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Depression and the Holidays December 21, 2011

Posted by Crazy Mermaid in Depression, Medication, mental illness.
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Traditionally, this is the time of year that heralds short-term depression. Not clinical depression, but event-caused depression brought on by too-high expectations. For whatever reason- be it unwanted relatives, too much to do and too little time to do it in, or financial problems- life isn’t good for one reason or another.  Generally speaking, problems with families or money problems lead to a case of depression.  But make no mistake:  this kind of depression is seasonal and temporary and not as debilitating as the clinically depressed.

Major depression, or clinical depression is a serious medical illness affecting 15 million American adults, in a given year. About 8% of the population is clinically depressed at any given time, and 16% will have a bout of clinical depression in their lifetime.

Major depressive disorder is a disabling condition that adversely affects a person’s family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide  and up to 90% of people who committed suicide had depression or another mood disorder.

Unlike normal emotional experiences of sadness, loss or passing mood states, major depression is persistent and significantly interferes with an individual’s thoughts, behavior, mood, activity and physical health. Clinical depression differs from short-term depression in several major ways.  It impacts the ability to function, affecting everything from sleep cycles to weight loss or gain to not enjoying the present.

In some cases, for example if the person is genetically predisposed to clinical depression or suffers from post traumatic stress disorder, short-term depression becomes clinical depression.  While the best way to prevent clinical depression is to minimize or eliminate short-term depression, doing this doesn’t preclude the possibility of it.

I have had one bout of clinical depression. It was when I was on massive doses of Haldol when my psychiatrist tried to stop me from having horrible visions. At the time, I couldn’t get out of my head pictures of gore and even murder and the voices in my head were exceptionally loud.  When I called Dr. K’s emergency number and told him what was going on, he prescribed 5 mg of Haldol twice a day.  To give you an idea of how much Haldol he gave me, the normal dose is .5 mg once a day.  But the alternative was going back to the mental hospital, which I had only left a week  before.  So I agreed to this treatment.

After about 5 days, the feeling of clinical depression came over me, but I didn’t recognize it. At first, I couldn’t get out of bed. Then I sat around and cried.  I had no reason to cry, even crying on my 25th wedding anniversary while we sat outside at a lovely restaurant in the middle of a beautiful summer day.  After a few days of continuous crying, my thoughts turned to suicide.  I so badly wanted to take a loaded handgun and blow my brains out that I would have done it in a heartbeat had I had the guns in the house. Incidentally, one of the requirements of my release from the mental hospital was that I had to get rid of all of my guns.  As a hunter, I had two shotguns and a rifle in the house before they made me get rid of them. Now I know why.

Anyway, when I became suicidal, my sister and husband insisted that I call Dr. K to tell him what was going on.  The only thing I could think of was that I didn’t want to “bother” him so I didn’t want to call him. Finally, after they threatened to call him if I didn’t , I called him. He immediately reduced the Haldol. Funnily enough,  I was willing to commit suicide but I wasn’t willing to disturb my doctor. Go figure.

Having suffered a major episode of clinical depression, I am empathetic towards those experiencing it . I wouldn’t wish it on my closest enemy.  It wrecks your quality of life and the quality of life of those surrounding you.

I can’t get the statistics out of my head. For example,  ninety percent of people who “successfully” commit suicide are depressed.  I am more convinced than ever, given my experience, that clinical depression is actually a case of a chemical imbalance of the brain and is nothing to be embarrassed or shameful about.  Detecting it earlier gives the person a better chance of being able to control it, both by medication and psychotherapy.  I don’t know why the psychotherapy works, but I suspect it affects brain chemistry in the same manner that medication does.

In my blog, my articles are tied to search engines. They pop up when certain key phrases are written in a search engine. The saddest and scariest search engine terms I have repeatedly seen in my blog are “how to commit suicide without people knowing what it is”. Fortunately, my blog entryis more of a “prevention” article, citing all of the ramifications of the act, rather than be a “how to do it”.  But even having that term come up on my search engine term at all is sad and scary.

Keeping holiday depression away is the best way to avoid clinical depression. But if you find yourself clinically depressed, it is critical to seek immediate medical help.  A psychiatrist is preferable to a general practitioner because he is more experienced in mental disorders.  It’s like going to a gynecologist rather than a general practitioner for a pap smear.  The more cases he has handled, the better your treatment will be.  Just remember: You don’t need to have your quality of life affected by this mental illness.

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In Our Own Voice December 4, 2011

Posted by Crazy Mermaid in mental illness, NAMI, Schizophrenia.
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The National Alliance on Mental Illness is a grass-roots organization that sprang out of the accusation by the medical profession that schizophrenia was simply the result of poor parenting.  Specifically, the mothers of schizophrenics were called “schizophrenogenic  mothers”.   Eventually, after years of being blamed for their child’s illness, the women banded together to fight the accusation that they had caused their child’s schizophrenia.  That first organization eventually branched out to include all people with mental illnesses and their loved ones and friends.  The organization eventually changed its name to National Alliance on Mental Illness, called NAMI for short.

NAMI has chapters in all States, and has several different Affiliates in each State. They can be reached at http://www.nami.org

NAMI has several “signature” programs that they offer in all 50 States, including NAMI Basics, NAMI Family to Family classes, In Our Own Voice, and several support groups.  Some of the groups are geared towards people with friends or loved ones who have a mental illness.  Others are geared towards people suffering from mental illness.  Because the needs of the loved ones diverges greatly from  the needs of those suffering from mental illness,  the two groups are kept apart.

I have been involved in a program called In Our Own Voice (IOOV for short) for several years.  This program is free, and it brings people who have a mental illness in contact with groups that want to learn about mental illness.  The program is structured into five parts, and includes a DVD that interacts with the presenters as well as a question and answer session at the conclusion of the class   There are two presenters, both of whom have been diagnosed with a mental illness.  I of course am one part of the team. My partner is a practicing chiropractor.  We are a good match, since we both have had psychotic episodes.  Coincidentally, we both purchased very expensive cars while psychotic.  I have been told that we are both fascinating people to listen to during our presentation.

Anyway, our favorite presentation is the one we do in front of a Family to Family class.  The free  Family to Family classes educate family and friends of people with mental illnesses about their illnesses. Generally speaking, these people are seeking to understand what is happening to their friend or loved one and how best to help them.  It’s our favorite class to give our presentation to because the audience is so thankful that we’re there.  I’ve been told many times that our stories inspire hope that one day their loved one can improve enough to live a better life.

In my portion of the presentation, I talk about what led to my psychotic episode and what it’s like to be in a psychotic episode.  The audience is allowed to ask questions, and we are supposed to make sure that we don’t answer any questions that we think are uncomfortable.  Keeping in mind that one of my “go-to” symptoms when I get under stress is hearing voices, I am asked often whether I’m hearing voices during that presentation.  Since I am uncomfortable admitting it, I deny that I’m hearing voices, which tends to surprise the participants.  I don’t know whether they believe me, but it is a form of self-protection .

I encourage anyone interested to call their local NAMI office and request an IOOV presentation. You’ll be glad you did.

Anxiety December 2, 2011

Posted by Crazy Mermaid in Uncategorized.
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The primary purpose of hospitalization is to administer powerful drugs in a controlled environment.  As the drugs begin to take effect, anxiety builds.  Most of the drugs, including antipsychotics and mood stabilizers, have anxiety as a side effect.   The resulting synergy from each medication’s anxiety side effect produces an incredible surge of anxiety, unlike anything most of us have every known. So the secondary reason for hospitalization is to learn to control the anxiety.

Learning to control that anxiety, as it builds up higher and higher with each passing day as the medications take effect, is how patients spend their time. At the mental hospital, we take classes on it, we do exercises on it, we learn various coping methods for it.  And in the end, we even take medication for it.  But the medication is never enough, and we are limited in the amount that we can take. So we have to learn how to handle the anxiety ourselves, to the best of our ability.

Although some people live with anxiety their whole lives, in general anxiety is not on most people’s radar. They have absolutely no concept about what anxiety is and how debilitating it can be. It’s difficult to put into words what anxiety feels like, but I’ll try:  Stand up straight, legs slightly apart. Now, tighten every muscle in your body. Ball up your fists. Clench your jaw. Next, try sitting down. Can you do it? Probably not for long. Imagine feeling like this all of the time, 24/7. You can’t relax, no matter how hard you try.

If you sit down, the muscles in your legs are still tight. The muscles in your entire body remain tight.  You can bend your limbs  in the right direction, but those muscles don’t relax- ever. Your whole body, though not rigid, can’t relax. You clench your teeth. It’s exhausting.  When the anxiety gets unbearable, you feel like you’re crawling right out of your skin.

One of the most common outlets for handling anxiety in a mental hospital is to pace the halls.  Those of us with severe cases would walk up and down the halls, over and over again, trying to work out some of that anxiety.  We couldn’t stop walking for very long, because the anxiety would come back in full force if we stopped walking.  And so we continued to walk the hallways, over and over again.  We walked miles every day, one foot in front of the other, up and down those carpeted hallways.

Everything that we did there was structured to teach us how to cope with that anxiety. Group therapy sessions discussed and sometimes actually showed us how to handle stress and anxiety. There were physical steps we could take with our bodies- everything from squeezing the flap of skin between our thumb and index finger to massaging our finger of choice to controlled breathing. Then there were steps we could take that weren’t direct acts upon our bodies. We could blow bubbles, color in coloring books or on blank white sheets of paper, watercolor, or do jigsaw puzzles. There was also aromatherapy. Lavendar was the favorite. But walking the halls was the single most valuable outlet for handling anxiety.

Unfortunately, the building’s psych ward wasn’t built with our anxiety side effect in mind.  The hallways were about 10 feet wide and about 50 feet long. So only a few of us could fit comfortably at a time.  Sometimes it got a little crowded with all the people pacing.  But when you’re that anxiety-riddled, pacing is your only option and crowded hallways are the least of your worries.

I seriously considered taking up smoking at the hospital because I heard from some of the other patients that it would help me with my anxiety. My mental hospital was the only one in the State to allow smoking, even going so far as to supply the tobacco and rolling paper for the homeless people who had no money to buy cigarettes.

Anyway, once I became convinced that smoking would help my anxiety, I actively tried to take up smoking, but my nurse/guard did everything she could to discourage me.  In the end, because she made it almost impossible for me to start smoking, I didn’t take it up.  I’m eternally grateful to her.

Before my breakdown, I went to sleep the minute my head hit the pillow. But with all the medication I was taking, sleep just wouldn’t come. The anxiety was just too powerful. Sleeping pills were discouraged long-term because they’re so addictive. So access to them was very restricted.

When I was released from the hospital in the care of my psychiatrist, he started right in trying to treat my anxiety so that I could sleep.  He pointed out that lack of sleep would put me back in a manic stage and I would have to return to the hospital.  Understandably, I became extremely anxious about trying to get enough sleep. So anxious that it affected my ability to sleep. I would lay awake until 2 am, knowing that if I didn’t get to sleep I would get manic. The anxiety was so bad that I would lay in bed trying to get to sleep, my teeth clenched so tightly that my jaws hurt. So we (my psychiatrist and I) worked on finding a way to get me to sleep and keep me asleep.

Over a period spanning many months, “we” went through many different drugs looking for one that worked.  I would buy one (expensive) drug, take it for a few weeks and abandon it when it didn’t work. Then I would buy another (expensive) drug and take it for a few weeks, abandoning it because it didn’t work. On and on it went, racking up hundreds of dollars for drugs that didn’t work. Finally, we found Seroquel. It’s an anti-psychotic that also acts as an anti-anxiety drug for me, and I can take up to 400 mg of it if I have to.  Although I take just 200 mg of it at night, just knowing that I can take up to 400 mg makes getting to sleep much easier.

Fortunately for me, I didn’t become addicted to sleeping pills or start smoking.  I’m learning other ways to handle my anxiety.