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

 

Why Wean off Psychiatric Medication?

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

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

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

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

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