Some Words on: Hyperfunctionality Disorder

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

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

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

  • You are hot

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

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

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

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

 

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

Some Words on: Psychiatric Violence

The term psychiatric violence, or psychiatric abuse, describes the mishandling of power and authority health care professionals in psychiatry, or entire institutions, can expose their patients to. It comprises all sorts of aggression – active or passive. Psychiatric violence can occur on all levels of interaction between treating professionals and patients: social, psychological, chemical or physical.

Progressive thought currents in psychiatry advocate equality between the treating and the treated. More and more often, the right of patients to make choices and utter demands is recognized and respected. However, the outdated model of an authoritative doctor and his dependent and subdued patient is still very much alive.

Psychiatric violence occurs wherever doctors and nurses assume that someone who has been diagnosed with a mental illness is a person of diminished worth and respectability, and where psychiatric institutions consider it their main purpose to keep the mentally ill our of society’s way, as opposed to helping them reintegrate. Violent psychiatry robs distressed individuals of their humanity and punishes them for being dysfunctional. Humane psychiatry, on the other hand, dedicates to them attention, support and empathy – in short, authentic interest. I have experienced both models in action and guess what: humane psychiatry is the one producing positive results.

I’ve mentioned here on my blog that I was hospitalized a bunch of times during my psychotic break, in three different clinics over the course of nine months. The first two institutions operated quite a lot through psychiatric violence, which ranged from physical restraint to psychological abuse. Ironically, one of those two clinics had posters in its hallways, inviting patients and the general public to talks on psychiatric violence! It was the first time I ever heard of the concept.

Violent psychiatry will attempt to coax patients into compliance. In fact, their definition of mental illness hinges on the degree of compliance (or non-compliance, for that matter) an individual under examination displays. The discourse used reminds of the twisted logic of medieval inquisition trials: if you admit to being mentally ill, well then you of course are. And if you insist you’re just fine, that belief in itself will be considered a symptom of your craziness. Catch twenty-two! The same goes for the acceptance of psychiatric medication. If you are docile and willing to take your pills, that’s recognizing you are ill. If you refuse, it means you’re mentally deranged, too, because your fail to admit you need them, so your perception of reality must be distorted! In other words, if you come across the wrong sort of psychiatrist, you are destined for disaster the moment you set foot in their office. One way or the other, you will be diagnosed with something – accurately or not.

On occasions, psychiatric violence can get rather blatant and bizarre. During my second hospitalization, a doctor yelled in my face in front of a group of fellow patients that I was sick to my head. An arts therapist at the same facility communicated to the prescribing doctors that I had “distorted vision” – she was convinced that every time I looked in another direction but hers, I was actually looking at her! In retrospect, I think it might have been nice of me to offer her some of my antipsychotic. Unfortunately, the prescribing doctors and higher ranking staff believed her without subjecting me to any kind of exam. They had no interest in finding out if I really had “distorted vision”. After all, the arts therapist was a qualified health care professional and I was just a nutcase whose words were not to be trusted, and who had been caught displaying yet another weird symptom of craziness.

Another genius of a psychiatrist asked me a handful of questions to find out if I showed any symptoms of schizophrenia. I answered all but one or two with “no”. His diagnosis after barely 10 minutes: “You’re schizophrenic. But that I already knew when I saw you sitting in the waiting-room.” And then, he added: “Oh, by the way, you’ll have to take pills for the rest of your life. I assume that’s clear to you.” I may have been psychotic at that time, but that made me neither stupid nor insensitive to inappropriate behavior. Fuck you very much, Doc! Or, yet a bit more blunt: during my first hospitalization in a “renowned” private clinic, I got physically restrained by one guy (who was a favorite patient and watchdog to the psychiatrist in command of the place), another man forced my jaw open and the doctor himself poured a medication cocktail into my mouth in order to knock me out. Again, I may have been psychotic, but I could still feel dread and I also remember the scene perfectly. That same doctor also had the unsettling habit of interviewing patients in his office with the blinds closed and sunglasses on. Even for someone perfectly stable, this setup would have been disconcerting.

Psychiatric violence goes far beyond treatment. In fact, critics of the psychiatric discipline accuse not only specific institutions, but the entire legal system of allowing for psychiatric patients to be robbed of their autonomy, their dignity and their human rights. This, the argument goes, is the case even when healthy patients are wrongly diagnosed.

For example, in some countries, legally assigned caretakers look after psychiatric patients. They are usually social workers who are authorized to decide on the patient’s behalf (yet not always in their best interest). They control communication with the prescribing doctor, survey the medication plan, and are authorized to have their protégé hospitalized whenever they deem it necessary – or convenient because they are planning a vacation and therefore need to get rid of the ill person for a week or two. I know this sounds cynical and certainly does not do justice to the many social workers who actually do have sound work ethics. Yet, I have come across sad cases. Families can turn to the legal system to have their problematic relatives hospitalized by court order and forcefully kept there for quite long periods of time. If they succeed in legally establishing the “insanity” of their kin, they gain complete control over his or her possessions and decisions. Families may legally be the closest instance to an individual, but they aren’t necessarily protective and well-intended. In fact, dysfunctions within the family are suspected to be a major cause of mental illness. Yet, by default, the legal system considers them the first ones who are entitled to decide in the ill person’s name. Thereby, family members can become yet another source of psychiatric abuse.  When a legal system is lenient towards psychiatric abuse, all sorts of parties can acquire power over the patient – psychiatrists, clinics, family.

The interface between psychiatry and the legal system acts very much like a fly-catcher: once someone gets stuck there, it will be very hard for them to ever free themselves and recover their autonomy. This is not an idea I have made up. Countless psychiatric patients spend years or their entire lives in and out of clinics, supported living facilities and under the “protection” of restrictive court orders. I need not go into detail about how that affects their chances of ever finishing an education, pursuing a career, or building a relationship and founding a family with a significant other. When I expressed my fear of ending up just like that to a nurse at an abusive clinic, she readily answered: “Well, the moment you set foot in here that became the track you’re bound to travel.”

Last but not least, another form of psychiatric violence is simple neglect. My second hospitalization was at a clinic where the prescribing doctor saw you for ten minutes once a week, if at all, and where the nursing staff refused talking to you if you had already addressed them with some kind of problem earlier in the day. Their therapeutic program was also utterly stimulating (yes, I am being ironical): the once weekly “gardening” activity consisted of grazing the parking lot for trash and discarded cigarettes for an hour or so. Hell is a place on earth.

Another feature of violent psychiatry is its propensity to sucking patients into a downward spiral of aggression and forced treatment. Whatever is done or said to you is supposedly all “for your own good”. How can psychological cruelty and neglect ever be for your own good? If your common sense is still functional enough to make you unappreciative of this kind of “help”, it is interpreted as another symptom of your desolate mental state. In short: if you allow psychiatric violence to be applied to you, you are being compliant and it is understood that you recognize you need it. If you speak up when feeling mistreated, guess what? You are deemed to be too ill to speak for yourself and the intensity of aggressions will likely be increased until you finally give in and shut up. Sounds familiar? I’ve talked about old school psychiatry’s witch hunt logic at the very beginning of this article.

The million dollar question is how to protect yourself or loved ones from psychiatric abuse. The keyword is “information”. Ignorance equals impotence. Gather information about your diagnosis and learn about your rights and treatment options. There is a lot of literature on psychiatry which is comprehensible and helpful for laymen (see the sources & reviews page). Luckily, mental health has gone from being a purely scientific matter to becoming a subject of general interest. If you are already caught in an abusive dynamic, your attempts of self-empowerment may be judged as paranoid, especially when you suspect your doctors or your family to be harmful to you. Even then, do not let anyone discourage you. Some doctors are in fact careless and some families are in fact harmful. As long as you are kept in the dark about your circumstances you will never be certain if you are as paranoid as they say or whether you are simply recognizing things for what they are. Do not let yourself be labeled as pathologically distrustful, ungrateful or obsessive. Seek information. You may eventually come across a piece that helps you find a new perspective, communicate more efficiently with your therapists and take informed decisions. In the end, it is irrelevant whether your inquisitiveness springs from paranoid ideation or healthy hunger for knowledge. It is your fundamental right as a human being to educate yourself about your condition. You are the one who is most deeply affected by it, so it is only fair if you know what is going on.

Psychiatric violence is a vast topic. I will stop here, at the boundaries of my personal experience with it. If you are interested in reading more, you can browse the internet or look for literature in online or local bookstores and libraries. If you Google search “psychiatric violence”, you will find that an overwhelming number of entries are about psychiatric patients developing violent behavior as a consequence of their illness or as a side effect of their medication regime. Searching for links on “psychiatric abuse” or “violent psychiatry” may yield better results. To save you some effort, I put together a small selection of links that offer information and are a good starting point for further research:

Websites:

Webpage on psychiatric abuse in English: http://www.psychiatric-abuse.org.uk/

Website in English on human rights in mental health: http://www.mindfreedom.org/

Webpage on different types of abuse, including psychiatric abuse, in English language:                http://we-are-survivors.webs.com/psychiatricabuse.htm

Website of the Citizens Commission on Human Rights in English. Apart from getting information, you can also report psychiatric abuse here: http://www.cchr.org/

Webpage in German, strongly biased against conventional psychiatry: http://www.zwangspsychiatrie.de/

Articles:

Wikipedia entry on involuntary treatment in English: http://en.wikipedia.org/wiki/Involuntary_treatment

Wikipedia entry on the psychiatric survivors movement in English: http://en.wikipedia.org/wiki/Psychiatric_survivors_movement

Article in the Journal of Medical Ethics: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1376496/

Article in English by The Guardian (British newspaper): http://www.theguardian.com/society/2011/mar/15/mental-health-patients-forced-detention

Article in German by the weekly magazine Spiegel (you can run it through a translation program): http://www.spiegel.de/gesundheit/psychologie/zwang-in-der-psychiatrie-das-letzte-mittel-a-836111.html

Blogs:

A British mother shares her experiences with psychiatric treatment in the UK: http://psychiatricabuseuk.com/

Personal experience of a former psychiatric patient in the USA: http://www.experienceproject.com/groups/Am-A-Psychiatric-Abuse-Survivor/239188

Audiovisuals:

Interview with a survivor of psychiatric abuse by the Citizens Commission on Human Rights:  http://www.youtube.com/watch?v=ve92-PFytAU

Some Words on: The Social Stigma of Mental Illness

I am very careful about whom I tell I had a psychotic break and am still taking psychoactive medication. It is only a few people who know. This is not because I enjoy being dishonest, and I am also not ashamed of my condition. The reason is that, no matter how intelligent or good natured most of our social and professional contacts are, they are very likely hardwired to start questioning your capacities and interpret whatever you do or say in terms of your supposed craziness from the moment they learn about it. It is not their fault. It is what society has taught them.

The mechanics of prejudice work like this: imagine you are at a dinner party. An acquaintance leans over and whispers in your ear: “See Henry over there? I think he’s gay!” For the rest of the evening, you will be looking for signs of Henry’s homoerotic preferences. He prefers Piña Colada over beer, strawberry ice-cream over chocolate and also dresses tastefully? Oh my God, he is SO gay! How could you not have noticed before? He brought his long-time girlfriend along to the party? Not a problem at all – he is probably in denial and hasn’t yet come out of the closet.

Along these lines, people who know about your diagnosis and your medication routine will read your every move as a sign of your condition. You forgot to send an email? That’s because you’re demented either by your illness or by your medication. You get pissed at a colleague who snatched a customer away from you? You have uncontrollable anger issues caused by either illness or medication. You tell someone in the office you had trouble falling asleep last night? Of course, you are a lunatic! Any of these situations happening to a “healthy” person is just stuff that happens naturally from time to time and need not worry anyone – after all, nobody’s perfect, right?

Again, I emphasize that this kind of over-diagnosing is not ill-intended in most cases. It occurs pretty much automatically. Most people, although educated and cultured, simply don’t know enough about mental illness and therefore are uncertain what to expect. This uncertainty generates mistrust, fear, and ultimately discrimination. I must admit I used to be no better. Years before my psychotic break, a fellow student at university admitted to being schizophrenic and taking medication. Although I didn’t want to be mean, I couldn’t help but fear that if I invited her home she might, out of the blue, snap and pull a kitchen knife on me. Now I know how unfair that was. Mental illness seldom is a threat to others. It is, unfortunately, a huge danger to the sufferer’s own happiness. The cruelty of my own prejudice hit me like a truck when I got diagnosed as psychotic myself.

My recommendation to you is: think through the possible consequences of telling any- and everyone. It is true that mental illness should finally be discussed more openly in order to put an end to discrimination. However, I warn you against thinking it up to you to make that happen all by yourself. Do not turn yourself into cannon fodder. Imagine calling up the Gestapo in the middle of the Holocaust and telling them “Hey guys, I wanna come clean, I´m Jewish…” No way! You need your lifelines intact. You need a job, you need your studies, you need your social contacts, you need a life! If you wish to make this world a better place for people with psychiatric diagnoses, there is a host of organizations you can support who will appreciate your contributions to their cause. See the appendix of this article for relevant links. Also, ask yourself if your diagnosis or your medication plan is relevant information at all, say, at your workplace. Can you do your job efficiently, just like everybody else? If your answer is “yes”, then what is the use of drawing attention to your problem? As long as you’re an accomplished, say, software programmer and reliably fulfill all demands, why would your boss or your co-workers need to know you’re receiving psychiatric treatment? It is not relevant. Imagine being at a job interview at some lab and saying: “Hi, I have a Master’s degree in molecular biology and graduated with honors. Oh, and I guess I should mention that I enjoy visiting swinger clubs on the weekends.” Why would you shoot yourself in the foot like that by disclosing a superfluous fact that will cast a shadow on your merits? It is neither intelligent nor honorable. Of course things are different when your condition does affect your performance negatively. If you suffer from an anxiety disorder which makes socializing difficult for you, you will not wish to be placed in the customer service department. In that case, your superior and your co-workers need to know and understand. Give them a chance to pick tasks for you that are manageable and offer you the opportunity of performing at your best.

To sum it all up, only tell someone you are on psychiatric medication when you are absolutely sure this person will not make your honesty backfire on you. The slightest doubt, the tiniest hunch that you feel, may well indicate it is not the right person to trust or not the right moment to speak. As a rule of thumb, do not trust people more than they trust you.

Your social network is made up of three kinds of contacts: those you must tell, those you can tell and those who – at least for now – you should not tell. Make sure you identify them correctly. People who absolutely need to know about your condition are your partner, your roommate, close family, your closest friends. Everyone else you have to gauge for suitability and trustworthiness first.

Is this way of proceeding ethical? Is it alright not to be an open book? If it is not relevant to the situation, there is no need for exposing yourself. Society seems to impose an absolute moral obligation to be open and sincere. But remember that the reactions you’ll get from people who can’t handle your confessions can be unethical and harmful to you (this is a parody of what I mean – watch this tragically funny NAMI sponsored commercial: http://youtu.be/Dw_I-G1smoo). It is one thing to be sincere and give others information they actually need in order to coexist with you, but it is another to unnecessarily feed yourself to the dogs. Being inappropriately heroic might cost you your job, your social circle, your inner peace and your dignity. Think twice. Decide wisely, for your personal integrity, independence and even your prospects of recovery are at stake.

 

Websites:

The following organizations aims to improve the life quality of individuals diagnosed with mental illness. This includes educating the public and those diagnosed with mental illness to create more awareness and better integration. Anyone can register as a member.

National Alliance of Mental Illness (USA, in English and Spanish): http://www.nami.org/

Mental Health Foundation (UK) has a similar mission as NAMI: http://www.mentalhealth.org.uk/

Rething Mental Illness (UK): http://www.rethink.org/

Canadian mental Health Association (CA): http://cmhanl.ca/

Articles:

http://www.psychologytoday.com/blog/why-we-worry/201308/mental-health-stigma

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/stigma-discrimination/

Article for the Canadian Mental Health Association (in English): http://www.cmhanl.ca/pdf/Stigma.pdf

http://www.changingmindschanginglives.com/2013/11/a-diagnosis-of-schizophrenia-set-me-apart-from-the-rest-of-the-world/

Audiovisuals:

Information video by the IWK Health Centre and the Canadian Mental Health Association titled Stigma and Mental Illness: http://youtu.be/LTIZ_aizzyk. Brief interviews with health care professionals and psychiatric patients portray the stigma of mental illness within the health care system. A must-watch!

Symposium about mental illness stigma hosted by Carleton University. You will find an extensive watch-list with videos of the speakers of the symposium here. http://www.youtube.com/watch?v=RMVfVuI0zwE&list=PL23BEAD8F06537216

A bold discourse not everyone may agree with, but that everyone should have listened to. Canadian essayist Stefan Molyneux talks about his theory on mental illness: http://youtu.be/J_O24tnqs_U (part 1) and http://youtu.be/mgqIUf8Jg-c (part 2).

Jayme-Lee Pablos, a psychology student reads her paper on social constructs and social stigma of mental illness: http://youtu.be/X3hJqB20r1g (part 1) and http://youtu.be/oiTCgxhKPok (part 2). Her work portrays an academic standpoint rather than looking to provide help, but it is interesting information.

Why Wean off Psychiatric Medication?

If everything is going so well, you might wonder, why am I intending to give up my tablets? For several reasons! A variety of sources claim that using psychiatric medication over long periods of time can have dangerous consequences. Quetiapine, for example, is associated with altered blood sugar levels and diabetes. Damage to the liver is another risk. Tardive dyskinesia and tardive dementia (involuntary movements and dementia occurring after long-term use of psychiatric drugs) are other potentially irreversible side effects. Cognitive impairment and chronic brain impairment (CBI) are not uncommon. The long-term effects of psychotropic substances on the brain are virtually unknown, but they are suspected to be devastating. Apart from that, case studies indicate psychiatric medication can induce manic states and drive people to commit suicide or other violent acts. The very companies who designed the drugs I am using admit they don’t know how exactly their products act within the human organism. Looking at the monetary aspect of taking antipsychotics and antidepressants, it can get very costly! Either insurance rates are insanely high if you declare needing treatment for a chronic psychiatric condition, or you have to pay for your medication out of your own pocket. We are potentially talking expenses of several hundred dollars every single month. Many of you may also find that having to swallow tablets at certain times during the day is tedious and violates your liberty. I, on the contrary, find no reason to complain about that. Being a woman, I have used contraceptive pills for many years, and those need to be taken at the exact same time every day. You can never forget one, even if you are still spaced out from last night’s party – now THAT sucks! In other words, I find things could be much worse. I simply take my antidepressant at whatever time I choose to get up and the antipsychotic at whatever time I decide to go to sleep. I have even forgotten to take the antidepressant a few times – no problem at all, I simply make sure to take it the next day.

This blog is no manifesto against psychiatric medication. Psychotropic substances put the fire out in my case. They brought the acute crisis to a halt and gave me time to pick up the pieces. I am fortunate my organism accepted the current combination of an antipsychotic and an antidepressant well. Yet, I emphasize it is absolutely vital for recovery to find complementary, non-chemical therapeutic measures to extinguish the embers after the big fire is out. Because they might alter your brain forever, I consider psychotropic drugs the very last resource to be employed. In my eyes, they are an emergency switch that should only be thrown when a temporary shutdown of the system is necessary.

While in some cases medication may be useful, most people with prescriptions from their psychiatrist would be better off facing their crisis and managing it with their psyche unaltered. Soliciting the attention of a psychotherapist, counselor or priest, spending time with loving friends or family, regular workouts, healthy nutrition and decluttering an overloaded agenda often prove more healing than pills. It is important to remember that stress is a natural and even necessary condition. All human beings eventually experience crises. They will occur repeatedly in everyone’s life, so it is important we learn to deal with them. Rough patches are part of the natural course of our biographies, same as joyful times are. Instead of suppressing emotional tension chemically, we’d do better learning to get over it and thereby grow stronger. Only when all measures fail and the individual sinks into utter dysfunction and alienation, as I did, should medication be prescribed – temporarily. This is my personal and subjective opinion. I make no claim of being in the right.

Not all psychiatrists would agree with me, yet even within the discipline there is no consensus on when to administer psychotropic drugs to patients, nor on how many, nor for how long. Scientifically unfounded affirmations such as “psychiatric medication has to be taken for life” or “mental illness is incurable” are spooking around under the guise of objective information. However, the entire concept of mental illness is still hypothetical in many aspects. Preoccupied about my future, one day I phoned the psychiatrist who had treated me during my last hospitalization. I asked him whether I needed to take my medication for the rest of my life. He did not hesitate one moment. Much to my relief and surprise, his answer was “No.” He said I could start weaning off by lowering the dose of the antidepressant a bit, and take it from there step by step. The conversation with the doctor happened a while ago. I wasn’t ready then. Today I feel secure enough to have a go at it. I am aware one should never go “cold turkey”, that is, stop taking the medication from one day to the next. After over three years of using those substances, my brain relies on them to be around. Also, reactions to spontaneous or rushed withdrawal have been reported to be just as dangerous and terrifying as some of the unwanted side-effects of psychotropic drugs. I shall write more on the perils of withdrawal in another post.

Withdrawing from psychiatric drugs being such a delicate undertaking, I must remind you again: do NOT use this blog as a manual on how to proceed in your case. If you wish to benefit from my posts, read them attentively, share them with others, or even let my blog inspire you to put together your own action plan. So, if I may use an already overused line: don’t try this at home! Unless, that is, you have researched carefully and designed a strategy for modifications in your treatment that is tailored to your specific needs. I will later describe in detail about how I am planning my withdrawal process and which sources I am using for information.

My Medication History – Why I Was Prescribed Psychiatric Drugs

Four years ago, I suffered what is generally called a psychotic break – a severe mental and emotional crisis that pushed me into total dysfunction in everyday life. In retrospect I believe the event had been announcing itself over time. In the back of my mind I had had a notion that something was wrong with me for a good while. I had not resolved various conflicts generated during my childhood and young adult life. I now believe they had kept accumulating and necessarily had to lead to a paralyzing overload someday. When the big crash finally occurred, it felt very much as if a knot that had been pulled tighter and tighter over the years had ruptured and left my existence in shambles. One could very well speak of a major seismic event in my head and heart. I could feel my mind racing, yet completely unhinged and in idle speed. Emotionally, it was such a traumatic experience that I found myself in a constant and paradoxical state of combined panic and numbness. I was convinced I was irreparably broken. 

My symptoms apparently were not easy to classify. I literally received as many different diagnoses as I saw psychiatrists: major depression, bipolar disorder, schizoaffective disorder, schizophrenia. It is true that some symptoms of mental illness are common to all of these. There are no clear divisions between one mental illness and another, and psychiatry knows no scientific test methods to determine what you are suffering from. It is up to the psychiatrist to interpret what he believes to see in you. Also, most of the doctors I visited did not dedicate more than 10 or 15 minutes to our sessions, which is evidently not enough to make qualified observations, let alone guide me out of the crisis. In fact, the doctor who helped me most and invested the biggest effort in his patients’ well-being was also the one who saw no point in sticking a label on my problem. What mattered was my recovery. Further on, I will talk in more detail about my experiences with the psychiatric discipline – both positive and negative.

Before I was prescribed medication and the psychosis was in full swing, symptoms included: racing thoughts, sleeplessness, unorganized and contradictory thinking, unstructured speaking, inability to concentrate, incapacity of taking even the smallest decisions, paranoia, restlessness (akathisia), rigid stare, exaggerated need to make contact with people in the hopes of finding support, feeling existentially uprooted. At one point, I collapsed with what I now suspect to have been a minor stroke. I could literally feel an electric explosion initiating somewhere inside my brain and engulfing all of it in a few seconds. I began feeling ice cold and fell to the ground. I almost passed out. Terrified, I forced myself to open my eyes and get up. During the following hours, my legs would fold up under me, I had to force my eyelids open because they were constantly falling shut, and my speech was out of control – I was unable to form a thought and express it. My sentences were mostly incomplete. I also had no control over which of the languages I speak came out of my mouth. Despite my insisting to the people around me that something had “happened to my brain”, they preferred to believe I was just “low on sugar”. Even the psychiatrist who saw me a few days later did not consider it necessary to examine my brain. I felt I was in the wrong hands, but was powerless and exposed to other’s decisions. I described the incident to other doctors, but none thought it worth investigating. The first time I got a brain scan was seven months later. Around that time, also my blood and my thyroid were finally checked for anomalies. Nothing was found.

The first drug I was put on was the atypical antipsychotic Zyprexa (the active ingredient is Olanzapine). It did make me sleep, which no doubt was important. Yet, overall it had numerous unfavorable side-effects which added to the psychotic features mentioned above.  The negative effects were rapid and noticeable weight gain (about 35 pounds in six months), loss of willpower, deactivation of the menstrual cycle, lack of libido, unhealthy skin, and I still had that disturbing stare and was overall unable to engage in life.

When I got hospitalized for the third and – hopefully – last time, my medication was changed to 300mg of Seroquel (an atypical antipsychotic substance called Quetiapine) and 150mg of Zoloft (the SSRI antidepressant Sertraline). This cocktail seemed to work significantly better for me, and it is what I am still taking. All psychotic symptoms have vanished. The only downside is that I haven’t been able to return to my original weight – I am still about 25 to 30 pounds heavier than I used to be before the psychotic break. I also have recurrent nightmares and all sorts of unsettling dreams, which is a known side effect of Quetiapine. Apart from that, I am leading a happy and healthy life. I have a job, a partner, friends, pets, hobbies and a good overall health. My cognitive capacities are as good as they have ever been – I am pursuing a Master’s degree and also enjoy acquiring new knowledge and skills in my free time. Nothing is missing. Luckily, I have not noticed any cognitive disabilities caused by the medication. Although everything has been going just fine, my lifestyle needed to undergo major changes. Today, I am more careful with myself than before the crisis. I have become more conscious and protective of my mental and emotional health. I didn’t really know how precious it was until I lost it! Before the psychotic break, I tended to be merciless with myself. My schedule used to be crammed with duties and I seldom allowed myself to rest. In fact, relaxing would make me feel guilty and useless. In those days, I was notorious for my iron discipline and efficiency. I was working non-stop to keep up with my obligations. Today, I am way less masochistic. In fact, I’ve begun liking and trusting myself. I now consider spare time an important and pleasurable part of my schedule. I am still a busy person, but I am more selective as to which chores I fit into my day and to which ones to say “no”. Even when things get a bit intense at times, I don’t allow stress to take over. Of all the tasks that are at hand, I figure out which should be completed first, and I focus on that one. Then, I pick the next one, and so on. Tackling challenges one by one works a lot better than looking at the huge pile of responsibilities and getting overwhelmed by it. I also find I have become more discerning as far as priorities and not-so-important matters go. Allover, I’d say I am living more consciously and more lovingly towards myself and others. Definitely, life is more fun and more fulfilling now. It is something I believe everyone should strive for – mentally ill or not.

Personally, I am certain that medication alone did not put me on this new, better path. Many, if not the majority, of my fellow patients at the clinic were just as miserable on medication as they had been without it. I believe that love, attention and spiritual support from people close to you are at least as important as the correct prescription. Also, the last clinic I was in had a tight schedule of therapeutic activities which forced the patients to remain busy and engaged in reality. The staff was available for one on one support most of the time. In my view, it was the accumulation of all these factors plus my own striving for emotional wellbeing that helped me back into life. In fact, I now feel more secure and at peace with myself than I had ever felt before the psychotic break. Why that is so, I cannot be sure.  My becoming better may be, and that I would consider the worst case scenario, the sole merit of my medication plan. It is also possible, which I hope is the true cause, that the pills have, metaphorically, pushed my reset button and thereby allowed me to tackle my old conflicts and the challenges of life step by step, until seeing me out of the worst.

The “Getting off” – Project

My name is Felicia. I am an artist and writer in my late thirties. The “Getting Off” project is about my gradually weaning off psychiatric drugs. It is intended to become a personal logbook through which I aim to document and to share:

  • Which circumstances made me start taking psychiatric drugs in the first place.
  • For how long I have been taking them and how they have affected me, both positively and negatively.
  • Why I wish to reduce dosage or, if possible, stop taking them altogether in the long run.
  • How I set up my dose reduction plan.
  • The measures I am taking to ensure my safety.
  • My experiences and observations throughout the process of progressive dose reduction.
  • The observations of significant others who actively accompany my progress.
  • Information gathered from external sources.

Creating a blog on this subject will hopefully help both me and you readers. For me, it will motivate me to be more structured and observant throughout the process of withdrawing. Thereby, I will hopefully be able to recognize both progress and setbacks when they occur, thus improving the odds of being successful and remaining healthy. The latter also implies evaluating whether a complete withdrawal is desirable at all. Depending on my reactions, I might have to be content with a dose reduction for now. Withdrawing from psychiatric medication is not an end in itself, and it is certainly not a sport. The main objective must always be general well-being. If that means I need to remain on a reduced dose, so be it.

As for you, you may be taking psychiatric drugs yourself or be close to someone who does, or maybe you just are interested in psychiatry. Possibly, you are trying to wean off your medications or planning to do so, or maybe someone in your family, a friend or a colleague is. In all of these situations, following my “Getting Off” project can be helpful for you.

In addition to my main objectives, I will be publishing articles on different aspects of mental health, or the lack thereof. Titled “Some Words on…”, these will also be vastly based on my personal experience and research, yet as an appendix I am going to list links to websites, articles and audiovisuals dealing with the topic in a more professional and objective way.

At this point, I have to stress though that this blog is NOT a substitute for one-on-one medical advice. I am not a doctor and also am not qualified to diagnose or to treat anyone. Please also keep in mind that every individual case is unique in background and in development, meaning that what works for me might not work for you, and viceversa. You and I might not even be taking the same substances, let alone the same dose. Getting Off is the documentation of my particular path. I am happy to share it and would be delighted to know that it is useful to you as complementary literature and additional support to whatever situation you have in your life.

I am very much looking forward to your company.

Yours sincerely,

Felicia