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.

Felicia.

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Finally, Moving On

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Hello Back.

I have kept this blog dormant for quite a while now, which I really feel lousy about. Luckily for me, it has been for all the right reasons. My life has changed considerably and kept me very busy.

After bringing a shitty contract with an abusive employer to a necessary end and having worked three jobs at the time throughout the month of June to bridge the gap, I am now very content with my new placement. Knock on wood, may it continue to go as well as it has begun.

Another source of stress is the disappearance of three of our pets, probably at the hands of a sociopath neighbor who had actually menaced us with “doing something” to them. We would love to denounce him, but unfortunately we have neither proof nor witnesses other than ourselves. Not knowing what happened to your little friends, nor where they are and how they are doing, weighs heavily on the heart. So does the inability to do anything about it.

Close friends have moved out of the country, but I hope to keep up contact with them – after all, this is the age of the internet! Hopefully, my partner and I will be able to visit them at some point. I do miss them.

I have even “survived” a reunion with close relatives without the feared psychological breakdown and without seeing anyone, including myself, resort to the dysfunctional patterns of behavior that have spoiled family meetings in the past.

My beautiful partner has supported me through all the changes and his part in everything having come out so positively is major.

I still have nasty nightmares on most nights. It had become better for a while, but they have returned. My subconscious keeps bringing up topics it wants to process and apparently fails at it, making another attempt the next night, and so on. In spite of this, I seem to get enough rest. I am productive at work and creative in my spare time, and enjoying both. My cognitive performance and concentration levels are fine.

A big setback, though, is that I am pretty much back to my original weight. It’s not like I have been binge-eating or anything. It has just come back on. Seven pounds lost, seven pounds gained. At least I am not heavier than I used to be. Still, I am frustrated at how I look. I have always had issues with certain body parts, as most people do, but these weak spots seem especially annoying now that I am not in my best possible shape. Back to square one! I’ll have to devise a good workout-plan.

Since my last post, I have not made any new modifications to my medication regimen. I decided that too much was going on to risk any additional instability. Today I’ve begun to lower my Sertraline dose. I have been taking 100 mg in the mornings for a few months, which is 30% less than the original dose. My next aim is to go down to 75 mg, which would be half of the original amount. Once this is achieved, I will follow up with the Quetiapine. I am confident it will work out. However, my partner will have a watchful eye on me and tell me if I act even weirder than I normally do.

I’ll be in touch.

Felicia

 

 

How It’s Going – Completion of Phase Two

I am now permanently on 200 mg of Quetiapine (Seroquel) and 100 mg of Sertraline (Zoloft), which means I am concluding phase two of my withdrawal plan. According to this schedule, as I had originally laid it out, I am supposed to stabilize these doses over the course of two to three months. However, given that I am experiencing no withdrawal symptoms or other anomalies at all, I might reconsider the duration of the stabilization period and possibly reduce it to somewhere between one and two months.

My current doses correspond to a 30% reduction of the amount I was prescribed when I first started taking my medications. I believe my organism is already perceiving some degree of relief. My overall well-being has been improving, certainly also thanks to a healthy diet and regular exercise. Mentally and emotionally, I feel perfectly functional and healthy. My partner is a great source of support, and I know I can trust him to report any unusual observations to me.

I am also pleased to see how each prescription of a hundred coated tablets now lasts one month longer than it used to. The medication supply that was meant to be good for three months is now sufficient for four. One could say I am 30% less stressed about getting my new prescription.

As for this blog, it has been slowly, but steadily, attracting more readers. My hope is for them to find useful or at least interesting information on its pages, be it for themselves or in order to help loved ones. I want to stress once more that your comments, questions and suggestions are more than welcome. Reader’s contributions make this kind of blog so much richer and so much more helpful. Feel encouraged to send me your thoughts and experiences – they will all be considered and responded to.

When Meds Get in The Way

Life is full of little things we take for granted to such a degree that we don’t even ever think of them – until they’re gone. When you begin taking psychiatric drugs, an unexpected plethora of such details opens up before you. What you once considered pleasant, but petty aspects of everyday life suddenly are luxuries you will have to do without, or cut down on, from now onward. You will need to revise and likely modify several of your habits in order to stay safe, and you may feel restricted in your personal freedom. To put it in plain English: you will be forced to redefine the terms “fun” and “freedom” for yourself, at least partially. I know how off-putting this sounds, but the good news is that it is possible as long as you keep an open mind. The following is a list of everyday luxuries I have had to reevaluate since getting on psychiatric medication.

Luxury #1: Booze

Officially, you are not supposed to consume any alcohol while you are taking psychoactive medications. Booze may alter the way your organism assimilates the active ingredients, and it also acts as a depressant. So, if you are already suffering from depression, regular pub-crawling is a no-no. Now, alcohol is an almost ubiquitous substance. What is more, we humans use it as a vehicle for social bonding. Drinking with others is not just about tickling our taste buds and our nervous system, but it is a social ritual. No matter if we are with friends, family or business partners: sharing a drink equals declaring you are on the same page with them, and on friendly terms. As alcohol is known to lower inhibitions, it also serves to break down barriers between people. As a consequence, being offered one or the other alcoholic beverage on all sorts of occasions is virtually unavoidable. Depending on your psychological equilibrium, you may have to reject those offers altogether. Personally, I have found I can have a few glasses of wine or juice with a shot of rum without experiencing any negative effects. As I have never been a heavy drinker, needing to set limits to my alcohol consumption has not been a big issue for me. Essentially, I am having the same amounts as always, only that when I first started taking psychiatric medication I had none at all for a few months and then carefully started experimenting with half a glass here or one shot there, until I felt certain it was doing no harm to me. However, if you are a customary drinker, you will need to become more self-disciplined.

Luxury #2: Caffeine

If you have ever been hospitalized in a psychiatric clinic, you may have noticed they offer decaffeinated coffee or decaf teas to their patients. Needless to say, caffeine is a stimulant. Depending on your diagnosis and your medication regime, you may have to say goodbye to your cuppa or at least reduce your intake. For someone with anxiety or mania, stimulants are not an option. In my particular case, I have found that coffee and tea do not affect me negatively, so I continue having them just as always during the first half of the day. I avoid caffeine after 5 pm, though, and given that I dislike most sodas, I never have coca cola or the likes. I also stay away from energy drinks or any other stimulants stronger than my habitual cup of coffee. Evaluate carefully, if possible together with your therapist or prescribing doctor, if sticking to your caffeinated drinks is alright for you. Try one cup of mild coffee in the morning and observe how you react both during the day and at bedtime, then make a decision based on what you experienced.

Luxury #3: Sugar and carbohydrates

In another article on this blog, I had written about weight gain as a negative effect of psychiatric drugs. Unfortunately, to limit the damage, you should reduce your intake of processed carbs and sugars significantly. Truth be told, if you are interested in healthy nutrition you ought to do so anyways. If you are on medication, avoiding processed foods becomes imperative. Eliminate them from your daily diet. Maybe allow yourself one eat-what-you-want day per week in order to keep cravings at bay. As I have a very sweet tooth, abstinence in this area is tough for me. However, I have found it extremely helpful that my partner and I have both decided to go low carb. In our fridge and around the kitchen, you will find no chocolate, no cookies, no cakes, not even white bread. If I ever felt like being “naughty” I would have to go all the way to the next grocery store, pick something out and stand in line for it, which makes breaking the rules a lot less tempting. Also, once you get the knack of maintaining a low carb and low sugar diet and explore some new recipes, your cravings for processed foods will diminish over time. As of today, I hardly experience any unruly longings and enjoy otherwise forbidden treats all the more when I come across them at parties or other special occasions.

Luxury #4: Foods you had never thought of as dangerous

If point #3 has motivated you to switch from drinking sodas to enjoying natural fruit juices, and you are sipping from a glass of refreshing grapefruit juice as you are reading this paragraph – stop! Grapefruit juice interacts with numerous medications because it alters the way your liver processes them. Interestingly, this fact does not appear on the label of juice packages, so you need to find out through research on the internet or consultation with a pharmacist. There are other natural foods under suspicion of interacting with certain medications: pomegranate is one of them, though studies haven’t yet confirmed how much it really interacts with medication. Some herbal medicines, such as Saint John’s worth and Valerian, potentially exacerbate or weaken the effect of psychiatric drugs. The same goes for some supplements. The following are links to pages with further information about drug-food interactions.

Free PDF on drug and food interactions for downloading by the FDA: http://www.fda.gov/downloads/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/generaluseofmedicine/ucm229033.pdf

Article by the Academy of Nutrition And Dietetics: http://www.eatright.org/Public/content.aspx?id=6442477646

Again, none of this means you necessarily have to avoid these foods and beverages completely, but you need to be moderate in the amounts you consume and extremely attentive about possible negative effects.

Luxury #5: Spontaneous sleepovers or travelling

Before I say anything else: ALWAYS carry one or two extra doses of medication with you! It is rare to be unexpectedly confronted with the option of spending a night away from home or prolonging a trip for an extra day. Yet, in good theory, it can happen. Your flight may have been delayed or cancelled, you are too tired to drive home after a get-together or weather conditions are too bad to get on the road, or you simply wish to stay somewhere nice for a bit longer. All those situations can turn into a problem if you don’t have enough medication with you. Therefore, make sure to take an emergency backup wherever you go – near or far. The longer your trip, the larger your extra supply should be. On a normal work day I will carry a tiny pillbox with one spare dose in my purse. When I go on longer trips, I habitually put enough medications for an extra week in my luggage, and I also keep them in different bags in case one of them gets lost or stolen. Once we’re at it: also record your medication plan – names of substances, doses and schedule – in your agenda or on a piece of paper to keep in your wallet. Accidents happen, and the medical team scraping you up from the street must know about your using psychiatric drugs. Don’t forget to add other basic information, such as your blood type or any chronic conditions and allergies you have.

Luxury #6: Over the counter meds

Have a headache? Before you head to the pharmacy for some Aspirin, make sure you can actually take it. Many over-the-counter drugs interact with psychiatric medications, which can turn a vulgar flu into an adventurous slalom around dozens of red flags. For more information, go to my article on drug interactions.

Luxury #7: Sunbathing

This is an issue I luckily escaped. Some medications, including the ones I am taking, potentially render you more sensitive towards UV radiation. Depending on your individual case, you may need to apply sunscreen to your skin before leaving the house or quit sunbathing and tanning sessions. As I said, my tolerance – and love – towards sunlight is unaltered, but I advise you to monitor your response to it for as long as you are on medications.

Luxury #8: Overall independence

By overall independence I mean the ability to adapt to your surrounding circumstances without having to worry about where you get your medications from. It is only a few exceptional situations that would really challenge your flexibility in this regard: wars, cataclysmic natural events such as floods, hurricanes or earthquakes, social upheaval or economic collapse. Even though these events are not the most likely to occur, they are an inconvenient possibility. When your well-being hinges on the availability of any type of medical treatment, you realize how dependent you are on civilization, the integrity of your society and a functioning infrastructure. You cannot simply revert to an ancestral lifestyle or an existence of scarcity the way most others could – if grudgingly. Unfortunately, I have not yet come up with a way of getting around this problem. Probably, precaution is the best protection from shortages in supplies. Just as it is wise to keep a few gallons of drinking water and some emergency lanterns or candles in your house, also have a backup of your medications. In addition, stock up on your drugs in time. Do not leave picking up your prescription for last minute, but create  a safety margin of maybe a few weeks.

Luxury #9: Hardcore partying

For some, parties aren’t over before daylight. However, if your medication plan includes taking a sedative or tranquilizing drug in the evening, you may have to retire from power-partying and clubbing. Even if you can force yourself to stay awake, you may not be in condition to leave the house or, let alone, drive anywhere. And much less will you be able to enjoy the party. My longest night is usually New Year’s Eve, and even then I hardly make it beyond 2 or 3 am. I take my anti-psychotic at that time and then sleep in the next morning. On all other occasions, I am in bed before or roughly around midnight. Before you give in to feelings of rebellion, take into account that altering your sleep cycle also implies tampering with the regularity of your medication plan, which in turn can affect your psychological stability and performance at everyday activities. Ask yourself if it is worth it.

Luxury #10: Recreational drugs

I have never used any recreational drugs, but now that I am on psychoactive medications I also should not consider trying them. They interfere with your mental functions just as psychiatric medication does, which means all sorts of unforeseeable interactions are possible. Some recreational drugs are actually believed to trigger psychosis. Stay away from them if you can. I have met people who continued using recreational drugs, mostly marijuana, despite taking psychiatric medications, and who were claiming it was not harming them. Yet, in my opinion it is preferable to play it safe. Mental health is one of our most valuable goods! Should you be addicted to street drugs, please consult with your prescribing doctor and/or therapist before making any decisions. Special considerations need to be taken to handle your case.

These were the luxuries I could come up with based on my personal experience with psychiatric medication. If you can think of more aspects of everyday life that turn into luxuries when you are in treatment, please leave a comment.

Coming out of The Dark – How I Recovered My Cognitive Abilities

I have mentioned before that during my psychotic break my cognitive functions were severely restricted. My concentration was below zero, and so was my ability to make even the simplest decisions. I was unable to put a list of items together that I wanted to have in the clinic with me, and it took me ridiculously long to pick an outfit for the day. Partly, this was due to my perceiving that even tiniest decisions could change the course of events obeying to a sort of butterfly-effect mechanism. The complexity of this idea was literally mind smashing. But to an even greater extent, I just could not hold on to an idea and follow it through. A thick broth of thoughts and notions was bubbling in my mind, and there was no way for me to put them in order or assign adequate degrees of relevance to them.

Being prescribed the anti-psychotic Olanzapine (Zyprexa) did calm the storm a bit, but it did not help my cognition. I still could not put two and two together. Even trying to complete an easy Sudoku was a major challenge. In addition, the Olanzapine seemed to dull my will and thereby actually accentuated my lack of direction. During my last hospitalization, the Olanzapine was substituted with Quetiapine (Seroquel), and I also took part in a structured program of coordinated therapies and received more thorough medical supervision for the first time. The therapeutic menu included arts therapy, social interaction practice, stimulation of sensory perceptions, psycho-educative sessions (basic information about mental health and illnesses), sports and outdoor activities and one-on-one conversations with the doctors. In your spare time, patients could do pretty much what they wanted: have a walk, go downtown, visit friends or family, sit in the park, organize table tennis or volleyball matches with other patients, etc. I soon became “famous” for devouring almost any sort of written text. With swarms of anxiety-ridden thoughts still frantically revolving around my mind, it was almost impossible to take anything in, but I knew I had to do it somehow in order to find even a little bit of peace and focus. I tried books at first, but I noticed I was not ready to follow the development of complex discourses, so I switched to reading articles in magazines. I read article after article, even if the topic of some was really outside my areas of interest, until I had read the whole magazine. Whenever I was done with one issue, I would go buy the next or lend new ones out from fellow patients. Gradually, I was able to digest longer articles, and eventually I returned to books, reading anywhere between one and three in a week’s time. Reading did not rid me of my anxiety and my racing thoughts, but it forced my mind to engage in the present moment and function, at least to a certain extent, in spite of the chaos.

I wasn’t the only one who instinctively turned to cognitive stimulation. Just as you would find me reading anything anytime and anywhere, a group of ladies used to crochet together. They tried to convince me of joining them, but I preferred to stick to reading. Although they were using a different activity, their need for focus also stemmed from an impulse to overcome anxiety and recover some degree of functionality, even if on a small scale.

As of today, my concentration and capacity for learning are healthy, possibly even improved in comparison to before my psychotic break, given that I have found myself embarking on explorations of my possibilities I hadn’t been able to open myself up to in earlier years. Maybe this is a sign of better cognition, but it may also be that after escaping a terrifying episode of zombie-like existence I have become more intrepid and willing to seize life. This is really not for me to determine, and I also feel my cognitive development has not yet come to completion. Many new – and positive – things and people have come into my life, prompting me to unlearn past thinking and emotional patterns to learn new, more constructive ones.

Although all of the aforesaid is based on my subjective perception, I would like to back it up with a few lines on recent trends in neuroscience. The regenerative powers of the human brain are being studied intensely, and the traditional idea of mental illness and brain damage as being irreversible conditions seems to become gradually dismantled in the process. In this context, it turns out to be untrue humans lose their ability to learn as they grow older, or that senile dementia is an unavoidable consequence of aging. What seems to be the case, instead, is that the brain can be exercised and strengthened through persistent stimulation just like a muscle can, throughout all stages of life. Cognitive training helps the brain stay fit and even regain lost functions. The term coined to denominate this property is “neuroplasticity”. I lack the scientific knowledge to competently explain neuroplasticity in depth, but I would like to recommend a book on it I believe everyone should have read, no matter from which background they come. The title of the book is The Brain That Changes Itself, written by Norman Doidge. It describes cognitive processes and neuroplasticity in terms understandable for the layman, illustrating its point through the narration of actual cases where a radical regeneration and reconfiguration of the brain appears to have taken place in an affected individual thanks to cognitive stimulation. The Brain That Changes Itself inspires without being inspirational in the sense of trying to lift anyone’s spirit by rhetoric means or philosophic meditations. The hope and encouragement inherent in this text derive from the portrayal of real people and real occurrences. Not in all cases described in the book all neurological functions are regained, but the overall improvement observed in the treated individuals’ quality of life is undeniable.

Personally, I acquired and read The Brain That Changes Itself before my psychotic break, and I am glad I did. More than one psychiatrist and more than one website with supposed information on mental illness transmitted the idea that mental pathologies equal a life sentence in some existential limbos – that the affected face perpetual residence in a state of forced stillness, not really participating in life, yet not biologically dead. Now, in retrospect, I can see how wrong they were. Here I am, living a happy and active life. But back then I had no idea if there was any hope for me or not. I certainly wanted there to be a way out, yet indications that there would actually be one were scarce. The Brain That Changes Itself, I believe, has the potential to be a source of valuable information and invaluable hope for someone in crisis.

Looking back at the insanely lucky and very unlikely concatenation of helpful people and circumstances that lead me back into life, I have to believe some benevolent power has laid its protective hand on my shoulder to lead me out of the darkness. Subconsciously, I also must have vehemently refused to give up, even though my conscious mind was paralyzed with terror. Now I recognize that every chunk of driftwood floating by can carry you the missing extra mile. The Brain That Changes Itself could be such a piece of driftwood for you or for someone you know. I really hope you read it, even if you and all your loved ones are doing fine right now. One day, they may need strength to overcome a crisis, or maybe you just wish to explore your potential and tread on a new path. This book is an eye-opener as to what your mind is capable of doing (and no, I don’t receive any commission for recommending it).

Websites

Norman Doidge’s official website, where you can get informed on his book The Brain That Changes Itself. http://www.normandoidge.com/normandoidge.com/MAIN.html

Here are links to the stores selling it: http://www.normandoidge.com/normandoidge.com/LOCATING_THE_BOOK.html

 

Audiovisuals

An impressive and inspiring testimony by Barbara Arrowsmith-Young, a psychologist who overcame a severe congenital learning disability through cognitive stimulation techniques: http://youtu.be/o0td5aw1KXA

 

How It’s Going – Completion of Phase One

Yesterday night was, hopefully, the last time I ever took the old dose of Quetiapine, 300 mg. So from today onward I will be taking 250 mg of Quetiapine at night and 125 mg of Sertraline in the morning. If you have a look at my dose reduction plan, you will see that I originally planned to stay in this place for a while. However, as I have had no withdrawal symptoms or other adverse reactions to the dose reduction so far, I feel I should move on to the next dose reduction sooner. Thus, I shall begin lowering the Sertraline dose further next week, in the same way I have already done it once. This modification is to be followed by another dose reduction of the Quetiapine. My next aim is to reach a plateau phase with 200 mg of Quetiapine and 100 mg of Sertraline. This corresponds to a 30% reduction of the original dosages, which I find to be quite a significant change. Once I get there, I still plan to remain there for at least a few months.

The question now is whether I have noticed any changes so far. As for negative ones, luckily not! On the positive side, I do feel slightly more alert in the sense that I make faster decisions, seem to have an improved concentration and feel more open towards learning new things. A lot of this, admittedly, has to do with my recent changes in lifestyle and the accompanying shifts in priorities. Logically, I have some restructuring and decluttering to do. Nonetheless, I feel that I am mentally and emotionally better disposed to pull through with these reconfigurations. Lowering the dose of my medications may be contributing to that.

Physically, there have been slight improvements as well, although these most likely have to be attributed to factors other than medication withdrawal. My weight has been going down very gradually, which is probably mostly a consequence of my doing daily yoga routines and eating a low-carb diet complemented with veggie shakes. I have a very sweet tooth, but lately I have managed to steer clear of too much self-indulgence in this area. My partner and I have agreed we can be naughty – in culinary terms – every once in a while on special occasions, but certainly not on a daily or even weekly basis. Our naughtiness in other areas seems to be improving. Our relationship is thriving, yet it is impossible for me to say whether lower medication doses have anything to do with that. I suppose, and hope, that we are simply doing things right.

Lately, my sleep is less plagued by nightmares. I used to have them every night, and they were intense enough to have me wake up screaming every so often. Since I have moved in with my man, this has not happened again, although most of my dreams are still weird and unsettling. They very evidently deal with traumatic experiences as well as the fears and conflicts derived from those. As a result, my dreams are quite repetitive in topic, which makes me assume I have a considerable quantity of psychological knots to untie if I want to get rid of them. Several sources on psychiatric drug withdrawal explain that as you lower doses, emotions and thoughts may resurface that had been lingering under the surface of your drug induced stability. To me, that makes perfect sense, as the drugs do seem to suspend you from hammering away desperately at your worst conflicts. So, as a consequence of medication withdrawal, I expect some serious processing and coping challenges to lie before me. At this point in time, such challenges have not occurred to an extent that would make me consider seeing a psychotherapist. My partner is a great source of support, encouragement, comprehension and love. The list of his wonderful characteristics could go on and on. My close friends are caring and sincere. In other words, I have a support network that wants for nothing. Thanks so much for that!

All in all, I am happy about how everything is going. My initial fear of lowering medication doses has receded. I am still very careful and slightly apprehensive about the process, but so far I have felt motivated to think that as long as I proceed in a sensible way, I should be able to minimize risks. I am glad I have started this process.

Some Words on: The Sickliness of Hospital Settings

“Hospitals make you sick”, said a person whom I met during my psychotic break, and whose kindness and understanding make me remember her as some sort of angel who came to shine a light into my darkest moments. She had picked the saying up from her father, and I was soon to find out what she meant by it. Evidently, the main purpose of hospitals is to cure people. Yet, some characteristics of hospital settings are surprisingly out of tune with that mission.

First of all, there is that smell. Even if you are just a visitor, it can turn your stomach inside out. Naturally, hospitals need to be kept clean at all times, and strong disinfectants are to help achieve that – but heck, can’t they develop one that doesn’t make the place smell as if a tsunami of cough syrup has just rolled through? There must be a way of eliminating those sick smells and introducing more pleasant ones. Smell can improve well-being significantly. Otherwise, perfumes or aromatherapy would never have been invented. It isn’t even a new concept. Human beings have used fragrances for thousands of years in the context of religious cults, all kinds of celebrations, in their homes or on their bodies. Essential oils, for example, have been a coveted luxury good for countless generations, and continue to be that. Only think of this: who doesn’t like to use incense sticks, aroma lamps or room fresheners to improve their mood? Who doesn’t keep one or the other perfume in their bathroom cabinet? Scents help us relax, energize, concentrate, and feel sexy; they can make a home feel warmer and a work environment more dynamic.

Remember that we experience life through our senses, including the sense of smell. The stimuli our senses convey to us are immediately interpreted by us as positive or negative, and therefore trigger different emotional reactions. It is all about associations. During our lives, we learn to associate smells with certain circumstances, events, rituals, places and memories. Cinnamon smells of a cozy day at home, sunscreen smells like a beach holiday, burned cookies smell of wasted effort, and hospitals… smell of sickness.

It is true that there is a lot of sickness accumulated in hospitals, so it seems only logical for it to be reflected in the general vibe of the place. Still, hospitals should also be places of healing, and healing can and should be stimulated through strengthening stimuli. Scent is just one of them. Let’s move on to hospital food. It is probably one of the poorest diets there can possibly be. When all the ingredients on your plate – the salad, the veggies and the meat – have the same color, gray, you know they don’t have much going on in terms of nutrients. Vegetables and proteins are usually boiled to death, and salads often consist of canned yellow beans and the likes. Desserts mostly seem to have been made out of some instant powder mixed up with water and typically come in sickly pastel colors. And let’s not even talk about flavors and textures. “Urgh” says it all.

Considering that science already knows how vital good nutrition is for our health, it seems insane how hospitals are still serving food that not only does not help patients to recover, but has the potential of making them even sicker because of its nutritional poorness. Even someone healthy needs a wide variety of vitamins, minerals, fats, and so on. Now imagine someone who has already lost their health and needs to regain it. This does not only go for physical illness, but also for mental pathologies. The brain functions thanks to elements our metabolism derives from what we consume. In every respect, hospital food should be absolute power-food, the very best stuff there is! The emphasis goes on the word “should”.

If you, or a loved one, are currently hospitalized, you may wish to complement the hospital diet with valuable snacks. Get fruit, or have fruit brought to you. Apples are a great choice. They are easily available and keep for a long time, even outside the refrigerator. There are, of course, bunches of other types of fruit, but none seems to be quite as practical as apples. Bananas, for example, are an excellent snack and very rich in dietary fiber, but their intense smell may bother your roommates. Also, they get squishy quite easily and attract fruit flies. Whichever fruits you decide to acquire, eat them instead of that awful, pale-yellow Jell-O with tiny beige chunks in it. Also, abstain from the mummified salad on your food tray. Alternatively, you can have a fresh cucumber cut in slices and with its peel still on. As a snack in the afternoon, you could enjoy carrot sticks dipped in peanut butter. All of these items – apples, cucumber and carrots – are relatively cheap, available all year round and do not need any preparation other than cutting them up. Also, drink a lot of pure water and squeeze half a lemon into it at least once a day. Whenever you have the choice between a soda and water or milk, choose any of the latter two. Avoid adding sugar to hot drinks. All these are small and easy hacks which help you improve your health.

Complementing the hospital diet with your own choices of fresh foods can also be an opportunity for social bonding with your fellow patients. During my last hospitalization, I was sharing a room with three other people. It was summer, so there was a lot of fruit on offer everywhere – cherries and plums from local farms, apples, imported peaches and so on. Spontaneously, some of us would go, buy a big bag of fruit and put it in a bowl on the table for everyone in the room to take. Other patients spontaneously formed salad initiatives. They would throw their money together and shop for ingredients for vegetable or fruit salads, prepare them together and share them among one another. All this does not sound like a big deal, but that little bit of human warmth and joyful interaction can make a huge difference for someone who has hit rock bottom. In this sense, bringing flowers to your room is also a small, but important boost for everyone’s psyche. And guess what, this is where smell comes into play again. The smell of flowers is always beautiful.

“Beautiful” is my cue for the next unfortunate aspect of hospital environments: visual ugliness. It must be acknowledged that, given the requirements of cleanliness and good illumination, the off-putting linoleum floors and ghostly light from uninspiring neon tubes are probably necessary evils. Still, a lot can and should be done to make hospitals look less cold and morgue-like. After all, it is in no-one’s interest to have patients slip even further into depression. Some clinics do make attempts to create a more mood-enhancing environment. Large windows, plants, colorful artwork and cozy sofas with coffee tables and magazines here and there go a long way. The access to green outside areas is another huge plus. Sometimes, all it takes to make someone feel less gloomy is to sit on the in the sunshine on a lawn or on a bench in the shade of a tree for a while – alone or with others.

And last but not least, hospital setting should offer ample opportunity both for socializing and for introversion and retreat. The last clinic I was in had generous outside areas with a park, benches and Ping-Pong tables, as well as an indoor sports court which was constantly open to patients who wished to organize volleyball matches or other activities. This was not a fancy private clinic – it was a public, if quite renowned, one. Admittedly, the place was guilty of giving out horrible food and committing several esthetic atrocities, but the overall intention was right. Another thing they did well was that the staff kept close contact with the patients. Not so much in a controlling way, but mainly by being available for communication and socialization. Patients would get to talk one-on-one with the treating doctors several times a week, and every morning both patients and staff would meet up to comment among one another on how everyone felt and on some randomly picked topic. Once every week the arts therapist would direct a huge cake bake-off, followed by a collective cake and coffee binge. On one occasion, as the weather was hot and sunny, all staff and patients from the station decided to go for a pick nick in a nearby park. You may guess by now this was not a closed facility, meaning that patients were not physically restrained or thought to be a danger to themselves and others. Still, some of them had symptoms comparable to those of people I had met in a closed facility some months before, possibly meaning that this clinic simply encouraged and trusted its patients more than other institutions. Along these lines, I remember being invited to a former patient’s birthday party on the other side of town. I commented to the nurse at the entrance that I might be back really late, and she just smiled and wished me a fun evening! All over, I felt that the staff of this clinic was more interested in motivating patients to return to functional life than in isolating them from it. This should be one of the core objectives of psychiatric hospitals, but as things are you have to be very lucky to find a place like this.

Being hospitalized at any psychiatric h clinic is always difficult and scary, because you are often so hopeless that you just can’t fathom a way out of your crisis. But definitely, the attitude of a psychiatric clinic towards its patients is crucial for your recovery. Being guarded by an institution whose staff works against you by violating your dignity and undermining your trust can be the last nail in your coffin. I am certain such places don’t even contribute to the destruction of their patients on purpose. They fall prey to an intellectual fallacy by thinking you have to recover by yourself, and all they have to do is medicate you and lock you up. If the day they examine you again you haven’t improved, they just assume you need some more drugs and additional time behind closed doors. Being locked in by people who disregard your personal integrity could drive a healthy person bonkers. Now imagine what it does to someone who is already weakened. If anyone ever comes out of there cured, it is a miracle rather than a medical success. Such clinics fail to recognize their role as active participants in your healing process, and therefore contribute to your sinking even deeper into illness. On the other hand, staying at a clinic that practices an attitude of encouragement and support towards its patients helps you greatly, if not decisively, in putting your act back together.

In my belief, the biggest shortcoming of hospital environments is how they isolate patients from life. When you are confined to a clinic, you logically cannot participate in society the way you do living freely. But it is that very sense of being stuck in limbo that can worsen feelings of depression and hopelessness in patients. Who if not the very institution our society provides for healing should allow the ill to gather new strength and return to active existence? I am sure the more life is brought to a hospital in the shape of social and artistic therapies, fresh foods, biological life such as plants, comforting scents, natural daylight, cozy areas for relaxation and fresh air, the more curative it will be. Staying at a psychiatric clinic may not allow you to be immersed in everyday life, but it must offer the clear perspective of equipping you for it.

Right now, many hospitals make people sicker. My acquaintance’s father was right about that. The practice of medicine and psychiatry is often still not humane, not loving, not caring, enough. To a culture devout to science and rational thinking this sounds amateurish and cheesy. Yet, it is a profound truth. If science has not been able yet to define or measure love, compassion, health and vital energy, it is by force also unable to produce those. It is one thing to give someone a pill for their intestinal cramps. It is another to attempt mending someone’s broken spirit in the same way. Our health system still has a lot to learn.

What Made Me Crazy And How Do I Deal with It?

When I broke down with psychosis, I had already been struggling with myself for many years, if not for all my life. Although as a teenager and as a young adult I had always been hopeful about my future – and I still am – I was also experiencing major insecurities which made me fear I was incapable of survival, let alone happiness. Even if other people praised me as a person or liked the quality of my work, I always felt like a cheat who is using a promising façade to hide a putrid ruin. I felt emotionally and socially disabled. During the years leading up to the psychotic break, I had been working hard to overcome my mistrust in myself, but I never shook off the fear that I might be a failure by design. Something seemed wrong.

Now, there are many definitions of mental illness and also many theories about its origins. As no clear answer has been found yet, the consensus is that mental illness results from mixed factors such as genetic predisposition, dysfunctional upbringing, traumatic experiences and substance abuse. The presence of any of these, or any combination of these, can push someone over the edge.

In my case, I can rule out substance abuse and traumatic experiences, not counting extreme stress as the latter. Thus remain genetic predisposition and a dysfunctional upbringing. I cannot prove nor disprove genetic disposition, but looking at family history on my paternal side there might be some. I would have to find out more about that issue. Just for the sake of argument, let’s say I am genetically predisposed towards mental illness, and my symptoms were triggered by a dysfunctional upbringing and other stress factors. An unhealthy upbringing I can prove to have had. I lacked nothing material, and also received a good academic education, but my close family was and still is emotionally damaged.

My parents had a miserable marriage, yet never split up. They shared a strange need to destroy, despise and blame one another for everything that had gone wrong in their lives. Fights and insults were their means of communication. My father retreated into a socially isolated lifestyle. He was super-sensitive and irritable, displayed signs of OCD (he feared the presence of germs and dust everywhere) and held no power of decision within the family. Hardly anyone took him seriously, or so I perceived it. My mother personified the theories about “schizophrenisizing” parenting you find in psychology literature. She loved me, but had no clue how to do it. She was possessive, controlling, over-protecting, manipulative, and eternally ambiguous about everything. She exerted power by instilling fear and feelings of guilt in me. Despite her addiction to control, she herself was desperately insecure and fickle. At times she was excessive in her demonstrations of motherly love, and at times she condemned me for being my father’s offspring. One day she could be encouraging and generous, the next she would make me feel unworthy. I could never confide in her because she might use whatever I said against me. My siblings, way older than me and living far away, just got the idea that I was a problem. My mother used to evacuate her complaints about me with them and other family members. When the first thing your cousin says to you, after a decade of not seeing one another, is “I know everything you’ve done to your mother”, you know for sure you’re the official fuck-up of the tribe. Now add years of bullying at school and you get someone who logically – with or without genetic predisposition – had to go nuts at some point.

So what was the ultimate trigger? My psychotic break was not my first crisis, but other than the previous ones it was cataclysmic. The breakdown was immediately preceded by the end of a long-term relationship (if not a very healthy one), a life-changing move to another country and a personal confrontation with my family I was unprepared for, and which threw me right back into my old conflicts with them. All of these together produced an acute feeling of having been uprooted and set adrift in existence. It was an extremely frightening and painful experience. There was nothing I could hold on to for catching my fall, most of all not myself. That is ultimate loneliness. I became shock-frozen in life, and a case for the mental clinics. Mental illness had always been presented to me as an incurable, invariably disabling and socially annulling condition. My terror was nameless when I got diagnosed as psychotic and medicated. None of the first bunch of doctors I saw gave me any hope of reconquering life ever again, and my initial medication regime also was not helpful. I literally became a zombie – wishing for an end to everything, but my body would go on functioning, keeping me prisoner in a biological existence devoid of meaning and direction. There was no curtain call for me yet. Back then, during my crisis, staying physically alive felt like a curse. I just wanted out! The winds began changing during my last hospitalization. After that, I hesitantly but firmly took up the reigns again. I cannot tell what exactly made me recover. A combination of many physical and immaterial factors must have come together in my favor, including an unknown energy deep in my essence that refused to let me go under.  Nowadays, I am glad I made it through. Nothing guarantees me psychosis won’t strike again, but as things are I am not fearful about it. Right now, I have a lot to live for and I love my life as it is – full of beauty and love. But getting here sure was heck of a trip!

Once you break down in crisis, society isn’t exactly forgiving, including people you had felt close to so far. They may give up on you for various reasons: they think you are just putting on an egocentric show and this unnerves them; in their opinion your problems are your own fault and you are an irresponsible fool for having invited them in; your shallower acquaintances simply don’t find you fun anymore; firmer bonds suffer because they find dealing with you and seeing you ill too painful. Your former co-workers or fellow students may prefer to forget your name forever. In the eyes of many, craziness is not an ailment which can attack anyone and eventually subside again. Society stigmatizes mental illness as an inborn, rotten part of the befallen individual, who is therefore worthless.

Right along the lines of supposedly being damned by birth, you will hear it said that what you didn’t receive in your cradle, you will never acquire. In other words: if you had a bad start you might just as well throw yourself off a bridge, because there is no remedy for you. To everyone out there who was lulled into believing this popular la-di-dah: it is utter and complete BULLSHIT. Certainly, teaching yourself is harder than having everything served to you on a tray. Still, your capacity of learning and growing is your lifelong gift. No-one but yourself can keep you from enjoying it. Never resign to thinking you are merely the outcome of your parents’ joined genes and educative efforts. Have you ever heard the saying “the sum is bigger than its parts”? It is true! There is much, much more to you. An unlikely source of wisdom, among many others, is the subtitle on the posters of the Hollywood movie “Gattaca”. It reads: “There is no gene for human spirit”. Neuroscience, in fact, backs this philosophy up. It turns out the human brain remains capable of rewiring its networks throughout our entire life. This ability is called neuroplasticity. How remarkably flexible and versatile our brain is, is impressively described in Norman Doidge’s book “The Brain That Changes Itself”. It is quite a fascinating and edifying read. According to the principle of neuroplasticity, any unhealthy behavioral and thinking patterns you fear were hardwired into you during your childhood and youth do not predetermine your future. You can modify them through willpower, practice and positive reinforcement. Thereby, you can even activate or deactivate certain genes. In other words: no matter where you are coming from, you are able to become someone you love and respect. Probably you will need help and also some powerful insights gained from difficult experiences, but you can mend your psyche. In this context, I would like to recommend another book. It is really written for therapists and the loved ones of people in need of help. Yet, as it portrays clearly which kind of help is the right one, I found it extremely useful for myself, because it taught me what my therapeutic needs are. This, in turn, allows me to seek out adequate help and instruct those closest to me how to deal with me should moments of crisis come up. The book I am referring to is Dr. Peter Breggin’s The Heart of Being Helpful”. This is a must-read for you, both if you are the one who is in crisis, and if you are a potential helper.

And finally, don’t let yourself become the problem. Also, don’t allow others to make you that. Unfortunately, even in the medical field, a mentally ill patient is treated as the personified problem. This does not happen to such a great extent in other areas of medicine. For example, a patient can HAVE a heart disease, but they ARE not a heart disease. Possibly out of general ignorance about the causes and nature of mental illness, someone with, say, schizophrenia, is considered to be inherently dysfunctional rather than suffering from a dysfunction that may well be temporary. Also, what if mental illness is actually not an illness in the conventional sense, not a medical defect? Could it be a reaction to the richness of observations an exceptionally sensitive and perceptive psyche is able to make of reality? Maybe some people are simply able to feel the pea under multiple layers of bedding, while others have a thicker skin and fall asleep anyways? It is easy to just stick the label of mental illness onto someone whose takes in a greater variety of stimuli, and who cannot always process their complexity. At first glimpse, you may judge extreme susceptibility as a weakness. In general, the psychiatric discipline and mainstream opinion fail to recognize that psychological hypersensitivity can also be a gift that stretches way beyond madness and alienation. In my personal view, it offers an opportunity for learning, healing, and growth that is less accessible to all those who are robust enough to just leave their conflicts unattended and carry on with their emotional load on their backs. If you break down under your world’s weight, you will be forced to sort the clutter and take only the useful things with you. Mental crises are a nightmarish ordeal, but they can also be your chance for renovation. I am not saying you necessarily need to become psychotic in order to make something out of your life. Of course not! What I suggest is that facing mental illness does not have to end in absolute defeat. Instead, it could well be the first step towards a more conscious way of living. I do believe that the destructive forces of madness can be turned around and redirected. Consider mental illness as a challenge, not as a final verdict. You can move on.

The following are links that lead you to people who are dealing with their conditions in inspiring ways, and to institutions which can help deal with your situation.

 

Websites:

Directory of organizations which can help people who are first diagnosed with a mental illness (UK based): http://www.bbc.co.uk/programmes/p01b3s86/features/info-and-support

This is the blog of Natasha Tracy, who fought herself back up to her feet despite her diagnosis: http://www.healthyplace.com/blogs/breakingbipolar/

 

Articles:

Christopher Tolmie writes about his documentary “Mental: A Family Experience”, which he exposed at the Scottish Mental Health Arts & Film Festival 2013 in Glasgow (http://www.mhfestival.com/). Here is the link to the article: http://www.changingmindschanginglives.com/2014/01/mental-illness-does-not-necessarily-incapacitate-someone/ Or go to:  http://www.mhfestival.com/news/interview/item/77-festival-blog

Audiovisuals:

“Ask A Schizophrenic – My Answers”: Questions and answers with Rachel Star (NOT Rachel Starr), who got diagnosed with schizophrenia and talks about how she manages her life and makes the best of her condition. To me, she appears quite admirable and inspiring. http://youtu.be/BAUlllDZqxg

This moving story recently went viral. In case you still haven’t come across it, it is about a man named Johnny Benjamin. He had been diagnosed with schizoaffective disorder and decided he was going to take his life. This was prevented last minute by a passer-by. After the incident, Benjamin began to turn his life around and is now giving thanks to his rescuer. http://www.bbc.co.uk/news/uk-england-london-25959260

The (Scary) First Step – Test Dose Reduction

The time has come! From tomorrow onwards, I will be taking a slightly reduced dose of my SSRI antidepressant. I will go from 150mg of Sertraline in the morning to 137,5mg for a week or two. This corresponds to a reduction of slightly less than 9%. Various sources recommend not to start with dose changes any greater than 10%. Therefore, although my next short term goal is to reduce my dose of Sertraline to 125mg, I will be going there through an intermediate step that will function as a test period at the same time. Both I and those closest to me will be monitoring my response – or the absence thereof – to this initial dose modification.

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My new toy – a “deluxe” (of course, I’m posh) pill cutter.

Now, how do I go about the dose reduction technically? I have 100mg and 50mg Sertraline tablets. They are of an oblong shape and dented in their middle in order to make halving them easier. But if I wish to try 137,5mg for a while, I will need to quarter the 50mg tablets. Even with my pill-cutter, that will hardly be possible. Reading through Dr. Peter Breggin’s book Psychiatric Drug Withdrawal (see sources), I found an easy enough solution to this problem. Breggin describes several drug withdrawals he was helping his patients with, and especially with very small dose modifications it was sometimes necessary to be inventive. This is what I’ve learned:

 

  • If a pill cutter won’t do the job, you can find out if your medications are available in liquid form as well. If they are, you can control your doses drop by drop.
  • Some drugs come in capsules filled with tiny pellets. Same as with drops, this gives you the possibility to make very gradual changes by removing some of the pellets from the capsule.

But careful: your mathematics must be very precise for both the drop-by-drop method and the pellet removal strategy. You need to figure out how much of the active ingredient is in a drop or in a pellet. If you are taking generics, you also need to make sure you are always using the same manufacturer, as concentrations and excipients may vary from brand to brand. And needless to mention, if you have trouble concentrating due to cognitive impairment caused by either your condition or your medication, you need to put an extra effort in getting your doses right. In the latter case, you may keep lists or put up sticky notes to remind you of how to proceed. If you live with someone who is willing to support you, you can also ask them to double check if you are handling your medication correctly and according to plan.

  • Given that I haven’t got hold of either Sertraline drops or capsules, I decided on another dose reduction method mentioned by Dr. Peter Breggin. I will be taking 125mg instead of 150mg every other day, simply by halving the 50mg Sertraline pill with the pill cutter and taking it together with the 100mg pill. Over time, the alternating doses of 125mg and 150mg will result in an overall dose reduction of 12,5mg.

If I tolerate this initial step well, I will proceed to definitely reducing my Sertraline dose to 125 mg. I am quite optimistic it will work because of experiences I have had with involuntary – alright, neglectful – dose reductions. For varying reasons, I have skipped taking my Sertraline altogether a number of times. Normally, I am rather disciplined and take the antidepressant immediately after getting out of bed and brushing my teeth in the morning. However, if a day is particularly eventful or something unexpected gets in between my waking up and my going to the bathroom, I run a slight risk of forgetting my Sertraline. The first few times it happened to me, I was extremely worried the omission was going to cause weird withdrawal symptoms or render me useless temporarily, but none of it was the case. My suspicion is that having used the same amount of Sertraline for about four years now, there might already be a certain concentration in my blood that keeps me stable even if I forget one pill every once in a while. This is just my personal hypothesis. Right now, I can name no sources to back it up scientifically. Also, so far I have never skipped more than one dose. Hence I don’t know how I would react to a permanent, if small, dose reduction. Still, for the above reasons, I am confident it should be no problem.

I will keep you updated on how things are going in my “withdrawal diary” section.

My Personal Withdrawal Plan – Sources and Outline

Although I seem to tolerate my current medication plan quite well, I have been striving to wean off my pills, or at least decrease the dose I am taking. But before I altered anything, I needed information. Despite my recovery from psychosis I have developed a profound mistrust towards psychiatrists and psychotherapists. Out of all the professionals who saw and treated me, maybe 20% actually knew what they were doing. The other 80% either didn’t care to help me, or they wanted to be helpful but didn’t have any idea how, or they were abusive of their authority, or they needed therapy themselves. No joke.

As a result, my first thought was that I needed information to be able to distinguish a competent psychiatrist from a quack, so I could pick the right support for my undertaking. Yet, by continuing to read about mental illness, treatment options and psychoactive drugs, I became more knowledgeable and eventually felt I was able to make informed and more autonomous choices regarding my recovery and withdrawal process. One book in particular stood out as being clearly understandable for any reader and for promoting a holistic approach to the treatment of mental illness and to medication withdrawal: Psychiatric Drug Withdrawal – A Guide for Prescribers, Therapists, Patients, and Their Families. It is one of the more recent publications of Dr. Peter Breggin, who draws on over half a century of medical experience in psychiatry. As a defender of the patient’s freedom of choice, Dr. Breggin promotes what he calls a “person-centered, collaborative approach”. Instead of turning the patient into a depersonalized and passive onlooker of their own treatment, Breggin places the patient at the very center of his therapeutic model. Around the patient, he constructs a support network consisting of a prescriber of psychiatric drugs, a psychotherapist, and significant others (family members, spouses and friends). The prescriber and the therapist can be one and the same person, but do not have to be. What is indispensable, though, is that the patient’s wishes and decisions are taken into account at all times, and that all participants in the collaborative, person-centered approach are communicating efficiently and monitoring the patient’s health development. As the title of the book reveals, Dr. Breggin writes for health care professionals, patients and their significant others alike. None of the information he gives is classified exclusively for one or the other. All people involved have the same right and access to knowledge. The patient and his or her loved ones are empowered rather than patronized. You might be able to guess by now that I highly recommend this book. Further on, I will be reviewing more literature, but for now this is my starting point.

First of all, it is important to understand that there is no standard recipe for withdrawing from psychotropic drugs. Every organism reacts differently to changes. Also, it is impossible to foresee how long it will take to wean off medication or to securely establish a new dose. As a general rule, however, slower is better, and small changes in dose are safer than big ones. This is especially true for those who have been on psychiatric medication for a long period of time. Certainly, you often hear stories about individuals who have successfully gone “cold turkey” or got rid of their pills in the course of a few weeks or months, but they were taking a high risk and were extremely lucky. They were literally playing Russian roulette with their lives. Reducing medication doses is not a sport, and there is no competition going on in who gets there first. The only reasons for withdrawing on the fast lane are life-threatening or disabling side-effects, dangerous drug interactions, pregnancy and medical conditions that turn the use of psychoactive drugs into an additional health risk. Personally, I am not in a hurry. Luckily, nothing in my life forces me to withdraw, and I can take it as slowly and safely as I like. And I like it very safe.

Evidently, withdrawal is easiest to plan being on only one drug. Now, I am on two different medications which counteract one another and are thereby meant to keep me in balance. In the morning, I take 150mg of Sertraline (SSRI antidepressant), which should have a stimulating effect. At night, right before going to sleep, I take 300mg of Quetiapine (atypical antipsychotic), to sedate me. My aim is to reduce doses alternately, maintaining the proportion between both drugs. I will start with the antidepressant. If everything goes well, the antipsychotic is to follow. Again, if the new dose works fine for me, I will keep it up for a period of time and eventually attempt another reduction.

As for the monitoring of my progress, my partner is around me every day and is in the know about my withdrawal plan. He will communicate any observations and concerns to me, is reading the same literature as I and is following my blog. Other friends will also be part of my private watch team. I do have a prescriber, yet I admit I haven’t decided on the involvement of a psychotherapist. Frankly, I feel reluctant to do so. Right up to my psychotic break, I had been seeing a shrink for several years, and she was unable to identify any warning signs or put her finger on the deeper causes of my troubles. I believe I’ve had it for now, as far as psychotherapists go. Also, after the ride I’ve sat through, I am quite confident I know myself better than a therapist who sees me once weekly could. In order to boost my general health and well-being, I will work out regularly, stick to a healthy diet, sleep enough and enjoy relaxation therapies – occasional foot reflexology and back massages.

The following is an illustration of how I ideally wish to proceed. This plan, as for now, has five phases that may be subject to changes, depending on whether I tolerate the dose reductions. If I don’t, I may need to return to the previous dose and postpone further changes for a long enough while to become stable again. You will notice I haven’t planned a complete withdrawal. While I was figuring out the graphics, the thought of actually putting this plan into practice made me feel all wobbly. In the attempt of outlining a sixth and seventh phase I might have fainted and slipped underneath my desk. So, let this be good for now.

I apologize for the miniature format of the graphics. The originals are a good size, but for some reason, they won’t come out bigger once inserted into this post. You can upscale your view of this page on the bottom right of your screen.

withdrawal plan phase 1

withdrawal plan phase 2

withdrawal plan phase 3

withdrawal plan phase 4

withdrawal plan phase 5