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This diary was originally posted exactly as I wrote it up in the 'heat of battle', including the real names of everybody involved. In this form the diary was what I would call reasonably readable. However, I was subsequently forced under threat to remove the names of the 'professionals' involved. The necessary editing has made understanding the diary that much more difficult and confusing, and has severely dulled the impact of the narrative. It has thereby greatly reduced the diary's usefulness for its intended purpose, which was to record data on the aspects of the on-set of relapse which professionals do not see, in the hope that this may be used to help improve the quality of life of the mentally ill and to alleviate the torture suffered by their families. The threat has forced me seriously to question my previous perception of professional priorities.
Dr X is the psychiatrist my wife sees from time to time as an outpatient.
My wife is adamant that she wishes to come off medication completely and permanently. CPN1 supports my wife fully with this wish. I also support my wife's wish on one condition: that if my wife, her CPN or I see any signs of relapse developing, she will accept corrective medication immediately.
Dr X is very unhappy about my wife coming off medication completely and offers to change her prescription from a 10mg haloperidol injection every 6 weeks to a more modern drug called quetiapine (commercial name Seroquel) which is far more benign to the patient's mind. My wife reluctantly takes the prescription for the quetiapine and gets a batch from the pharmacist.
My wife tells Dr X that she is not going to take any more medication. My wife thanks Dr X for weaning her off the haloperidol gradually. My wife is supported in this decision by Dr Y, her GP, CPN1, her CPN and me, her husband. My support, however, remains conditional on her agreeing to accept corrective medication immediately any one of us - including me - suspects the first signs of a relapse.
Dr X repeats emphatically that it is in her opinion unwise to be without medication, but that since my wife has decided to come off medication completely, she must, after a certain time (two or three months is my impression) spend a month in hospital without medication for intensive observation. My wife says that under no circumstances is she going into hospital.
This was her scheduled visit. It is 20 days since I expressed my urgent concern to the nurse at the local mental health support unit!!! CPN1 did not bring forward her visit in response to my expressed concern. It appears that she dismissed completely the concern which I communicated to her, and declared my wife to be perfectly well - just a little angry at having spent so long on the medication.
The car journey from Bishops Stortford to Dunmow is a shouting tirade of hyper-criticism, accusation and condemnation. It seriously interferes with my ability to drive the car safely. It lasts the entire journey until we come to rest in the car park in Dunmow. She changes her mind several times as to where she wants to be taken. First to Dunmow, then to 'somewhere nice' that I should decide, then to Maldon on the coast, then to Dunmow again.
Once we enter the chapel in Dunmow her mental state switches instantly into a pleasant good natured religions chapel member. Apart from bursting into a couple of spates of hysterical laughter (for which nobody else seemed to understand the joke) she behaves well.
Then she volunteers to push a wheelchair bound old lady around the market to do her shopping. I have to go with them. I am under extreme stress myself. I do not know what little thing could trigger her back into her violent state. Fortunately I manage to get them back to the chapel without event and get my wife back to the car.
On those Tuesdays I often look in on my ageing parents who live in Braintree some distance further on. My wife says we should now go on to my parents. I am very dubious about doing this but it seems she will explode again if I do not.
We go to my parents. Shortly after arriving, my wife and my mother have a fierce exchange. I have to engineer our departure as quickly and as diplomatically as possible. My wife rails at me all the way back from Braintree to Bishops Stortford.
Late that night there is a phone call from my wife's brother, Brother Z. He says he is coming to take my wife for a few days rest in Kent. I tell him she is ill and that it is better for her to be in her home area where the medical infrastructure knows her. I say that if he does take her to Kent it is certainly against my wishes and better judgement. He is still going to come, but I eventually persuade my wife to tell him not to come. He does not come the next day.
This is the last straw for our son. He leaves to go and stay with his sister in London. He does not return home until my wife has left.
Later, my wife rings CPN1. I speak to her also. I ask when I am going to get some help. She says that my wife should go to stay with her sister in Kent to give us both a break. I say that if my wife falls into full relapse in Kent, she will most likely be put in Canterbury hospital which is over 150km from our home. I could not possibly afford to visit her there. To this, CPN1 says that it does not matter because her sister Sister X can visit her instead. This strikes me as a very strange thing to say. I would have thought it more important for a husband to be able to visit his wife in hospital rather than for her sister to be able to do so. It suggests to me that the objective is to get my wife away from me, and that CPN1 thinks I am the source of my wife's problem.
I later tell my daughter. My daughter telephones Sister X, my wife's other sister. She asks her what she thinks she is doing having my wife taken to the farm in Kent against my wishes when I have told her full well that my wife is ill. Sister X retorts that CPN1 has discussed the matter with her and that they agree that my wife is simply angry and not ill and that all my wife needs is some time away from home. Sister X then reinforces her point by asking my daughter if she thinks that I know better than a professional. She is referring to CPN1. It appears that CPN1, contrary to what I have known since late August, still thinks that my wife is not ill at all, and that the best thing for her is to spend a few days away from me at the farm in Kent.
It appears that my wife's two sisters, advised by CPN1, have 'pulled rank' on me and relieved me of my responsibility as my wife's carer.
I reply to this letter saying that my wife is not here and is unlikely to agree to attend the meeting. In this letter I reiterate my opinion that she is ill and should never have been taken to Kent. I take this letter by hand to the local mental health support unit and put it through the right-hand letter box.
Later, in the evening, Sister Y (my wife's sister) telephones me to say that my wife has been bad and that they are getting the doctor to her tomorrow.
I phone our GP's surgery. The stand-in doctor will not be available until this afternoon. I also ring the local mental health support unit at 8:30 am to ask for contact details for Dr X. I ring Sister Y to give her the contact details. She tells me that they do not think they could drive my wife back here without sedation. This is why they want their local GP to see her.
11:40 am Sister Y telephones again and says that my wife is all right again now and is asking that I go down to the farm and stay there for a few days. I say she is ill, needs treatment, and that the present period of calm does not mean she is suddenly well again and that she should be brought home as soon as possible.
Later, my wife telephones me in a very irate state saying that her sister Sister X has called the doctor and that he is there. The doctor (Dr Q) then speaks to me asking what medication my wife has been on before. I tell him she has been on 5mg [I was wrong. It was in fact 10mg, but there was talk of it being reduced to 5mg at the time] of haloperidol every 6 weeks but her psychiatrist Dr X proposed to change it to Seroquel. He said that he would have to order the Seroquel and that it would be there tomorrow.
At about 2:30 I receive a telephone call from Sister X (my wife's sister) saying that, since the doctor left, my wife demanded to be taken home and that Sister Y and Brother Z are on their way with my wife bringing her home to me. She phones me again a few minutes later to say that Dr Q has said that my wife must not drive. Dr Q gets in touch with my GP's surgery and advises him of the circumstances.
Sister Y and Brother Z (my wife's brother and sister) arrive back here with her at about 4 pm. She is highly strung but is relatively calm.
I call my GP's surgery and tell them that my wife is being brought home and needs attendance. I am told that the locum doctor standing in for Dr Y while he was on holiday will visit my wife after surgery. The locum (a Dr Z I think) telephones me to ask which pharmacy I use so he can order the Seroquel that Dr Q would have prescribed. I tell him and he issues the prescription document before coming to visit my wife at home.
He comes and speaks privately to my wife for half an hour. Afterwards he says that he does not think there is anything wrong with her, but since he has issued the prescription, he will leave it in case my wife decides that she wants to take it, but does not have to do so. She chooses not to take the Seroquel. The prescription document disappears and the medication is never collected from the pharmacist.
My son and I are then subjected to our evening tirade of verbal abuse. My wife goes to bed at 10 pm.
When she arrived home yesterday my wife said how nicely I had cleaned all the dead leaves, mould and filth off her windowsill and how nice the plants looked. This morning she explodes into a tirade telling me I have completely ruined her plants and that she wants her plants in the state they had been before I cleaned the windowsill.
At the moment I am considering my position and my future. It is clear that the medical infrastructure is convinced still that there is nothing wrong with her. I think they see me as having 'cried wolf' once too often and that I am the problem. It seems that in the present circumstance I will simply have to live with the unending abuse which at the age of 58 I am no longer able to bear - physically or mentally.
My son leaves for work this morning - tired, stressed, late and with no sandwiches as a result of the morning tirade.
There is a telephone call shortly after 9 am. My wife naturally intercepts it. She goes for the phone faster than Billy the Kid for his gun. I hear her giving whoever it is a damn good telling off. I suspect, therefore, that the caller is CPN2 the CPN. She then makes a phone call for which she instantly switches into 'goody two-shoes' [name deleted]. I therefore suspect that the call is to her Strict Baptist minister. I am unable to make unmonitored telephone calls and if my wife disapproves of whom I am calling or what I say, she intervenes with a tirade.
It is now 11:45 am as I write. There has been a miraculous silence while I have been writing. I go to the living room. My wife is there. She is writing a letter. She is my pleasant loving wife. She remains so for the rest of the day. She cooks our evening meal.
My wife starts to get irritable. She locks herself in the bedroom. She demands personal privacy from me, which is not normal. Short blips of extreme nastiness close together. These merge into a paranoid episode lasting from 11:30 am to 12:10. Sister X and I are now tarred with the same brush. Because we each called the doctor to her at different times, we are branded as 'power freaks'. She goes into a detailed tirade about her mother (dead 21 years) and her father (dead 4 years). Then about me. Very cutting accusations, out of all proportion and bearing little parallel with reality.
3 pm my wife demands to be driven and left down town to do shopping. 4:30 pm she phones to be brought back. We see our daughter and son in a café and they beckon us in. Later, my son and I take shopping home, leaving my wife with our daughter. My wife and our daughter arrive home at about 6 pm. My wife goes into a severe violent paranoid episode at about 6:30 pm. Our daughter leaves to return to her home in London at about 9:45. My wife's episode is in full flood until about 11:30 pm.
1:30 to 2:40 pm my wife's Strict Baptist pastor visits. She talks with him privately in my study. I have no idea what she says to him. I take the opportunity to catch up on sleep. All I can sense is the gentle babble of conversation. No shouting or railing.
Quiet the rest of the day, but poised on a knife edge.
She is very quiet at the moment, but I think she was up and active for a large part of the night.
11 am starts on a very severe raving tirade which lasts until 1:30 pm when I have to go out to buy a new knob for the washing machine which she has broken. When I come back she is 'nice as pie'.
Doctor's secretary rings. She offers my wife an appointment at the close surgery at 6 pm. My wife goes to appointment. Comes back. It appears from what she says that the doctor still thinks she is not ill but just angry.
I manage to sneak a phone call to my parents. Discuss the option of divorcing my wife on the grounds of my health. I love my wife but I do not know how much more of this I shall be able to endure. I cannot even face the prospect of caring for her after she has been put back on medication.
Quiet until 7 pm when she develops a phobia about the space in our living room. She says our inner sanctum has been invaded by other people. I ask her what has changed in the room. Things are still in their proper places. I simply tidied it and vacuum cleaned it while she was in Kent. She says it is not the room but the space within it. She seems to be suggesting that the space within it has undergone a change to its attributes or properties. It has been invaded by other people. She had tried to compensate for this earlier by removing some flowers my parents had given us and putting them in the bin outside. What surprised me more was that she had also removed a plant given to her by her pastor and his wife, saying that they were too invasive also. However, she has no object she can remove which will get rid of the invasiveness of CPN2 the CPN. This seems to be her biggest problem. Then she watched 'Third Rock from the Sun' on television.
At 8:20 pm she begins a tirade. She rails at me to tell her when I was last her dog. She shouts questions at me like a quiz master asking things like what does a dog do? It is not a game. It is a murder trial. Calmed down at 10:30 and went to bed about 11:30 pm.
At 3:15 am she comes up to the bedroom and talks about the Pakistani family whose house backs onto our garden. Their 3 bright quartz halogen lights which go on and off at all times of the day and night are disturbing. They point straight at our son's bedroom windows and wake him up. She tells me they get up and burn rubbish in the middle of the night and that is why the lights keep going on. She is very worried about them coming through the fence and stealing our things.
About 4:45 am I notice that she is banging about in the shed and the garden outside. I am aware of her getting into bed at 6:30 am. 7:30 am the telephone rings. She dives for it. It is a wrong number. She does not go back to bed.
8 am my wife is sitting in the corner of the sitting room and says to me "Don't worry. I have found the solution to our problem." She say this in a way that makes me consider that she could harm herself or is even suicidal.
My son has been kept awake all night by my wife's activities. He gets ready for work but he is absolutely drawn and exhausted. He goes to work about 20 minutes late.
I type a quick note on the computer to the GP saying of the very traumatic circumstances my son and I are facing. I have an excuse to go out. I have to sign on at the Jobcentre. I would rather not leave my wife alone, but I have no way of avoiding the Jobcentre if we are not to have our money cut off. I drop the note off at the surgery on the way to the Jobcentre.
I wait in the queue at the Jobcentre. After some time I feel very uneasy about my wife. I rush to the mental health clinic which is next door to the Jobcentre. I ask to see CPN2 the CPN because my wife is in a very disturbed state. CPN2 is not there. The receptionist asks and I explain the problem. I am told all the CPNs are in a meeting and I am asked to wait. I feel I cannot leave my wife on her own any longer. I excuse myself not having seen a CPN and rush home.
My wife is in a fuming state. She is on the phone to the council environmental officer. She is talking about how the Pakistani's lights are causing her divorce.
Eventually I manage to persuade her that she must come with me to the Jobcentre. After a couple of false starts she comes with me. I am late at the Jobcentre without a provable excuse. I think the clerk who is dealing with me senses that there is something very strange about my wife. The clerk cuts short the NATVACS vacancy search and says it was OK if I go now.
During the walk home my wife is very accusing of me and is giving me ultimatum after ultimatum. She is very difficult to handle in the street. When we get home she insists that I stand in the bath while she goes to the toilet so that I cannot dive out and make a phone call. She then insists that I go into the garden with her to show me what she had done between 4:15 am and 6:30 am this morning. She describes what she was going to do. It all seems very irrational.
She brings the plant her pastor had given her back into the sitting room. She says it is not he who is invading our inner sanctuary: it is the Pakistanis. She goes into the garden with her art kit to paint a picture. A couple of minutes later she decides to do some gardening. She has now been active for over 36 hours without sleep.
1:30 pm: Absolutely no response so far from the GP or the CPNs at the mental health clinic. In this tribulation it seems I am well and truly on my own.
We awake about 8 am. My wife has decided that her chapel is no longer the right one for her and that her pastor is leading her the wrong way. She has decided to give up going to chapel and study the Bible at home. I cannot get away from her. While she is getting washed I telephone Carers In Hertfordshire to ask if there is any form of temporary refuge for my son locally so that he can get some sleep at night and keep his job.
I feel my health and abilities ebbing, but I must drive myself to keep this diary up to date.
11:45 am Two people from the Hertfordshire Environmental Department arrive. I get my wife to see them. She starts to complain about the Pakistani's security light and takes the environmental officers into the back garden to show them the light. The Pakistani man comes out and the environmental people say to him that although there are no regulations regarding lights, would he please point them in a direction that did not shine into our son's bedroom. The man agrees and says there was no need go to such official lengths. My wife need only have asked.
My wife then starts railing about the fence. There is absolutely nothing wrong with the fence. She starts railing about a stack of roof tiles which she thinks could be blown over onto her tree. By then the Pakistani man and the environmental officers begin to see that she is not behaving normally. Then she shouts abuse at the Pakistani man telling him to 'keep to his own women' and not to bother her.
Later in the day, my wife goes to talk to the Pakistani man and he tries to make peace with her. He gives her a rose bush as a 'peace offering'. She thankfully accepts it, plants it, and gives him a cyclamen in return. All is peaceful.
About half an hour later my wife comes to me in a fuming tirade which is to last the rest of the day, through the following night and into the next day. She says that the Pakistani man, by giving her the rose bush, has according to Muslim culture, claimed her as one of his concubines. She says it is my duty as her husband to go and throw the rose bush back into his garden and take back her cyclamen. I tell her not to be so silly, but she continues to rail at me about it. Eventually she storms out of the house. I wait and wait, but she does not return home.
At 9:45 pm my GP, Dr Y telephones me. He says that my wife came to his house while he was on duty at the [name deleted] Hospital. He says that my wife spoke at length to his wife who persuaded my wife to allow her to take her to see Dr Y at the hospital. My wife agreed. He tells me that he had a long talk with my wife saying that unless she agreed to take medication starting the next morning, he would doubtless end up having to 'section' her. It seems to me that now, at this late stage, Dr Y has begun to realise that she is ill. She agrees to take the medication in the morning. Dr Y pays for her to be brought home in a taxi.
She arrives at about 10 pm. She goes straight away into a rage about the Pakistani and the plants they had exchanged. She then telephones Mr & Mrs B. They are a minister and wife belonging to her Gospel Standard religious sect. They live in Smallfields, Surrey. This is about 120 km from where we live. I hear my wife tell Mrs B about the Pakistani and the exchange of plants and what it meant as she saw it. Then she goes on at great length about the abuse she is suffering from me. Then at last I get her to bed.
At about 11:15 pm I hear her down stairs again on the telephone. From what I can hear of her shouting, she is talking to the pastor of the chapel in Dunmow from which she has decided to resign. I get the impression that she is railing at him about his inadequacies. The end of the call sounds quite final. I will be surprised if there is any further dealings between them.
She stays down stairs. I fall asleep. At 3:15 am I am awakened by the sound of her tinkering about downstairs. At 4:40 am I hear the front door slam. She has gone out. I hear the door again at 5:05 am when she returns.
I awake at 8 am. My wife is in the bathroom. She opens the door. She is quiet but offish. She is still obsessed by the exchange of plants. Just past 9 am Dr Y telephones me. He says he has left a prescription for Seroquel at reception at his surgery just around the corner. I get dressed and go to collect it. I take it to the pharmacy to get the medication which my wife promised him she would take, starting immediately. When I get back at about 10 am, my wife has disappeared.
My son (who is off work with flu) says that the Pakistani man came round while I was out getting the prescription. He was extremely angry. It seems that my wife had dug up the rose he gave her last night and dumped it on his front doorstep in the early hours of the morning. She had also posted a very abusive racist letter through his door condemning his Muslim religion and demanding that he return her cyclamen. He brought it with him. I ask my son where my wife said she was going. He tells me she said she was going to [location name deleted]. This is the local mental health support unit.
I rush straight round to the Pakistani's house and apologise for my wife's disgraceful behaviour. He invites me in and is totally sympathetic. He understands that she is ill. I excuse myself. I tell him I must try and find her. She needs the medication. I rush onwards to the local mental health support unit. I am told she has not been there. I rush back home. I fall asleep on the sofa. I wake up at 1:15 pm and see my wife talking to a young woman across the road. Then she comes into the house. I say she must take the first medication tablet. She refuses, saying that she will only take it if Mrs B comes up from Smallfields, Surrey to stay with us. She will take the medication from her. This is simply an impractical condition which my wife has thrown in the way to avoid having to take the medication. She makes several long telephone calls. One is to [name deleted], one of her religious friends in Charlwood, Surrey. I hear her telling this person about the unbearable abuse she is suffering at my hands and is asking her to send Mr & Mrs B here to save her.
Her paranoid state is now continuous. There are no gaps of placidity. I think she is now 100% 'sectionable'. She is arranging by telephone for Dr Y to telephone her after surgery to discuss the taking of the medication under the direction of Mrs B. Mrs B has told me that she does not understand anything about mental illness and has no experience of it. I think this is why my wife wants her here. All my son and I can do is wait and endure this hell until hopefully a less tolerant neighbour than the Pakistani actually calls the police.
It seems that at long last my wife has actually come around to agreeing to take her first Seroquel tablet. I am so relieved. We go to the kitchen. I bring the Seroquel starter pack. My wife had previously extracted the first tablet during the night. She had pushed it back into its recess in the pack. It is just resting there. She flies into a rage. She demands I give her the pack. I hand it to her. She snatches it out of my hand. The loose pill goes flying off onto the kitchen floor. I look for ages for it but cannot find it.
09:25 am 28 Oct 2000 my wife takes out the second Seroquel pill of the pack and takes it. She washes it down with water. This is the first medication she has taken since her final 10mg haloperidol injection on 19 April.
She launches once again into her paranoia about the Pakistanis. Then she switches to some weird esoteric analysis of a flower painting on the wall which she did for me shortly after we were married.
My son was disturbed by my wife several times throughout the night. He is once again exhausted. He gets up too late to get to work on time. Suddenly my wife becomes very violent and starts pushing me round the kitchen shouting and swearing at me because I let the Pakistani take her as his chattel. My son stays with me. He is worried for my safety.
With all this strife, my son forgets to telephone his employer to say he will be late. His employer telephones to ask if my son will be into work today because Saturday is the busiest day. I explain the position to them. My wife picks up the bedroom phone and start railing at my son's employer about the Pakistanis. She appears to be giving my son's employer a damn good talking to. Memories flood back about what put pay to my career in 1976. The same, it seems, is about to happen to my son. I tell my son not to worry and that I think he would be far better out of the house and at work. He goes to work.
Suddenly there is quietness again. My wife is in bed. She seems to be asleep. At last, I think, the pill has kicked in. But it hasn't. She gets up in a screaming crying rage. She complains that the pill has made all her joints stiff and given her stomach cramp. She drinks a ridiculous amount of water and is sick. She says she is trying to save her heart and kidneys from the effects of the Seroquel. I think she got this from the quetiapine drug monograph she got off the Internet in the Spring. This carries on until about 2 pm. Now quietness reigns.
4 pm I start to boil the rice for the meal of egg and onion spiced rice to be ready for when my son arrives home at 4:50 pm. I hear my wife heaving things around up stairs. My wife comes down stairs. Her eyes are wild. She has a Bible in her hand and a hand written sermon. She demands my complete undivided attention. I say I must stir the rice. She shouts "No!". I am forced to sit on a chair in front of her. I try to get up. The rice will stick to the pan. She throws me down. She makes clear that I am to sit and listen to her because I am 58 years old and it is my last chance. And on no account am I to go up stairs.
She launches into the sermon, forcing me to read references from the Bible she gives me. It is a sermon dedicated to her by her former chapel pastor which he preached in her absence at her chapel the Sunday after she was admitted to hospital on a Section of the Mental Health Act the last time in 1986. The sermon is a railing hell, blood and thunder thing which does not make any sense to me. I remember typing it out for her some years ago. She uses the original hand written copy. I have to see to the rice occasionally. Each time I do she starts from the beginning of the sermon all over again. She is getting increasingly wild.
4:55 pm my son returns home from work. My wife runs to the front door, opens it, drags him in and orders him to stand next to where I am sitting on the chair. She rails the sermon at us. The often repeated text is "He shall divide the spoil with the strong." She decides we are not paying sufficient attention. She rushes up stairs and starts to throw all my son's clothes, bedding and other possessions down the stairs. Down also comes the bowl in which she had been sick earlier. It goes all over my son's bag he plans to take to stay at his sister's flat this weekend.
The situation has now become so serious that I am no longer sure of the time. I think it must be around 6 pm when I call the doctor. The duty doctor tries to persuade me to take my wife to the health centre in my car. She has for over a week been far to prone to unpredictable violent behaviour to even consider taking her anywhere by car. Also I had several days ago disabled the car in case she tried to drive off in it herself. The duty doctor's voice suggested displeasure as he said he would contact the paramedic doctor on car patrol.
A few minutes later my wife becomes far too violent for my son and me to handle. She starts to attack us. We fear for our safety. First we manage to lock ourselves in the toilet. My son has his mobile phone. It does not work. We hear her shouting. Then she rushes up stairs. I think she is going to use the bedroom phone. My son and I open the toilet door and rush and lock ourselves in my study. My son puts a large chair against the door and sits on it. I pick up the phone. My wife has taken the bedroom phone off hook so I cannot use it. I unplug the house circuitry and plug the study phone straight into the BT line socket. My wife is throwing herself against the door. We have about 10 minutes maximum before the door breaks. I dial 999 and ask for an ambulance. I wait while the phone rings for over 5 minutes. The ambulance service tells me I need the police.
The police arrive with the doctor and paramedic. We come out of the office. My wife is standing by the front door having locked it with the dead bolts. The back door is locked also. My son rushes to the back door to open it for the policeman. My wife launches after him and attacks him. He cannot undo the dead bolts and unlock the door. I manage to open the front door.
The policeman cannot restrain her so he calls for urgent backup. They manage to calm her and call for an ambulance. It takes over an hour to get here. It takes a lot of time and effort to get my wife into the ambulance. I go in the ambulance with my wife. She is admitted to [name deleted] Hospital, [location deleted] under a section of the Mental Health Act at about 11:30 pm. She is forcibly given a calming injection. She is taken to the ward and put to bed. I am interviewed by the responsible social worker. The social worker then runs me home. The upstairs of the house has been totally trashed. It is about 1:30 am 29 October 2000.