Greg Bottoms

Headline, 2001, £9.99
ISBN 07472 5271 8
Rating: ***

"My brother saw the face of God. You never recover from a trauma like that.” This is the beginning of Michael Bottoms's descent into madness. The journey was a long and painful one characterised by desperation and ultimately despair. Consequently, this—his brother's account of the journey—is a dark and arduous book.

Michael developed schizophrenia after taking LSD. Perhaps the LSD contributed; perhaps it precipitated that first psychotic episode; perhaps it played no part at all. Bottoms remembers that Michael had always been odd, mean, and violent. There was more than a hint of mental illness through the generations in the family history: alcoholism, depression, and suicide ran in the family.

Psychosis is perhaps the ultimate psychiatric disorder and one that all medical students are encouraged to do a case study of during their psychiatric attachment. Angelhead demonstrates the flip side of psychosis: psychosis from the perspective of the family and the patient. It is a sobering and chastening insight. This book reminds the enthusiastic medic that while “first rank symptoms” are good fodder for a case, they are real and frightening for the patient experiencing them. For the family, they create confusion, fear, guilt, and shame. While mania as it was described by Redfield Jamison might be an experience to be envied, paranoid schizophrenia as described by Bottoms is something to fear and dread.

Unlike other accounts of mental disorder, where the patient turns author and is able to present himself whole, intact, and sane at the end of the story, Angelhead tells a sadder tale. Michael Bottoms's tale is one of distress and debasement. His family knew that something was wrong, but did not have a name for it. It took time to arrive at the correct diagnosis. The medical profession seemed dismissive of Michael and of the family—here's the diagnosis, these are the bad things that might happen, get on with it. The medication never adequately controlled the symptoms. Whereas others graduate and take their medications, Bottoms ended up in a high security prison after attempting to murder his family.

Of course, contrary to popular media representations, few people with mental disorders commit violent crimes, and if they do act violently it is most likely to be towards themselves. Thirty to 40% of those with schizophrenia attempt to kill themselves: 10% will die by suicide. But mental disorder is common: an estimated one in four of us has some form of mental illness every year. Someone who has never experienced it can barely imagine what it is like to suffer from psychosis—this book conveys a vivid account of that experience.