Books: Depression, S.A.D, Manic Depression etc

I found this book to be fascinating. I really related to it because I was one a locked ward for a month.
Jim S

[b]Voluntary Madness [/b]by Norah Vincent

2008. Viking, NY, NY

The author posing as someone needing hospitalization was admitted to three different facilities for the insane. Her description of the people, places, and her reactions are very insightful. One hospital mostly dealt with people at the bottom of the socioeconomic ladder; the staff was overburdened and indifferent. Putting the patients on strong medication was the only treatment provided. Another was a peaceful private clinic. The third offered alternative treatments that seemed to be able to really help those who wanted help.

Although the book does not set out to bash the widespread use of pills as many books do, the author does report on drugs formed the backbone of treatment in some of the facilities. She shunned drugs for herself. Her opinion of the nearly life-long use of medication by the mentally ill was summarized with "I just didn't want to be dependent for the rest of my life on a drug whose effects neither I nor the professionals could understand or predict, and whose glowing reputation had been based almost entirely on the meticulous propaganda of the companies that were profiting hugely from its sale."

Reading Norah Vincent's observations of the public hospital, I alternated beween rage and pity. The patients were treated in an almost inhuman fashion. They had little hope of having any sort of life. Most of them had been in an out of such places many times and would probably be in and out of those places for much of their lives. They were given heavy doses of pills that caused awful side effects. Yet, the author saw beyond the poor behavior of the institution. She said, "...developing relationships with people who are not only disturbed but quite often uncooperative, manipulative, and willfully irresponsible is a job that people with an overabudance of fellow feeling often find too unrewarding, infuriating, and exhausting to perform." At the hospital she found the patients confused and disoriented, but not dangerous. She described communicating with her fellow patients: "When I spoke to them, I wasn't speaking to someone who processed information in socially common or easily navigable ways. It was different, and often it was harder, more off-putting, and even unpleasant."

The other two facilities she lived in offered much more in the way of help, but the patients did not all do well. When she saw that excellent programs did not always give excellent results she drew some insightful conclusions. "... a person's condition has less to do with his recovery than his personality, his willingness to change." ".. the number of people in any group who were willing to take responsibility for thieir own lives and behavior is always small. " "the vast majority of people don't want to participate in their own recovery. They are unwilling to try.." "...are often lazy, stubbornly self-indulgent, passive, and irresponsible. Twelve-step groups say as much. A major tradition in all such groups is that the requirement for membership is a desire to change (stop drinking, stop using drugs, stop gambling, etc.). Forcing someone to go to rehab or to meetings does not often work.

I was impressed with how the author compared physical diseases like diabetes to mental illness like depression. Although a person does not cuase his own diabetes, often he does things that greatly aggravate it. He eats too many sweet foods, does not exercise, and picks up a lot of weight. Research for many, many years has proven that exercise helps depression, but very few depressed individuals will even try any exercise.

I recommend the book for everyone with an interest in mental illness. It should be read by every professional who has the power to send someone to a hospital. Perhaps the book's greatest benefit is in describing how one really feels when locked up in a mental health facility. As one who was once locked away, I know that many people just do not understand the hell one experiences during and after being on a locked ward.