When do I get my shoelaces back? is Suzy Johnston's raw, emotionally-driven first-person account of an individual suffering from a psychotic breakdown. The use of explicit and unyielding language vividly demonstrates Suzy Johnston’s harsh and messy reality as she experienced this horrific episode. Beginning with Johnston’s admittance into a psychiatric ward, this diary follows her scary, torturous, and at times hopeless, road to recovery. This diary truly captures the unique and painful emotions involved in facing one’s inner demons and overcoming personal barriers related to mental illness.
What made you decide to publish this very personal account of living through a psychotic breakdown? What did you hope to achieve?
While I was in the Ward I would hand that day’s diary in to my Named Nurse at several points during the day. That way he/she could see how I was doing as the day progressed. The reason for this was that I found it REALLY difficult to communicate verbally in a face to face situation, particularly when I was unwell. What you’ve just read as the book “When Do I Get My Shoelaces Back?” is the folder I collected from the staff office on the day I was discharged containing all of my daily diaries. To be frank I really wasn’t that sure what I was going to do with the contents of that folder and it languished in a dusty pile under Michel’s and my bed for around 6 months. At that time I was scared of reading about the places I had visited mentally and, as I was still fairly vulnerable, I thought it best to leave well alone.However, time can be a great healer. Six months on I dragged the folder out from under the bed and, with Michel sitting beside me holding my hand we slowly read through my thoughts, feelings, fears, delusions, paranoia, worries and, eventually, recovery from severe mental illness. I hadn’t been sure what to expect. Inarticulate ramblings? Chaotic prose? Actually, what I encountered was a book full of confusion and illness, but more than that I found a nursing staff who REFUSED to give up on me who would spend HOURS with me gently helping me to untangle the agonising mess inside my head and quietly and compassionately refusing to let me kill myself. They seemed to understand, even without asking, where I was coming from. Without them I simply wouldn’t have made it. Of that I have no doubt. So, after a LOT of thought, debate and pondering with Michel we decided to take the first step and transcribe the diary onto my laptop. However, I felt I had to do this responsibly so I made the decision to exclude certain parts of the diary from the transcription. Why? To preserve my sanity. There are excerpts in that folder that will never see the light of day, not because they are horrifically bad, but because I still find some of the experiences I went through emotionally disturbing and I genuinely think that there is NO point in publishing something that is going to haunt me and have a detrimental effect on my recovery.So, I guess I wanted to achieve 4 things by writing this book: show that, with help, it IS possible to recover from even the darkest, most confusing places: to help people who don’t have a clue about mental illness to try and gain some understanding about what it is like: to show those who have, or are going through an experience like mine, that you are NOT alone and yes, you CAN recover: to express what an AMAZING job those often unheralded souls, psychiatric nurses, do.
In the book, you spoke frequently about the role your husband Michel played in your recovery. Is he still one of your biggest supporters? Who or what else helped you through this difficult life situation?
Michel is an ASTOUNDING person and I love him to BITS. I am extremely aware how much of a relentless help and support he was during that admission. He REFUSED to give up on me especially when I had given up on myself. Now that I am a LOT better we live a very happy and NORMAL life together. I think we both appreciate what we nearly lost and because of that we hold on to each other, metaphorically and sometimes literally, very tightly.I’m hugely fortunate in that my family is also very supportive and I have some pretty cool friends who are there for me but let’s not forget that friendship and love are a two way thing so I am there to provide them as much care, support and love as I can.
Was there ever a moment where you felt ashamed of being diagnosed with bipolar disorder and/or having suffered from a psychotic breakdown? Did you ever feel victimized by the negative stigma surrounding mental health?
I’ve NEVER felt ashamed of my condition simply because I can’t afford to. If I felt ashamed of it I would have had to plonk all that shame on top of what I was going through and it doesn’t take a genius to figure as to what road that would have sent me sprinting down. Now? No, I don’t feel ashamed, actually, quite the opposite. I feel immensely proud of recovering from what I went through. It was probably the hardest thing I have ever done.
Do you ever find yourself struggling with past thoughts of suicide or your stay in Christie Ward at The Vale of Leven’s hospital? If so, how do you cope with these intruding feelings and thoughts?
Yes, I do. Actually, part of my post inpatient care involved some pretty intensive input from a psychoanalyst simply to help me deal with those memories and flashbacks but also to help me readjust to living in the community again. When I asked the psychoanalyst why I was still finding it so difficult to escape those extremely negative and potentially destructive thoughts he explained that it was more than likely that I was experiencing a degree of Post Traumatic Stress Disorder – not unexpected after all that I had been through. How do I cope? Michel, obviously, is the rock that I can lean on as are my family and friends. Credit too must also go to my Community Mental Health Team – my CPN, my psychiatrist, my GP, and my Pharmacist. But, I guess, when it comes down to it the person that I HAVE to rely on the most is ME. So I take care of myself. I eat healthily, I don’t drink alcohol, don’t do drugs and don’t smoke. I go for walks, and when I read or watch TV/DVDs I make a conscious effort to stay away from subjects that evoke bad memories or disturb me. I see my GP, a smashing lady, regularly to nip any looming crisis in the bud or if necessary, to get me an appointment with my psychiatrist ASAP. I listen to a lot of music, rest often, play my guitar, and take my medication with TOTAL compliance and regularity. I attend ALL my outpatient appointments, have gingerly started work again, take the time to acknowledge and value every positive experience I have – no matter how minor. I have a rather eccentric cat who follows me around the house keeping me company, playing with me and has rather bizarre conversations with me too! I am learning to like myself a little bit and I am helped in that by my husband who easily and comfortably reassures me, tells me that he loves me about 300 times a day, makes me laugh like no one else and is always available for cuddles and solace when I am struggling. He never criticises, complains or portions blame. I sometimes find it hard to believe that he wants to spend his life with me but he tells me with a grin that he couldn’t imagine being anywhere else. Man, am I lucky!
Being familiar with the services available to individuals dealing with mental health issues, what are some community- or national-level changes that you feel will help encourage youth to reach out and get help or to at least aid them (and their families) in navigating the mental health system?
I think a few things could be done. First of all I think that across the board access to a 24/7 mental health crisis line would be a HUGE help. The problems with the crisis line at the moment are twofold – in some areas, including mine, the crisis line is only available from 9am – 8pm weekdays and 9am – 5pm at the weekends. Not that great really. The number of times I have had a crisis only to realise that 8:30pm on a Tuesday (for example) and that my options are reduced to only the emergency doctor hotline. The problem here is that there is NO guarantee that the doctor you will speak to has ANY experience of dealing with psychiatric issues and maybe completely unfamiliar with psychiatric medication. As a patient you often know more than they do! As such the crisis line needs to expand so that it is ALWAYS there – this means that trained psychiatric nurses are on hand to talk to you, offer advice and, if necessary, come out and visit you.The other problem with the current crisis line is that it is only available to people already in the system. I feel this leaves those experiencing first episode symptoms without a “safety net” and extremely vulnerable.I also think that a permanent post for a psychiatric nurse should be mandatory in emergency rooms. I recall sitting in the waiting room after being told that, whilst suffering from pretty intense lithium toxicity, that I would have to wait four hours to be seen! That wait could have cost me my life. Fortunately, a nurse I knew previously recognised the seriousness of the situation and advised that I should be seen and put on a drip immediately. I don’t blame any of the general nurses for what could have transpired – they have hardly any psychiatric training – but the number of horror stories I have heard about A + E from fellow psychiatric patients is shocking. This needs to be addressed.
Based on your experience and knowledge, what do you think poses the biggest barriers for youth to seek help when dealing with mental health issues?
The desire to “fit in” and not appear “different” is a huge issue for the youth of any generation, really. Words such as “Nutter”, “Headcase”, “Psycho” and “Loony” are bandied about by young people all the time so when someone aged, say, 17 starts developing mental health problems, not only do they have their symptoms to deal with but often a very real fear that their friends will reject them. Stigma is a shitty thing and it affects us all to a greater or lesser extent. So, what often happens is that young people are reluctant to approach the health service at the beginning of their illness and it often takes a crisis for there to be any sort of intervention. Sadly, that is when some so – called friends choose to walk away. It really hurts. I know. Combating stigma is a HUGE issue, one that needs to be addressed by the mainstream. If cancer can, in today’s society, be an illness that the vast majority of people understand, see as a valid concern and are keen to support financially when only a few decades ago it was a symbol of fear and only talked about in hushed tones, why can’t the same happen with mental illness? After all it affects many more people AND has a higher death rate.
What is the biggest piece of advice you can give to youth who may be experiencing mental health issues?
1. Don’t drink or do drugs. You’ve got to start giving yourself a chance.
2. Sit down with someone you trust and write down the best description that you can manage of how you are feeling and what’s going on in your head. I’ll explain how this can help in a minute.
3. Find yourself a GP who you feel you can talk to. When you’ve found one take that piece of paper with the description on it with you just in case you find you can’t get the words out.
4. If you’re been given any medication take it as instructed. Always ask how long it will be before you can expect to notice a difference.
BUT, THE MOST IMPORTANT PIECE OF ADVICE?
5. Don’t give up on yourself. You’re too important.