The haunting reality of a mental breakdown, by a woman who survived

Telegraph

05-05-2025

Recently, while working with a group of psychiatrists and emergency mental-health workers, I heard uncanny echoes of The Episode, Mary Ann Kenny's meticulous and frightening book about her breakdown and its aftermath. The language they were using, in talking about how Britain treats – or fails to treat – mental illness, could have come straight from Kenny's account.
'It's chaos,' one psychiatrist told me. Three nodded agreement. One of them prefers to work with homeless people than practice on overwhelmed wards. 'It's too mad,' he explained, to face waves of patients whom the system wants quickly processed – meaning: medicated and back on the street. 'We're getting hit with 'productivity',' said a mental-health social worker. 'We're supposed to be seeing more, discharging more – it's completely counter-productive.'
Now, if that's what it's like being a psychiatrist or case-worker, imagine being the patient. Mary Ann Kenny is a high-flying Irish academic and mother of two. The sudden death of her beloved husband, their boys' father, afflicts her with terrible grief. That soul-deep devastation leads her to doctors, who first prescribe sleeping pills (Zopiclone), then Xanax, then the anti-depressant sertraline.
But the sertraline causes 'excruciating and persistent burning' under her skin. Kenny fights crippled cognitive processing, and the rampaging terrors of depression. Her prescriptions are changed, and increased: venlafaxine plus clonazepam, then added olanzapine, plus bupropion. The questions from the mental-health services become more insistent. 'Do you have thoughts of suicide?' 'Any plans to kill yourself?' 'How about harming others, and your kids in particular?'
These three forces – the depression; the drugs, which plunge her into a paranoid mist of confusion; the attitudes of the clinicians – bring about an acute crisis. Kenny becomes convinced that she has poisoned her children with her medication, and she's finally taken into a psychiatric hospital, where she will spend the next 12 weeks.
Stories of mental collapse are, tragically, not uncommon, and always filled with pain. They thus set any writer a stiff challenge – but it's one to which Kenny rises magnificently here. The Episode is written in beautifully honest prose, and illuminated throughout by something rare and invaluable: the notes kept by those who dealt with her.
Some of those records show how kind individuals can be. Of Kenny's heroic mother, who's with her every hellish step of the way, a doctor writes: 'Very well at 90 years of age, a charming and wonderful lady.' Others expose the medical system itself, and the damage its obduracy, insensitivity and mechanical processes wreak on those it's meant to help: 'Blunted affect. Poor self-care, dirty nails, looks poorly nourished, tired. Spent long periods laying in bed staring at the ceiling.' You can find dozens of these shattered figures, awash in drugs and paranoia, in our psychiatric wards today.
Kenny is given no meaningful counselling, let alone the expert clinical psychotherapy she now realises she needed. Branded 'non-compliant' for missing a dose of medication, she's criminally neglected, under the very eyes and noses of the staff, when she develops chronic constipation she is too ashamed to admit. 'Fetor of urine evident in her bedroom,' says her patient record. No one investigates or helps.
'I know I have myself,' Kenny concludes, and it becomes a mantra of her recovery. With the help of therapy, she returns to her family and successful career, and now publishes this gripping and important book, speaking up about her experiences and advocating for change. But no one should have to survive mistreatment as Kenny does, and as many like her – including me – have and do. Many sufferers' lives become battles to cope with the effects of inadequate or absent care. Kenny was in the Irish mental-health system, but this differs little from our NHS version. Here in Britain, it shames us that a fifth of psychiatric-ward patients are readmitted within six months.
It isn't our clinicians' fault that this crisis continues to worsen, and it will not be solved by politicians blaming over-diagnosis. The problem is the system itself, which reaches for pills in the absence of therapy, and sees sufferers as defective rather than in need. Saving it is conceptually straightforward. Currently, psychiatrists are being pushed to become 'medication reviewers' – dispensing more meds in shorter appointments. We need the opposite: longer, slower appointments with psychiatrists, drawing on their therapeutic training and ability to understand individual needs. But where are the politicians and clinicians of influence who will give them to us?