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“Rules” At Mental Hospital March 5, 2015

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, Uncategorized.
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Fairfax HospitalNAMI (National Alliance on Mental Illness) has a few signature programs for people living with a mental illness. One such program is a series of 10 classes called Peer to Peer. The classes are designed to help people with a mental illness understand their illness better and build a fulfilling and satisfying life. All classes and programs are free, and are led by volunteers. The Peer to Peer class is led by two people who are successfully living with a mental illness. NAMI Snohomish County is holding their first ever Peer to Peer class, and last night was Class 9.
In that class, we discussed a stay in the mental hospital, which most people in the room were familiar with, including me. The focus was on the “rules” of the stay. Some are known, and some are not.
One of the biggest “rules” was how long the stay was going to be. Although there are guidelines, there are no hard and fast “rules”. During my hospital stay, I was told by several patients who had been in the revolving door of the hospital that their average stay was 2 weeks. But no one in authority gave me any indication of how long I would be there. When I point blank asked my psychiatrist daily, he was cagey about this point. He wouldn’t even give me a ballpark number. I was held, against my will, in a mental hospital and no one would tell me when I could leave- or even what I had to do in order to be released.
In the days before I was involuntarily committed, I was supposed to be helping my best friend, Becky, move from her home in Washington to Minnesota. But as the day of her move got closer, my psychotic episode worsened. I was supposed to help her drive back to Minnesota the day I was hospitalized. In retrospect, the added stress of her move was the straw that broke the camel’s back.
But the nature of my psychotic break was such that I suppressed the memory of helping her move.
Unfortunately for me, about all my psychiatrist had to go one was this one thread of information. My husband told the people at the hospital emergency room that I was supposed to be helping my friend move, so that’s what went on my chart. My psychiatrist read the chart, and, absent much else, laser focused on that one fact and built a treatment plan around it.
Day after day, my psychiatrist tracked me down and asked me the same question: Who was I supposed to be helping move?
I was bewildered by this question. I had no memory of anyone I knew moving, much less helping anyone move.
After a few weeks of this, I figured out that the answer to the question was my passport out of the place. But I couldn’t figure out the answer, much as I tried. My mind was blank.
Eventually, I came to believe that my husband and sister were having an affair (not true), and that they were keeping me locked up so they could continue. I even told my theory to my psychiatrist, who didn’t seem convinced.
After every one of our “sessions” where he asked me the question, I asked him when I was going to be released. He told me he didn’t know, but that I would be there awhile longer.
I realize now that my psychiatrist was using my ability to remember that event as some kind of “wellness” gauge. In his defense, he had very few tools at his disposal. All he knew was what was written on my chart.
As it turns out, my hospitalization was a good thing, but I didn’t see it that way until months later, when I was in recovery. My civil rights were violated, and no one explained why. There is no written documentation that I was ever told I was being held because I was a danger to myself or others. And although you aren’t supposed to hold someone involuntarily because they don’t remember who they were supposed to be helping to move, that is in fact what happened to me. Oh yeah: and I wore gold clothes.
Apparently my psychiatrist picked up on the fact that I favored gold colored clothes. When I figured this out based on some comments he made, I switched to blue and turquoise colors, and he noticed. But it wasn’t enough to get me released.
Even the day before I was released, my psychiatrist told me I would be there awhile longer after he asked me the question I had no answer for. I didn’t believe my court-appointed attorney when she told me I would be released the next day, because my psychiatrist told me something different that morning. I didn’t know who to believe, so I chose to believe my psychiatrist because I thought he had the most power. As it turns out, he didn’t.
Although I understand the difficulties of treating someone in my condition, I feel my case was mismanaged.

Schizophrenogenic Mothers and Mental Illness March 13, 2011

Posted by Crazy Mermaid in mental illness, Schizophrenia.
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In reading a mainstream article in a mainstream publication about Eleanor Owen, the founder of Washington State’s National Alliance on Mental Illness (NAMI), I  was shocked that mental illness, especially schizophrenia, had come out of the closet enough to warrant front page news on a Sunday morning. The article made reference to a term that I had heard once before. Schizophrenogenic mother was, according to a March 13, 2011 article in Pacific Northwest Magazine, a title that Eleanor Owen was tagged with back in the late 1960’s. What, I wondered, was a schizophrenogenic mother?

It turns out that  “schizophrenogenic mother” was the term given to the mother of a schizophrenic. It meant “a woman who was blamed by psychiatrists for her child’s schizophrenia”. Viewed as the cause of her offspring’s illness, she was blamed because of her poor parenting skills for her child’s terrible affliction. In fact, up until the late 1970’s this was mainstream thought in the world of psychiatry. How did this come to be?

In the early 1950’s, a man named Dr. Theodore Lidz wrote a book called Schizophrenia and the Family. In that book, he expounded his theory that schizophrenogenic mothers were responsible for their child’s affliction. They were, the theory went, too self-absorbed and dominating, and the result of their behavior was that their child became schizophrenic. Other psychiatrists jumped on the bandwagon, and the theory took on a life of its own.

This theory was the dominating one from the mid-1950’s through the late 1970’s. In fact, even as he lay on his deathbed in 2001, Dr. Lidz continued to maintain that psychiatry was going in the wrong direction by focusing on medication rather than psychotherapy in the treatment of this disorder.

The results this mainstream thought that the mothers were the problem was threefold.

First of all, the parents of schizophrenics had a tremendous quantity of guilt added to their already heavy burden of dealing with their child’s symptoms.  Rather than obtain the support of their friends and families as they went through the trying times of dealing with the symptoms of the illness, the parents, especially the mothers, became social pariahs.

Additionally, it goes without saying that if the child’s childhood was causing the illness, then the solution was to remove the child from the household so that he could “heal”. Instead of getting the needed psychological support of their parents, these children were taken away from them. It goes without saying that the emotional damage done to those children was enormous.

Lastly, research money for schizophrenia dried up. Why bother looking for answers that you already have?

Fortunately for the rest of us, a few of these “schizophrenogenic” parents banded together, convinced that psychiatry had it wrong. As the band of parents got larger and larger, they formed a formal group, dedicated to getting a better understanding of mental illnesses. In Washington State, Washington Advocates for the Mentally Ill was born, with the help of Eleanor Owen. Eventually this group would change its name and team up with others across the country. You might know this group as National Alliance on Mental Illness (NAMI).

Partly as a result of the efforts of this group, in the late 1970’s  it became fashionable once again to actually search for answers. What was the cause of schizophrenia? Why did it appear to run in families? What are effective treatments of the symptoms of the illness?  Can there ever be a cure for it? Money and effort was expended to help answer these questions and more.

The result is that almost everyone in the world now believes that schizophrenia is a brain chemistry disorder rather than a sign of a broken childhood. Parents are once again free to give comfort to their ill children. They’re not social pariahs any more. They aren’t blamed for their child’s illness. And drugs have been found to help relieve many if not most of the symptoms of the illness. People who were once relegated to a life of horrible symptoms are now able to live a worthwhile life.

Thank you, NAMI, and thank you, Eleanor Owen.

(Note: This story is documented in the PBS documentary When Medicine Got It Wrong)

I’m Not Crazy February 11, 2011

Posted by Crazy Mermaid in mental illness, Schizophrenia.
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Many people sing the words of songs without considering what they really mean.  Had people stopped to consider the lyrics of certain popular songs about mental illness, I doubt the songs would have made it onto the pop charts.  One such song that slipped between the cracks was by Matchbox 20, called I’m Not Crazy.  When you really listen to the words, you realize that the song is about a paranoid schizophrenic going through a psychotic episode.

While I was going through my psychotic break, I latched onto the song, singing along to it with my imaginary friends to and from work.  Although I didn’t consciously consider the possibility that I was crazy, my subconscious must have entertained that thought, because it became my favorite song.  I didn’t realize the true meaning of that song until after my psychotic break. I was stunned when I first truly listened to the lyrics.

Here, then, are the words:

I’m Not Crazy I’m Just A Little Unwell
I Know Right Know You Can’t Tell
But Stay Awhile And Maybe You’ll See
A Different Side Of Me
I’m Not Crazy I’m Just A Little Impaired
I Know Right Now You Don’t Care
But Soon Enough You’re Gonna Think Of Me
And How I Used To Be…Me

Talking To Myself In Public
And Dodging Glances On The Train
And I Know…I Know They’ve All Been Talking About Me
I Can hear Them Whisper
And It Makes Me Think There Must Be Something Wrong With Me

Out Of All The Hours Thinking
Some How I’ve Lost My Mind

I’m Not Crazy I’m Just A Little Unwell
I Know Right Now You Can’t Tell
But Stay Awhile And Maybe Then You’ll See
A Different Side Of Me

I’ve Been Talking In My Sleep
And Soon They’ll Come To Get Me
And They’re Taking Me Away

[ From: http://www.metrolyrics.com/im-not-crazy-lyrics-matchbox-20.html ]

Penny Smart, Pound Foolish: Stopping funding for Mental Illness Medication November 28, 2010

Posted by Crazy Mermaid in Health Insurance and Mental Illness, Healthcare, Medication, mental illness.
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Today I went to the pharmacy to pick up my 30 day supply of prescriptions for my mental illness.  My prescriptions consists of Geodon, Lamictal and a few other drugs. My total bill for 30 days of medication was $1057 per month. Multiplying that out by the number of months in a year, I spend $12,684 for a year’s supply of medication.

Then there’s the psychiatrist visit. If – and this is a big if- I don’t have any major emergencies like hearing voices, I can get by with seeing him about every 4 weeks or so.  That’s about $250 a month.  Then there’s my therapist.  She runs $125 an hour. I see her twice a month. $250 (it used to be weekly until the bill got too expensive).   Between my therapist and my psychiatrist, I spend another $500 a month for their services.  Don’t get me wrong: they’re worth their weight in gold.

The grand total for a year of care is $18,684.  With a price tag like this, it’s easy to see why medication for mental illness is an easy target for a Legislature turning over every rock trying to find ways to cut their budget. But doing so would be penny-wise and pound-foolish.

People who are used to having their prescription drugs paid for by Medicaid, will no longer be eligible for those drugs if these budget cuts go into effect. So what will the net result of this change be?

A significant portion of people with severe mental illness are on disability. Surviving on less than $12,000 per month, they will no longer be able to afford their medications or therapy. Heck, they would have to spend more than what they make in a year on medication if their subsidies went away. Impossible.  They will have to go without.

What does that mean for society as a whole?  It means that we will have a significant percentage of the severely mentally ill off their medications.  Although having the State pay for drugs for the mentally ill appears to be for the benefit of the person with the mental illness, in fact this is a matter of public safety.

Unlike someone who needs medication to thin their blood, a person with a severe mental illness won’t die if the drug coverage is discontinued. They won’t bleed to death or go into a coma without the drugs. So it’s attractive to the cash-strapped Legislature to cut out prescription drug coverage for the mentally ill from their budget. At a cost of thousands of dollars per person, it seems a logical way to save money.

But I hope the Legislature wakes up to this fact before it’s too late: mentally ill people need their medication for public safety reasons. If they’re disabled, they won’t be able to afford their medication without subsidies from the Government. They’re essentially unemployable because of their debilitating illness. They have no reserve of funds, living on the edge of poverty because of their disability.  Without Government interference, there’s simply no room in their meager budget for medication.

The Legislature needs to understand that the medication for the mentally ill is needed as much as or perhaps even more than someone who takes drugs to thin their blood.  If the guy needing blood thinners goes off his medication, there’s a good chance that he will suffer severe symptoms, including the possibility of his death. That isn’t the public’s and the Legislature’s perception of drugs for mental illnesses.

In fact, the un-medicated mentally ill are going to be much more expensive than the medicated mentally ill. Take me, for example. Without my medication, I would be in my own world, disconnected from my family and friends, lost in my own mind. I would once again be that mermaid, disrobing in public.  Trees would talk to me. I would once again believe I had ESP. But the main problem is that without my medication I would become a danger to society.  Believing that zombies are after me, or that I’m being held hostage or numerous violent scenarios will cause me to strike out at whoever tries to subdue me.

Imagine what the world would be like if suddenly all the people with severe mental illnesses- bad enough to be on disability- went off their medication at the same time.  What if the people on antipsychotics stopped taking them after their “free” supply ran out?  All of those psychotic people concentrated in Washington State won’t go quietly off their meds. They need those drugs to prevent their return to a psychotic state.

Washington State has the fewest hospital beds per capita in the Nation, so it’s not like we’ll have any room for the mentally ill in the mental hospitals. If they can get in, mental hospitals cost around $3,000 per day. But  before they go there, they’ll pass through the doors of a “real” hospital- likely the understaffed, overcrowded, cash-strapped emergency room. Think of it: a person in a psychotic state in a room full of sick people.

If they commit a crime, which many are likely to do, they will swamp the legal system and the jails. Police taking on the task of dealing with this situation will short-change other areas of their responsibility.  If you think medication is expensive, think about how expensive incarceration is. The last figure I remember reading is about $50,000 per year.

And what about the mentally ill people who injure others? A paranoid schizophrenic without medication will not be a pretty sight. Won’t those injured “sane” people and their loved ones appreciate what a good job the Legislature did by saving all that money?

I hope that the legislature comes to its senses before cutting those drug benefits.  I hope they recognize it for what it would be: a public health crisis.

Mental Illness Medication Side Effects October 12, 2010

Posted by Crazy Mermaid in Medication, mental illness.
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Friends and loved ones of those with a mental illness have a hard time understanding noncompliance with medication.  Why, they reason, if the drug helps control the symptoms of the mental illness, doesn’t the mentally ill person take the medication?

One of the biggest reasons for noncompliance is the side effects of the drugs. Especially for those with more severe cases, the side effects of strong doses of medication can cause horrific side effects. So horrific, in fact, that the patient makes the conscious decision to stop taking the medication to avoid those side effects. Living with the mental illness becomes more appealing than living without it.

In order to get an understanding of exactly what those horrific and debilitating side effects are, I have highlighted the ones that affected me when I became medicated.  Although these side effects settled down after about 4 to 6 months, there was no way of knowing exactly how long I would have to put up with them. As it turns out, six months is a long time to live with them. And in some cases, such as non-Parkinson’s, there was the possibility that the side effects would become permanent.

I can safely say that were it not for the patience, cajoling, and encouragement of my family, I, too would have joined the ranks of those who refused to take their medication due to the debilitating side effects. Here, then, is a look at some of those side effects that I personally experienced.

Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements, such as grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the extremities may also occur. Impaired movements of the fingers may also appear. Patients with tardive dyskinesia have difficulty not moving.

Tardive akathisia involves painful feelings of inner tension and anxiety and a compulsive drive to move the body. In the extreme, the individual undergoes internal torture and can no longer sit still. It is a syndrome characterized by unpleasant sensations of “inner” restlessness that manifests itself with an inability to sit still or remain motionless. Akathisia may range in intensity from a sense of disquiet or anxiety, to severe discomfort, particularly in the knees. Patients typically pace for hours because the pressure on the knees reduces the discomfort slightly, then they sit or lie down, because of fatigue in the knees. The feeling is there from wakeup in the morning to sleep at night.  High-functioning patients have described the feeling as a sense of inner tension and torment or chemical torture. (Note: this made me feel like I was going to crawl out of my own skin).

Non-Parkinson’s disease mimics Parkinson’s Disease, which is  a degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills, speech, and other functions It is characterized by muscle rigidity, tremor, postural abnormalities, gait abnormalities, a slowing of physical movement (bradykinesia) and a loss of physical movement (akinesia) in extreme cases. (Note: this was absolutely horrible.  I have a new understanding at how those with Parkinson’s must feel, and how lucky I am to have come out of it without permanent symptoms).

While research is underway to find medications with fewer side effects, the process is slow, cumbersome and expensive. But with newer therapies able to target specific regions of the brain through the application of relatively new brain imaging techniques to subjects, I hope that progress in this realm can be sooner rather than later.  Because if we can reduce the degree of debilitation of side effects of medication, we can increase the number of people willing to stay on their medication regimen.  Imagine what the prison population and homeless population would look like if the mentally ill currently among them were to become medication compliant. How different this world would be.

LSD and Mental Illness October 8, 2010

Posted by Crazy Mermaid in mental illness, Mental Illness and Medication.
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Everyone knows that LSD is a dangerous drug, capable of driving us out of our minds.  We’ve heard this refrain all of our lives:  LSD is the most dangerous of the dangerous drugs. Stay away from this drug at all costs.

But new evidence suggests that we reconsider this idea. It’s quite possible that this drug is a solution rather than a problem. Instead of driving us out of our minds, new evidence suggests that LSD is capable of restoring a sense of sanity to the insane.

Even in the early 1960’s the drug began to change the face of psychology as we know it. Prior to this, it was common “knowledge” that mental illness was caused by environmental factors.  For example, bad parenting, the theory went, was responsible for schizophrenia.

But LSD’s ability to induce psychotic symptoms in otherwise perfectly normal people gave rise to the concept that chemical changes in the brain were causing the psychotic symptoms characteristic of certain mental illnesses such as schizophrenia.  A paradigm shift in thinking about mental illness resulted, and we began to seek solutions to the terrible symptoms of mental illness in pharmacology.

So how did a drug with so much possibility end up on the short list of the most dangerous drugs in the world?

First synthesized in 1938, the drug was made illegal in the United States in October 1968 after it became synonymous with out-of-control counterculteralism of the 1960’s.  The last FDA approved human study with LSD, for use in dying cancer patients, ended in 1980. Even Switzerland stopped its use in 1993.

But today, we are reconsidering the advisability of this action.  Banning a promising drug because of social unrest associated with it seems unwise at best and foolish at worst. As it turns out, current research points to successful use of LSD and other psychotropic drugs to reduce the clinical symptoms of mental illness such as bipolar disorder, schizoaffective disorder, and schizophrenia.

In the mid-1990’s Franz Vollenwider’s research showed that LSD, combined with behavioral therapy, could alleviate the symptoms of various psychiatric disorders such as schizophrenia and bipolar disorder. With the ability to study the effects of the drug using new tools such as functional magnetic resonance imaging, scientists are now able to use the new technology to see which areas of the brain are specifically affected by the psychotropic drugs. With this new knowledge, they will be able to make inroads into new treatment options for mental illness, including the administration of LSD.

It’s time to dust off the medicine cabinet and take another look at LSD and other psychotropic drugs. This is 2010, not 1960. We can’t afford to hold possible cures to mental illness hostage to long-ago prejudices.


Suicide and Mental Illness August 19, 2010

Posted by Crazy Mermaid in Medication, mental illness, Mental Illness and Medication, Psychiatrists, Suicide.
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While at the NAMI Conference this past weekend, I was exposed to the concept of suicide in all its forms except for one.  With the exception of seeing someone actually commit the act in front of me, almost all other aspects were covered in some form by someone or something at the conference.

There was the mother/daughter team that dealt with attempted suicide many times as a symptom of the daughter’s bipolar disorder.  There was the wife who serenaded us about her survival from her husband’s unexpected suicide. There was the daughter whose father committed suicide during the filming of a documentary about him (“Unlisted”).  There was the woman whose son committed suicide (“When Medicine Got It Wrong”).  Suicide was everywhere. There was even a booth addressing the various aspects of suicide, all from the standpoint of the family.

Missing was in-depth coverage of suicide from the perspective of someone who considered it or tried it.  I know these people are around.  I qualify for the first part and know people who qualify for the second part.

Back in July 2008, after I was released from the mental hospital, I had a major relapse of symptoms.  The choice I was given by my psychiatrist was to either return to the mental hospital or go on a drug called Haldol.

Wishing to stay out of the hospital at any cost, I chose the Haldol. I should have had a clue about the task I was to undertake (stopping the psychotic symptoms dead in their tracks) when I had trouble filling the prescription.  The usual dose carried by pharmacies is .5 mg.  My prescription was for 5 mg.  Calling around to various pharmacies, we finally found a Fred Meyer pharmacy that carried the dose I needed.

Taking the pills the second I got in the car, I felt the symptoms subside within hours.  But the prescription said to continue the Haldol beyond the point that the symptoms disappeared.  As I continued the Haldol, I became more emotional, crying at nothing at all.  My husband took me to a very nice restaurant for our 25th wedding anniversary, and I could do nothing but sit across from him and cry. Fortunately it was summertime, so I had an excuse for wearing dark sunglasses. It was a miserable time for both of us.

At around the second week of taking the drug, I got the twinge of a desire to commit suicide. As the days progressed, my desire got stronger. I cried and cried, wanting desperately to end my life.  I spent hours thinking about the method I would use to do it.  That was my sole focus. My guns were gone, confiscated by my dad as a condition of my release from the mental hospital.  I didn’t think I could get away with a knife because someone would stop me.  The same went for pills. I was stymied. I didn’t care one ounce about the people around me, who it would hurt, what kind of a terrible wake it would leave behind me.  None of that mattered.  All that I could focus on was how good it would feel to be dead.

In the meantime, my psychiatrist had given me his emergency telephone number during my first visit with him a month before, with strict instructions to use it to contact him during a crisis. Interestingly enough, I didn’t want to bother him with my crisis. Despite my family begging me to call him, I repeatedly refused to call him to tell him about what was going on.  As I lay there suffering, my family swarmed around me, not knowing what to do.  They were helpless.  They were scared. They wanted to make the emotional pain go away, but they didn’t know how.

Finally, I was persuaded by my husband and sister that this was precisely the condition my doctor meant when he gave me his emergency number. So, after much cajoling, I made that call to my doctor. But he didn’t answer the phone immediately.  So I left him a message, and then I got up from the couch that I had been sitting on and walked around the room.  I felt a little better after having made the call, but I still felt like committing suicide.

Besides imparting the urge to commit suicide, one of the other side effects of Haldol was that it increased my anxiety level. Not able to just sit around and wait for his call, I decided to take a walk.  I thought the activity would be good for me.  My family didn’t know whether to leave me alone while I went on the walk, fearful that I might find a way to commit suicide while I was out.  In the end, they decided to let me go for the walk unaccompanied.  In hindsight, I realize that their decision could have been a huge mistake had I realized that all I had to do to die was to step in front of a moving car.

In the meantime, while I was on my walk, my doctor called. As I wasn’t there to take the call, he talked with my husband instead. He probably did a better job of explaining what was going on, being more objective that I could have been. When I returned from my walk, my husband told me the doctor said to stop the Haldol immediately.  As I discontinued the Haldol, it left my system over a period of days.  As it left my system, my suicide desire gradually left.  But my family couldn’t be sure exactly when I was out of danger, so they continued to swarm around me, trying to assess when the danger was gone.  Finally they satisfied themselves that I was out of danger and life returned to normal.

Having lived through this episode of wanting desperately to commit suicide due to a reaction to a medication, I am convinced that most, if not all, suicides are caused by brain function impairment of some sort.  The brain chemistry of the suicide victim gets messed up, just like mine did.  But the difference is that they aren’t put on “suicide watch” and aren’t under the care of an experienced psychiatrist. Those two things are what saved my life.

Mental Illness and Smoking July 29, 2010

Posted by Crazy Mermaid in Mental Hospital, mental illness, Mental Illness and Medication, Smoking and Mental Illness, Stress.
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Not a smoker myself, I had the luxury of watching the etiquette of cigarette smoking unveiled right before my very eyes as I roamed the small courtyard at our 15 minute cigarette breaks during my three week stay at “Hotel Fairfax”, the mental hospital.

Without the luxury of time afforded their rich brethren with their ready-made cigarettes like Camel and Virginia Slims, the homeless patients- who comprised more than half the mental hospital population- managed to use their ingenuity and creativity to make cigarette rolling into an art form, combining speed and efficiency.  It was fascinating to watch a patient impress his rolling technique with his own personality. Some rollers – mostly men- fancied thick, squatty joint-looking rolls. Others- mostly women- preferred thinner, more ladylike looking cigarettes. Each cigarette had its own distinct look. It was amazing how much variety could be squeezed out of the same ingredients. Who knew that tobacco and rolling paper could be formed into so many individual shapes while still retaining their purpose?

As a nonsmoker, I was initially offended by this dichotomy: serving cancer sticks to the ill seemed morally bankrupt. Later on, I came to understand the stabilizing influence of tobacco. Its anti-anxiety effects became crystal clear to me as I watched the nicotine-deprived mentally ill patients visibly calm down after the administration of a cigarette or two.  Forcing a psychotic patient to suddenly stop smoking was not good medicine, I came to realize. Besides, if the nicotine was looked upon as an anti-anxiety drug, then its administration to a suicidal patient became an action similar to administration of morphine to a cancer patient. Side effects, in other words, are relative.

Watching the daily calming influence of nicotine became a siren call for me to take up smoking, much to my husband’s chagrin.  His daily visits, usually during smoke breaks, were spent watching me learn to roll cigarettes, and then having to listen to my explanation of why I was going to start smoking. To his credit, he neither discouraged nor encouraged me, sensing that any direction whatsoever to a psychotic mentally ill person- especially his wife- would be useless and even counter-productive.

My announcement to the nursing staff of my intention to start smoking was met with less than enthusiasm. The nursing staff, viewing my intentions as simply another manifestation of my mental illness, did everything they could think of to discourage me from lighting up. But the reality was that the same tobacco and rolling paper the homeless used was also available to anyone who wanted to start smoking. Even me.

My anxiety, from the medications as well as the illness, was enormous. Unbearable, even. It was so awful that I would do anything, try anything, to alleviate as much anxiety as I could.  The prospect of dying of lung cancer paled compared to the anxiety of desperately wanting to crawl out of my skin. If smoking would relieve even a small portion of that horrible anxiety, I reasoned, then the price was more than worth it.

While not outrightly engaging in any sort of discriminatory behavior, the nursing staff nevertheless managed to communicate their dislike of smoking, stopping short of suggesting to the smokers that it might be a good time to quit. They realized the very strong stabilizing effect of tobacco on their charges’ psyche. But while they didn’t actively engage in trying to get people to stop smoking, Hell was going to freeze over before they were going to allow a non-smoking patient to take up smoking.

Their first line of defense was to try to reason with me.  Didn’t I realize that the reason the drug (tobacco) calmed people down was because it was a “fix” from the habit of smoking? That it really didn’t alleviate anxiety like the anti-anxiety pills did?

But I wasn’t buying any of their bullshit. They were lying to me.  I was convinced the drug really was like an extra dose of the anti-anxiety pills. Besides, the doctors limited the number of pills we could take, but not the number of cigarettes we could smoke. It was, I believed, like getting an extra dose of Klonopin.  Besides, all my new friends smoked.

In the end, I couldn’t make my mind up whether to start before I was discharged from the hospital. Once out of the smoking environment, I totally forgot about my desire to take up smoking. Besides, the tools- the tobacco, paper, and rolling machine- were no longer at my fingertips.

M medication is stabilized and I no longer have that incredible surge of anxiety through my system…most of the time.  Although I am glad that I never took the habit up, I no longer pass judgment on the smokers of the world.

My Own Voices Return (Again) July 7, 2010

Posted by Crazy Mermaid in Hallucinations, Hearing Voices, mental illness, Mental Illness and Medication.
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My sleep cycle got off a few days ago when we were camping.  I was sleep-deprived more or less when a 1 ½ year old boy belonging to one of the families we were with kept waking up about every 2 hours during the night. Combined with the inconvenience of sleeping in a tent in a strange place, my sleep and my schedule took a severe beating which meant that my stress level increased proportionally.  Not surprisingly, I began hearing voices again.

Although hearing voices would be scary to the average individual, someone like me, who has a history of hearing voices, isn’t frightened by them for several reasons. The first reason is that they’re relatively comfortable- like an old shoe. I’ve had them before, and I will probably have them again.  Secondly, thanks to my wonderful psychiatrist and counselor, I know that with proper treatment they will go away. Just how severe that treatment has to be to get them to leave is the real question.  Can I just reduce the stress and make them go away by myself, or do we need to escalate treatment up to the Haldol level or commitment to the mental hospital level?

Whenever I hear voices, I have an agreement with my family and physician. I must always tell my husband and sister, whether I want to or not. I realize that not telling them is a slippery slope, leading me back to the point where I once again get comfortable with them.  I want to discourage that mindset as soon as it starts to rear its ugly head.

Regardless of my own relative lack of concern, learning that I’m hearing voices again is always scary from my family’s perspective. Besides my family’s fear factor, one of the more unfortunate and upsetting points about hearing voices (for me) is that once again I have to come face to face with the fact that I have a mental illness.

Before the camping trip, I was feeling so good that it was easy to convince myself that I was no longer mentally ill.  Maybe, in fact, I had never really been mentally ill. Maybe it was all a mistake. Based on the relative stability of a couple of weeks or months,  I had convinced myself that I no longer needed any counseling and that soon I would be going off my meds entirely.

But now with this latest episode bringing back the voices, I must once again confront the fact that obviously am not “cured” like I thought I was, and that’s a major disappointment for me.   I really had myself convinced that I wasn’t sick any more.  I believed that I had grown out of my illness (or was misdiagnosed), and that very shortly I would be going back to my old way of living and working.   I thought I didn’t need my medications anymore because I was no longer mentally ill.  Things were going so well before the camping trip vacation that I really thought I had the illness under control and maybe whipped for good.  It was so nice to feel that good, looking forward to an illness-free future.

My latest episode of hearing voices returns me back to the point where once again I have to acknowledge that I have a mental illness and that I have certain limitations in my daily living.  I have to adhere to those restrictions or else I will find myself going back into my old psychotic ways.  Because I took action right away, although the voices came back, they weren’t nearly as loud and dominating as they used to be.  But when they returned, I realized that if I didn’t do something about them (get more sleep and reduce my stress levels as much as possible) the voices would increase in loudness and frequency, and it’s possible that I would find myself hospitalized once again.

And so yesterday afternoon I began my program of doing nothing, and today I continued that program.  The only thing I accomplished today was doing a blog on anosognosia, which is the inability of a person with a mental illness to realize they are ill.  It’s ironic that I did that blog, since I believed based on my own personal lack of symptoms for several weeks that I no longer had a mental illness. Because I had been symptom-free for so long,  I was so sure that I was no longer mentally ill that I was prepared to stop my medication because I believed that I was close to being “cured”.

It’s easy for me to understand how someone with a mental illness can be in denial.  It’s  a lack of symptoms kind of thing.  I think that’s what a lot of people on medication get caught up in.  It’s a logical point: If I take medication and I get better, then I actually get well entirely and no longer need that medication. Therefore, I can discontinue its use and return to my old way of life. It’s a cause and effect thing. No symptoms for a certain amount of time means that I am no longer ill.  It’s such a symptom-driven illness that the absence of the symptoms indicates an absence of the illness itself.

And so, it’s not particularly surprising to learn that roughly 70 percent of people with mental illness stop taking their medication at some point in their life.  We so badly want to be cured that we wish ourselves into being cured.  In my own case, I was really, truly symptom-free for weeks  (which is forever in the mental illness realm).  No voices, not even a hint.  And with a little lack of sleep and stress, a cocktail of mental illness symptoms raised its ugly head.  That fast.

Of course, going off my medication, had I decided to go that route, would have doubtlessly put me back into a severe case of psychosis, bringing me to the point (possibly) of hospitalization.  At the end of the day, I would have returned to a much stronger cocktail of medication designed to make the psychosis, whatever its form, go away, along with the voices that would surely accompany it.  It likely wouldn’t have taken me long to fall back into that abyss of voices and psychosis. And what a horrible thing that would have been to do to my family.  So I’m glad that I had that little episode while camping. It kept me from having bigger problems than just a few voices.

Out-of-Body Experiences and Brain Chemistry May 5, 2010

Posted by Crazy Mermaid in Delusions, Hallucinations, Medication, mental illness, Mental Illness and Medication.
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During the course of my psychotic break with reality, I experienced a deep understanding of God and the Universe. As part of this experience, my sense of “self” expanded to include the entire universe and everything in it, including God.  I was literally One with the Universe.

As the hospital personnel administered increasingly larger doses of antipsychotics and mood stabilizers in an attempt to snap me out of my psychotic state, the medication brought my sense of “self” back inside the physical confines of my body.  My sense of Oneness with the Universe was gone, replaced with a sense of containment inside the constructs of my human body.

As the medication continued to course through my bloodstream in ever-larger doses, it eventually built up to a point where my sense of self was removed from my body entirely.  I viewed my body from a point about a foot above my head at a 45 degree angle, experiencing life as an observer.

Complaining of this symptom to my psychiatrist, he knowingly shook his head, declaring it a side effect of the lithium. Reducing the dosage of lithium and eventually replacing it with a different drug served to return my “self” back into the confines of my physical body, where it continues to reside to this day.

Based on my experience, it is clear that we can induce an expansive sense of self as well as a minimalist sense of self in the same person using chemistry.   The expansive self incident was induced by stress-related changes in brain chemistry, while the minimalist incident was induced by direct injection of a drug that changed my brain chemistry.  Both incidents were two sides of the same coin.

Illegal drugs are another route to induce either an expansive sense of self or a minimalist sense of self, as evidenced by the popularity of drugs like LSD. In fact, when I have relayed my psychotic experience to acquaintances that ingested LSD, they said the stress-induced state of psychosis I experienced is almost identical to the drug-induced state of psychosis they experienced.

Some acts, such as meditation and talk therapy, help a person get a more expansive view of themselves and the world around them which seems to change their brain chemistry (for the better).  Yoga acts something along these lines, helping the individual bridge the gap from containment inside the physical body to expansion of the “self” beyond the boundary of the physical body.

It’s well-known that some people experience an out-of-body sensation while in surgery, viewing the action from outside their bodies.  The chemical changes in their brains from the drugs used in the surgery are the obvious culprits. I experienced the same phenomenon as a result of antipsychotic and mood stabilizer drugs I took. It’s easy to discount the out-of-body experience as not legitimate.  And yet let us not discount the reality of the experience by saying that it isn’t “real” because a “self” can’t really be outside someone’s body. The perspective of seeing life from outside the physical confines of your body is as legitimate as any other perspective.

(Note: This blog was inspired by the Neurophilosophy blog of December 2008 titled The Body Swap Illusion)