‘The IQ test score is lower than expected based on the patient’s level of education (university). This could indicate cognitive decline.’ I tried to take in the words over and over again. For ten years, I’d put my heart and soul into my work in science – people said I was a future professor – and now this result, in black and white.
I felt even worse than before, and the strong feeling that I wanted to die returned. Why on earth did I take this test? Why didn’t I trust my gut when I started this test and felt concerned? After this dramatic result a close family member suggested to my psychiatrist that my medications should no longer be reduced, because I was already showing signs of brain damage. Fortunately I got a lot of support from my sister and my friends. And I found the strength to carry on, despite the big losses I had already suffered and this latest outcome.
Discuss whether an IQ test is useful at all
I had just been admitted and was unemployed for a certain period of time (2014). That’s why the psychiatric nurse that looked after me at the time – and with whom I always had pleasant conversations – suggested I take an IQ test. Because I was very bored I thought it would be a nice activity. However, the morning before the test I started having doubts. I felt a bit drowsy because of my medication, so the chance the IQ test would go well was pretty small. What if the result was bad? What if the outcome was really bad? I rang a close family member, who suggested I take the test regardless. And I did it, to my regret. During the interview I said “What if the result is really bad?” It was duly noted and included in the report, but there was no response to my question.
Indicate that the patient is being observed and why
When I got the test back I read that I had been observed extensively. ‘We’re seeing a well kept 42 year old lady. Appearance in accordance with calendar age. She is well-tempered. Easy to make contact with, accessible…’ etc. I was also observed whilst taking the test.
‘She is easy to make contact with…’ Like I was a newly discovered animal, a mermaid, or an alien from outer space!
I felt like a lab rat. I didn’t know anything about this. I think it’s inappropriate to observe people without their permission and then to report on it. I would like to be treated on the basis of equivalence, even though I am sensitive to psychosis and manic episodes.
After I got my test result back, for a day and a half I thought I lost everything and I wanted to die. It is odd, because I have a wonderful son, a sweet younger sister and parents who love me, but I suffered so many losses I felt like I couldn’t handle life any more.
I don’t remember how, but my sister cheered me up, like she had cheered me up more often when I had felt depressed. My friends told me they didn’t even notice my diminished intelligence. Cautiously I regained my confidence.
Make raw data available if the client asks for it
It occurred to me that one part of the test consisted of drawing from an image. I remembered I thought it to be a useless exercise in the time of copiers. When I had to draw the image from memory I mindlessly drew a few lines on the paper. The psychologist who was testing me looked disappointed. In the report it said that my working memory was poor and below average.
I wondered how the results of the different parts of the tests were added up and how a comprehensive result came from that. When I asked about the raw data I was told that I wasn’t allowed to see it.
An IQ test can be used to discourage reduction of medication
I was really suffering from the side effects of the antipsychotics. When I visited the psychiatrist after getting my IQ test results a close family member came with me. He told the psychiatrist that the psychosis had already caused me serious brain damage, and therefore any further reduction of medication was undesirable. The psychiatrist nodded in agreement. And though they meant well, I felt incredibly sad about the fact I had nothing to say about my own life. It was a hopeless situation.
Because of the dramatic result of the IQ test my medication would not be reduced, which led to the chance of decrease in side effects and recovery becoming smaller
In my opinion, A mental illness is a bit like a shattered knee. When the psychiatrist has diagnosed the illness, it is pointless to keep staring at the shattered knee, and it would be better to focus on the muscles around it. If you consider taking an IQ test, ask yourself why you would take it and how you’d feel if the result were disappointing. When in doubt, I’d advise you not to do it. Especially if you’re in a situation in which you have already suffered many losses.
My advice is to make the healthy parts of your brain stronger by doing things you enjoy and with which you can activate the healthy part of your brain
For example, I became active in politics again and I wrote a piece about ‘media and destigmatisation’. I also founded the charity ‘Peace SOS’ last year. I work in a place for people who are self-employed, Seats2Meet. It’s lovely to be surrounded by friends and colleagues again. I also exercise with a good friend twice a week. Another thing that really helped my recovery was that I got a new psychiatrist. With her, I look into finding the right balance in my medication. Enough medication to make sure I don’t get ill again, but as little as possible to reduce the side effects. Because of this I haven’t felt depressed for two years and once again it ‘sparkles’ in my mind. I also have a lot more energy to raise my son.
It helps that I now remind myself to take it slow from time to time
At my request I had a conversation from the psychologist who supervised the testing and the psychiatric nurse who was treating me at the time. Fortunately they were very open to my feedback. The psychiatric nurse indicated that the test failed to achieve its objective. With other patients she would discuss whether an IQ test was useful. She also let me look at the raw data. From now on she would let the patients know they were being observed. She will feed my case back to the peer review group ‘Gooi en Vechtstreek’.
I hope that by sharing my negative experience I can help other people. At the end of our conversation the psychiatric nurse asked me whether I would do another IQ test in the future, to see if the result is any different. ‘No chance!’ I said. ‘And my psychosis has really taught me something.’ This reflects beautifully in John Nash’s quote: ‘Perhaps it is good to have a beautiful mind, but an even greater gift is to discover a beautiful heart.’
That is a recommendation that in my opinion also applies to mental health care.
Look after patients, really taking care of them may be even more important for recovery than the correct, but exclusively cold and clinical analysis