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Working with top shrinks drove me mad; High-flying health boss Jim ended up suicidal, homeless and divorced having electric shock therapy in hospital he once ran.


AT 44, Jim Kiddie seemed to have it all - a challenging career in the NHS, marriage to another high-flier and all the trappings that go with success.

It seemed the perfect lifestyle. Yet, within a few short months, Jim lost everything after suffering a nervous breakdown and trying to commit suicide.

The irony is that his condition was brought about by the stress of being in charge of mental health services in Grampian, with a pounds 13million budget.

He ended up as a patient in Kingseat Hospital, outside Aberdeen, being treated on a ward which he had personally opened two years before.

Now recovered and happily remarried to his first wife, Jim can look back rationally on the events that led to him to losing his job and undergoing electro-shock treatment which has left his short-term memory severely affected.

Jim was working 12-hour days trying to implement tough strategies set by Government, but often felt thwarted by unco-operative colleagues.

His then wife, under enormous pressure herself as an NHS manager, could not cope with his need for support and their marriage began to crumble.

Looking back, Jim, now 55 and living in Aberdeen, talks about it with dry humour.

He joked: "Working with psychiatrists was very bad for my mental health. I spent three years bashing my head against a brick wall, being expected to meet certain targets, when some psychiatrists were not keen to play ball.

"As a general manager, I would go on to the wards and meet patients, but I was not in day-to-day contact with them.

"That wasn't the strain on me. It was dealing with psychiatrists that was the strain.

"I remember one of them looking me straight in the eye when I suggested he went on a management training course and saying: 'As a psychiatrist, I am trained to know everything'.

"They simply weren't going to co- operate with me and my management team.

After three years of feeling got-at all the time, I started to doubt myself and finally disintegrated.

"My successor had a heart attack at the age of 42.

"In my experience, psychiatrists - or at least some psychiatrists - are 10 times worse to deal with than other consultants.

"I trained as a manager and ended up running mental health services through an accident of NHS reorganisation.

"Managing psychiatrists was an incredible challenge which was perhaps beyond me.

"On top of dealing with that sort of attitude, I was having to work far too many hours. I was stressed out of my mind.

"My then wife was also under immense strain. She wasn't able to help me and I wasn't able to help her and, between the two of us, it was disaster."

Even though Jim was surrounded by mental health professionals every day at work, none spotted he was heading for a breakdown.

He said: "For about a year before I cracked up, I was saying to friends that I felt as if I had a cement bag on my head. There was this feeling of tremendous pressure. I didn't feel right.

"By now - about six months before I cracked up - I was quite manic. At times I would just stare at my office wall for hours on end."

Finally, he became paranoid and terrified.

He recalled: "I was seeing things, imagining all sorts of things. I suppose I was losing my grip on reality."

In March 1990, he took an overdose of every pill he could lay his hands on, washed down with half a bottle of whisky, then phoned his first wife, who called the emergency services.

When he finally woke up, the most horrifying episode was yet to come.

Jim explained: "I thought my suicide attempt had succeeded. For about 18 months afterwards, I thought I had killed myself and I was in hell."

He was admitted to Ninewells Hospital, Dundee, because it was considered better for him to be treated in a hospital where he had not previously been in charge.

There, he was given anti-depressants, but his confusion and distress did not lessen.

He said: "I thought the River Tay was the River Styx which, in Greek mythology, you cross to reach the underworld. I was a mess - a mental wreck."

"What I needed was asylum, a place of peace and tranquillity where I could have time to talk and to recover.

"A huge teaching hospital where the emphasis was on hi-tech medicine was not the right place.

"Almost no one visited me - my second wife had left me, I wasn't in touch with my first wife or our two sons and other friends could not make the 66-mile journey from Aberdeen to Dundee."

Three months later, he signed himself out to return home to Aberdeen, but it did not help.

Admitted to a ward at Kingseat Hospital because his clear need for help over-rode possible ethical problems, he found himself being treated by consultants with whom he had worked.

Their approach to him was caring and professional, but he could see them only as enemies.

Jim said: "One part of my mind was saying this was all happening to me in hell.

"Another part was saying that these psychiatrists, whom I'd had difficulty with as a manager, were trying to kill me and I'd better get it over with as quickly as possible."

That was his state of mind when he agreed to have ECT - electroconvulsive therapy.

ECT is a controversial treatment. The patient, under general anaesthetic and having taken a muscle relaxant, has an electric current passed through the brain to induce convulsions.

No one knows why the treatment, first used in Italy in the Thirties, works, yet it has a success rate, according to American studies, of 65 to 70 per cent - at least as high as Prozac and without the three-week wait for anti-depressants to kick in.

But it causes severe memory loss in some patients and has been blamed for others collapsing into a catatonic state or committing suicide.

The success rate is measured by psychiatrists who assess how they believe their patients' mood has changed after a few weeks, rather than by long-term studies carried out by independent researchers.

Jim's experience of ECT, which is banned or severely restricted in many nations, was extremely traumatic.

He said: "I can recall walking to the ECT suite and being given a general anaesthetic. The next recollection I have is of walking back to the ward supported by nurses, not knowing who I was.

"It was one of the most terrifying experiences of my life. I had no sense of myself as a person.

"Part of my brain was struggling to break through to who I was, but my main sense was of being a non-person and having the most incredible headache.

"After a few hours struggling with bits of my past, I would be able to piece things together, but I forgot a lot.

"Then two days later, I would have another session of ECT and it would happen all over again."

In total, Jim had six sessions, spread over two weeks.

He is convinced that the treatment did him only harm.

He said: "I was suffering from acute anxiety and ECT made it worse because it made me start worrying about my brain.

"I still have terrible problems with short-term memory. It can be very difficult for me to remember what I did five, 10 or 30 minutes ago. I feel like I bluff my way through a lot of the time.

"I don't say that everyone shares my experience of ECT - I have come across people who swear that it saved their life, but for me, it didn't work and I think, given that the psychiatric profession is divided on this and that no one knows exactly how it works, there should be a great deal more research."

Jim remained an in-patient at Kingseat for another six months, when he was discharged against his will.

After seven months, still unwell and homeless, he told his GP he would take his story to the newspapers unless he was given some help.

He was quickly re-admitted to Kingseat, which has since closed, then transferred to the Royal Edinburgh Hospital, where his seven months as an inpatient finally started him on the road to recovery.

He said: "I met a wonderful nurse who had a psychology degree and knew about cognitive behavioural therapy. She helped me re-build myself.

He began voluntary work with a group for people with dementia before getting back into paid work in 1993 as a support worker for the Patients' Council, looking after patients' interests in the Royal Edinburgh Hospital where he had been treated 21 months earlier.

One of the unexpected bonuses of his illness was that he got back in contact with his sons from his first marriage and, through them, their mother Bobbie.

After a second courtship, he and Bobbie remarried in 1998.

Jim said proudly: "My first wife is also my third wife. Every cloud has a silver lining."

Now he is manager of the National Schizophrenia Fellowship's Carelink line in Aberdeen.

He is involved in political campaigning and sat on the Millan committee examining mental health law in Scotland.

He said: "I feel like myself again - I'd go further and say I'm blissfully happy now. I have acquired a bit more wisdom than I had a few years ago.

"I now know that we are all struggling to get through life and at some point we are all going to have problems."

But if anything, finding himself a patient rather than a manager has confirmed Jim's qualms about psychiatry.

He said: "Psychiatry is not an exact science, yet some psychiatrists behave as if it is. I'm not denying the importance of anti-psychotic medication or anti-depressants.

"I am even open to persuasion that ECT has a place for some patients.

"But treating the symptoms of people who crack up because of their circumstances without dealing with the underlying cause is a waste of time."Pros and cons of ECTAROUND 1000 people a year have ECT, according to a study carried out between 1996 and 1999 in Scotland by the Scottish ECT Audit Network, (SEAN).

Nearly three-quarters of those having it for depression showed a definite improvement.

Almost a fifth of patients were treated without their consent.

Dr James Hendry, a director of SEAN, said: "They would be unwilling or unable to give consent to treatment, with the vast majority being unable to because of their profound depression."

The shock, lasting three or four seconds to induce an epileptic fit lasting between 20 and 30 seconds, was usually given twice a week for six or 12 sessions.

However, some people needed only two or three treatments. The average number per course was 6.7.

Most treatments were carried out bilaterally - that is with electrodes on each temple.

Dr Hendry said: "I suspect we will see that changing. Research is continuing, but it looks increasingly that the most effective treatment is by unilateral, high-dose ECT, which seems to cause less memory loss."

For 54 patients - 4.1 per cent - treatment was stopped early because of side-effects. SEAN points out that between 28 and 31 per cent of patients stop taking anti-depressants because of side-effects.

There were two deaths among elderly patients from pre-existing heart disease within a week of having ECT. One patient committed suicide.

SEAN did not record other side-effects. However, other studies have reported headache and nausea in between 1.2 per cent and 23 per cent of patients.

Problems with short-term memory affect around 60 to 70 per cent of patients for a few weeks after a course of ECT.

A small number of patients lose memories from their past which do not return even after many years.

However, depression itself can affect memory, concentration and mental agility.

Dr Hendry said: "ECT is not without its adverse effects, but in some cases, it is a life-saving treatment for people with severe forms of mental illness, particularly depression.

"It can be effective for patients who have not responded to any other treatment."
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Title Annotation:Features
Publication:Daily Record (Glasgow, Scotland)
Date:Apr 25, 2001
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