Mental Illness and Smoking November 16, 2012Posted by Crazy Mermaid in Anxiety, Involuntary Committment, Smoking and Mental Illness.
Tags: Anxiety, Involuntary Committment
Not a smoker myself, I had the luxury of watching the etiquette of cigarette smoking unveiled right before my very eyes as I roamed the small courtyard at our 15 minute cigarette breaks during my three week stay at the mental hospital.
Without the luxury of time afforded their rich brethren with their ready-made cigarettes like Camel and Virginia Slims, the homeless patients- who comprised more than half the mental hospital population- managed to use their ingenuity and creativity to make cigarette rolling into an art form, combining speed and efficiency. It was fascinating to watch a patient impress his rolling technique with his own personality. Some rollers – mostly men- fancied thick, squatty joint-looking rolls. Others- mostly women- preferred thinner, more ladylike cigarettes. Each cigarette had its own distinct look. It was amazing how much variety could be squeezed out of the same ingredients. Who knew that tobacco and rolling paper could be formed into so many individual shapes while still retaining their purpose?
As a nonsmoker, I was initially offended by this dichotomy: serving cancer sticks to the ill seemed morally bankrupt. Later on, I came to understand the stabilizing influence of tobacco. Its anti-anxiety effect became crystal clear to me as I watched the nicotine-deprived mentally ill patients visibly calm down after the administration of a cigarette or two. Forcing a psychotic patient to suddenly stop smoking was not good medicine, I came to realize. Besides, if the nicotine was looked upon as an anti-anxiety drug, then its administration to a suicidal patient became an action similar to administration of morphine to a cancer patient. Side effects, in other words, are relative.
Watching the daily calming influence of nicotine became a siren call for me to take up smoking, much to my husband’s chagrin. His daily visits, usually during smoke breaks, were spent watching me learn to roll cigarettes, and then having to listen to my explanation of why I was going to start smoking. To his credit, he neither discouraged nor encouraged me, sensing that any direction whatsoever to a psychotic mentally ill person- especially his wife- would be useless and even counter-productive.
My announcement to the nursing staff of my intention to start smoking was met with less than enthusiasm. The nursing staff, viewing my intentions as simply another manifestation of my mental illness, did everything they could think of to discourage me from lighting up. But the reality was that the same tobacco and rolling paper the homeless used was also available to anyone who wanted to start smoking. Even me.
My anxiety, from the medications as well as the illness, was enormous. Unbearable, even. It was so awful that I would do anything, try anything, to alleviate as much anxiety as I could. The prospect of dying of lung cancer paled compared to the anxiety of desperately wanting to crawl out of my skin. If smoking would relieve even a small portion of that horrible anxiety, I reasoned, then the price was more than worth it.
While not outrightly engaging in any sort of discriminatory behavior, the nursing staff nevertheless managed to communicate their dislike of smoking, stopping short of suggesting to the smokers that it might be a good time to quit. They realized the very strong stabilizing effect of tobacco on their charges’ psyche. But while they didn’t actively engage in trying to get people to stop smoking, Hell was going to freeze over before they were going to allow a non-smoking patient to take up smoking.
Their first line of defense was to try to reason with me. Didn’t I realize that the reason the drug (tobacco) calmed people down was because it was a “fix” from the habit of smoking? That it really didn’t alleviate anxiety like the anti-anxiety pills did?
But I wasn’t buying any of their bullshit. They were lying to me. I was convinced the drug really was like an extra dose of the anti-anxiety pills. Besides, the doctors limited the number of those pills we could take, but not the number of cigarettes we could smoke. It was, I believed, like getting an extra dose of Klonopin. Besides, all my new friends smoked.
In the end, I couldn’t make my mind up whether to start before I was discharged from the hospital. Once out of the smoking environment, I totally forgot about my desire to take up smoking. Besides, the tools- the tobacco, paper, and rolling machine- were no longer at my fingertips.
M medication is stabilized and I no longer have that incredible surge of anxiety through my system…most of the time. Although I am glad that I never took the habit up, I no longer pass judgment on the smokers of the world.