Car­o­line C Rav­el­lo

Last week, in re­sponse to re­cur­ring con­cerns shared by read­ers, I wrote of my con­vic­tions about tak­ing med­ica­tion as one method of ther­a­py for men­tal ill­ness­es.I've had a rel­a­tive­ly suc­cess­ful jour­ney with coun­selling and med­ica­tion, the lat­ter be­ing the long-term af­fair. I strong­ly rec­om­mend every­one do an as­sess­ment of their men­tal health, es­pe­cial­ly if there is sus­pi­cion of a prob­lem. What's trou­bling are the oc­ca­sions where rel­a­tives are ask­ing what to do if some­one who is as­sumed to be ill or ex­hibit­ing signs of clin­i­cal de­pres­sion re­fus­es to go to the doc­tor.

There is no straight­for­ward an­swer. Each sit­u­a­tion is dif­fer­ent; each com­pli­ca­tion varies in sever­i­ty; the af­fect­ed per­son could be any­where along the scale from mild to vi­o­lent. So, for a non-clin­i­cian, it is be­yond my pro­fi­cien­cy to make rec­om­men­da­tions, but I'll share my ex­pe­ri­ence, if it would prompt some­one to ac­cept re­spon­si­bil­i­ty.Since the age of 16 I want­ed to be well. In fact, I want­ed to be nor­mal. But fate twist­ed me in­to a tight­ly wound knot of over­whelm­ing anx­i­eties at every stage. Since life does not of­fer al­ter­ation of the past, it is what it is: for the most part I've been a bro­ken ves­sel–a boun­ti­ful, yet flawed cru­cible.

These days I'm giv­en to in­tro­spec­tion but there was a time dur­ing the pe­ri­od of my break­downs and sundry di­ag­noses when I slight­ed any sug­ges­tion of ill­ness. As a young adult, I lived a life of ex­cess­es. I dat­ed and par­tied; worked hard and played hard­er. Leo Toro dis­co in San Fer­nan­do and At­lantis, in the west were my home-away-from-home. I drank, and re­call on oc­ca­sion fet­ing for five nights in a hol­i­day week­end, and eight nights in a row for Car­ni­val.

I bought stuff: cos­met­ics, clothes, and shoes, five pairs at a time, while whol­ly ne­glect­ing my fi­nan­cial com­mit­ments. Sleep re­mained a three-hour af­fair and get­ting to work on time was a nui­sance. Man­agers who thought they could cor­rect this through dis­ci­pli­nary ac­tion found they had barked up a thorny tree.I drank what I want, ate what and when I want and re­mained a size ten, which I flaunt­ed. My wardrobe was at­ten­tion-get­ting slits and neck­line plunges. I shaved my head one morn­ing on the way to work be­cause I did not like my hair­style that day.

I was hap­py–or so I thought. I was hav­ing such a good time be­liev­ing I was nor­mal. If any­one said to me some­thing was amiss and I should get help, I would think they were mad.

The truth is I was man­ic. These were all in­dica­tive of that fact.Those with whom I en­gaged may re­mem­ber an er­rat­ic, neu­rot­ic, fre­net­ic in­di­vid­ual with al­most no re­gard for any­one's feel­ings. The world be­longed to me and every­thing was sub­ject. You can imag­ine how pop­u­lar (not) I was!

Ret­ro­spec­tive­ly, my two friends at my work­place in that pe­ri­od, Judy Ram­cha­ran and Ald­wyn Collins, were the on­ly ones I had. I know be­cause they have re­mained faith­ful friends un­til now, through sick­ness and in health, theirs and mine.It's at that place, too, I met the man who fa­thered my child, and I hard­ly cared that that re­la­tion­ship was an "ex­tend­ed" fam­i­ly, yet my choice of that ren­dezvous would al­so con­tribute to my last fugue state.

It's easy to think or pre­tend you are "nor­mal" even when you know you're not. I won­der now, would I have paid at­ten­tion to my men­tal health if I had not bro­ken down in the mid­dle of my first year at UWI, St Au­gus­tine?And yet, in an­oth­er ten-15 years I would again ne­glect my men­tal health, mak­ing a com­pa­ra­ble, cost­ly mis­take, which one man de­scribed as court­ing an en­raged beast un­der my skin.

In 1999, I took ab­solute re­spon­si­bil­i­ty for my well­be­ing and there will be no turn­ing back. I know my­self. I know my ca­pac­i­ty. I un­der­stand my re­al­i­ties. My knowl­edge about sero­tonin im­bal­ance and ser­tra­line were gleaned to take con­trol of the jagged graph that maps my life.At times I am anx­ious for the fu­ture: will I have com­pan­ion­ship, can I pro­vide for my needs, would I make a bet­ter grand­par­ent than par­ent? It is a haunt­ed ex­is­tence, but I re­main stead­fast.

I share this roller­coast­er vi­su­al of my life to say to the con­cerned par­ents that heal­ing/sta­bil­i­ty is an in­di­vid­ual re­spon­si­bil­i­ty that comes with ac­cep­tance. But get­ting some de­pres­sives to ac­cept med­ical at­ten­tion is dif­fi­cult. There may be re­sis­tance, with guardians hav­ing to re­sort to trick­ery, where threats have no ef­fect.In one in­stance, where the di­ag­no­sis is al­ready es­tab­lished and the med­ica­tion is re­fused, my girl­friend tricks her child in­to tak­ing the re­quired dosage by prepar­ing din­ner each evening and in­clud­ing the med­ica­tion in the bev­er­age or the meal, whichev­er is more suit­able.

Ac­cept­ing treat­ment comes from the de­sire for sta­bil­i­ty. But the men­tal­ly chal­lenged in­di­vid­ual may not be suf­fi­cient­ly sta­ble to ap­pre­ci­ate that and that's part of the dilem­ma in view.