Some Words on: Nightmares and Restless Sleep on Psychiatric Medication

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

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

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

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

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

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

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

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

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

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

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Some Words on: Drug Interactions

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

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

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

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

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

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

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

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

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

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

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.