Saturday, January 12, 2008

Mental Ward

It is now accepted that alcohol related brain damage is the largest cause of mental retardation in the United States.

When I was "hospitalized" some years ago, before coming to terms with my illness, I was admitted to an old psychiatric institution. It was a huge place, covering over 100 acres and used to be a self-sufficient town in it's own right. Back then, it was where you ended up if you were found in breach of what was known as the Inebriates Act. It also applied to other substances. In fact, everyone in the area whom society found distasteful because they were intellectually/physically disabled or mentally ill ended up there. But it was the safest place for them, and for society.

When I was allowed to have my "clothes" back, I was also given the privilege of being able to explore the hospital grounds. I used to walk as far away from the building as I could, into the paddocks, to be on my own and escape the screaming and antics of the tortured souls of the ward.

One day I came across a clump of trees, and in amongst these trees were mounds. They were old graves, probably from the late 1800s and early 1900s.

Men, women and children - forgotten, no names were on the wooden crucifixes. Some of those people went to their deaths no longer remembering who they were either.

Today, the "hospital" is closed, it is no longer somewhat a refuge to those who cannot look after themselves. While it wasn't a pleasant place and many frightening things occurred while I was there, it was still home for me and many others.

My 9 months as a patient taught me many things. They were hard lessons to learn at the age of 21, but looking back, I consider myself very lucky to have been in that place, unpleasant as it was. Before I did my "tours of duty", I really had no idea what the terms ARBD, Wernicke-Korsakoff Syndrome and DIP really meant.

There I met a 17 year old who had just "done" his first line of speed. He was stuck in a psychotic state, which will probably be forever. I met many people suffering from paranoid schizophrenia, which is a terrifying illness - for everyone. Many of these people were marijuana users. Don't let anyone ever tell you that marijuana is a soft drug. If you have mental illness running in your family, such as endogenous depression or schizophrenia , marijuana will often trigger it - and will exacerbate the illness. And perhaps what may have been an intermittent problem in your life will become your constant companion.

There were other patients who had burnt their brains out with drugs like LSD, bad cocaine (cut with all sorts of toxic materials - dealers often mix powder drugs with cheap materials to increase profit margins). You name the poison, it's final effects lived (if you can call it that) in that hospital.

There were people with HIV and all the forms of Hepatitis, mainly IV drug users. Many patients had mild ARBD (alcohol related brain damage/birth defects) to accompany their various mental illnesses. Common symptoms of ARBD include difficulty in planning new tasks, difficulty in learning new things, aggression, paranoia, deterioration in work performance, confusion, or poor coordination.

Then there were the men of Ward 13 - Mainly Wernicke-Korsakoff Syndrome (WKS) patients. Many of these people are the ones you see huddled in alleyways, drinking strange and poisonous liquids out of brown paper bags. This is a disease that many long-term alcoholics seem to contract. It is also commonly known as "wet brain". As the brain shrinks the ventricles become enlarged. It basically eats away at the frontal lobe. It is caused through a B1 (Thiamine) deficiency. Alcohol destroys B1. Approximately .5 - 2.9% of the population have WKS in some form.

Based on clinical research studies, between 22% to 29% of individuals with dementia are found to be heavy drinkers or alcoholics

Amongst its many symptoms are:

- double vision
- uncontrollable or twitching of the eyes. Sometimes one eye may be permanently askew
- eyelid drooping
- loss of muscle coordination
- unsteady, uncoordinated walking
- weakness
- hand tremor
- muscle contractions
- muscle atrophy
- facial paralysis
- sensation changes
- decreased sensation in the feet or hands, numbness
- abnormal sensations, tingling
- thin, malnourished appearance
- loss of hair
- dry skin
- swallowing difficulty
- speech impairment - slurring, choked
- hoarseness or changing voice
- mood changes, emotional changes, and behavior changes, including aggression
- loss of memory, can be profound
- confabulation - pathological lying to fill in gaps of time
- decreased intellect/cognitive skills
- decreased problem solving, confusion when presented with minor challenges
- loss of ability to think abstractly
- orthostatic dizziness
- constipation
- inability to tolerate cold environment
- incontinence

WKS is incurable.

Some of the people I met in Ward 13 were once doctors, lawyers and scientists. Some of them were under the age of 40. Addiction does not discriminate. The lucky ones die, the rest get diseases like "wet brain". When I spoke to a nurse about the condition, she told me that in some of the patients their memories were so bad that they could not remember one minute to the next.

She told me that she could call them in for breakfast, they would eat and return to the courtyard. Five minutes later, she could call them again and they would return and start breakfast all over again. They would have forgotten that they had eaten.

Some of them had forgotten how to use a toilet and had to wear diapers. From a scientist to quivering, dribbling, incontinent carcass with a heartbeat. It was tragic.

One man that I walked past outside the ward proudly declared to me that he was "going home today, family is coming". He had been waiting there every day for 8 months. The saddest thing was, he truly believed it. Confabulation. He had forgotten that his family had disowned him.

When I came to terms with my condition and went to a detox clinic instead of a psychiatric ward, I met a farmer who thought it was 1969. It was 1994. He had lost the farm in 1969 after a massive binge. He did not know what his name was. His condition was so bad when he came into detox that they had to administer Valium intravenously. For two days he took seizures every 15 minutes or so. Watching these seizures occur is truly frightening.

Some people who have Korsikoffs, ARBD, and DIP get caught in a space in time that is absolute agony. Remember that movie "Ground Hog Day"? It was set in a quaint little town. Now imagine the setting being the worst day you have ever experienced in your life. That is what these people experience, every day for the rest of their lives. Do they deserve it? Some may say yes, but while most of us consciously chose to drink/use, none of us chose to be alcoholics/addicts.

But, here's the catch.... once we have the education we need to be responsible our our own illness. There were some days that I hated the people who helped me, because the education they gave me also gave me the burden of knowledge. I could no longer claim ignorance.

Many of us "fall off the wagon" in our struggle for recovery, it is a life-long battle and the stakes are high...it is sometimes very tiring. But "falling off" shouldn't prevent us from trying again.

I saw my future as an addict/alcoholic and learned..

There is something worse than death.

There is insanity.

There is Ward 13.

Michael Bloch
michael@worldwideaddiction.com
http://www.worldwideaddiction.com