A variety of possible conditions
May-September 2023
This waiting room [for an examination of our mental health] might be the puzzle we're all here to solve.
Case in point: Peter Sharrock, born September 1958. Enjoyed a fairly normal childhood, although prone to melancholia. And so, when they thought he was a little too lethargic, our family's GP would prescribe a supplement of iron.
In adolescence I courted an engaging eccentricity. I frequently played truant from school, and occasionally ran away from home. Although it really wasn't a bad home, I felt my fragile nature was being ground down by the mundane realities of a life that I would imagine might eventually destroy me.
I preferred to live my life in a daydream. When I was seventeen years old, I chose to be homeless on the streets of central Manchester, naively unaware of all its many dangers, but protected by guardian angels, some of whom were real and others ethereal.
I had imagined the beautiful life in Paris or San Francisco, but England's equivalent (Brighton) was as far as I got.
From 1982, I trained at Merrydown Park Hospital, and in 1985 qualified as a psychiatric nurse.
In 2001, I was treated for depression with Venlafaxine (a serotonin & noradrenaline re-uptake inhibitor) which -after one year- I decided to stop taking since it had made very little difference in the long term; the side effects were somewhat disturbing; and I'm only infrequently depressed.
For most of the time I’m a relatively happy bunny. However, from time to time, I do get depressed: and then it’s serious – clinical – not just some bout of unhappiness. So, I concluded [as a consequence of some readings from Wikipedia and the opinion of an amateur psychologist] that I suffer with a thing called Recurrent Brief Depression which would be reactive rather than endogenous: probably triggered by an elusive personality disorder.
Unfortunately, the NHS doesn’t have the time or the resources to figure out an accurate diagnosis for someone like me, so my own opinion has to be the one that counts [although one has to be careful with these throw-away opinions. Once upon a time (during an early getting-to-know-each-other exercise) I had informed my fellow trainees that I am a narcissistic and manipulative pathological liar. And, unhappily ever after, they had assumed that they knew me and all my motivations].
Apart from that antidepressant medication and some perfunctory counselling, I was offered no other kind of support. Even now, I'd still like to access those services (such as art therapy) that are being offered to those with a personality disorder in Brighton & Hove, but – as things stand - I wouldn’t be accepted in those places since I don’t have the right diagnosis. So, I invented for myself an imaginary art therapies unit (ATU) which is helping me to frame this mindful dialectic.
I continued to work as a staff nurse at Merrydown Park, but then I was feeling increasingly drained and finding all the responsibilities of professional nursing quite overwhelming. So, in 2014, I decided that I wouldn't renew my state registration. I did however choose to stay [and to this day remain] in work at Merrydown Park as a healthcare assistant.
I have wondered if some aspects of my ‘personality disorder’ could be described as schizotypal – in particular:
social anxiety; strange behaviours or inappropriate affect; having unconventional beliefs; reacting oddly or not responding in conversations; dissociations (including derealization, fugues, and alternate personalities); dwelling in perceptual illusions; being prone to ideas of reference while frequently interpreting situations as being strange or having an unusual meaning; and even experiencing the occasional transient psychosis.
Or one might draw on certain aspects of a schizoid personality disorder - such as:
apathy and detachment; secretiveness; preferring a solitary or sheltered lifestyle; emotional coldness together with an inability to tolerate the emotional expectations of others; and frequently feeling as though one is an ‘observer’ rather than a participant in life whilst simultaneously possessing a 'rich and elaborate but exclusively internal fantasy world’.
It’s not uncommon for the schizotypal to seek treatment for depression & general anxiety rather than to report any of the signs & symptoms outlined, above. And, of course, masking one's condition can be quite exhausting.
Last year, I took a course of cognitive behavioural therapy (CBT) which appeared to indicate that I needed to focus more on my thought processes than on any physical behaviour.
I'm reasonably lucky. I don’t have any substance misuse issues; my diet and exercise routines are adequate; I’m adequately housed; I have a job; I’m not in any debt; and I’m blessed with good family and friends. So, what's the problem?
I've had two or three meetings with my GP surgery's Mental Health Specialist. She’s less convinced that my symptoms are indicative of a personality disorder. She thinks I might be on the autism spectrum, or that I might have an attention deficit hyperactivity disorder (ADHD).
So, now I'm on this waiting list. I've been told it could take as long as five years before I get to speak with a psychiatrist regarding my scoring borderline for ADHD and 82% for autism. And I'm told that there's probably no chance that I'll be referred to an NHS art therapist (which is all that I had originally wanted).