Patient "Unrecognisable" After ECT Psychiatric Treatment | Our Life

i mean everybody tell you that i am the last person they've ever felt that i'd have nerve trouble right spoiled anyone who you talk to lovely job late because i talk to anyone now if it was the winter i'd be putting a shot of scotch in here two spoonfuls one doctor said to me it's like an air on your head uh our final areas is one side of it and the other side of it that's a thin the margin is of being mentally ill or normal this is the world's oldest psychiatric institution it used to be known as bedlam a place we hid those we called mad we need some medication now known as the south london and maudslay i need to speak to you treats 50 000 patients a year any sign you yourself i don't think so and numbers are rising the staff and patients open their doors [Music] today you mentioned the mostly they go that's the loony bin i say it no it's not there's people there that's got an illness it's an illness but they won't have it they think you're all made if you get to 65 without a serious mental illness you probably think you're going to be okay [Music] so did these people don't understand me [Music] nine months ago lorraine was enjoying her retirement with her husband alan after a 25-year career working as a [Music] nurse vera was volunteering as a home help but now she can't look after herself [Music] how did all this happen how did that end up in a psychiatric ward among all those people [Music] i don't know and last year peter was teaching english in istanbul after a life spent traveling the world [Music] i was an exhausted person and i knew it i really hadn't got any get up and go if you'd call it that you know get up and go in my gift of gold got up and gone [Music] none of them knew their lives were about to change and that they'd end up here on al2 a psychiatric ward for older adults at the moorsley hospital sylvia has bipolar disorder she had a four-month stay on the ward despite being discharged she came back as a volunteer helper they don't know what they're in here for half of a there's not one out there that thinks they're made well they're not made i don't like to think that i'm calling them made but they'll just go to you what am i doing here and you've got to work that one out what to tell them i should say you're in here for a rest you know what else to say people are afraid of old age and of course they're afraid of mental illness and they're afraid they're afraid of them because they don't understand them and which is why we pretend that there are different species because then we haven't got to encounter that prospect that is going to be us one day [Music] as a society that kind of values perfection and as you get older it becomes harder and harder to remain perfect [Music] morning david good morning good morning good morning how are you i'm very well a bit wild but you know that's normal peter was the first patient we met he seemed a bit eccentric until we were told he had a serious mental illness schizoaffective disorder characterized by mood swings and delusions [Music] i'm here because i took a few tablets and got picked up by an ambulance who decided i tried to take my life i don't think it's true maybe it was leaving what i've been doing for years after all i've been teaching in istanbul for 12 years maybe to 15 years i'm not quite sure but it's a long time and i did break from it and it caused me some problems which i wasn't handling very well when i came here he took an overdose at the time he was describing how angels or some force in his right hand were forcing him to take it so he was he was felt to be a very high risk of suicide and it was an unknown quantity we didn't know whether he had a depressive illness that he was perhaps masking whether he had a schizophrenia where the voices were telling him to end his life and so he came here for an assessment how many tablets did you take peter 15. that's nothing wouldn't kill a cat in my opinion but the doctor would say yeah that's his opinion but the intention why did you take them then to get help there's a way wasn't it although he refuses medication the doctors are satisfied peter's now become much more stable and is ready to be discharged no people don't understand me they're not me it's not me i don't lorraine's been here five months and continues to baffle the staff she was brought in by her family after becoming confused about who she is she can't recall anything about her past [Music] it happens suddenly almost overnight we're sort of trying to understand the behaviours the things that she's saying about i'm not me and i don't think she does recognize herself at the moment and i think it's very painful i don't think she does know who she is my conversations with she said actually you should lock me up you should take me away and lock me up somewhere and i kind of said her actually you are you know this this this is a psychiatric hospital right and and then she said you should kill me just kill me and then she said actually i want to take a knife and i want to cut my head open i can't stand it anymore i can't stand it hello lorraine lorraine was admitted with depression but as times passed the staff now believe she's suffering from an extreme case of dissociative disorder it used to be known as hysteria and is rarely seen today it's probably fair to say that lorraine is one of the most challenging patients that we've had to deal with because it's quite difficult for everyone to get their heads around exactly what's wrong with her but it was clear to us very quickly that this wasn't a straightforward case of their depression [Music] remember me look at your brain it's really hard isn't it not not knowing who you are [Music] it's really difficult [Music] and you just don't recognize yourself anymore do you this isn't the person you remember i don't remember me i [Music] diagnosis is one of what we call the dissociative state the best way to kind of think about it is that we all struggle as we go through life there are things that we have to do that we find difficult sometimes life can throw something at you that sends you into a fantastic spin a terrible kind of conflict with yourself and you can't deal with it so the way that you cope with it is by escaping to a sort of different state what i thought really started me off was i lost my husband at 45 i lost my mum and my dad within 10 months all the three of them never said goodbye to one of them my mum was playing bingo a hole my dad went was around the town all paying his rent and my husband he was indoors but he was in the in the bathroom and he just our attack and went over and whether after a little while that got to me because i felt as though death was following me bad because i had relations dying friends and you know and it seemed terrible it seemed as though people was dying all around me and is that it was my fault i don't know why i thought that but that's what i did [Music] okay okay no one quite knew how to treat lorraine medication wasn't really working but over the next six months we were to witness something remarkable something no one on the ward could have predicted peter would you give vera a compliment with all the charm that you can master al2 at the maudsley is a psychiatric ward for over 65s in crisis what what charm can you find can you turn off only the charm of honesty i'm telling this truth for me i've said it to you you think about it i think that yes when vera was first admitted she was frankly psychotic very very paranoid and agitated and suspicious and the delusion that she had about myself and the nurses was that we we weren't really doctors and nurses we were actors pretending to be doctors nurses and this wasn't really a hospital that everything was going on here was somehow a sham and a duplicate of a real hospital and she had a conviction that something dreadful was going to happen to her can you give peter a compliment back with all the charm you can muster yeah i did say i'd join this group today and just sit and listen and you're trapping me into am i trapping yes you are before she came here vera had never suffered from a mental illness medication has brought her psychotic delusions under control but now she suffers with extreme anxiety oh she hasn't been home for six months tonight she's spending a night alone in her flat to see how she copes oh i can't do this i don't want to do it i don't want to stay here and i don't want to go there what do i do where do i belong i really want to have a cigarette the nurses have booked fear are a taxi but even that has set off her anxiety it won't be there [Music] it won't be there you watch it won't be there see it's not there [Music] it's not there it won't be our cab yeah where'd he no can you wait a minute radar thank you he says they can [Music] and how do you feel about the prospect of spending your first night at home i'm nervous oh very nervous it's been about six seven months [Music] since i was at home [Music] now i don't know if i can cope with it i don't know oh god [Music] uh i've always been a fairly strong confident person but i'm not now am i i'm not now so can it feel quite lonely in there even though there's lots of people sort of but it's even lonelier here because there isn't anybody so what's the answer vera i don't know i don't know when were you at your happiest with my first husband and with my second but it wasn't quite the same [Music] was he your first love oh yes oh yes he was 57 when he died and i was 35. i got married at 19. no children you see so [Music] so there we are [Music] i don't know if i can cope with staying tonight i don't know whether to phone and go back to the ward or not i don't know what to do i can't just sit here all night can i after just an hour at home vera telephones the hospital asking if she can come back to the ward yeah the thing is i don't i don't feel i'm doing well thank you very much thank you bye she's phoning me a date first day i went on didn't want to go home letters all over the floor and oh and then in the finish i didn't want to go back i said no i'll stop and i stopped and then i stopped for a week and i went back and they discharged me and touched wood i've been back since only to do voluntary but i can understand how some of them people feel in there it is hard to come home it's different now well you used to have right tight neighbours years ago i mean me and josie next door we still talk over the fence but i i couldn't tell you lives over there not like it used to be but it's a different world now in it it is really and i think sometimes it's a cruel world lorraine has been here several months but the staff are still trying to work out what triggered her sudden breakdown she's been with her husband alan for 32 years but doesn't recognize him lorraine's deterioration happened soon after she saw alan newly killed i mean alan allen has had throat cancer and he's also got a heart problem then he collapsed in the street and she was looking out her window and saw a car coming and alan collapsing in the street and she witnessed that i want my wife back okay everybody i never leave her never like the worst thing i was when she first come here for two weeks they thought she was gonna die but she's coming back to compete me firstly i hope she comes back lorraine lorraine has had a traumatic life she was abandoned by her birth mother soon after she was born what's not right lorraine and in later life struggled with alcohol for lorraine something about the loss of potential loss of alan those kind of attachment issues are huge for her so i think that's something we've got to work on and again you know it is her sense of self who is she [Music] [Applause] we've come back with the keys i don't think it's been done before peter's preparing for a life away from the hospital he's just viewed flat in sheltered been housing been getting a house where you live where are liv i don't want you near me when are you going monday you're not you're leaving here monday yeah i've got to go to bed i'm going to get carpet i've got to make it right you can't go in and like lie on the floor is it the lightest wooden floor like this no needs a garbage it's going to cost you a few barbaric hmm you'll have to get a job yes that's what i intend to do oh you've got all your necessities what you need accepting a good woman a good flat a good woman yes i only react to love [Music] you better watch out women ran that way really yeah all right [Music] yes fantastic do you feel excited a little bit off normal what do you mean a little off normal normal it's behaving myself in keeping with the ward because i don't want to upset it really but do you think off the ward you can be a little more off normal yes peter didn't want to be medicated he'd always refused drugs on the ward but on his own in the outside world it was a choice that felt more risky do you know what when you get better should we have holiday in las vegas right when you get better shall we go to las vegas yeah you've been there before where las vegas no i haven't oh gambling have you been home anymore once um [Music] is [Music] vera is struggling to cope with the idea of returning home on her own [Music] peter on the other hand was hoping he'd be free to live as he pleased when he left the ward [Music] but he's still being monitored by a community mental health worker where is the safest place to cross how do you mean safe place um okay you me you showed me where to go to cross well actually i dodged the cars because i've got to have it we've got a habit in this stuff we don't live so carefully ah i do though that's not safe i want you depends what you classify as life now here i suppose the truth okay but there's a i'll do you across you wait for the light to change or you're pressing i'll wait for the traffic to stop because this traffic i think you'll press this button peter well yeah well press it if you like but i never do you never do it oh yeah oh no i didn't want to go this right okay we were going to crossfit well anywhere you like yeah maybe we shouldn't have to look for a crossing feet i don't want you to cross the road hold up peter hold up hold up hold up the thing here awful thing is my responsibility to help you to but when i cross the road oh yeah but i have always done it and i always will [Music] i know you're not but it's still not safe and i still have to tell you well you have told me okay i'd rather you use the pedestrian crossing next time i'm being honest a little bit yeah please don't go on it's only crossing a bloody road yeah but cars was moving peter and they have to stop i'm not moving yeah oh for god's sake andrew all right don't get upset with me i'm just being honest yes of course i am because i'm being mothered and smothered i came out of istanbul which is a city where they live fine peter struggled to accept his mental illness he was a proud man maybe that's why he didn't want help whether through medication or from support workers am i discharged from that you're discharged from the hospital one but you're not discharged from our care too so you're still under the home treatment care and that is our responsibility to come daily and make a report how you're coping in the community well not coping very well in the community okay fair enough but i'm obviously not coping with the home care i'm gonna press the buzzer peter press the button yes there you are thank you now that's delighted you oh make you feel good you made me feel good well it works doesn't it see the buzzer miss lorraine lorraine i've got your morning tablets can you set up for me please yeah thank you hair's all sticking up right painkillers and your multivitamins and you're metaphoric can you sit up again for me lorraine lorraine akurst is on an antidepressant searchling she's on sena carcismo she's on vitamin b forces hip and metaformin and timing there are no signs that lorraine is regaining her memory or any sense of her identity can you tell me a bit about your life okay now this is not my this is my oh this is my old room when i was looking out the door when people were coming what i was seeing was the new version rather than an afterlife place or that's where i would be gone people look to me to remain cheerful and positive and and confident that we can get people out if i lose confidence that i can get someone better then the team isn't going to be confident either now sometimes what that means is that i have to maintain a kind of confident exterior and confident kind of facade even though inside i'm thinking this is the most difficult patient i've ever looked after don't put yourself in the floor professor howard has decided on a drastic step for me ect stands for electro-convulsive therapy which is a terrifying name for treatment i have colleagues who will never use ect for their patients and just don't believe it's a useful treatment but that's very different from my experience my experience is that ect is a fantastic effective treatment for patients who have very severe depression and the wonderful thing about ect is that it gets patients better very very quick [Music] they inject you with something that's freezing cold goes through your vein freezing cold for everyone then they put things on your head and then you're out by then and you don't know nothing peter had been out of hospital just a week when we began to notice his thinking was becoming more disordered home is where the heart is where is that the heart uh home i should say it's where we fell from i've got to say that and when i say i've got to i'm telling the truth the home is is there we fell we're this is not our home we've adopted the earth and we've we've destroyed the surface of the earth completely it's not natural anymore it's all buildings and we've done that right across the face of the earth and now we want to do it to mars we haven't done what we're supposed to do find out what we are where we are who we are and why we are we haven't found out any of that who are you me i'm a human being but i'm more than that i'm someone else as well [Music] peter's psychotic delusions were also re-emerging this hand talks to me quite a lot i ask always i follow guides yes of course he does he's the son when did you last ask your hand something my hand just now i don't remember what i asked before probably asked are we all right and the hand said yes you're more than all right thank you and left foot talks to me but i've not had a lot of communication with hermes who i've been arguing on his behalf and i don't need to because they do their own arguing but the world has been neglected i've said you've neglected this world and they have it's true isn't it yes it is who's going to listen to my right hand that's the daughter of the queen of the king of heaven is there whether you believe it or not it's the truth it was the truth down in egypt at the time of ramesses ii and it's the truth now [Music] so shall we start by seeing lorraine talking about lorraine because she's having greasy and everything's good to jessica so i mean i've heard all sorts of stories she was very restless and agitated after her ect and it did take three of us to a sister with her personal care because she was so agitated and aggressive and after she was changed and she sat down on the couch she was just fine and then i went over about an hour later and i was just chatting away to her and i was like do you remember my name and she was like yes emma and there was just a few other staff around the lounge and i was like do you know their names and she was like yeah and then i was like what about your doctor is your consultant and she was just like thing for about 30 seconds then she was like howard howard so i've never had a conversation a proper conversation with her so i guess it'll be quite interesting to do that and see what she thinks about these things hello lorraine hi i feel like i'm introducing myself for the first time i'm professor howard hi good good nice to meet you good to meet you good to meet you come and have a seat next to me so thank you very much there's an enormous crowd of people here wow wow many of them have been involved in your care well there's nine months i have no recollection whatsoever right gosh none at all none at all no amazing and a bit frightening i think too isn't it well it was hard to believe a couple of days ago when i was told i've been here for nine months yeah and i don't even remember talking to you right well you've never had a proper conversation no you've you've come into this room and sometimes lay down on the floor at my feet while i've talked about a couple good great to see you like this thank you wonderful well done nice talking to you nice meeting everybody i don't remember your names the transformation was remarkable after two sessions of ect the rain was barely recognizable from the woman we first met how amazing and um and how weird too talked about that because like she was i came left on friday evening and then when i came back in yesterday morning and jennifer had been here all weekend and she was like oh my god wait you see her then yesterday morning i was like just totally stunned how she was and isn't it fascinating that it was ect that finally it worked because it's such a powerful intervention that she was able to believe that that's what made her better and i think yeah it was it was just like so we saw with with with with the sort of stimulant drugs and with the antipsychotics we saw little little but not sustained improvements didn't we yeah so this is just a bigger version of that thing [Music] the ect had worked like a placebo by radically changing lorraine's treatment appeared to have given her the belief she needed to get better she calls it waking up when i first woke up what she was really keen to say was you know what i was a nurse i did this i did that you know this is who i am i am this person and and it was like she was you know needed to tell people exactly who she was and that was very very important because for nine months she she'd laying there and said i don't know me i don't know me i don't know who i am out in the community peter's mental health was deteriorating he'd been called in to see psychiatrist dr rao where would you like to see it anywhere you like okay would you like to sit over there okay yes of course one of my jobs is to make an independent and objective opinion about your mental state okay okay never have i met you before and having read the previous notes what is it what problems do you feel that you have at the moment none but no problems at all no no i haven't okay how are you sleeping at the moment very well you're sleeping well without any medication whatsoever no medication okay and what about your energy what's your energy like it's all it's all right when do you have your first drink in the morning i don't have a drink in the morning okay so what i drink coffee so during the day when do you have your first alcoholic drink i don't have an alcoholic drink so you don't drink at all now well not unless i'm meeting a friend or i go out and i have one have you had any problems with with drinking in the past probably drank much more yes how much would you been drinking in the past paul thought i drank a lot in istanbul what are we talking about well i drank 15 liters one night we were trying to emulate alexander the great one two of us and we discovered that he went to atoms and drank 15 liters of wine and he drank another 15 liters of wine and he died but you had 15 liters that day oh we did drink 15 liters but we mixed it beer and rice right okay and i had an accident broke my shoulder falling off a stairway but that's a long time ago now yeah but if i said to you mr rawlings that if i said to you that at the moment our feeling and my feeling and and that the the home treatment team's feeling is that you're probably in unusually good spirits and as you get older mental illness because mental illnesses can be more subtle they don't always present in a characteristic way no way and my my my observation mr orleans is is that you you have got what we call hypomania now you may not agree with that you're slightly on the upside of what we would conventionally call normal overactive yeah it's slightly more than that it's actually type of a type of illness that's causing you to to be like this oh well i mean you better go back to istanbul hadn't i do you think there's any any scope for for trying some medication that might help regulate them no i don't want to change myself no intentions of changing myself a bit of a tricky one when the psychiatrist is saying to you that you might need treatment and you don't feel that you need it's always a dilemma with mental health i've been discharged from the hospital doctor i know i know it's your choice whether you take medication that's right psychiatry hasn't changed but when the man said you will not do this i left england there's several pizzas if you like out there maybe hundreds of pizzas out there who are not a danger to anyone they're functioning well they may be slightly regardless like eccentric but they're mentally unwell it's only after the second third fourth episode of coming in with a single presentation and going out like a revolving door it then brings home to the patient the fact that there is something wrong [Music] i always thought people being in a hospital two weeks was long enough we're seeing the rio of the true lorraine i don't know because we're used to seeing you lying on a couch all day and not talking and me you never used to speak to us never mm-hmm no you used to mumble and be like i'm not who you think i am no i thought yeah and you used to say that you don't have a husband and i don't have a family no and i don't have a daughter can you imagine yourself lying down on a couch for nine months and not speaking no not me the side we know of you is that lorraine not talking not communicating not even opening her eyes just wanting to lie down having to set you up for your meals i'm shocked i know the danger is that lorraine just wants to pick up and be busy again and and get her sense of self that way rather than kind of peeling back some of the layers which which will be painful actually and thinking about who she is really [Music] [Music] you know i never would say something was wrong with me you know i always were worried about everybody else and i didn't like to bother anybody so i probably kept it in too much and didn't realize what it was doing to me did you think this day would ever come he's being discharged from the ward i can't believe i'm on the ward that you know i've just always been me so this type of environment it would only be work-wise for me looking after people so for me to be here and not knowing how i got here or anything yeah it's quite overwhelming well i want to get a double cheeseburger from mcdonald's although lorraine's finally leaving the ward behind she'll return for regular psychotherapy sessions and counselling lorraine didn't disappear into that dissociative state for no reason at all i mean she disappeared into it because she was unable to cope with the pressures and strains of her life now those pressures and strains you know may return and may still be there but by coming back into life she's exposing herself to the anxieties and the difficulties that that drove her into that dreadful state peter's meeting with psychiatrist dr rao has made him even more determined not to take medication what's your opinion oh you think he was rude he was talking to a patient yes he was that's philly doing that i can talk to him but i like doing that i love my system i'm not going to have it tranquilized by an idiot he wants to put me in hospital and put me on treatment i know what he wants exactly he's got to be able to take me somewhere and prove that i need medication what you going to give it to me for being active isn't that my lucky day that i'm 86 and active he didn't expect me to say no he thought i would acquiesce and say okay what treatment if i'm a bit active yeah i don't want slowing down that's the last thing is he made veer has been on the ward for almost a year but has gradually started to regain the confidence she once had and is going home [Music] no to me that's what was a bad period in my life i want to forget him i'll miss the kind staff but i won't miss being on the board because that means i'm a patient [Music] i hope that's the last locked door i see [Music] this how this is home vera was home and this time she was happy to be there thank you pleasure i just hope that um it'll be all right and that i just grow old a little bit gracefully i hope i'm old enough as it is i'm 82. but um i don't know what how many years ahead i've got or not i'm just hoping that it'll be all right in a society old people and people with mental health problems come right at the bottom of the heap really so if you're old and you've got mental health problems you've got this sort of dreadful double whammy of disadvantage and those of us who work in this area we kind of feel well if older patients who've got mental health problems are being well looked after then at least that's right down the bottom of society's kind of interests and levels of importance but somehow you can hope the rest of society will look after itself so long as the people down here are being well cared for the time we'd spent on the ward made you think about your own parents your own life and how fragile everything was how easily things could change oh we've got another new woman bloody hell see what i mean it must be the weather i never really say um well i am all right but you get scared when you say that because you know how easy it is to go the other way that's what i am bipolar i just remembered it i do remember these things but i don't know what it means i ain't got a clue i think it means that i'm double nutty [Music] since leaving the ward lorraine has been readmitted twice she continues to present a challenge to the doctors and 86 peter is still managing his mental health the way he wants to [Music] you

Channel: Our Life

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Id: PSdkGwUZed8

Length: 46min 40sec (2800 seconds)

Published: Sat Mar 13 2021