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Irish Examiner
23-05-2025
- Health
- Irish Examiner
Author interview: Psychiatric care left wanting — ‘I lost so much' as a psychosis patient
When Mary Ann Kenny's husband John collapsed and died while out running near their home in Co Dublin, she was blindsided by the sudden and devastating loss. But for Mary Ann, the nightmare was only beginning. The circumstances of John's death and having to tell her two young sons had a profound impact on her and she struggled to cope in the aftermath. She was prescribed sleeping pills, sedatives, and finally anti-depressants, to which she had a severe physical reaction. Soon after, she experienced psychosis, believing her children had somehow been poisoned by her medication, and ended up in psychiatric care on two occasions. In her compelling and affecting memoir, The Episode, she describes how the whole experience, including being denied access to her children for a period, left her feeling dehumanised and even more traumatised. 'I felt cast out by society. I had no rights, I had no voice. And that is the greatest kind of trauma. On an evolutionary basis, we need to be part of a society,' she says. We need connection with other people. We need care when we're sick and that had been withdrawn from me. It is 10 years since John's death and Mary Ann's admission to a psychiatric hospital; her career as an academic is thriving and she and her sons, now teenagers, are in a good place. However, the anger she feels about her treatment stayed with her, which eventually led to her writing the book. She says: 'I couldn't put it behind me. It was consuming me and my every thought. I have a very strong sense of injustice, and so did John. 'When my involvement with psychiatric services came to an end, I felt liberated, but I was also full of questions about what had happened to me. 'I requested my files and I was enraged by what I read, about the way I had been treated as a person who had suffered a very sudden and tragic loss and was at the lowest point of my life. 'I felt I hadn't been treated with the compassion and care that I deserved. Yes, I lost John but I lost so much as a patient.' That astonishing lack of care and compassion towards a grieving wife and mother is evident throughout Mary Ann's treatment as recounted in the book. Kindness needed more than psychiatric treatment She acknowledges that while she did require psychiatric treatment, what she needed even more was kindness and most of all an opportunity to process the overwhelming accumulation of grief, uncertainty, and anxiety. She also felt tremendous guilt for relying on her friends and her own elderly mother who herself needed care. As she writes: 'What I needed most was to rest my tortured brain and my exhausted body.' Instead, the death of her husband was barely mentioned and she was subjected to endless questions and team meetings where some staff didn't even introduce themselves or acknowledge her presence. 'It was absolutely torturous and excruciating to me to be asked perpetually about my thoughts at a time when I was heavily medicated, seriously ill, and exhausted and unable to verbalise my thoughts anyway, and certainly not in front of a group of professionals, half of whom I might never have met before,' she says. Mary Ann received no talk therapy during her admissions and it was only when she left hospital and attended a cognitive behavioural therapy group that psychotic depression was explained to her. 'It is beyond belief,' she says. 'When I would say to people that I didn't get any therapy when I was in hospital, they would be like: 'What? You must have'.' It's shocking, and it's seems to be much more a feature of psychiatric treatment. She compares her experience to one she had when she was admitted to hospital for a serious injury two years ago. 'One of the big differences was that I was kept informed the whole time,' she says. 'I was never sent copies of any letters that went from my psychiatric consultant to my GP, whereas, when I had my physical injury, every single communication between my surgeon and my GP was copied to me so I was kept up to date the whole time. 'The first time I saw the equivalent letters for my psychiatric treatment, and I'm talking about my outpatient care as well over the following years, was when I requested my files. 'I was kept completely in the dark. It is all part of that dehumanisation and disempowerment.' According to Mary Ann, the psychiatric system views mental illness as a chronic condition, which is counter-productive to recovery: 'There was no sense from them that this was ever going to end — they did not hold out any hope that this would resolve itself.' They view the person who's mentally ill as a collection of symptoms — weight loss, insomnia, delusional thinking, in my case — and they treat those symptoms in a vacuum. When her brother visited her, he told her what she describes as the single most helpful thing that anyone said to her during her period in hospital. She writes: 'It's an episode… and an episode has a beginning, a middle and an end… you're now in the middle — and the middle is horrendous — but episodes always end, and this will end. 'No mental health professional ever said anything remotely similar in all the months I spent being treated by them. It would have helped if they had. 'As it was, my brother's mantra gave me hope. And it turned out to be true.' Mary Ann refers to being caught up in a mental health system that is itself sick. She says she would be 'delighted' if mental health practitioners and social workers read the book and learned something from it. 'I have been as fair as I possibly can to them,' she says. 'It is a hard position that they're in, but it is not black and white. 'I hope that they see that there is a human being at the heart of this particular mental health emergency and every mental health emergency — a human being who is suffering. 'We all need to have a bit more compassion — professionals and society.' She found the process of getting her experience onto the page cathartic to an extent but it was also a journey of discovery as she pieced together what had happened to her. 'I wanted to put my story on the record,' she says. 'There were other records — this is my record. But I had to unravel it. 'It was very therapeutic, it hugely aided my understanding of what had happened to me.' While she has achieved clarity, she says her experience in psychiatric care is never far from her thoughts: 'I still think about so many aspects of this story all the time. I think about John all the time and his death, it was his anniversary recently. 'It's spring again, the sun is shining, the clematis is flowering … and then the next few months come and it's July and I'm thinking, this is when … so it's never too far from my thoughts, any of it.' The Episode not only serves as a reminder that there is always hope but also as a way to remember her husband John and celebrate all that he brought to his family's lives. 'We are a very close unit and we have our sad moments, but we keep John alive and we talk about him a lot,' Mary Ann says. 'I wove whatever I could about him into this story. He would have been incensed about what happened to me but overjoyed by this book. 'His spirit lives on in it, it really does.' Read More Book Review: Danny Morrison looks at a history of psychiatry
Irish Times
11-05-2025
- Health
- Irish Times
‘Losing my husband, losing my mind': Author says she is living proof people can recover from severe mental illness
We meet in Fitzpatrick Castle Hotel in Killiney , south Co Dublin . It's near home for Mary Ann Kenny, and also near where her husband John collapsed one fine April day in 2015 while jogging, and died. His death left Kenny, a lecturer in German, and their two primary-school-aged boys stunned, grieving, their lives suddenly torn apart. Over the following months as they groped through life, Kenny's grief became intense, with depression and several physical and psychological symptoms, including delusions that her boys had taken her medication and been harmed. She lost touch with reality and developed psychosis, spending 10 weeks in a psychiatric hospital. It was a dark time. Ten years later, life is healthy and happy and she has written The Episode, a memoir about her personal experience of severe mental illness. It's remarkably detailed, drawing on her own memories and observations, and multiple medical and social-work files. There's a dizzying array of professionals, medications, treatments. Professionals and friends are anonymised, as is a day-care centre and psychiatric hospital. She steers an arresting course between an academic's rigorous research and pacy, insightful readability. Today there's no hint of what she's been through. 'I've been very good for a long time.' She's calm, analytical, articulate. READ MORE Many people go through grief, but hers was extreme, 'particularly cruel, I suppose'. Because it was sudden. Because she had two small children ('it's impossible to overstate the burden of that'). Because of her 'aloneness': John was an only child, her siblings lived abroad; she had very good friends but her main support came from her 90-year-old mother Bernie ('she's the hero'). Grief triggered a series of events, leading to psychosis. She talks about complex traumas: 'I lost control of everything ... I was obsessed with this belief that I had damaged my children, ruined my children's lives. It was one of the most traumatic things you could imagine. That there's no hope for them.' And then, 'what happened to me in hospital', where, she says, 'my identity was just torn to shreds'. Writing The Episode has helped her tease out the interplay of her feelings of guilt. The feeling that she hadn't protected the boys enough from life's cruelties somehow became an obsessional belief that she had damaged them, and led to psychosis. Over a few months everything spiralled and she went from attending a day centre to being admitted twice to a psychiatric hospital. She vividly portrays what it's like on the other side of constant questions, over and over, from multiple healthcare professionals. She'd like professionals 'to see what it feels like at the receiving end', she says. Mary Ann Kenny: 'I felt annihilated by my treatment, annihilated as a person.' Photograph: Dara Mac Dónaill After intense assessments, she went on to tell professionals in October 2015 that she wanted to harm her own children, and herself. It's shocking to read. She writes: 'Why did I do it? Why did I say such appalling things – none of which was true and none of which I believed, even at the time, and all of which were guaranteed to make my situation so much worse? Because I thought I was living in a parallel realm and believed that what I was saying didn't matter in the real world inhabited by everyone else? 'Because I was close to collapse, having barely eaten during the preceding weeks, because of the effects of the antipsychotic medication on my prefrontal cortex, the part of the brain responsible for executive functions? 'Because it seemed to me that the professionals with their faces of mistrust and frustration believed that I was guilty of something , and I myself thought I was guilty too? Because I had been asked the same questions over and over for two months and I couldn't fight them off any more? Because I wanted to be agreeable and to give the medical staff what they seemed to be looking for?' But having said what she said, 'my fate was sealed', she observes now. There has to be a better way of treating somebody in such distress. I felt annihilated by my treatment, annihilated as a person — Mary Ann Kenny The reader feels the frustration of the constant interrogation, but feels pity for the professionals too. Kenny knows this. She says 'the worst of the lies, the self-incriminating details, I blurted out in the first 10 days. Then I stopped. I started to come to my senses. It's incredible how quickly I actually regained my sanity after that, started to realise the delusional belief was wrong.' [ How I coped when grief became my new reality Opens in new window ] She realised, too, 'the seriousness of what I'd said'. Kenny acknowledges what the professionals must have feared, when she said she planned to harm her children and herself. 'I never did have those plans and intentions ... There's nothing more tragic than those cases, of a parent doing something to their children because they are mentally ill, maybe in ways not dissimilar to me." However, she says: 'I felt annihilated by my treatment, annihilated as a person, as a human being, as a mother, as a daughter, as a friend. I felt literally torn apart.' Psychotherapy later, privately, helped her process the trauma of 'losing my husband, losing my mind … Mostly I needed therapy to help me come to terms with my hospital experience'. Mary Ann Kenny exposed her inner turmoil and psychiatric illness, for reasons that were 'bigger than any need for privacy'. Photograph: iStock She observes, from reading about psychiatry as well her own experience of it, 'they treat symptoms. But they don't ask about the cause.' Our psychiatric system, she says, is 'all about risk assessment and risk prevention, for the severely mentally ill anyway, rather than care or therapeutic intervention for patients' sake.' [ Huge variations between hospitals in treatment of mental health emergencies Opens in new window ] She felt disempowered, she says. 'I thought I was going to die in there. I thought my children were going to be taken away from me. There has to be a better way. This was a person in distress, suffering, who led a completely normal life up to the day her husband died. Something has happened to her, and we have to help her.' She felt 'cast out. I felt a complete social failure. That is incredibly traumatic.' It was eight months out of her life. She sometimes thinks of it as 'having to break down in order to get the help I needed'. But it was an episode. It ended. 'And it never came back.' Ten years later, she's still working. Her sons are in secondary school. 'They're absolutely wonderful. We're a very, very happy, close unit, the three of us.' The weird thing is, after the episode ... I have never looked back. I've never had a day's depression since — Mary Ann Kenny 'Maybe the drugs worked. Who am I to say they didn't work?' Key was her delusions waning. 'I stopped believing I had harmed my children.' In her experience: 'Antipsychotics, they dull your cognitive activity, as well as your emotional feelings.' With a self-destructive, delusional belief, 'maybe that's exactly what you need. If you become like a zombie, which I did, maybe that's, in the first instance, beneficial.' Or 'perhaps it was the passage of time', and removal from daily life. [ Adam Loughnane asked for help at a Galway hospital. Three hours later he was dead Opens in new window ] 'All I know is, I was no longer obsessing about this one thing,' and instead started to worry about 'real-world worries. Maybe I just had no space left to worry about the imaginary thing ... And then I was better. It's extraordinary. How could you get so ill and then you get better?' Her experience puts in context how anyone can be vulnerable. Bad things happen; perhaps any person's life and mind could fall apart. But also, that people can recover from severe mental illness. 'I'm the living proof.' 'The weird thing is, after the episode ... I have never looked back. I've never had a day's depression since. I have never been crippled by grief again. There's a poignant, melancholic sadness about John ... I experienced an extreme collapse of my entire life. So when I got my life back, I was overcome with joy.' Ultimately, 'the whole experience made me stronger'. The first draft of what was to become her book took three years, writing for herself, to make sense of it all. She felt she'd gained insights into the psychology of her breakdown worth sharing. 'I think other people can learn from it. I didn't set out to bash the professionals, and I don't think I did.' [ Mental health in Ireland: 'Should we not be helping people before they get down to the breakdown stage?' Opens in new window ] She has exposed her inner turmoil and psychiatric illness, for reasons that were 'bigger than any need for privacy'. Reading her own records, she felt 'that's not my story. My personal truth about what happened to me is different from those files. And I want to put my story on the record.' The Episode, A True Story of Loss, Madness and Healing, by Mary Ann Kenny is published by Sandycove, an imprint of Penguin Random House
Telegraph
05-05-2025
- Health
- Telegraph
The haunting reality of a mental breakdown, by a woman who survived
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?
