Olga‘s Story

June 20, 2007

There is a rare, but familiar voice in Olga’s life. Deep and menacing, it lets loose a nonstop string of profanity.
The voice is inside of her head, and she was its mercy until she started taking an anti-psychotic medication 30 years ago.
The first drug she tried gave her an alarmingly high sex drive (that one was very short-lived). “Probably some people would pay for that,” she laughed, “but it sent me reeling and I wanted something else.” Another caused her to gain 85 pounds. But those side effects were well worth the peace she now enjoys, she said.
Olga is attractive, pleasant, and a little plump. She’s indistinguishable from other 60-year-olds you’d meet—perhaps calmer, more careful with her words, and she easily tires. She spent her youth in the1960s in Ann Arbor, studying early education and protesting the war. Frustrated with the country’s war policy, she and her husband moved to Tokyo for a couple of years.
But living in the relative isolation of a foreign country, she soon realized her husband was an alcoholic and they parted ways. She moved back into a quiet Ann Arbor neighborhood. Quiet except for the voices. Sometimes it was the angry, male voice, other times it was just a cacophony of voices. She couldn’t really make out what they were saying, but they seemed real, unpredictable, and absolutely terrifying.

STRING OF PHOBIAS
Day after day, Olga would cry for an hour or so, and this went on for six months. Her temper would flare. She had a string of phobias—fear of flying, fear of driving on the freeway, fear of crowds and thunderstorms. She told no one.
Finally, a psychotic break sent her to the hospital for three days: “That was really scary. You’re totally disassociated from yourself. You’re not in any control over your feelings or your thoughts.”
The breakdown prompted a visit to a therapist who counseled her and gave her medications to calm her. Then he referred her to a therapist to help her tackle lingering childhood issues.
Several months later, Olga was diagnosed with paranoid schizophrenia. She wasn’t shocked. Her father suffered a severe breakdown in his 40s. Her paternal grandma saw a therapist in the 1920s and 1930s and later committed suicide. Olga was relieved to finally have an explanation for the voices and phobias.
Accepting the diagnosis of paranoid schizophrenia and taking medicine for it was the single most transformative act of her life.
“The voices stopped, the crying stopped, the temper flare-ups stopped, and only occasionally did I hear voices when I was extremely stressed. Then I’d either go for a walk or listen to music. That did help,” she said. “Looking back, I probably should have gotten help as a teenager.”

‘REALLY ROCKY’
Olga initially balked at taking her medications because it made her mental illness too real. “I was really rocky. At that point, my doctor sat me down and told me it was my responsibility to take my meds.”
She only confide her mental illness to her closest friends and family—certainly not to those at work. For reasons of confidentiality, she is using a pseudonym for this article.
Soon afterward, she met the love of her life—a war veteran who accepted Olga and her mental illness. “He was like that with most people. ‘Just be who you are.’ He was very upbeat. He listened to happy music, laughed at everything. He was very intelligent.”
Those were the good years. She worked as a full-time researcher for the University of Michigan and saw her boyfriend often (they lived in separate homes and both liked it that way). But in 1991, her father died and she began spending most of her spare time as an emotional shoulder to her grieving mother.
Then one September day in 1993, her boyfriend asked her to take him to the hospital. He was in terrible pain, and had been for months—he had never told her. In October, he, too, died.
His death shattered her, and she was too emotionally fragile to work. At the age of 50, Olga went on permanent disability and moved to a co-op where she was surrounded by people. She eventually moved to her own home, watched a lot of TV, but found she could no longer read books or long articles. “It was like having a limb removed.” She saw friends and went to the Community Mental Health (CMH) community room a couple of times a week, but mostly cared for her mom.

HOMESICK
Olga moved here in 2000, following her mom and sister who had earlier moved to Traverse City. “A loving family has been so important to my mental health, but it was a huge adustment. I was pretty homesick.”
People here were friendly, she said, but it was hard to get past the barrier of tightly knit groups to form real friendships.
Several years ago, she began taking Seroquel, a second generation drug that’s reputed to make patients feel less “druggy.” But that wasn’t true in Olga’s case (every patient is different). She began sleeping a lot and gained 85 pounds, although she attributes part of that to menopause.
Just a few months ago, a caseworker at Northern Lakes CMH recommended she switch to Geodon, a different second generation antipsychotic because it doesn’t cause the weight gain like Seroquel. She’s also taking Abilify, an anti-psychotic, and Celexa, an anti-depressant—all with no apparent side effects.
“Geodon made a vast difference for me. I lost 20 pounds and I feel less groggy, more in touch, more in tune. I can now get along on four hours of sleep and a nap during the day,” she said.
Olga said her CMH caseworker is her biggest advocate. He sits in on doctor visits, and makes sure he is aware of any pressing issues. Her psychiatrist is well aware of the medicine’s potential side effects and works closely with her doctor and caseworker.
“It’s a strategy of sharing that is really important. …But I can’t stress enough, how important medication is. Whenever we get together at CMH, we exchange information. What’s working, what’s not working, what are the side effects.” Her friends at CMH are willing to tolerate the side effects.

MIRACLE DRUG
Yet even side effects are well tolerated—glazed expressions, feeling groggy, permanent muscle twitches, a stiff gait. “It’s because they feel it’s so important to be able to function—even a little bit. Without the medication, your mind would be chaotic.”
One man she knows takes Zyprexa, which he calls a “miracle drug.” Before that he was out of touch, living in what he called an ‘altered state’—passive, no enthusiasm, flat. But now he is much more social and interested in the world outside of himself.
“He did have a big weight gain, and diabetes associated with that. But now he walks, and is losing some of the extra weight. Before the Zyprexa, he wasn’t even able to walk. He was just too medicated.”
Her harshest reality: poverty. Living on a disability check isn’t easy. She buys second-hand clothes, hits garage sales, eats a lot of pasta, and drives much less since gas prices skyrocketed. She has to save up for haircuts.
“I budget down to the penny. It’s like living on a student income all your life,” she said, laughing.
The increased tax on cigarettes will really hurt. Olga smokes and finds it impossible to quit. “I don’t know why so many of us smoke,” she said. “We just do, and it makes me so angry that smokers are getting the brunt of the state’s budget problems (with higher cigarette taxes).”
Living on so little money is stressful. Olga tries to get enough rest and surrounds herself with the beauty of music and flowers.
The light of her life is Northern Lakes CMH, which provides services to the mentally ill who are mostly on Medicaid and Medicare. She plans to attend her very first support group this week: “They’re very attentive here. They really care about you.”