TRUE SCHIZOPHRENIA

The specialist said that although Andrew was misdiagnosed as bi-polar with schizoid affect, he had been given the correct treatment. 

It was then that we learned that the differential diagnosis is determined by the chronicity of the delusions. Bi-polar disease is episodic, true schizophrenia is constant and unrelenting without medication. 

Some sufferers do not get complete relief even with treatment. Andrew was one of these.

THE VOICES

Again, Andrew told me, “Mom, you just do not get it. These voices are real”. 

He still had not been given the diagnosis of schizophrenia. This would come less than a year before he died. A specialist in the medicinal treatment of delusions at HUP saw him and said Andrew was most definitely schizophrenic. 

This specialist said Andrew had been misdiagnosed as bi-polar when he had his first psychotic break after entering the Citadel in 1999.

I NEVER PROMISED YOU A ROSE GARDEN

Instead of trying to understand, resonate, and maybe somehow relieve Andrew’s pain, I was pushing him to conquer the voices. 

I had read I Never Promised You a Rose Garden and felt that it was possible to give up the voices. This is what the patient/heroine had done in this case history of the successful psychoanalytical treatment of a young female schizophrenic in the time before antipsychotic medication. 

Reading this book had given me much hope.

ANDREW'S NOTE

Well, lets take little time to rest on Sunday. Everybody needs some rest even John Andrew Gillis. Amen. I am relaxing for the rest of the day. Okay. Just keep on trucking. I drive a Hyundai Sonata. 

May 28, 2009. My heart, my fear, my love, my mind will be free forever.

          Okay, I will be wiser and stronger each day of my journey, Is it crazy to follow your dreams, maybe, food and drink is awesome.  Passion, I don’t get it. But that is how it is. Freedom. Who? USA, that bad, that good. We will whe the Back th straight up. Eas does it okay. He is the best. Believe he would not be where he is unless he earned.  JAG. Mr. President. 

     The best obviously he is older and wiser. Those are the facts. I do it all for  love and peace and oh yeah honor!

Well deserved break. Thank you and good night. I love you all. Peace. 

TERRIBLE VOICES

During this time, Andrew had terrible “voices”. Some days the voices would be worse than others and in the end, they would become unrelenting. 

What would I have done to get him some relief ? He needed a rest, as he would tell us in his final note.

SIX MONTHS BEFORE HE DIED

I had spoken with John about Andrew moving back in with us. 

We both felt that it would be better for all if he did not. Before I spoke to Andrew, I asked Eileen what she thought of Andrew living with her and Rich. 

They had bought a home that had a big finished recreation room with its own bath—no outside entrance. She thought it would be fine. They could charge him rent and that would help them pay for some improvements they were trying to make to the house. 

So Andrew moved in with them about six months before he died. 

REHAB

Looking back it seems that some of the time after Andrew began rehab was very good. Some was okay and some time was not good at all.

In the beginning when he was taking only his prescribed medications, he was definitely feeling better. He was able to organize himself to get the kind of job he felt good about. He joined the firm where Eileen worked, although they worked in different locations.

I wanted him to go back to school but he was already aware that he could not be successful at that.  During this time he and Melissa became engaged and bought a house and became unengaged and sold their house and Andrew moved in with Rich and Eileen.

TERMINAL ILLNESS

After we learned that Andrew was taking OxyContin, he and I were discussing how long he had been using it. 

Somehow it came into the conversation that he had been taking it the night of his father’s birthday party. It came to me then that he was pain free when he was taking OxyContin. 

I came to the conclusion,  judging by the difference in his countenance the night of John’s birthday, that  he must be in a lot of pain most other times. 

Certainly, we know now that he had an illness that was terminal for him. He would only live three more years after starting in the drug and rehab program. 

JOHN'S 60TH BIRTHDAY

I was always vigilant about Andrew’s reaction whenever we were having a party even if it was just a few people. In the end, even Marnie and Corbin coming for the weekend could send him back to Eileen and Rich's basement. 

Our house was under construction for Marnie’s wedding that was in our yard in june 2006. John’s 60^th Birthday was approaching. We had been to several 60^th birthday celebrations and I had asked John if he would like a party when he turned 6o and he immediately said yes.

So I decided give John a surprise party and to do it at a local golf club. We had about 60 guests. Normally Andrew would have been withdrawn and maybe even a no show. This night Andrew was fully engaged and seemed to be truly enjoying himself. I was in heaven seeing him in such a good place. I noted that he seemed in a good place after the party and he just agreed with me with no additional details. 

MY GOD!

“My God! Maybe that is it. Why not? How is this different from the chronic pain of other debilitating and life threatening diseases? No, no Marge this is an opiate, a highly addictive product that would just lead to ever-growing needs for higher and higher doses. Don’t be ridiculous, he needs to get off this drug immediately”.

 This was the essence of the conversation that I had with myself. I think if I had it to do over again, knowing what I know now I would have definitely tried to get him a prescription for the OxyContin.

SOME OF THE BEST DAYS OF MY LIFE

I was impressed by Andrew’s immediate and committed response to our demand that he take charge of the Oxycontin problem. 

Several weeks after he started the program at Penn,  I asked him how he had managed to go cold turkey.

I assumed  that after we discovered and stopped the cash withdrawals from our account, until he was established on the Suboxone.that he had been without oxycontin. 

Andrew said, “Mom, you cannot really go cold turkey. I had some (OxyContin) left and I dosed it out slowly over the days until I started treatment”.

I asked him if he missed taking the OxyContin. He said, “Of course. It produces a wonderful feeling, some of the best days of my life”.  

WHAT A CONUNDRUM.

I include myself in those who think we understand or know about mental illness but are really only slightly aware of the enormity of the problem and the suffering it entails. Much of the “crime” associated with drug and alcohol abuse is efforts at self-treatment—that is, stopping the pain.

If I had understood the level of Andrew’s suffering, would I have lobbied for him to be given a prescription for OxyContin to help him manage the pain of schizophrenia? I was so concerned about him becoming addicted that I did not really even begin to contemplate the other side of his conundrum.

SELF-MEDICATING

It is just occurring to me as I write this, that Andrew, in his use of OxyContin, was managing his incredible chronic pain.  If he had arthritis or cancer, the OxyContin would have been prescribed for him.

Mental illness is still poorly understood, under treated, under diagnosed, maybe incurable, and often seriously debilitating. People with serious mental illness are frequently perceived as antisocial. They can be misunderstood, punished and / or exploited because we do not understand that their behavior is caused by a physical malady and / or an effort to self-medicate their pain with drugs that can worsen their ability to cope.