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People with psychiatric disabilities cannot take for granted that we will always have our full faculties. While most people seem to assume their minds aren't playing tricks on them or failing them in other ways, people with mental illness cannot make that assumption, for numerous reasons. 

In the aftermath of a psychotic break, especially one that happens beyond a person's twenties, we've probably lost significant ground, mentally. We probably could carry an intelligent conversation and we may present as rational and competent, once we are stabilized. Yet there are some mental functions that probably don't work as well as they did before. This is something where it can take several years to get back to square one. 

I've interacted with people whose minds are somewhat burned out by a string of repeat episodes of psychosis. Repeatedly going off and on antipsychotic medication has very bad effects on the brain. This is probably as bad as the effects of hard narcotic use. Either way, the person may have lost fifty percent of their wits. This becomes apparent when having a conversation with them. They may not enunciate clearly, and their sentences could be badly structured. Additionally, their eye movement may appear different, and so could their body language. They may have excessively wrinkled skin on their face, more so than would be expected for their chronological age. They may have poor grooming and poor or no teeth. 

I apologize if the above paragraph adds to stereotypes--that isn't my intention. Rather, this week's manuscript is intended to warn mental health consumers of the dangers of not taking a psychiatric condition seriously. 

Being in a psychotic state without treatment has very bad effects on brain tissues. When schizophrenia is allowed to run its course, eventually the patient reaches a "burnout" phase. The brain gets what is called 'enlarged ventricles." Ventricles are the spaces between parts of the brain. The person's brain has lost mass. Full functioning will never return. 

I've had a total of three relapses, the most recent one in 1996, and I find that I just cannot do many of the things that I once could. I've worked very hard at writing, and this has caused development in some types of mental functioning, such as intellect. 

Yet, at one time, I was capable of driving in San Francisco. I can't do that any more. I have difficulty in social environments, especially at crowded restaurants--it is difficult for me to tune out the larger surroundings and to enjoy the restaurant visit. Working at a full-time job, which I did when young, is now out of the question. 

The term "use it or lose it" is applicable. If I'd maintained more activity other than sitting at home and writing, I might have retained more capacity for that. 

The psychiatric illness and the medication, both, can affect faculties. Putting effort into mental and physical activity can help counteract these effects. Even something as simple as washing dishes can help brain condition. 

Being medicated and not monkeying with meds, and a regimen of brain-intensive activities are probably the best solutions available. Also, and this is basic, but we all need to eat and sleep. If sleep or food deprived, the brain doesn't get what it needs. 

The term "compliance" has bad undertones to it and brings up bad connotations. I wish that the term would be replaced with something friendlier. "Cooperation" might work better as the term representing that we are voluntarily accepting treatment. 

Also, it would be obliging if treatment practitioners and authorities in the mental health treatment system would cooperate whenever possible with the wishes that we express.