Losing David

The Early Years 

David was born in 1981, the only child of professional parents, both graduates in their early thirties. There were no problems during his early childhood. We considered him to be the perfect child. Up to the age of five he attended a kindergarten and spent part of each day with a family friend who looked after two other children. In this way we hoped that he would benefit from an association with children of his own age. However, David very rarely formed relationships. Since the early years of infant school he seldom saw anyone outside school despite extreme efforts on our part to remedy this. He claims to have been completely alone and friendless in school but his teachers have not always agreed with his view. He was allowed complete freedom to visit friends or bring friends home. He had one acquaintance he saw infrequently but only if we pressed him to make the effort.

 

Playing Lead Guitar  at Margate 2006

 He was very keen on physical activities. He would join and regularly attend clubs but with little social participation on his part. These have included:

 Judo – he won gold and bronze medals as a junior in regional contests.

 Kick boxing – he reached blue belt standard. At 14 his teacher told me that he could take him no further. David would turn up for a two hour session and refuse to practice with the others. Instead he would move to a corner of the room and repeat the same kick for hours over several sessions so that any real progress was impossible.

 At different times he took up roller skating, dry slope skiing, swimming and cub scouts. All of these activities were encouraged so we would often attend to give our support. We hoped that David would form some sort of relationship with other children but this never happened. No-one ever telephoned or called for him and he would never make any contact with anyone outside the event.

 During his mid teens David developed a more intense interest in his fitness and weight. We were very impressed with his determination. He took up weight training, running and swimming and adopted a sensible diet. He became very fit and lean, developing great strength for his age. We did not know at the time that this new diversion was to become an all consuming obsession and a focus for his illness. (David has always maintained that his fitness regime has nothing to do with any illness.)

 At 16 he gained 8 A-C GCSE grades, a score which was above average.

Fristral Bay 2005

 The First Signs of Illness - as yet unrecognized 

 At 18, David was finishing his "A" level courses. He was predicted to gain two ‘A’ grades in his main subjects with a ‘B’ and a ‘C’ in two others. (some of David's artwork from this time)

 Shortly before he was due to leave school for good David was in one of the school laboratories finishing some coursework. Several students from another year group were causing a disturbance and one made some remarks to David who punched him several times. David then smashed some glassware and chased another group into an adjoining room. From what we are told he caused a great deal of fuss and has not been allowed on the premises since. Years later, after he left hospital, David said that he had become convinced that some of these students had knives and they were about to attack him and that this was the reason for his over reaction. At the time we had no idea he had such thoughts.

Following this incident we persuaded David to see a psychiatrist recommended by our GP. We had to tell David that it was a condition from the school so that they would not prosecute him for the damage he had caused. We had asked David on other occasions to seek advice but he was always very resistant to these requests. Following a long interview the psychiatrist could find no evidence to warrant further action.

 David also felt incapable of attending the examinations for two other ‘A’ level subjects.

 Strange, unexplained incidents were now becoming more frequent.

 He would sometimes make unfounded statements, out of context, and reiterate them many times later even though we explained that they were not important or could not be true. One day, he announced that people with short hair were immature. Nothing we said could shake him of this idea which he kept repeating for weeks.

By this time we were very concerned, not only about his lack of focus, but also his tendency to think about incidents over and over, sometimes years after the event occurred. He would form opinions about people, which seemed totally divorced from reality. He would ask us if we were spying on him or if we had spoken to other people about him. One morning he woke with a headache and asked if we had put something in his food.

 One night we were awoken at 2:30 am by a terrible scream. David was standing at the top of the stairs with blood gushing from his forearm. There was a large pool of blood on the floor and splashes all over the wall next to him. A right angled cut about 4cm by 4cm went at least 1 cm into the flesh of his forearm so that a large flap of skin hung down to reveal the underlying muscles. The mirror in the adjacent washroom had been smashed, leaving broken glass all over the floor. We presumed that David had woken in the night and hit the mirror with his forearm. He could give no explanation of how or why it had happened. We were later to suspect that David sometimes hated to see his own reflection.

 On another occasion David was walking through a nearby town alone in a deserted street and for no reason smashed the glass of an advertising hording causing several hundred pounds worth of damage. He made no attempt to get away. In fact, he was still near the premises some minutes later when, attracted by the noise, the owner arrived at the scene. Again, he could give no sensible reasons for this action apart from being very unhappy.

 It was at this time that we came to a standstill regarding David’s career. He had a place at University but refused to go. He also refused to make his mind up about anything else. He was of the opinion that he could live at home and spend all day “getting fit” and losing weight. He was already exercising for several hours a day and it was hard to see how he could improve from the peak physical condition he had already achieved.

Since his mid teens he had become very strict about his diet. No tea, coffee, reconstituted or alcoholic drinks; no junk food, sweets, chocolate, biscuits or cakes. Food labels were checked for fat content, red meat was out with only the leanest cuts of chicken or turkey allowed.

On the rare occasions when he did relapse and perhaps eat some biscuits or a piece of cake he would become agitated and within a few minutes of eating say that he could “feel” the extra weight around his body and “see” that he had got bigger. He would then engage in a long period of exercise when he might swim lengths of a pool for up to 6 hours or run for 12 miles.

  We allowed him a year living mainly off our resources without the need for him to pursue a career. During this time he had two short periods of casual work which both ended badly after David became convinced that people were talking about him or were plotting against him.

He had a car and would drive around on his own for long periods. He also took to visiting local night clubs. We were delighted with this development because we saw it as a sign that David was at last socialising. However, from his account very little developed. He would go in alone and leave alone. He was well built, presentable, polite and good looking but seemed to have no desire or ability to form relationships.

 He had become intolerant to noise and reacted badly if touched unexpectedly. He was also becoming short tempered and difficult at home but there was no sign of the horrors to come.

 One day David came home at about 7 o’clock without his car. At about 12 mid-day he had run out of petrol in a vehicle recovery area from were he was towed to a car park behind a garage about a mile from home. He had a petrol can without a spout so could not get the petrol into his tank. He then went to pour the petrol into the top of the engine where the oil should go. Observing this, another driver suggested that he add water, not petrol. David then spent over 4 hours fetching water and pouring it into the engine where the oil would normally go. When, at 7:30 we arrived to retrieve the car it was sitting in a huge pool of oil and water. It seemed that apart from the muddled thinking at the start, once he had embarked on an action it was repeated over and over for no sensible reason.

 On another occasion David had an interview in Brentwood about half a mile from a dual carriageway which led him directly home. He had been taken over the route five times and so was left to complete the 15 minute drive home on his own. Three hours after his expected arrival he telephoned. He was in Piccadilly Circus, London which was about 20 miles in the wrong direction. David had taken a wrong turning and had been unable to deviate whilst battling through 20 miles of traffic in the London suburbs.

Crisis Times

 Shortly after David’s 19^th birthday our house was severely vandalised leaving extensive damage which cost over £52,000 to rectify. We had been out for the day and arrived home at about 7 o’clock to an unbelievable scene of destruction. The contents and fabric inside the house had been subject to a sustained and frenzied attack over many hours. Several expensive pieces of antique furniture were reduced to firewood. Sinks and toilets were shattered to ground level with the water pipes broken and left to run all day. Even the rails in the banister had been knocked out and snapped into pieces. The TV, a stereo, a computer, a microwave, an oven and every light fitting was smashed – not just damaged but put beyond repair. For instance, almost every key on the computer had been pulled out, one at a time. Every mirror, picture, vase, glass and piece of crockery was reduced to fragments and spread around the rooms. It was difficult to find anywhere safe to walk because the whole floor area was covered with glass. Most of the doors in the built-in cupboards in three bedrooms and kitchen were in pieces. In every room the internal walls had been caved in or marked with deep grooves. Three quarters of the whole floor area was sopping wet because water had been pouring for hours from the broken pipes. Most of our clothes had been removed from the wardrobes, cut up and left in the rubble. Food jars and drink bottles had been hurled at the walls. The beds and a three piece suit had been slashed with a knife. The family photographs recording the events of a 35 year marriage had been taken out to the garden and burnt.

(Damage pictures and descriptions)

David claimed to know nothing about the damage and there was no forensic evidence to link him to the event. For several years he had been very responsible when left in charge of the property during our absence. As an only child he is the sole heir to all our assets.

 After living for two weeks in a hotel we moved back to the wreck of a house, having cleared two rooms of debris. David continued to run, swim or weight lift for most of every day. One evening, three weeks after the major damage had occurred, he was troubled by some recurring thoughts regarding the lecturers on a course he attended over a year before. He was worried that they would become stronger and fitter than him. Nothing we could say would reassure him and any attempt to rationalise or change the subject gave rise to sudden anger. That night he was pacing around the garden and gesticulating until after 1:00 AM.

The following morning at about 10:00 AM we were sitting in front of a double bay window overlooking the rear garden. We were reading and dealing with correspondence. David was in view outside. He did not seem to be troubled and we had not spoken to him for at least half an hour. Without warning he picked up a metal garden chair and threw it with all his force at the window just in front of us. The outer pane of the double-glazing shattered.

I went out to him to try to prevent any more damage. He muttered something about us looking at him and shortly drove away. I called the police because he was in an agitated state and we were not sure if he should be driving. When the police arrived they advised us to have him assessed because they would not be able to detain him. In his present state we thought it would be unwise to press charges when he would be immediately bailed to return home. The police left and David returned later that day. We saw his GP who said he would arrange for a psychiatrist to visit the house.

 The next evening David was again having recurring thoughts about the lecturers, (who he had not seen for over a year) and there was more about people with short hair being immature. We could make little sense of any of it. He was also worried about his weight. We went to bed at about 11:45 PM leaving him pacing around the garden. At about 1:00 AM we heard a crash as he threw a metal chair at the greenhouse shattering several panes of glass and bending the frame. By the time I had got dressed and discovered this all was quiet. We did not mention the incident the following morning.

 Shortly after this our doctor managed to arrange for a psychiatrist to interview David at the house. He suggested David go into hospital for further observations and three days later, after much effort, we persuaded him attend as a voluntary patient. David was just 20 years old.

In Hospital

David was first given his own room in a modern mental health hospital. The long corridors could be accessed only by a key card carried by the staff. There was an overpowering smell of tobacco smoke from the smoking room. This permeated the whole building which, along with the occasional cries from some of the other patients made us very uncomfortable on our first visit the next day. The smoke was particularly distressing to David.

David was calm and co-operative for the first few days of close observation after which he was asked to take some medication. This was too much. Tea, coffee or alcohol and any sort of drug was out of the question. Very early the next morning he forced open his window and escaped, only to return voluntarily, after spending 24 hours wandering about alone. He was then sectioned under the mental health act and sent to a more secure hospital which stank even worse of cigarette smoke. He was given medication. David was still determined to stick to his strict regimen so this again made him very agitated. He reacted by smashing a stereo unit in the patients lounge and so was put on Haldol or haloperidol.

 Haldol took effect quickly and prevented David from reacting physically. However, in many respects it is a very unpleasant drug. He could sit for a few minutes but would take no part in the conversation. He then had to walk around for several minutes. We learned that this drug caused him to pace the corridors almost the whole time he was awake. He seemed to be experiencing some very disagreeable sensations without the ability to explain or do anything about it. We pressed hard for him to be taken off this medication but it took several weeks before he was tried with something else.

 Over the next 18 months, whilst still residing in hospital, he refused to acknowledge that he was ill. His consultants prescribed several anti-psychotics in turn. These included Olanzapine, Risperidone, Quetiapine and Sulpride. They made little difference to the psychosis or the irrational, persistent thoughts. David always looked very worried, often angry and could not engage in any meaningful conversation. He continued to have no insight to his illness and denied that there was anything wrong. He would sleep for up to 15 hours a day and forget to wash or change his clothes if he was not reminded. Making decisions about his future, reading correspondence or filling in forms were out of the question.

Mullion Cove 2005

 Stability and Recovery?

 David made little progress until Clozapine (or Clozaril) was suggested. Within three months he began to gain some insight into his condition. He began to engage in limited conversations and on some days made the effort to make himself look presentable. The worrying thoughts were less pervasive. He would even smile occasionally.

 After 21 months in hospital he was transferred to a hostel with 24 hour cover. The excellent staff created a safe, ordered atmosphere where he  became more independent. He has now been a resident for about 18 months and despite much progress towards regaining his previous quality of life he is still a long way from normality. He still sleeps for about 12 hours a day. Every day is almost the same as the previous one. His motivation and intellect are still limited and his socialising skills are low, although he does express a growing empathy toward others.

 So, what are we left with?

Schizophrenia is a very debilitating illness. Some of the worst symptoms have succumbed to medication but much of David’s character and potential has been irretrievably lost. Schizophrenia has taken away all reasonable prospects of a partner, children, friends or career. At the age of 24 he can look forward to daily medication for the rest of his life with the prospect of serious side effects. He will very likely spend much of his life in sheltered housing. He will have very little money and suffer from ignorance and prejudice at the hands of the public.

(note - several years after this was written things have not turned out so bad - go the the blog to see how.)

David is not defined by his illness. He is not a mad. His reactions are a perfectly reasonable response to what is happening to him. He has schizophrenia or a Neurological Brain Disorder. It is also sometimes referred to as Kraepelin's disorder (KD) in honour of the doctor who first described it, Emil Kraepelin (1856- 1926).