Some words on – “Stability”

I haven’t looked it up, but there must be several posts on my blog where I mention the importance of waiting for periods of emotional and existential stability in order to make changes to your medication regime. I believe it is important to remember that such stability is oftentimes ephemeral and can vanish without notice. This is not to scare anyone or to make them renounce from weaning off their drugs, but I´m saying this to make sure no-one out there is waiting in vain for a complete standstill of affairs that may never occur.

Many changes in life are not initiated by us, but by external factors we cannot control. On such occasions, we may find ourselves sucked into a stream of events we never chose to be a part of. One day, we can be enjoying great peace and contentment, and the next day all hell can break loose, with us at the center of it. All we can do is try to limit the damage through appropriate reactions.

Some months ago I perceived myself to be walking a pleasant, smooth path. Everything seemed wonderful, including my new job. It took nothing more than a co-worker, whom I scarcely even knew, to walk through the door and furiously accuse me of a serious infraction I had – honestly – not committed. She herself had not been a witness of it, but was acting upon hearsay. She also reported me to the superiors. With me being the new one and her well established at the workplace, she had all the credibility. She also informed me very loudly that “everyone” was talking badly about me anyways. She refused to tell me who “everyone” was, but insisted it was literally the whole staff of the institution. My immediate impulse was to grab my bag, leave and never go back. It took quite a bit of willpower to continue my workday and remain halfway functional. The following weeks, I was internally boiling over with outrage and couldn’t help but look at other colleagues wondering “Is so-and-so among those who are talking badly about me?” As for the woman who attacked me, to this day she has been unable to look me in the eyes. I believe this speaks for itself. I also admit I now find slightly perverse amusement in facing her with a calm I-am-Buddha smile whenever our paths cross.

To make a long story a little bit shorter – lightning strikes wherever it wants, whenever it wants. Even out of the blue. So how can you make sure life doesn’t throw you a curve ball as you are in the middle of a dose reduction? You can’t. There is just no way of telling. Yet, you can do a lot about how you react, and about whether you look for support from people close to you.

Let’s talk about the support. If you are trying to recover from psychiatric crisis, undertaking a medication switch or readjusting your drug dose, you should have a personal support system mapped out. Let people you trust know what you are going through, and ask them to help you with careful observations, attention, honesty, good judgment, constructive input, friendship and love. An open conversation, a firm hug and an outside point of view can work miracles when you find yourself in distress. Plus, when you have a history of mental illness and psychiatric treatment, you are probably very vulnerable to self-doubt. Am I crazy? Am I sliding into a crisis? Is my reaction healthy? Commonsense could calm down such self-interrogation, but it is very reassuring and comforting to hear from someone else they understand you and think you are actually doing fine. And, in the opposite case, should you really be at risk of derailing psychologically, having this pointed out by someone is a vital contribution to preventing the situation from getting out of hand.

Now let’s move on to the reaction element. Depending on your personality, obeying to your momentary impulse may or may not be best. In my particular case, it is generally not. Impulses typically cater to an ancient fight-or-flight mechanism which is very useful when you are being chased by an enraged mammoth. In an office or other postmodern setting it is less practical. As you can tell from the incident at my workplace, my spontaneous, gut-driven response was to wrap it up, show off my middle finger, shout “Fuck y’all!” and leave with flying colors, in pursuit of unspoiled horizons. Similarly, upon receiving offensive or otherwise inappropriate e-mails, my impulse consists in proving to the unfortunate emissary of the message that my rhetoric is better than theirs, and that I can be an even bigger cunt than they are attempting to be. It can take a few re-edits before my response becomes suitable for sending at all. Experience has taught me that cooling heart and mind down improves the outcome of my actions. This also goes for emotions other than anger. Fear is another bad adviser. As simplistic as it sounds, succumbing to impulses fueled by negative emotions is never a good idea. As refreshing as spontaneous displays of affection, generosity and joy are, as devastating can the uncontrolled liberation of their opposites be – for others and for yourself.

This does in no way mean you should sugarcoat all your negative perceptions. They are there for something: they warn you of unfavorable situations, toxic relationships, bad intentions others hold, and so on. You need to recognize unhealthy circumstances for what they are in order to protect yourself from harm. The art lies in distinguishing impulse from intuition. Impulse is a reactionary force which can be laden with either positive or negative emotions, and serves to vent those. Intuition, on the other hand, is your inner voice expressing the observations and needs of your personal essence. Impulse is the lightning that strikes where and when it wants, blinding you as you act out. Intuition is subtle, constant and truthful, providing you with insight and strength. Impulse will say: “So-and-so is such an asshole, I totally hate him/her!” Intuition will simply advise you not to engage with that person because they might be harmful. The coworker who attacked me was being impulsive, and I almost would have been the same in response.

The million dollar – or yen, or euro, or pound – question is: how to make out your intuition among all the thoughts, feelings, images and ideas scrambling about inside you? There is no standard recipe, and finding out how to do it is one of the great tasks in life. It seems nobody ever masters this skill completely, otherwise disgrace would not continue happening all the time and everywhere on our planet. However, everyone is able to improve.

Finally, I shall tie the know with the subject of psychiatric treatment and life skills. Even if you have been in crisis and are taking one or more drugs, you can and should exercise your intuition, as well as other life skills. Never assume that, because you have been labelled mentally ill and prescribed neurochemical crutches, you are doomed to be handicapped forever. Consider yourself in the process of rehabilitation and keep in mind that most people are in need of healing, too. Just because they have not been diagnosed does not mean they are healthy. Society is sick in many ways, and will imprint some of its illness upon its members. Within countless families, toxic emotions and destructive behavioral patterns are handed down through generations like old, creaky furniture. And one traumatic experience with an abusive individual can throw formerly strong people off kilter for years to come. It so happens we call such wounds “psychiatric illness” when they are particularly evident or render someone dysfunctional in regard to the current social norms. However, it is a type of injury everyone suffers from in varying degrees. There would be nothing for us to learn and grow by if this were not so. Walk ahead. Always walk ahead.

How it´s going – Completion of phase three

Hello Everyone!

I am now taking half of my original dose on both medications. So now I am on 75mg of Sertraline and 150mg of Quetiapine. There have been no unfavorable reactions to the dose reduction whatsoever. Again, I have to stress that I do not simply switch to a smaller amount of any of my medications from one day to the next. Every decrease in dose takes me about three weeks to complete. Also, I never modify the dose of both medications simultaneously, but do it one after another. This adds up to a total of six weeks for the change to be complete. I always start with the antidepressant, and finish with the anti-psychotic.

Given that I am feeling so well, I have decided to continue dose reduction throughout the month of December. I will take the Sertraline down to 50mg. In January, I will be travelling abroad, which is why I intend to wait with the further reduction of the Quetiapine dose until after the trip. I should point out that we will be visiting my partner´s family, and that I have made this same trip twice before. In other words: we will not be exposed to exotic stimuli and strange locations, but rather be welcomed into some sort of home from home. I find this important to mention because dose reductions are safest when there is no stressful situations or emotional turmoil ahead. Of course, these can come up unexpectedly at any moment and even in the middle of a dose reduction, but why deliberately risk any instability in the face of anticipated psychological pressure?

Once I am down to 50mg of Sertraline and 100mg of Quetiapine, which corresponds to one third of the original dose, I will not make any further changes for at least half a year. Frankly, I have not even clarified for myself if I should ever be completely medication free. The habit of popping those pills every morning and evening has become so strong and reassuring that the idea of not having them as a safety-net gives me vertigo. Knowing myself, I might be able to overcome that fear once I am getting closer to the right moment, but I am more of the one-step-at-the-time type, so for now I will be dealing with the next dose reduction and nothing beyond that. This tactic has worked fine for me until now, and not just regarding my medications but also other matters in life, so I shall stick to it.

I will keep you updated.