. But I also think I can hear the police, or I’m under surveillance or I can hear my Father, or I can hear. SAS or security services. But I do have excellent hearing, so you never know. And they’re certainly not voices coming in from inside my head. Like now I can’t hear any voice. I can’t hear any voices up there or here. So when you get distracted when I’m talking to you, or socially with friends or family I don’t hear them. When I’m by myself, I hear the voices again. I might just have excellent hearing, who knows?

 

And what do you think about the voices, do you …?

 

Well I try and ignore them as much as possible. Although it’s difficult, very often I usually end up responding to the voices. So if you’re by yourself you’d hear the voices and respond to them, which is always tricky. That’s borderline schizophrenia for you. It’s difficult. The most acute stage of course is up to 20 or 30, up to 30 or so. But post 30s, I don’t think it’s because the voices go, it’s just as you get better at handling your existence, and handling the pressure, and knowing not to respond to them, if that makes sense. 

 

André had an unpleasant experience of staff and the diet available in a secure unit he was in.

Obviously don’t expect to be given beluga caviar and champagne, but likewise, I’ve got a piece of cheap steak, frying steak in my fridge and that’s just not cheap to give them cheap frying steak. That’s no expensive to give with a cup of tea if they want one. It is not expensive to, even in prisons to have an exercise yard to go outside. Those sorts of things are not expensive. I mean obviously NHS cuts corners so does [Name of hospital]. But they cut corners in that institution on purpose. Perhaps to make you aware of your existence. Perhaps humility. Make you face up to who you are. But obviously I’m not a murderer. I’m not a rapist. I’m not a paedophile. I’m not a drug trafficker. I’m trying to think what other things it can be. So all of them, you know, I’m in the wrong environment. If they try and make you face up to who you are. Anyway.

 

What was your experience of the staff like in there?

 

Well they were blowing whistles and things. They used to do their concentration camps. When they are Jews to go off, but when […] I think, when they have taken off the drugs, they start blowing whistles to get stumpf comments and that . And they were doing a similar thing and of course they were lazy, the staff, extremely lazy. And I, because I was allowed carbohydrate and the only thing there was a pack of biscuits, but they wouldn’t give them to me, even though they had like, you know, like 300 in the store cupboard, and also they wouldn’t give me fruit. They wouldn’t buy any fruit. It’s bad for diet.