What’s a difficult decision you recall making?
Lately, for me it’s been choosing what films to watch or contemplating where to go for slightly longer walks.
Totally inconsequential. These are not hard decisions. The outcome of such decisions do not affect me in any way, nor are they memorable. What was the name of that film I just watched? *shrug* Whatever, who cares.
What’s a hard choice to make? Here’s one:
Would you rather be: mad and thin OR sane and fat?
No this is not a casual ‘Would you rather…’ game where you choose between two seemingly equal and terrible made-up situations. It’s a choice some people with severe mental illness have to make …with real-life consequences.
Many antipsychotic medications (to treat schizophrenia, bipolar disorder, and other mental health disorders) are known to have side effects in the form of weight gain. I spoke with several people with various mental health diagnosis who had this experience. One lady told me she went from a size 10 to size 18 in just a few months after taking antipsychotic medication. Another lady’s situation was more extreme. She went from a size 8 to 26 within a mere 7 week period. I was sure I heard her wrong until my research colleague confirmed it. These individuals explained that they would always feel hungry and never full when taking the medication. The medication would increase their appetite and they don’t realise they’re putting on weight. Until it’s too late. “You’d go for anything cause you’re just that hungry” one of them told me.
So when Stanley’s (not his real name) psychiatrist tried to prescribe him the antipsychotics, he refused.
“I rather be mad and thin than not mad and fat”
Those words stayed with me. I probably would make the same choice under such circumstances.
Another difficult choice for people with mental health issues to have to make is around smoking. Did you know that people with poor mental health die on average 10 to 20 years earlier than the general population, and smoking is the biggest cause of this life expectancy gap? Yikes.
While it’s easy to say yes smoking is bad, quitting smoking is an entirely different beast. Especially if it helps with coping with mental conditions. Dory (not her real name) who’s been diagnosed with Bipolar told me:
“I’m not in a position in life where I want to stop. I’ve done it so long now, for 10 years. Even though I don’t want to be a smoker, I worry about my mental health.”
Would you still force her to quit after hearing this? I don’t have the guts. Not unless I can offer her a magic pill to cure her.
Then I had a disturbing thought:
Are cigarettes and antipsychotics the same?
I know this correlation is ridiculous and can be considered heresy. But if you think about it, both have severe side effects and both ‘help’ to cope with mental health. Maybe they’re both inevitable as long as there aren’t better opinions made available and accessible.
There are all sorts of smoke cessation programs out there trying to solve this crisis. None has come on top. One promising alternative that’s been gaining popularity is vaping using e-cigs or vapes. Smoking alternative with less severe health risks. I learned about this a bit last night from watching an episode called ‘Big Vape’ on a Netflix series called ‘Broken’. Martin Dockrell, The Tabacco Control Programme Lead at Public Health England, says “The biggest cause of preventable death in England is smoking …and it affects the vulnerable communities the hardest.” If we can’t get people to quit, maybe we can find a substitute that kills fewer people. So bold initiatives like offering free e-cigs to help smokers quit started. Though e-cigs/vapes also have their health issues, in Martin’s words, “compared to smoking, where half of the lifelong users of a product will die directly as a result, plainly, vaping is much less harmful than smoking.” So in this case, the decision to choose the less poisonous option seems like a no brainer.
I’m grateful I have not been confronted with such difficult choices thus far in my life. But if and when I do, I’ll recall what Stanley told me:
“Being happy is far more important than being healthy. Rather 5 years of happiness than 10 years of living miserably. I can’t bear being miserable. I spent too long being miserable, such waste. I’d prioritise mental wellbeing over physical health. Why take meds if they make you feel miserable?”
He picked his poison. I’d pick happiness too.
Side note
After a light googling for an appropriate image for this post. I came across this fun game: Pick Your Poison. Suitable title don’t you agree?
