Some words on: Splitting the atom with pill-cutters and patience

Logically, as I move on to lower doses of medication, also the adjustments on the way to the next smaller dose need to become finer. Pill-cutters work great when it comes to halving tablets, or even splitting sufficiently large, round tablets into quarters. But unless you can get hold of low-dosage pills, the utility of this gadget has its limits. More often than not, my attempting to cut pills into exact portions smaller than one half, has resulted in me plucking minute white crumbs out of the pill-cutter and piecing them together to approximately one day´s dose. Some pills simply resist being cut precisely. To avoid such hassle, I prefer using my pill-cutter in combination with a method of spacing out the intake of the old, higher dose in favor of the next lower one. The underlying idea is to gradually diminish the average amount of the respective substance in my organism until reaching the following lower target dose. Here is an example of how I have been doing it:

graphic sertraline withdrawal

I came across this procedure in Dr. Peter Breggin´s book Psychiatric Drug Withdrawal, and have mentioned it briefly in an earlier post on this blog as well. The graphic above does not reflect the exact way Dr. Breggin helps his patients decrease their drug intake, but it is an adaptation of his idea to my own circumstances. Another way of doing it by blocking high and lower doses according to a weekly plan would be to take the new dose on one day of the first week, two following days of the second week, three following days of the third week, and so on. It could look something like this – red spaces represent the old, higher dose of a drug and blue spaces the new, lower one:

suggestion weekly withdrawal plan

As you can see, the concept is flexible. You or your doctor may come up with other variations, even shortening or lengthening the duration of each step in your withdrawal process according to your own needs. In addition, I have to point out, once again, that I am not a professional in the medical field. This blog documents my individual way of handling medication withdrawal, but I am in no way qualified to give anyone else instruction in this matter. My hope and purpose is to encourage you to acquire the means and the support you need to improve your health. If you believe the method of psychiatric drug withdrawal I am describing in this article might also be helpful in your case or for someone you know, please seek further information with professionals and consult relevant literature. I am sorry if I am repeating myself with this sort of disclaimer, but I truly do not wish for anyone to get hurt in the execution of domestic experiments with psychoactive substances.

Up to now, I have been faring well using this method of dose reduction. All that is necessary is to keep track of where you are at in your plan – and to have your plan for each dose reduction written out for your reference. Personally, I keep a handwritten list of days and corresponding dosages, and tick off day by day. This way, each decrease in dosage takes me around five to six weeks. After completing the change, I wait for another couple of weeks before I make any modifications to my intake of the other drug I am using. Thereby, I hope to make sure each alteration of my medication plan is well under control in that I can recognize any adverse reactions and, most importantly, relate them directly to specific changes I have made. In order to take psychiatric medications, and also in order to wean off them safely, it is vital to notice the effects using them – or ceasing to use them – has on you. When you experience negative side-effects or withdrawal symptoms, you need to find out what caused them. A clear-cut medication and withdrawal plan helps generate such transparency, provided you follow up on it diligently. Being structured also allows for making well thought-through modifications to your plan if things should not go smoothly. Suffering adverse effects is, in itself, a destabilizing experience. The less panic-driven and better informed your subsequent actions and decisions are, the more likely you are to get back on track and prevent a full blown crisis from developing.

At this point, I would like to remind you always to remain process-oriented, rather than goal-oriented. Diminishing psychiatric drug intake is not about reaching the lowest dose possible in the shortest amount of time possible. Your success in this area is not defined by numbers. Drug withdrawal is not a sport. It is a process, which in turn will be accompanied by further processes regarding your overall health, your attitude towards life, your relationships with others, and your personal development. All those processes and gradual shifts are what you are after. Do not attempt to force spectacular changes. Instead, care for yourself and intend to remain grounded enough to weather your everyday life. If, at some point, looking back you can say you are feeling better about yourself than a while ago, you are headed in the right direction. Let every step forward and every choice be the natural result of your inner development and a subtle stimulus for further growth. Do what you can, but never try to find out where your breaking point is by challenging yourself to your limits. Do not hurry. Keep in mind it is better to walk calmly and securely than risking to stumble, fall and having to pick yourself back up all over again. Take all the measures you can to stay at peace. Protect yourself, nourish yourself.

Funnily, at present I am reading a book about writing and just came across a sentence I wish to quote here: “We´ll see progress in time. But we can´t expect to every day.” (Louise De Salvo, The Art of Slow Writing). In other words: do not drive yourself bonkers with undue pressure, nor let anyone else do so. As long as you are honestly working towards your health and your life´s improvement, you are doing well. Or, regurgitating a quote De Salvo took from Stephen King, describing his return to writing after a devastating accident which forced him to undergo long and painstaking rehabilitation: it all is about “[…] getting up, getting well, and getting over. Getting happy, ok? Getting happy.” King was referring to his writing, but really these words describe the essence of healing. Take note, in particular, of how King uses the verb “getting”, which clearly denotes process. PROCESS! This is what you are looking for. Getting healthier and, why not, happier!

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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.

Some Words on: Hyperfunctionality Disorder

If you are following this blog, you likely do not have this problem, but to be on the safe side, go through this checklist:

  • You are successful in your career
  • If you go to school, you are an inquisitive and efficient learner
  • You have a good relationship with your family
  • You live in a harmonic relationship with your partner
  • You are nice to others
  • People like you
  • You never use inappropriate speech and always act gracefully
  • You dress neatly
  • You have kids and a full-time job and pursue academic studies, yet there are no dark circles under your eyes
  • You are well organized, your house is clean and orderly and you know where all of your important documents are
  • You handle money and other resources responsibly

Can you respond to more than six of these affirmations with “this applies to me”? If so, you suffer from a lesser or greater degree of Hyperfunctionality Disorder.  Now answer the following:

  • You are hot

If this applies to you on top of the common symptoms of Hyperfunctionality Disorder, you are not human…

Alright, so why am I writing an article on a disorder that does not appear in the DSM, for I made it up, and posting it on a blog about mental health? Because what society expects us to be ideally is abnormally perfect, and this expectation is driving many into despair and mental illness. Therefore, I suggest that it is a disorder in its own right. Yes, you do sometimes get people who glide through life with an almost spooky smoothness, but it is important to note it is not the rule, thus it is not normal. If you are not like that, there is nothing wrong with you! It merely means you are not fully and completely adapted to the ideals society promotes, and that is not necessarily a bad thing! Who ever said the societies we humans construct are healthy? I even believe it is an advantage to have a few bumps in your road and some edges to your personality, because they give you a chance to grow and enrich your life experience in ways no one could have foreseen for you.

So, the next time you come face to face with someone who shows signs of Hyperfunctionality Disorder, let them be. No need to get suspicious, or envious, or hateful. It is a natural, yet toxic impulse to feel any of these in the presence of people who unintentionally rub our own imperfection in our faces by being so relentlessly functional. And maybe they really are not that immaculate. Let’s admit it: we’re relieved every time we find someone seemingly flawless has a skeleton in their closet, too. It makes us feel a little better not to be the only deficient specimens around. And truth be said, you can never know what exactly is going on behind the façade. Of course you see your own weak spots with more clarity than those of a colleague, a fellow student or a neighbor. Even friends and relatives can have an inner life they never disclose to you. Still waters can run very, very deep.

But whether others are perfect or not should not even be your concern. You need to appreciate your own qualities, even the “negative” ones, because they nourish you through what you make of them. They all are energy sources you can use to move forward! Still more: you can be a gift to others because you, in your own, special way of being, contribute to the amazing variety of human existence. My message to you is: if you do not test positive for Hyperfunctionality Disorder, be glad, not worried! You have a challenging and unique path before you. Embrace it!

 

Some Words on: Generics

There is still no end in sight to the debate on whether generic drugs are – or are not – an equivalent substitute for the original brands. Generics use the same active ingredients as the originally patented drugs, yet a large party of both physicians and patients claim they do not work in the same way. And in fact, there can be slight chemical differences between original and generic drugs. Every medication, psychiatric or not, contains substances that are not meant to have any effect on the consumer, but have other functions, such as helping the absorption of the active ingredients into the organism or binding them so the tablet does not crumble. These compounds are called excipients. This is where variation can occur. Some generic drugs may not use the same excipients as their original counterpart, or the ration between active ingredients and excipients can be different. However, this does not necessarily mean generics are any worse, or that their users unavoidably will experience negative effects they would not be suffering taking the original drugs.

It is hard to pick a side in the controversy, especially when you are a user of psychiatric drugs or know people who are. Obviously, you will be inclined to project your personal experiences into your argument. At the same time, being personally involved can give you a more hands-on approach to the matter and look at it without getting caught up in the technical details of medical studies and statistics, and without being influenced by professional links to the pharmaceutical industry or second-hand-anecdotes from colleagues in the medical field. This perspective is the one I am going to expose. I am not a health care professional, but I have been taking psychiatric drugs for slightly over four years, with an unknown amount of time still to follow. Moreover, some people who are very close to me have used them in the past or are still doing so, and I have seen psychiatric drugs in action on fellow patients in psychiatric hospitals. One thing I can say in advance – I have no clear-cut answer to the question if generics are as effective as the originally patented drugs. There is a huge number of companies producing generics, in different countries, under different safety standards, with differing levels of work ethics. Evidently, the aspect of safety is an important one, if not the most important one. Are generics as safe as original brands? Also this I cannot say. But then again, it is doubtful whether taking psychiatric medications in and of itself can ever be safe. The knowledge we have about possible side-effects and our ignorance of long-term effects on the human brain speak for themselves. If you must take psychiatric drugs, my first and best recommendation is to be careful about where you get them from. Further on I will go into more detail about this point. First, let me describe my personal experiences with generic drugs.

Pretty soon after starting on Seroquel and Zoloft, my physician switched to prescribing generic versions of the substances Quetiapine and Sertraline. Every three months, when I needed a new prescription, I would receive a generic by a different company, produced in another country. So far, I have never noticed any adverse effects, although I always feel wary about experimenting with my mental health. My level of trust in a generic is based – rightfully so or not – on where and by whom it was produced. All the generics I have used so far came from European countries, and they are available through the public health care system I am ensured in. All this certainly does not guarantee their effectiveness or safety, especially not considering that every individual potentially responds in unforeseeable ways even to minute changes in their medication plans. Still, I assume that the generics I am using must be safer than the ones you can acquire through the internet yourself. For those who want it, self-medicating is made relatively easy and also relatively cheap in financial terms. You can order psychiatric medications from India, for example, just as you can walk into a corner shop to buy candies. This is not to speak badly of any country, but I do believe one should be critical of online drug-discounters. As convenient as they may seem, their informality is also a risk to their customers. Within my close personal contacts is a tragic case of fatal medication abuse, greatly enabled by online drug commerce.

But even the safety of generic drugs that are approved by the health care system depends on how the individual using them reacts. A friend of mine tried a generic version of her antidepressant, for which she did have a prescription, and almost immediately experienced obsessive and profoundly unsettling thoughts. These disappeared almost overnight when she returned to the original brand. Did this incident occur because my friend had fallen prey to a low-quality generic or because her organism was very sensitive to changes? Hard to say. I cannot overemphasize how radically different people’s reactions to psychiatric medications can be. All you have to do to find out is log into one of the numerous forums on the topic. Drugs that are described as “zombifiers” by some are hailed as life-savers by others. Quetiapine and Sertraline, the substances I am currently taking, are no exceptions. I am doing fine on them, but I have read desperate posts on how they turn individuals suicidal, manic, emotionally numb, paranoid, and so on. The ugly truth is that psychiatric drugs – generics just as much as originals – are a Pandora’s Box. There is no way of knowing beforehand what exactly will result from using them.

And then, there are the many cases of people using original brands which either do not alleviate the symptoms of psychiatric illness or do so at the terrible price of disabling and humiliating side-effects. Defenders of original psychiatric drugs will argue they were patented and released onto the market only after a lengthy and thorough process of testing, and that therefore they are safe to use. This statement, unfortunately, is not accurate. Although a psychiatric drug can only make it into the pharmacies after having been institutionally approved, several incognitae remain. The biggest one probably is what the drug actually does to the brain, apart from potentially diminishing certain symptoms of mental illness. So far for example, no published study has explored the sequels of long-term psychiatric drug use. Typically, drugs are tested over the duration of several weeks or a few months, when numerous users are really taking them for years on end or even for life, in varying dosages and combinations. It is also unknown, and feared, what psychiatric drugs could do to a young brain in plain development. Children or teenagers being medicated has become common practice. Detractors object this might slow down or even stunt their cognitive, emotional and social growth and thereby cripple their lives before they have even begun. Last, but not least, it has to be remembered that the array of possible negative effects, also called side-effects, is virtually endless, some of them being extremely dangerous or horrifying at best.

On a theoretic level, considering the safety of psychiatric medications is debatable in the first place, I feel compelled to wonder if questioning the quality of generics makes any sense at all. From a practical perspective, I have seen evidence for their safety in myself and for their unsafety in others. My recommendation to you is to handle psychiatric drugs in general with utter care. I wish I could be more concise.

Here is a brief list of aspects you can take into account in order to protect yourself from unpleasant experiences or more serious dangers:

Means of acquisition – Only use psychiatric drugs you have obtained through prescriptions. Do not shop for them on the internet.

Ingredients – Make sure you are not allergic to any of the ingredients. For example, lactose is a common excipient. If you are lactose intolerant, you will need to find out which companies offer the same active ingredient with a different excipient.

Country of origin – Make sure your medication was produced in a country you find trustworthy in terms of quality standards. Unfortunately, there isn’t much you can do to find out if they really live up to your expectations.

Follow your doctor’s indications – Be observant of the doses and times your doctor established in your medication plan.

No spontaneous dose variations – Do not make any changes to your medication plan unless they have been systematically planned. For example, do not take more of your antidepressant when you feel down, or less of it because you are having an especially nice day.

Monitor your reactions at all times – Always watch out for any adverse reactions your medications may be causing. Constantly keep an eye on your general well-being. Also evaluate your performance at work or at school, your memory, your social capabilities and your emotional reactions to everyday situations. Have people you trust help you monitor all these aspects.

Some words on: Inspiration and Creativity

Mental illness is a dark, lonely and scary state. It brings with it a blackout of basic survival skills and thereby exposes the individual to the whim of circumstances and people surrounding them. Uncaring and abusive treatment facilities, health care professionals and relatives can turn such an existence into hell on earth. But even if you are in the best of hands, your recovery depends on one indispensable ingredient: you. It is understood that you may not be able to take care of yourself. Still, you can attempt to stimulate your mind and emotions.

In fact, many clinics offer arts therapy, music therapy, sports activities, animal therapy, walks, and other stimulating experiences. Those are not meant to simply kill time and break the monotony of another day in a dull hospital setting, although these are certainly important aspects. In the first place, they are aimed at “defrosting” you. Mental illness is, so to speak, a general paralysis of the spirit. Thoughts and feelings, which help a healthy person to evaluate situations, take action and define their direction in life, fail to develop that traction in someone going through a mental crisis. Instead, they form something like a ball of yarn, if you will, with no visible loose end to pull at. In more rational terms, the confusion and erratic choices associated with mental illness derive from the impossibility of prioritizing thoughts and feelings functionally. The result is a disabling, smothering information overload. Therapies providing sensory stimuli intend to focus the patient’s mind and reactivate its capacity for healthy judgment, in the hopes of making the individual find the end of the metaphorical thread again.

Particularly artistic therapies challenge the patient to reawaken their power of judgment and decision. Creativity relies on the processing of given resources – materials, techniques and motifs – and their elaboration into a product that represents the uniqueness of its author’s interpretation. In a nutshell, creativity is the application of preexisting, generic ideas to a specific situation, in order to produce a new circumstance or object, the creative person’s individual experiences and capacities of judgment being the catalyst for this process. In plain English: when we are baking an apple cake, recipe in hand, and notice all our apples have gone bad, we will evoke the generic idea of “fruit” and look around our kitchen to see if we have something that could work in a similar way to apples. If we are lucky, we’ll find pears or plums, and use those. That is creativity. As the culinary example shows, creativity occurs not just within the fine arts. It is the motor of our survival and evolution both as a species and as individual beings. All our life decisions are necessarily creative, because we constantly attempt to adapt our circumstances to our individual needs and wishes. No matter how unadventurous and conventional a person is, they will always need to take decisions and create situations nobody else has ever taken before in the exact same way, simply because nobody else IS them.

Interestingly, numerous theories on the causes of mental illness sustain it can be triggered by dysfunctional or abusive relationships – may they occur in childhood or in adult life. If we try to define “dysfunction” or “abuse”, we will likely conclude that the destructive manipulation of the individual’s capacity to make healthy choices is an important part of these concepts. In other words, dysfunctional and abusive relationships affect or stunt the victim’s creativity, thus injuring their survival skills.

Herein lies the relevance of therapeutic approaches that involve the stimulation of creativity. Painting or making mosaics is more than a nice pastime producing pretty results. It stimulates vital cognitive functions and can contribute significantly to a patient’s return to a functioning and satisfying life.

Another aspect of creative therapy that should not be underestimated is the fostering of self-confidence. Not just mental illness, but also the stigma associated to being in psychiatric treatment can shatter your self-image. I have come across more than one person who suffered a painful transition from successful professional to hospitalized nutcase. Among them was a woman who used to be a psychotherapist and, after collapsing and having been diagnosed with schizoaffective disorder, will likely spend many years in supervised living facilities or in and out of mental hospitals. What I wish to say is that people who were socially “normal” can end up with the label “crazy” stuck on their foreheads. The stigma of it alone, even when it is the result of a misdiagnosis, is powerful enough to down individuals who so far had been high-flyers. While creative therapy will not magically reestablish anyone in their previous position, after a catastrophic collapse it can be one of the few things left showing you that you are actually able to accomplish something. Every ounce of hope counts. Accumulate many of them.

Now, at the top of the present article I stated the importance of the individual’s wish to get better. Mostly, what counts is for you to just give something new a try. Some people may argue they are not the artsy type, but as I have argued above, that is also not was creative therapies are mainly about. Creativity is an indispensable life skill because it empowers you to take your life in your own hands and make the best out of past experiences. Creative therapies also help individuals lessen the weight of trauma on a deeper level than spoken or written words ever could. Fear and pain can be nameless, but it may be possible to encrypt them in color, shape, sound or movement. Also, the socially established connotations of verbal language often provoke feelings of shame and defeat, especially when it comes to describing a victimizing situation. Not so the arts. They allow even humiliating experiences to be expressed in a shrouded and abstract manner, therefore being emotionally less taxing than a verbal account. Words are powerful on a conscious level, but in order to release pressure accumulated in the subconscious, the arts can be more efficient. Any activity that helps you exercise your creativity will ultimately strengthen your self-confidence and enhance your coping skills.

Creativity is also a source of joy and social interaction, which are also pillars of mental health. Just to add another anecdote, from my last stay in a psychiatric hospital, I remember a gentleman who, if I am not mistaken, worked as a transport entrepreneur and was treated for depression. He looked anything but an artist. Yet, through arts therapy, he discovered his passion and talent for oil painting. In an amazingly short period of time, he became skillful enough to produce a series of remarkable, very expressive floral still lives, which the clinic decided to display in its corridors. Both staff and fellow patients openly admired his work and encouraged him to stick to his new found love. Frankly, I have no information on whether he ultimately recovered from his depression. The last thing I know, before I myself was discharged from the clinic, was that he had become an outpatient and gone back to living at home. I would not go as far as saying that his mental health improved due to arts therapy, but I am convinced that his motivating experience within the clinical setting must have given him a good push forward in everyday life as well.

Personally, I believe the all-encompassing benefits of creative activities are the reason why so many people engage in crafty pastimes. On the most immediate level, creating something beautiful or practical is an uplifting experience. It makes you feel productive and gives you aesthetic pleasure. But also, making something which has not existed before tells you that you are able to shape your surrounding circumstances. You may have only crocheted a doily or lined a shoe box, but spiritually it is a symbol for your power to contribute to reality and bring the things you desire into your life. It means you are capable of making choices which lead to a good result on a small scale, which in turn should encourage you to believe that, on a higher plane, you will succeed in the making of bigger decisions as well.

Arts therapy, as the term suggests, includes an element of systematic psychological support in addition to the application of creative skills. But even if you, or someone you know who is in need of help, have no access to arts therapy, taking up a creative hobby is always an option for you. Depending on the materials and the equipment some arts require, they can be more or less costly. Therefore, consider your budget before you get started. Also, if you don’t feel like committing to one specific activity right now, browse the internet for DIY blogs. They are literally everywhere, and many of them offer tutorials on smaller, varied arts and crafts projects. You can even look for tutorials on how to redecorate your home in an easy and low-cost way, or how to pep up your wardrobe with self-made accessories, if you wish for a practical rather than a purely aesthetic approach. Creativity has no limits, so take your time and enjoy the many ideas buzzing around on the www. Feel free to share your thoughts on creativity and mental health below in the comments section.

Websites:

The Art Therapy blog offers descriptions of various types of creative therapies, articles on related topics and information on educational options for people who are interested in becoming therapists. First and foremost, this blog is informative and inspiring. It is not a support website for those in crisis or otherwise in need of help. Still, remember that knowledge is always empowering. So, no matter on which side of the table you sit, it is a useful website to visit. The Art Therapy blog also runs a Facebook page. http://www.arttherapyblog.com/

Some Words on: Nightmares and Restless Sleep on Psychiatric Medication

As for all states of distress, APA also has a fancy name for nightmares: nightmare disorder or dream anxiety disorder. It is known that everybody has nightmares from time to time. They are believed to be caused by our mind trying to process conflicts, fears and stressful life events. In other words: nightmares are a healthy and necessary phenomenon that helps us deal with our issues and move on. Yet, when unsettling dreams become so frequent and so intense that they disrupt our sleep patterns and affect our mental and emotional balance during the day, they no longer help us to cope, but they add to our problems. Not only do nightmares leave an ugly aftertaste and cloud our mood. Deprivation of restful sleep can exacerbate already existent psychoses. Sleep, and in particular restful sleep, are a vital component of mental health.

Although it is meant to improve symptoms of mental illness, psychoactive medication commonly causes sleep disturbances, including nightmare disorder. In general, psychotropic drugs will affect your sleep cycles in one or the other way, for whatever acts upon your mental functions during your waking hours, logically also does so when you are asleep. Both my antidepressant (Sertraline) and my anti-psychotic (Quetiapine) list nightmares as a frequent side-effect, along with other sleep abnormalities, such as insomnia or excessive sleepiness. So far, I have gotten away with only the nightmares.

Ever since I got on psychoactive medication, I have had hardly one night without unsettling dreams, and this is not an exaggeration. The topics are nauseatingly repetitive. Being far from home at a place I perceive as threatening and fearing not to be able to leave, is a classic. Typically, in my dream I am anxious to leave that place before the onset of winter with its cold and darkness. A variation of this scenario is my having to travel to a threatening place. Luckily, my dream-Self has learned by now to just say “I am not going. I have a right to be where I feel safe and happy.”. Often, these dreams are coupled with scenes of confrontations between me and relatives whom I am also in conflict with in real life. Typically, they would attempt to tear down my self-confidence or force me into life choices I feel strongly opposed to. Before I moved in with my partner four months ago, I also used to dream I was living in a house that was crumbling. Cracks would appear in the walls, or big chunks of plaster would fall off them. In those dreams, it was understood that the structure could collapse and crush me any minute. I believe I can see clearly which fears all these nightmares spring from. My interpretation is that, after having seen my existence and my personal autonomy disintegrate during my psychotic break, my psyche is still fearful of it to possibly happen again. Over the last years, I have returned to a good life. In fact, I would say my life is now happier than it has ever been before. To me, it seems only logical that my not-so-subconscious is afraid of losing it all again.

Plane crashes are another frequent dream. I am actually afraid of flying, so the source of this scenario is also quite obvious. The origin of other nightmares is less evident. An interesting one is the vision of a cataclysmic volcanic eruption or simply a nearby active volcano that scares the crap out of me, but apparently out of nobody else. In my dreams, I regularly find myself in groups of enthusiastic people who absolutely want to climb up to the crater, while I am desperately trying to convince them not to. In reality, I do live in the proximity of three volcanoes, but I have never witnessed an eruption. I realize such an event is a possibility, but it is not something that occupies my conscious mind. So far in my life, I have scaled five volcanoes and slept at the foot of another three without being overly concerned about it.

A few posts ago, I had already mentioned that I am beginning to have less intense nightmares than has been usual for me over the last four years. And finally, last week, I got a break from my nightly horror-marathon. I actually dreamt something pleasant! I will abstain from going into details, but the sweet afterglow of that dream stayed with me throughout the day. It has been a while since this last happened to me. I am quite delighted! Placing the dream in the context of my current life situation, I have to assume a huge part of the improvement is certainly due to my moving into a new, lovely home with my partner and us both making healthy changes to our lifestyle. And although I have only just started to wean off my medications, I also hope the reduction of my medication dose to have something to do with the improved quality of my sleep. Could it be that my brain was too numbed down to process topics of conflict and therefore brought them up again and again through my dreams, similar to a broken record that can’t get past a certain content, but replays it in an endless loop? Could the dose reduction have begun to reactivate those parts of my psyche, allowing me to finally deal with and eventually overcome the unresolved issues? I cannot know for sure, but it is a hypothesis that I find logical.

Whether or not you consider weaning off your medications, you can – and should – attempt to improve the quality of your sleep. Actually, some speak of “sleep hygiene”. Taking measures of sleep hygiene is recommendable for everyone, even “healthy” individuals. The equation is simple: the more restful your sleep is, the better you feel all over – mentally and emotionally – and the better your cognitive functions are. If you are tormented by insomnia or by nightmares to a point that you perceive sleep as an unpleasant duty, try the following:

  • Establish regular sleeping habits. Try going to bed and getting up approximately at the same time every day, and allow yourself at least seven hours of rest. Even if your sleep gets interrupted during the night or you can’t fall asleep in the first place – stick to those seven hours and get out of bed at the established time. Eventually, your organism will recognize this resting period as its opportunity for distension and revitalization.
  • Create an optimal sleep environment in your bedroom. Make sure your mattress is comfortable and your pillows allow you to rest your head without straining your neck and upper back. Switch off all the lights and, if possible, do not keep any electronic devices in your bedroom. Use curtains or blinds which block street lights and the morning sun effectively. Try out if you prefer complete silence or soft noises like the gurgling of a small fountain or the regular ticking of a clock. Make sure temperatures in your bedroom are moderate. Neither excessive heat nor cold will help you sleep.
  • Avoid caffeinated beverages, stimulant medication or other energizing substances during the late afternoon and evening. Funnily, although alcohol can make you feel drowsy in the beginning, it is a major sleep disruptor because it messes with your sleep cycles. Same as for stimulating substances, take care not to have booze right before going to sleep. Personally, I know some people who actually have a cup of coffee or even espresso right before going to bed. They insist it helps them sleep. If you are one of that kind, fair enough, but probabilities are that you react to caffeine like most other mortals do – by staying wide awake. To be on the safe side, stay away from coffee and maybe have a glass of hot milk or soothing herbal infusion before going to sleep.
  • Just before going to bed, give yourself 30 minutes of time out. Spend them on a relaxing activity: meditation, reading, cuddling with your pet, chatting with your partner, watering your plants or just putting things in place around the house. Give yourself an opportunity for winding down and cleansing your mind and emotions at the end of every day. Studying for an exam or watching an action movie and then hitting the hay immediately is not a good idea. Just like a train can’t come to a dead halt, you need to gently let your mind come to rest.
  • Eat at least two hours before going to sleep. Going to bed with a full stomach is almost certain to make you toss and turn. If your schedule doesn’t allow for this, prepare a light snack rather than a full meal in the evening.
  • Exercise! Any type of workout, especially if performed several times a week, will not only help you burn off calories, but it will also improve your mood significantly. It is not necessary to do anything extreme or spectacular. Yoga and long walks are perfectly fin. Of course, if you wish to go for something more intense, feel free! Regular exercise will help you find a more restful sleep and balance your mood. Just remember that, if you exercise intensely in the evening, you need to come off your adrenaline rush before going to bed, so don’t hop right from the treadmill into bed. Maybe do a short yoga routine, have a nice warm shower or engage in some activity you find soothing.
  • Follow a healthy diet. Prefer whole, fresh foods to highly processed ones. Processed foods are typically rich in all the wrong things: sugar, fat, sodium, artificial sweeteners, preservatives, colorants. At the same time, they are almost devoid of vital nutrients and contain very little dietary fiber, which you need to cleanse your intestines. Thinking you can make up for your dietary deficiencies by taking supplements is a wrong assumption. Cover as many nutritional necessities as you can through your food intake. My partner and I, for example, are going low carb and mainly eating vegetables, lean meats, soy and dairy products. We have also developed the habit of drinking vegetable smoothies every morning. They taste great, and depending on which veggies and fruits you combine you can obtain different flavors, colors and nutritional benefits. We use kale as a main ingredient, and from there we just improvise according to what we have at home: spinach, strawberries, beets, celery, raspberries, carrots, apples, lettuce, and so on. Be creative, it’s your call to design your own liquid salad!

As you can see, there is a lot you can do for your sleep quality, even if you choose to stay on psychiatric medication for now. Try any or all of the above measures before asking your prescribing doctor for tranquilizers or sleeping pills. Adding medication to your treatment plan may seem like a quick fix. Yet, it only delays your getting to the root of your problems, compromises your liver and will make it even more difficult for you to ever wean off your medications. When you’re lost in the jungle, don’t add more trees. Consider taking further medication as the very last resort, or as an emergency solution to treat acute insomnia or psychosis temporarily.

Last, but not least, make sure you have the support of those living under the same roof with you. You can make your room as dark and as quiet as you like, but if your roommate insists on having noisy reunions or listening to loud music during the evenings, you will have a hard time finding sleep. Whoever you share your space with – family members, your partner, friends or fellow patients – explain to them why and how you wish to improve your sleeping habits. You might even be able to make them join in! Everybody needs restful sleep, and certainly everyone enjoys it. Personally, I find it extremely helpful that my partner and I are on the same page in terms of looking after our health. We share the same diet, do yoga together and follow the same sleeping schedule. Doing all of these things together is also a beautiful occasion for bonding. We research and discuss new food recipes, try out different yoga routines and have a small chat before going to sleep. Incorporating healthy habits into our lifestyle has been a wonderful contribution to a harmonious relationship and a happy home.

I would love for you share your own experiences with nightmares or other sleep disturbances, and with measures you have taken to overcome them. Feel free to comment. I will read through everything you send me and publish it here on my blog. Looking forward to hearing from you!

Some Words on: Inner Strength – Your Contribution to Your Healing Process

There are many forms of treatment for you coming from the outside – medication, psychotherapy, creative therapies, physical exercise, and so on. Health care professionals and loved ones can be looking after you and trying to help you surmount your conflicts. Yet, there is someone whose participation in your recovery is indispensable: you. The least you can and must do is to accept help, but there are more active measures you can take to allow for healing to set in.

Our attitude playing a decisive role in creating success in all sorts of aspects of our lives is a generally accepted idea. Medicine has begun to recognize that both psychosomatic illness and healing actually do exist. Attitude, thought and intention appear to determine the outcome of our actions more than western science has been willing to admit so far. On the other hand, in philosophy, spiritual practice and even folkloric wisdom all over the globe, this idea is ancient.

You can play an active part in your recovery and cultivate your Inner Strength even when your mind is broken. Deep in your core there is a source of energy that cannot be destroyed, and that will only disengage from your body upon death. You can put whichever name you please to it, depending on your world view: Inner Strength, Survival Instinct, Inner Self, Essence, Spirit, or Soul. No matter what you believe or do not believe in, you possess this energy. It is what carries you through all good and bad moments of your life. Often, we only notice it is there when we are in crisis. Maybe you remember situations where you told someone, or where you heard someone else say: “Looking back, I have no idea how I made it – I must have been very lucky.” Well, that was the Inner Self at work. Something inside you is determined to see you through your ordeal. You must give it room to act.

Again, depending on your beliefs, there are many ways you can allow your Inner Strength to help you. First of all, you must connect with it. Religious or otherwise spiritually oriented people may resort to prayer and meditation, while rationalists who prefer a more practical approach can choose positive thinking, autosuggestion or exercises of willpower and mental discipline. It does not matter HOW you do it. It is just very important THAT you do it. Anyone insisting you need to belong to this or that religious group or a specific school of thought in order to achieve healing is misguiding you. Of course, if you feel it puts you on a good path, you can practise a religion! What I am meaning to say is that you need to find your very own way of dealing with yourself and your active role in this world, and no one should coax you into anything.

The following is how I, under consideration of my world view, attempted to drag my cart out of the mud. I repeat: this is not the only way to do it, and you need not share my beliefs in order to recover. It is just an example. Personally, I am wary about religious dogma and even more wary of people who try to impose it on others. However, I am a spiritual person. I do believe in a universal, conscious force some call God. I also believe in the existence of the Soul and its immortality. In my view, all elements of creation are energetically interconnected. As a consequence, I am convinced praying for others or the idea of sending them love or light is capable of reaching them through this energetic network. In a similar way, asking God (or The Force, or Maradona, or your Self) for strength and healing will help you activate those within you. No matter what or whom you invoke will come to your aid. As for myself, I know many people were praying for me or thinking about me caringly when I was hitting rock bottom. I firmly believe their good intentions made a huge difference. Also, despite cognitive difficulties during my psychotic break, I kept praying and meditating. I was terrified because my situation seemed completely hopeless. Nonetheless, I was unwilling to accept my condition as the endpoint of my life’s journey. The circumstances felt a bit like being adrift in the middle of the ocean and blindly firing flares into the night in the hopes of some ship noticing them eventually. Rescue was out of sight, yet not requesting it would have made it even less likely to ever arrive. How much of my recovery can be attributed to support from the forces I believe in is open to speculation. Still, I consider it must have been an important constituent of my healing process.

When your existence is in a fleeting state, being able to hold on to something edifying and encouraging also makes it easier for you to receive help from external sources. It can be your first step on firm ground. Just to use another metaphor: it is easier for others to extend their hand to you when you have managed to remain stable on the water’s surface, as opposed to panicking and chaotically panting and kicking around you. Inner Strength and hope can and should be stimulated even when you are at your weakest mentally and emotionally. Probably, no overnight miracles will happen, but look out for a gradual improvement of your state over time. A constant drop of water will finally fill the bucket.

My advice to you is to pick some entity you can ask for help. If you are religious, it can be your God or a saintly figure. If you are agnostic yet spiritual, it can be the universal consciousness, a deceased ancestor, your spiritual guide, an angel, or whichever other being. If you are a skeptic and non-believer, meditate over your own willpower, practise positive thinking or seek inspiration in motivational literature and time spent with loved ones. As you can see, the list of options is quite eclectic. If you do not feel up to any spiritual or intellectual commitment, you can still indulge in small rituals to invigorate you, such as the contemplation of beauty and nature. But be careful not to use your state of weakness as a justification for remaining passive. Your intention is what counts, and intention is active. You need to wish for healing. Your aim is to awaken your Inner Strength by whichever means you are able to use. This is your invaluable contribution to your recovery.

Some Words on: Drug Interactions

Being on psychiatric medication will force you to question some of your habits. It might also make you wary about other drugs that had seemed harmless to you so far. Little things you took for granted may suddenly become big no-nos. I am talking about interactions your medication may have with other substances. For example, if you are taking a tricyclic antidepressant, popping an Aspirin against your headache is out of the question. You may have to renounce to alcoholic beverages and quit smoking bong. Possibly, you can’t even have caffeinated drinks.

Before you consider suicide, I wish to stress that despite the many restrictions your medication imposes on you, you will still find ways of enjoying life. I am just saying you need to be careful. The first step you need to take is to find out about the interactions your medicines may have with other prescription and over the counter drugs. Personally, I am on Quetiapine (Seroquel) and Sertraline (Zoloft). As a result, when I have pain from flu, from a migraine or caused by some lesion, I pretty much have to rely on Acetaminophen to fix it. It is the only analgesic and anti-inflammatory I can use without putting myself at risk. Every time I am about to try a new medicine I have to check and double-check if it is really safe for me to take. I admit to feeling quite nervous whenever I experiment with a new drug, although it is reported not to interact with my psychiatric medication. However, sometimes there is no way around playing guinea pig. Once I have successfully tried out a new drug I usually stick to it like glue. My list of compatible drugs is still short. Luckily, I don’t get ill often. Yet, eventually I should definitely make a list of all the medications I have found work fine for me.

It can be frustrating to find an entire group of medications is counter indicated for you, especially when you’re having an acute and debilitating health problem. You may have read in my withdrawal diary that I had been suffering from back pain. Unfortunately, I had to stick it out because there seemed to be no compatible muscle-relaxants. Usually, though, in every medication family, there should be at least one variety you can use. For example, there are several antibiotics which would interact with my psychiatric medication, but some are alright for me. The same goes for anti-allergic drugs. A couple of them would be dangerous for me to use, but Fexofenadine (Allegra) is harmless.

Not just other drugs can interact with your medication. Natural substances and food products can, too. All beverages containing caffeine are stimulants, meaning that, if your psychiatric treatment is aimed at calming you down, you will have to cut those out at least for a while. It is no coincidence that mental clinics usually offer their patients decaffeinated coffee and tea throughout the day. This may sound off-putting to the coffee-gourmets among you, but the nice thing about non-stimulating coffee is that you can literally have it around the clock and as much of it as you like. Personally, I love having several cups of coffee and tea per day. Yet, in order not to let it disturb my sleep, I stop consuming caffeine before 5 pm. Alcohol, on the other hand, is a potent depressant. So, if you are already down, having a few shots at your neighborhood bar will dig your grave a bit deeper. Doctors will generally recommend you to abstain from alcohol while taking psychiatric medications, or to enjoy moderate quantities on rare occasions. Your medications are broken down by the liver, so anything that would affect its functioning or strain it unnecessarily should be avoided. Now, alcohol is often a staple at social events. For many, having a glass of wine, a beer or a cocktail is part of the fun of hanging out with friends or colleagues. Probably, you can drink a glass or two without risking any negative effects. As for myself, I can have a few drinks without difficulty. I have never been a heavy drinker, not even a regular one. When I am at a party or at a restaurant, I like my share of red wine or a round of sake at sushi places. I never have booze on an empty stomach and also never let myself get drunk. If you decide you’d like to try a drink, accompany it with a glass of water to dilute and help you flush it out. An exotic item on the list of forbidden foods is the grapefruit. It alters liver function and therefore should not be consumed in combination with any drug at all – psychiatric or not.

Then, there are psychoactive natural remedies, such as Saint John’s Worth or Valerian. Extracts made from those plants are tranquilizing. In other words, they act on your brain. Only use them if you can make sure they won’t interfere with the therapeutic purpose of your current treatment. For the ladies, it might be an interesting fact that Saint John’s Worth, on top of its psycho-activity, also diminishes the effectiveness of hormonal contraceptives. So, hands off this shrub if you would like to enjoy your freedom for a bit longer!

Talking of natural psychotropic substances, there is a host of them. Probably the most commonly used is marijuana. Although it is illegal in most places, it is probably less dangerous than many psychiatric drugs. Still, it should not be used in combination with them. I am acquainted with people who are on anti-psychotics and smoke weed at the same time, but it is risky and therefore not recommendable. It can go well, or it can go wrong, without there being any way of telling beforehand. Unfortunately, little data is to be found about the risk factor here. It appears to be that recreational drugs can actually trigger mental illnesses. During my last stay at a mental clinic, I came across fellow patients whose diagnosis of schizophrenia or psychosis followed the use of marijuana, heroin or other illegal substances. Spontaneously, I can recall four or five cases, just out of the people I got in closer contact with. There is no way for me of knowing whether the physicians at the clinic recognized the cause of mental illness correctly, or whether factors other than recreational drugs were in play. Still, it is a possibility.

Sometimes, an illness or injury can require extra medication with great urgency. If it so happens, you will have to grind your teeth and weigh possible interaction symptoms against the gravity of your condition, then choose the least compromising of the two. Note that not all drug interactions are necessarily dangerous. Depending on their severity, they are usually categorized as major and minor interactions. Hence, if you are seriously ill, you may be willing to risk interactions as long as they are not menacing to your life. Just as side effects, interactions may occur in some individuals and in others not. If an undesired symptom is expressed in a very small percentage of the sample population, the odds are on your side.

Most importantly, you need to find reliable information on the interactions your medication may have. The package inserts (or PILs – Package Information Leaflets), usually only contain a basic paragraph on the subject. You can, of course, ask your prescriber, but he or she will likely not be familiar enough with the specific combination of drugs you are going to take. Remember your doctor sees dozens of patients every day, all of them with their specific medication plan. It is virtually impossible to bear all possible drug interactions in mind. Then, there is the internet. Several sites offer interaction finders where you can type in the combination of drugs you wish to check for safety. It is hard to say whether these webpages have complete data at their disposition. New medications are thrown onto the market and new studies with already existing medications are conducted all the time, so there is a constant need for updates. The advantage of online interaction finders is that you can type in any number of substances, which allows you to learn about the safety of multiple drug use. You can also find interaction lists on the internet. But be warned: the number of interactions for your psychiatric drug can literally be in the hundreds, so prepare for a Sisyphean task.

Last, but not least, your using psychiatric medication may be socially and professionally compromising. Not because you may have to turn down friendly offers of alcoholic or stimulating beverages, but because your medication may render you unresponsive to everyday situations. One day, instead of taking my antidepressant in the morning, I accidentally took the anti-psychotic. What a knockout! That day, I had visits coming over. Later in the afternoon I was supposed to shop for a birthday present and attend a theater rehearsal. I am hard headed as a ram, so I forced myself to pull through with my agenda, but it felt like attempting to pull myself out of a swamp. I won’t forget that day so easily. Normally, I am supposed to use my anti-psychotic right before going to bed at night. Now, there are some evenings where you have no intention of going to bed any time before the early morning hours of the following day. New Year’s Eve is one of those occasions. As a consequence, you may end up flushing your sedating medication down with a fruit punch at 2 am or so. As long as you have nothing important to do the next day, it’s not a problem. Just make sure you have no job interviews, driving lessons or college admission tests coming up, because you will be feeling quite heavy. Luckily, I am not much of a night owl, so the anti-psychotic does not really get in my way much. If you are into clubbing or have to work graveyard shifts, you will need to make adjustments either to your activity schedule or to your medication plan. Discuss this in depth with your prescribing physician. You may have to modify your lifestyle in some regards, but do not feel discouraged. If an aspect of your life is really important to you, there should be ways to conserve it. Stay motivated and think outside of the box.

Some Words on: Weight Gain on Psychoactive Medication

It is, very sadly, true. Using psychiatric medication often leads to substantial and rapid weight gain. When I was first put on an antipsychotic, which was Olanzapine (Zyprexa), I gained over thirty pounds in a matter of just a few months. After switching to Quetiapine (Seroquel), my weight stopped going up, and through a healthier diet I even managed to shed some of it, but I never went back to what used to be my normal weight. Now, I am constantly teetering on the edge of overweight. My BMI (Body mass Index) oscillates between 24.9 (which is borderline acceptable) and 25.1 (overweight). In addition to the weight, my entire body texture seems to have changed. Even without regular exercise, I used to be athletic and lean by nature. Now, I have cellulitis bumps on different parts of my body and look slightly out of shape. The only good thing about being fuller is that also my boobs have grown by one cup size. I’ve gone from A to B. This is not to say that you should try psychoactive drugs as a measure of breast enlargement. Absolutely don’t do it! Fact is, these medications mess with your metabolism on top of potentially messing with your mind and with all sorts of biological functions. So no games, please! Every now and then, marketing of psychiatric drugs includes enthusiastic statements like “does not cause weight gain” (the atypical antipsychotic Aripiprazole, aka Abilify, for example), which are to increase their attractiveness among the target group. This, more than anything, shows how common weight gain is as a side effect of these substances.

But what if you are already there? Is there any way of losing the pounds? First of all, it is important to remember that diets and exercise regimes which work fine on people who do not use psychiatric drugs, won’t be as efficient on someone who does. Weight loss will likely be slow and unspectacular. It is not impossible, but it is harder to achieve. Still, you should not feel discouraged. Both a healthy diet and regular workouts will boost your overall health and help you stabilize your mood. In fact, exercise has been found to be highly effective against depression. Also, physical activity offers a great opportunity for leaving the isolation of your four walls, getting among people, breathing some invigorating fresh air and catching lovely sunlight for some extra vitamin D. If sports and healthy eating habits fail to lower your BMI in a direct way, they can still contribute to it by making you less in need of medication. Both are, in any case, worth the effort.

If you decide to diet, do it responsibly. Please do not embark on a starvation course. Your body and mind need their nutrients, especially when your health is already compromised. Put together a balanced nutrition plan rich in fresh vegetables, fiber, “good” fats (red fish, avocado, nuts, etc.), protein and fruit. Avoid processed foods, refined sugars and carbs, sodium laden snacks and in general anything that reeks of junk food. Also, abstain from artificial sweeteners, preservatives or colorants. If you are on psychiatric medication, you are already consuming potent and potentially dangerous chemicals. Try not to add even more through your food.  As a rule of thumb, note that the less processed – or the more natural – a food is, the better. As for drinks: have no sodas; just water, teas and smoothies without added sugar. It is not necessary to take radical measures like turning vegan or saying goodbye to dairy products. If you associate the concept of healthy eating with a bunch of barefoot, skinny tree-huggers gnawing on raw carrots and celery, then you will need to reeducate yourself. Healthy eating means experiencing real food with real flavors made of real ingredients. Subsisting mainly on junk food is neither cool, nor manly, nor useful. Knowing what it can do to you, it is plain stupid and a waste of money, time and life. For those who sustain that “Junk food is so much cheaper”: Buying sodas and fries may save you a dollar in the moment, but an extra expense for whole foods can save you hundreds, if not thousands of dollars in medical treatment and work incapacity in the long run. I am not saying you should never set foot in a fast food restaurant again. I myself do it on rare occasions, and when I am at a party where a decadent buffet is winking at me… what the heck, I am at a party! So, be naughty every once in a while, but never let highly processed foods become a staple in your diet.

Nowadays, most foods are, first and foremost, designed to please our taste buds. The real purpose of food, which is to provide nutrition, is presented as a collateral benefit by the food industry. Creaminess, fluffiness, sweetness, crunchiness – all these are prioritized over nutritious value in food marketing. Most often, the “healthy”-tag is just another means of selling you virtual garbage as nutrition. Milk chocolate contains milk, which contains calcium, which is good for you. So, chocolate bars are healthy, eat as many as you like! Having been exposed to this type of discourses since childhood, many consumers have never developed a clear idea about what food actually is. They would never expect their car to run on soap water, but they do expect their own bodies and minds to run on meals and snacks devoid of nutrients. In other words, they eat things that are, in fact, not food at all. Popular wisdom such as “sugar is energy” or “if I feel full, then I have given my body what it needs” is completely misleading. You can feel stuffed after having eaten a shoe sole. Yet, your organism will get nothing out of it. You can fill a car tank with soap water – until it spills over, actually! It will no doubt be full, yet the car won’t run.

Nobody knows exactly how much damage our trashy diet is doing to us. We are likely to have seen barely the tip of the iceberg so far. Probably, more physical ailments, mental conditions and cognitive disabilities are a result of intoxication and deficiencies induced by our diet than we can fathom at this moment in time. Mainstream eating habits and ruthless food marketing have created a paradoxical scenario. People who consume processed foods can be morbidly obese and still malnourished. You can eat monstrous amounts of calories and still be dangerously deficient on nutrients. Many diets out there are just as much of a health threat as our trashy eating habits. Dieting is often misunderstood as selective starvation. The idea behind it is that achieving a lower weight will supposedly make you healthier. Every new issue of any women’s magazine will promote another grotesque diet, and each time it is advertised as finally being the real thing to get you into lollypop-shape in no time. Having only apple cider vinegar with chili powder for two weeks in a row while keeping your habitual level of activity should definitely make you lose a few pounds. But will it make you healthier? And remember, you are (likely) not a celebrity! You have no millions to spend on personal nutritionists, private doctors and plastic surgeons to patch you back up again. Celebrity diets can be survived only by celebrities.

So, masochistic dieting will not result in a healthy weight, but only being healthy will. In other words, the first thing you want to do is establish optimum health. You need to get rid of toxins, balance your hormones and provide your organism with the necessary nutrients. Reformulate your eating habits into a plan that leaves out damaging food products and embraces whole foods. And don’t worry: whole foods are at least as delicious as processed and prepared food. You will be astonished at the mind boggling variety in flavors, textures and colors nature offers you. No junk food can ever keep up with that.

If you are using psychiatric drugs, in addition to following a healthy diet you will need to make an extra effort in detoxing your metabolism and achieving hormonal balance. Very likely, your liver is working overtime to process the substances you are using. Give it a hand by consuming liver-cleansing foods and drinks. Mostly, that is going to be certain vegetables and teas. Cruciferous, slightly bitter veggies such as broccoli, kale, Brussels sprouts and cauliflower should be staples for you. In fact, cauliflower is incredibly multifaceted. It can be made into low-carb pizza dough, lasagna, hash browns and many other delicious dishes. Another advantage of vegetables is that you can practically eat as much as you like of them without putting your health at risk. Which other food allows for that? So, enjoy your greens! As for drinks, you can have freshly pressed lemon juice mixed with pure water, veggie smoothies and organic green tea. Many websites will also promote grapefruit juice as liver-cleansing, which is correct. However, remember that grapefruit can interact with your medication, so please abstain from consuming it in any form. There are more than enough safe options for you out there. For further inspiration, you can also browse health food stores for liver-cleansing herbal tea blends.

When you put together your new diet, there are three factors which determine what you will be eating: what your body needs, what you should avoid and what you like. If you keep an open mind, these three need not clash. Don’t be afraid to try out recipes you had not known yet. This is also a good moment for having yourself checked for food allergies. Give your eating plan a thorough clean-up! As a result, you may have to quit a number of eating habits, but you will also discover a wealth of new options to compensate for those. And always remember to go for the fresh and natural! Now, keep in mind you won’t drop three sizes overnight. Although your medication-induced weight may be bothering you, its loss is not your primary goal! Your primary goal is to become healthier and strengthen your body and mind. As a secondary effect, weight loss is likely to follow an improved overall health.

Websites:

For those who prefer a conventional approach to weight-loss, turn to www.weightwatchers.com or www.weightwatchers.co.uk.

Articles:

This post from the blog beyondmeds.com deals with the author´s personal experience with weight gain on psychiatric medication and weight loss after coming off the drugs: http://beyondmeds.com/2012/08/06/weight-psych-meds/ You may want to have a look at the rest of the blog, too. It is elaborate and full of valuable articles.

Here is a blog article in English by athlete Cathy Brown on how she successfully managed her depression and her anger issues through exercise: http://www.changingmindschanginglives.com/2013/05/sport-changed-my-life-for-the-better/

Audiovisuals:

Seminar on the functioning of the liver in English by nutritionist Barbara O’Neill: http://youtu.be/KAGEhkZ-ssY Should you wish to find out more about O’Neill, visit her website at http://www.barbhealth.com/.

Dr. Eric Berg has developed a nutritional theory based on different metabolic types. According to Berg, every person corresponds to at least one of these types. As a consequence, different individuals metabolize food in varying ways and function at their healthiest on different food plans. Berg does not refer to the added complication of psychiatric drug use, but still his discourse offers fascinating and useful insights. To learn more, watch the following videos in English:

Dr. Berg’s Body Type Seminar: http://youtu.be/_m-R4RqRQqM

The Body Type Diets – What to Eat for Each Type: http://youtu.be/xvOwfkg9p2o

If you are interested in more of Dr. Berg’s theory, go to http://www.drberg.com/

Some Words on: Mental Illness as a Sales Hit

“Mental Illness” has become a ubiquitous term in mainstream media. In many instances, they are promoted with the same nonchalance as over-the-counter medications, and little is said about their negative effects. As a consequence, consumers are more likely to start using psychotropic medications. At the same time, doctors are getting increasingly casual about prescribing them under the pretext of a hastily made diagnosis. Strangely, having a (not too scary) mental disorder is now almost a fashionable accessory to your personal presentation. Remarking at a cocktail party you have ADHD or anxiety disorder at the same time as being a successful professional makes you incredibly interesting. Don’t try this with schizophrenia or other spooky sounding conditions, though, unless you want to have the couch you’re sitting on all to yourself. Read more on social isolation and psychiatric conditions in my post “Some Words on: The Social Stigma of Mental Illness”.

The idea that you can have a “normal” life despite being mentally ill is one of the strongest messages the pharmaceutical industry uses for marketing psychiatric drugs. But they don’t only target potential consumers; they also offer attractive deals to prescribers. Tagging a patient with some or the other “disorder” and sending them home with a prescription is profitable for psychiatrists just as it is for pharmaceutical companies. As a consequence, prescribers with less than very sound work ethics are prone to over-diagnosing patients. Conveniently, the Diagnostic and Statistical Manual of Mental Disorders (DSM) gets thicker with every new edition, so more diagnoses can be cooked up and more prescriptions issued. Evidently, this puts patients at risk of being inaccurately diagnosed and unnecessarily drugged. They fall prey to the trust they learned to have towards health care professionals since early childhood. If something is wrong, Doc knows best how to fix it – or does he?

Where a psychiatrist draws the line between an emotional crisis and mental illness is up to his personal judgment. If you wonder why prescribers don’t simply test their patients for mental illness just to make sure they really need medication, the answer makes the psychiatric discipline appear in a rather unfavorable light. There are no tests. Not medical tests, in any case. No blood tests and no brain scan can reveal mental illness. Psychiatrists have no choice but to take at face value what the patient discloses about their state. In a clinical setting, doctors can also recur to observing patient’s behavior, but even that can be interpreted in many different ways. Apart from that, it is usually nurses or other clinic staff who deal with patients more directly and more often than the prescribing doctor, who therefore works with a lot of second-hand information. Then, there are the psychometric tests. Patients may be presented with a questionnaire, for example. Now, questionnaires are statistical tools, but they are no means of exact measurement. If you have someone do the same test twice, they are likely to give slightly different answers the second time – especially if the list of questions is long and graded answers are possible. Also, what does answering “no” to questions like “Do you enjoy social gatherings?” mean in psychiatric terms? Do you suffer from social anxiety or are you just not a party animal? And finally, what if a patient, out of shame or whichever other motivation, gives inaccurate answers? Again, questionnaires are a fine statistical tool, but they are not equivalent to a medical exam. Yet, this is what psychiatrists base their diagnosis on: personal accounts given by the patient, psychometric tests, observations of clinical staff or significant others. At the end of the day, the psychiatrist has to patch all these puzzle pieces together and try to match the resulting impression to one or the other mental pathology in the ever-changing DSM.

Just for laughs here: I got tested with those famous ink blotch cards by a psychologist when I was in my psychotic break. Her conclusion: I was “too creative”, because apparently my perceptions were not classical enough for her. Where other people would have seen an evil moth, I made out two dancing African ladies. When I remarked that I had a couple of degrees in arts and that it was therefore my job to be creative, she just said: “No, no, even as an artist you still need to be adapted.” In other words, I failed to be crazy in a normal way… Woman, I was immersed in psychosis and all you found wrong with me was my creativity??? No further comment.

So, a significant number of psychiatric diagnoses are given to people who are fundamentally healthy, but who are seeking medical help because they are naturally – and necessarily – struggling to overcome a personal crisis. Few psychiatrists will remind them emotions are our connection with reality, be they positive or negative. Instead, both prescribers and the pharmaceutical industry have a political and economic interest in making you forget that humans need grief, need sadness and need anger. In fact, it is questionable whether the feelings we call negative deserve such a bad reputation. After all, they warn us when things are going wrong, when we need a change, when we are in danger, when we need to take a break from our daily grind. Can it ever be healthy to suppress these signals? Wouldn’t it be better to acknowledge them and discover their source? Is conflict solving not the natural way of reestablishing balance and well-being in our lives? If you choose to numb your instincts with drugs, you may temporarily escape the discomfort of facing your problem, but you will also steer further and further into it without even noticing. What would be healthier: worrying about a difficult curve ahead or blissfully driving off the cliff? Not everything in life is made of pink cotton candy – it was never meant to be.

Then why are people so anxious about being “normal”? Whoever defined what normalcy actually is? Well, just look around you. Mass media bombard us with consumerist utopias 24/7. Wherever you turn, beautiful men and women with impressive careers live in stylish homes, throw hip parties, enjoy perfect health and, most importantly, have found the laundry detergent that makes all this possible. Tragically, the pharmaceutical industry has joined this very profitable ride. Feel imperfect in any way? Feel troubled, fearful or sad sometimes? Or have you simply not learned how to be happy? No problem, help is nigh. We won’t teach you how to resolve those issues, but we have a pill that can make you forget you have them. If your life is a mess, just sweep all that emotional clutter under the carpet and your existence will look as if it were perfect.

Psychiatric medications are made for halting acute, disabling crisis, and nothing less than that. They are not dietary supplements you can just take on a daily basis to supposedly optimize your performance in everyday life. Yet, that is how they are being marketed. In countries like the USA and New Zealand, psychiatric drugs can be advertised on TV, along with cars, shampoos and what have you. Those commercials make it look as if mental illness were as minor a thing as the occasional headache or dandruff. People are made to believe they can just try any psychiatric drug and see if it helps them get along better with their boss or feel less stressed out by the tornado of over-sugared brats who obliterate their homes every day. In fact, many prescriptions nowadays are issued to patients who demand a specific drug they know from an advertisement. Way too often, prescribers comply without much ado. After all, the waiting room is crowded with people and every minute saved on one patient equals money earned on the next one.

Mental illness has become a booming market. No doubt should we be grateful for the many life-improving medications we have at our disposal, including psychiatric drugs. But just where does care end and exploitation begin? How is a consumer to distinguish between information and marketing? What means does one have to confirm the prescriber’s diagnosis unequivocally? Few medical disciplines are as double-faced as psychiatry is at the moment. Try convincing a non-diabetic of injecting themselves with insulin, and try making someone believe their life could be even better if they took psychiatric drugs. While the first is virtually impossible, the latter is easy. It is what happens many times over, every day, all over the planet.

It would be futile to wait for the health industry to change. As long as consumers believe medicine is always altruistic and trustworthy, they will be vulnerable to manipulation. Medicine, and psychiatry, SHOULD have a humanitarian mission rather than being a cutthroat business. But not all health care professionals and pharmaceutical companies want to know about that. However, the situation is not hopeless. You as a consumer and potential target sit at one end of the lever. You can ask questions and have a right to utter your skepticism. If you are unsure whether you need a prescription for psychiatric medication or not, the following actions can help you obtain a clearer vision of things:

  • Go for a second or even third opinion from another doctor.
  • Have a general medical checkup. Nutritional deficiencies, allergies, a damaged liver or thyroid dysfunction may be causing your symptoms. Also, have a neurological exam in order to rule out anomalies in your brain structure.
  • Take a critical look at your lifestyle and habits. Are you getting enough sleep, and if not, why (do you ingest a lot of caffeine, do you have sleep apnea, is your bedroom not dark or quiet enough, etc.)? Are you consuming any recreational drugs (including alcohol)? Are you getting enough movement and fresh air? Do you eat well? Are you regularly exposed to toxic substances?
  • What is going on in your private and professional life? Which stressors can you change or at least shield yourself from?
  • Are you carrying around an old childhood trauma or other painful experiences? These have to be worked on!
  • What is your universe made up of? Is life cold and empty to you? Find things to fill in those existential gaps. I am not necessarily talking religion here. I mean bring something into your life to help you appreciate your existence.
  • If you have a prescription, evaluate if taking the drug is worth the risk. If its negative effects outweigh the damage you are suffering from your perceived problem, refrain from using it.
  • Talk to a psychotherapist or counselor. Maybe your problems can be solved through therapy rather than drugs. If you are a believer, you can also consult with a spiritual guide.
  • Ask close friends, relatives or other people you trust how they perceive you. Their perspective may vary greatly – and in your favor – from your self-perception. Don’t be shy to accept their support and their love. Those are invaluable gifts.
  • Read, read, read. Remember: knowledge is power.

Having gathered enough information, make an educated choice. Whether you wish to try psychiatric medications or whether you prefer doing without them, both of them are valid ways, and for both you deserve respect and support. There is no shame and no guilt about any of the two. All is about building a life you’re able to love. Pick the best help you can find to get there.

The following are links you can learn more from.

Webpages:

MindFreedom is a website defending human rights in the mental health system. On this page, you can find links to various articles on doubtful marketing strategies for psychiatric medications. http://www.mindfreedom.org/kb/psych-drug-corp

Articles:

“Inappropiate Prescribing”: Article for the American Psychological Association (APA) by Brendan L. Smith, in English. http://www.apa.org/monitor/2012/06/prescribing.aspx

“The Psychiatric Drug Crisis”: Article for The New Yorker by Gary Greenberg, in English. http://www.newyorker.com/online/blogs/elements/2013/09/psychiatry-prozac-ssri-mental-health-theory-discredited.html

“Drug Companies Just Say ‘No’ to Psychiatric Drugs”: Article in English for Psychology Today, written by Pulitzer Prize nominee Robert Whitaker. http://www.psychologytoday.com/blog/mad-in-america/201106/drug-companies-just-say-no-psych-drugs

Audiovisuals:

“The Marketing of Madness” is a documentary on the marketing strategies employed by the pharmaceutical industry and the prescription of psychotropic drugs to patients who would not have really needed them. A must watch, available in English language on YouTube. http://youtu.be/IgCpa1RlSdQ

“The DSM – Psychiatry’s Deadliest Scam”, in English language, documents the shortcomings in the edition of the DSM, and how the manual impacts the entire psychiatric discipline, thereby affecting thousands of lives – not always for the better. http://youtu.be/PcuhhJ1BaMk

“How to Read Your Body”, by Dr. Eric Berg, gives simple guidelines on how to assess your overall health, in order to help you and your doctor pinpoint any underlying problems. http://youtu.be/VaUAe-csKjY.

Another video by the same author is “The Ultimate Stress Lowering Technique”. Apart from proposing stress reduction exercises, Dr. Berg also taps into the subject of inaccurate psychiatric diagnoses in stressed individuals. http://youtu.be/lsoYk5rioyw