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

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

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

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

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

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

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

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

Websites

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

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

 

Audiovisuals

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

 

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Some words on: Inspiration and Creativity

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

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

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

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

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

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

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

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

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

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

Websites:

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

Some Words on: The Sickliness of Hospital Settings

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Websites:

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

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

 

Articles:

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

Audiovisuals:

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

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

Some Words on: Mental Illness as a Sales Hit

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

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

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

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

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

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

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

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

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

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

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

The following are links you can learn more from.

Webpages:

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

Articles:

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

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

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

Audiovisuals:

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

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

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

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

 

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.

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