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

 

 

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.

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: 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.

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/