Wednesday 16^th    June

I stayed up late on the computer last night to have a good look through the effects the tablets may have and what they do. I did read through the leaflet which came in the box, but being a curious creature I wanted to know more. It seems that it may take upto seven days to build up in the brain. There are lots of case studies, family stories, and facts and figures out there about the drug and most make positive reading. It works well for some, others move onto a different drug, but there are many options. Suddenly I don’t feel so alone anymore. I felt a tiny spark of hope.

The medication is called Aripiprazole, an anti psychotic, which sounds very extreme, but in blunt terms it corrects the chemical imbalance in the brain and thus makes the voices go away. Joshua takes his tablet again although he is still withdrawn. I think he is hoping that there will be instant quiet, so I try to explain that it may take a few days to start to work, that we must hang on in there. An article I read last night also stuck in my mind regarding young men and the medication which I keep thinking about.

It said that the trick is to make sure the medication is taken every day. Often young men may take it for a short while, feel they are symptom free when in fact it is the medication which makes them feel that way. They wake up one morning and feel great, then decide not to take it any more. Within a few days the levels drop in their systems and they go back to how they were before. They relapse to their old angry, upset, volatile self. It frequently happens, and then they are often taken to hospital until the medication is back in the system, and things calm down. So I must nag him to make sure he takes it.

Thursday 17^th June

Joshua isn’t working anymore, he just can’t cope. He says his head is really noisy. They keep him awake at night when he needs to sleep. It must be so frustrating. They get louder when he is on his own, it gets unbearable while he does even simple tasks like taking a shower. In the day time it all catches up and he ends up napping, so the sleep pattern has also gone horribly wrong which makes things even worse for him.

He told me the voices goad him to hurt Ethan and me which makes me really uncomfortable. I packed all the sharp things away. I sobbed as I did it as I never thought I would feel so threatened in my own home, but I do, incredibly so. It is affecting us quite deeply already. I worry for Ethan. He has seen and heard so much over the last few weeks but every day he still pulls himself out of bed, gets ready and goes to school. On his return home he religiously does his homework, has his tea, and then goes off on his bike with his friends.

Joshua came home earlier and looked completely dark in his face. I could see he was about to spiral. He got nasty, he refused his tablet as he said they are doing nothing, I couldn’t get him to understand it will take time, he wouldn’t listen, very irrational. He punched the kitchen floor and made his knuckles bleed, he slammed his head several times against the door, then punched himself hard many times in the head. It was with such force, the sound of the thud as it made contact made me feel sick inside. He lunged at me a couple of times, he is much bigger than me at six foot tall, and very strong, and although it may have looked to an outsider like I was standing up to him, being tough even, in fact I was welded to the spot in absolute fear. Scared of him, scared of them.

We went nose to nose, the look in his eyes I will never forget. Wide eyed, but full of hate, real nasty, vile, hate and growling through clenched teeth. And then in a second, as quick as it started, it stopped. He dropped like a dead weight to the floor in the hallway. From a rigid dark, angry form, to a slumped wimpering mess huddled in the corner. He sobbed. His words all jumbled, he apologised as best he could. He explained that me, his mum, make the voices mad, they dislike me, they know what I am doing, and if he listens to me and takes the medication, they will release Mr Questionmark and he will kill me.

Terrified, he is caught between two worlds. Our reality and another which is not real, but to him it is, and it’s taking him over, consuming him rapidly.  The thought that he may hurt me, or worse, has forced him to make the choice to stop his tablets.  I sat with him for some time, and just held him really. I didn’t know what to say to make it all better. There were no words. He is trying to protect me from them.

Tuesday 15^th June

We went to CAMHS today at 3:30pm and met Dr Steve Forrest. He is a tall man, greying, with a friendly face and disposition. He is a psychiatrist. It all felt very surreal though. It reminded me of when you sit in the comfort of your own home all relaxed watching a fly on the wall documentary, and you end up being open mouthed, and shaking your head in disbelief, and think to yourself how some people must struggle. I always end up feeling bad for them, those people on the tv, and often think about it the next day, or speak about it at work.

And now it feels like it’s us - that we are the subject, the camera is focused on us.  Once again Joshua was given the option to go in on his own as some of the stuff discussed would be sensitive. He said that he wanted me to hear it all, and he wanted me with him, that he had nothing to hide.  I’m glad I went in with him – the appointment lasted just over 2 hours.

It felt a bit disjointed at first as Steve had to start up his laptop and was typing notes as we went through the introductions. But after ten minutes or so, it was ok. Joshua explained, very clearly and bravely, his symptoms, as he had done on Sunday at the hospital and in return Steve took everything on board, and asked lots of detailed questions. I was also asked about Joshua's history, going right back to my pregnancy, the birth, development both physical and mental, family, friendships, school, relationships, all up until the present time. It was quite a journey I must admit.

Joshua spoke of his huge regret of smoking cannabis, his secret lifestyle that happened at the weekends to begin with, then as the voices became more prominent he smoked it most days, until he was discovered. He feels that is the reason why he is as he is now.  I wonder if smoking that that made him this way? Is it really that potent to cause this? And why are none of his friends suffering the same symptoms? I’m not so sure but sit and listen as he seems to relax and completely opens up. He tells us that he smokes it to get his head back to himself, just for a few hours, when he smokes it the voices go away, if only for a short while, the voices subside, it goes quiet – respite from it all.

Steve called it ‘self medication’ which seemed a very fitting description. He also speaks about things that I know nothing of. I know he has been involved in the odd scuffle or fight as boys do, and to my knowledge had always told me afterwards. Or so I thought. What he didn’t tell me is that sometimes he just got so angry, over something quite trivial, and would literally lose it, then physically take his frustrations out on someone. Unable to stop hitting, punching, and although the other person would retaliate they were often no match for Joshua and Mr Questionmark.

I can’t begin to imagine how he must feel, to be sharing his mind, his thoughts and his everyday life with this, with them. After making what seemed to be the adult decision to stop smoking it he now has this to deal with. We speak about medication, what it can do to help, and are given a chart showing a breakdown and comparison of the different sorts available, and talked through it, including the possible side effects. Steve explains as best he can what he thinks is going on in Joshua's head, in terms he thinks we might both understand -  mixed messages between brain transmitters and receptors.....auditory hallucinations.....chemical imbalance.

He is prescribed Aripriprizole, 10mg per day and we book another meeting with Steve to see how things are progressing in two weeks time.  If we need advice or help in the interim then we must call CAMHS and leave a message for him and he will get back to us as soon as possible. He also passes me a number which can be called at weekends.

He says I need to ‘proof’ my house. I must have very little medication at home, cleaning agents such as bleach and toilet cleaners must be hidden or thrown away. And knives, scissors, tools, and anything sharp which could be used as a weapon must be put away. He explained that when Joshua has an episode subconciously he will know where everything is at home as it’s all familiar, and he may grab for these things and hurt himself or others with them. He also says that Ethan and myself are at high risk until at least the medication starts to work, which could be a week or more. He has targeted us before and there is every chance he will do it again. I must be vigilant at all times.

We stand to leave, and Steve shakes our hands and wishes us well. I look him straight in the eye and  thank him for his time. I know he sees my pain and desperation. I’m so grateful that we ended up with this guy today.

Joshua says thank you too, and then starts to cry. He tells Steve that he is so happy that someone believes him, that he thought everyone would dismiss him and think he is mad. And Steve filled up too! We stop at the pharmacy and collect the medication. He takes his first one straight away.

 As I listen, I can’t believe he has been dealing with this for so long, alone. At 6pm, after an 8 hour wait the psychiatrist comes. Joshua wants me to go in with him. She seems very young, apologises for keeping us waiting, then asks what happened.  He tells her everything while I sit, watch, listen and hold his hand. All the details come out.

Two voices, either side of his head. They chat amongst themselves, and also to him. They speak in rhyme, or rap, and it’s fast. When they talk to him it’s all rather derogatory, putting him down, and making him feel worthless, useless. He likened it to a conversation overheard in the next room. The door is closed but he can hear them albeit a bit muffled. The two voices are scared of the third ‘being’.

Number three is the important one, he lives in the middle of his head, between the other two, pretty much on the crown of his head as he pointed out. He is the one that completely takes over. He can control Joshua's body movements, actions. He can see himself drinking and stuffing tablets, but he has no control, as if he is removed from his own body, it sounded like a so called out of body experience. So we are told about Number three, or as Joshua now calls him Mr Questionmark. He says that as he feels himself getting more and more anxious and paranoid when the two voices are getting louder and clearer. They take over his head, and invade his thoughts. As this progresses they are not so much behind a door, it’s as if they are behind a sheet of glass. He knows as they get louder, the pane of glass is getting thinner day by day, hour by hour, until it gets paper thin and about to shatter -  then he knows they are about to release Mr Questionmark.

He said it’s like the two voices either side are like zoo keepers. Mr Questionmark is the caged wild animal. The zoo keepers hold the key to open the cage, and when they do, and he is set free, his aim is to hurt and ultimately destroy Joshua, and anyone else in his path who tries to stop him.

 I’m a mixture of being stunned, but also proud that he said this to a complete stranger. The psychiatrist is taking it all in, making notes, and asking many questions. She asks if we have been to our GP. So I tell her that yes we did, some months ago, but was fobbed off with anti depressants. She asks if we have heard of CAMHS. Its the Child and Adolescent Mental Health Service, and we should have been referred there by the GP.  She starts to put things in place, makes a few calls and assured us we will get help. We should get a call tomorrow. He is shattered and needs to sleep. We went home. This is all very hard to comprehend.

Monday 14^th June

We are all exhausted today. Not so much the physical aspect, but mental I think. Brain is constantly whirring away, thinking about the conversations yesterday. I do feel we turned a corner though, and I’m hoping this is the start of getting things heading in the right direction. I’m sat on my phone all day waiting for CAMHS to call. This is who we should have been referred to several months ago by the GP when Joshua was feeling very down. It’s frustrating to think that much of this may not of happened, or even gone this far if there had been intervention some months ago. I don’t understand why we were not listened to, taken seriously. I think of the very few times that the children have been to the doctors over the years there has always been a valid reason. The hours slowly passed and we heard nothing from CAMHS so Dave started chasing them in the afternoon. Joshua got irritable as the day went on he felt that he laid his feelings bare yesterday which was really a big step, and now they have forgotten him. To be honest I feel the same too. It transpires there has been a paperwork mix up, so everything could be held up. Finally, late in the day we had a call to say that an appointment has been made to see a Dr Steve Forrest the Psychiatrist tomorrow at 3:30pm. Joshua continues to be up and down, he is strained and losing weight, he looks exhausted by it all.

No major upset or episodes of anger today, but I know he is very fragile. I'm scared.

He said he has voices in his head, they have been there for sometime now. That it started roughly 2 years ago. He was with a group of friends at the local park one evening, just a social gathering as kids do, and they all decided to smoke some cannabis. So they did, he did. As he walked home to his Dad’s house that night, probably still under the influence, he thought there were people walking a short distance behind him as he heard them chattering. He turned to look and no one was there. The voices continued to whisper, and after getting home, he realised the voices were in his head. The detail in which he speaks astounded me. He said the voices have names – identities. It’s too much to take in. Too much information all at once.

 As I listen, I can’t believe he has been dealing with this for so long, alone. At 6pm, after an 8 hour wait the psychiatrist comes. Joshua wants me to go in with him. She seems very young, apologises for keeping us waiting, then asks what happened.  He tells her everything while I sit, watch, listen and hold his hand. All the details come out. Two voices, either side of his head. They chat amongst themselves, and also to him. They speak in rhyme, or rap, and it’s fast. When they talk to him it’s all rather derogatory, putting him down, and making him feel worthless, useless. He likened it to a conversation overheard in the next room. The door is closed but he can hear them albeit a bit muffled. The two voices are scared of the third ‘being’.

Number three is the important one, he lives in the middle of his head, between the other two, pretty much on the crown of his head as he pointed out. He is the one that completely takes over. He can control Joshua's body movements, actions. He can see himself drinking and stuffing tablets, but he has no control, as if he is removed from his own body, it sounded like a so called out of body experience. So we are told about Number three, or as Joshua now calls him Mr Questionmark. He says that as he feels himself getting more and more anxious and paranoid when the two voices are getting louder and clearer. They take over his head, and invade his thoughts. As this progresses they are not so much behind a door, it’s as if they are behind a sheet of glass. He knows as they get louder, the pane of glass is getting thinner day by day, hour by hour, until it gets paper thin and about to shatter -  then he knows they are about to release Mr Questionmark. He said it’s like the two voices either side are like zoo keepers. Mr Questionmark is the caged wild animal. The zoo keepers hold the key to open the cage, and when they do, and he is set free, his aim is to hurt and ultimately destroy Joshua, and anyone else in his path who tries to stop him.

 I’m a mixture of being stunned, but also proud that he said this to a complete stranger. The psychiatrist is taking it all in, making notes, and asking many questions. She asks if we have been to our GP. So I tell her that yes we did, some months ago, but was fobbed off with anti depressants. She asks if we have heard of CAMHS. Its the Child and Adolescent Mental Health Service, and we should have been referred there by the GP.  She starts to put things in place, makes a few calls and assured us we will get help. We should get a call tomorrow. He is shattered and needs to sleep. We went home. This is all very hard to comprehend.

Sunday June 13^th 2010

I felt really anxious going to the hospital today as I had no idea what I was walking into, he could be calm and tired, he could be up tight and heading for an episode. Joshua was in a side room on his own, and calm. They bought us tea when I got there, the nurse was lovely, and also a tuna sandwich for Joshua. The psychiatrist was due to turn up at 10.  At 11am he still hadn’t turned up. This was feeling like déjà vu from two weeks prior especially when they move him onto the Clinical Decision Unit.

The ward was full of some right old characters. The guy opposite must have been seventy years old. He was walking round in his underwear which wasn’t a pretty sight. He came over and told us that he had fallen off a ladder whilst doing DIY. He had huge bruises on his back and legs but was very cheerful. I imagined his wife telling him ‘left a bit, a bit more’ and him trying to please, and then falling down. I think she rang him, he had to go to the nurses station to take the call. The whole ward heard the conversation! He did stumble over to our corner and ask Joshua why he was here. He fobbed him off with a ‘I drank too much last night’ story. I welled up with tears, and tried to be polite, but I think he knew there was more to it. He wished us well, he was glad to be going home, and shuffled back to his bed.

I kept crying.  I didn’t mean to, it just happened, I couldn’t control it. It made Joshua feel bad but the more I tried to hold it back the more tears rolled out. I desperately want to know what is going on. Joshua goes from being calm one minute, to getting annoyed, to becoming literally a monster. We break the day up by taking a stroll to get some food in the hospital shop. I will do anything to take his mind off the waiting, and keep him here. After eating and returning to the ward it’s past 3pm and still no sign of the psychiatrist. Every time we ask they say it won’t be long and it was wearing us down. At one point he got so angry and agitated about waiting he ripped off his hospital bracelets and ran off, just disappeared. The nurses closed in on me, they came from nowhere and said he will be taken under the mental health act if I didn’t bring him back, and they will call security. That was very scary, and also made me feel even more protective. I found him outside, near where the ambulances pull in. He was sat on a rock, part of a decorative feature, looking so alone. I explained what the nurses had said and that he needed to come back inside – which made him angry again. He was seething. People were walking past going to and from the hospital, just minding their own business, but I could see them crossing the road, or taking a swift divert to avoid us. Eventually he calmed down so we went back to the ward. I’m not sure for how much longer I could hold it together. It’s been a rollercoaster day.

 I need to know more around how he feels and while we are holed up here I will seize the opportunity ask him. So I press him slowly, over the course of 4 hours or more, it was very hard work. He looks like he is about to say something several times, purses his lips, then he stops, looks at me, says it doesn’t matter, and goes quiet. I assure him it matters very much, and that he needs to tell me, of all people. We go round and round in the same circles, getting nowhere.

Then he finally spilt the beans. He confided in me. At last a break through. Though I was not prepared for what he was about to tell me. It was one of those conversations you never will forget. He spoke frankly and quickly, maybe he was thinking if he said it fast then it wouldn’t sound so bad.

The next two weeks are pretty much a blur, I’m on my own at work for the first week as my colleagues are on holiday. It’s a blessing in some ways as I can pace myself - check then re check my work. With broken sleep, awake at all hours, I’m so worried I will mess up. There is no need for me to make polite conversation, or swivel my chair round to chat while I eat, in fact I don’t want to eat. My stomach is continually in a huge knot, and my hands have started to tremor, which worries me – it must be nerves. I think I might have had a panic attack too – I had a moment where everything seemed too much. I came over light headed, my chest went tight, and I gasped for breath. It was frightening. Every time my phone rings I absolutely dread what the call will be about. Just the constant worrying where Joshua is, who he is with, what he is doing. He is working for his Dad, but is struggling. His focus has slipped, and although he goes to bed at a decent time, I often wake in the early hours to hear him up and about. He paces up and down, his face contorted into a mixture of anger and frustration. When I hear him moving I get up and ask if he is ok. He says he feels he is going mad. I try my best every night to open the doors to a conversation, so he can express his thoughts and feelings. It has never been a problem before, we have always been close, but here he is, slowly closing down, and I feel powerless. Can stopping smoking cannabis really have this effect? – it just feels so – extreme. When he pulls up on the driveway on an evening, I never know what to expect. Will it be Joshua Grizzly Bear, or Joshua Teddy Bear? Even the Teddy Bear often turns into the Grizzly Bear. I don’t know him anymore.

Saturday, June 12th 2010

I was at the ice rink with Dave, watching Ethan skate. He is very proud of his achievements, and rightly so. To digress just for a moment, I took Ethan on a rainy day some two years ago to the local ice rink for something to do, as you do. He held on to the rails and dragged himself around, but completely loved it. Anyway, we went back more and more, and within a short space of time he was skating really well. He just looked so comfortable on the ice. He made new friends and it became a regular thing. He aspired to be an ice hockey player, he would go on youtube and watch film clips of matches, or players moves. In April I emailed the ice hockey coach and asked what we needed to do for Ethan to join. He was offered a trial. We went, and as I sat and watched the other hopefuls try and be turned away, I felt it difficult to watch when it was Ethan’s turn. Completly nerve free he sailed through and was offered a place to train with the wannabees. He was so made up. And so, every Monday he learned and I watched. He soon became aware of things he needed to brush up on, and as training time was limited, the social skating sessions soon became a time when he could practise his moves as well as catch up with his friends. Saturday evenings were often sacrificed so that he could get on the ice and do his thing. So this evening both Dave and myself had gone to watch Ethan. He had not been on the ice for more than ten minutes when my phone rang, and Joshua called in hysterics.

He said he had done it again, and he is sorry. He was absolutely distraught on the phone. It was difficult at first to piece the conversation together. He said there were empty blisters and bottles of tablets on the worktop, along with empty bottles of spirits. That he knew he took them, he saw himself take them, but didn’t mean to. Dave left straight away and dashed to him, I followed shortly afterwards with Ethan. He was taken to the Hospital in Camberley. I took Ethan to Dave’s house to camp out and wait for news. Dave got back at 1am. As I said before I just felt this would happen again, but nothing prepares you for it. The emotions take over, the tears fall, and still no answers. Joshua is poorly after taking lots of tablets mixed with Vodka and Whisky. He had to drink a charcoal mixture which I think is the norm. Again I’m beat by it all, he never usually drinks, why was he so desperate to end his life? I really don’t understand. He is exhausted, in hospital, and crashed out. I know he is in the best hands, and try as best I can to explain to Ethan even though I have no answers myself. Pretty much a sleepless night again, it haunts me – this now feels big, enormous. He wants to self destruct, to throw the towel in. What if he does it again and succeeds?

Monday, May 31^st 2010.

I was back at the hospital with Joshua this morning. When I arrived on the ward and found his bed it was empty as he was in with the Psychiatrist, he is seventeen, should I be with him? I didn’t sleep – wide awake in the early hours, beating myself up all night as to why he took such drastic action. He has a good life, he works, he has a car, a girlfriend, and of course his family who all love him to bits. As much as I try to find answers, nothing adds up. He came back to the ward, said hello, and then slumped on the bed looking so sad, and totally tired and beaten by it all. The Psychiatrist introduced herself and then proceeded to tell me that she had a good chat with Joshua and she feels he needs a hobby to keep him busy – is she for real? I thought I heard wrongly so asked her to repeat herself – no, I heard her right the first time. I questioned her but she really didn’t want to engage in conversation. I’m far from happy. So, if you drink bleach and swallow handfuls of tablets you need a hobby to take your mind off things? I don’t think so. His ID labels were cut off, his few belongings dumped into a bag, and we are pushed out to make room for the next person.

 It’s a Bank Holiday, the sun has made an appearance, but our smiles faded some weeks ago.  I feel the psychiatrist wants to be able to tick us off her ‘to do’ list so that she can go home. I know deep in my heart last night’s events will happen again, as we have no answers as to what triggered it, what is eating him up so badly, and there is no plan going forward. Whether it’s a cry for help or something else I don’t know, but it’s extreme. It will happen again, of that I am sure. Joshua is withdrawn and looking poorly, surely anyone can see that? How could they let him come home? He doesn’t want to talk – he is exhausted, so he goes to his dad’s house, he just wants to sleep. I take Ethan to my parents’ house as we planned some time ago to visit for lunch then onto a Summer Fete.  I tell them of last night’s events, of how life has been – they are supportive, but shocked. I don’t think they know what to say.