Tag Archives: Mental Illness

When Intense Emotions Take Over My Mind

Okay, this year’s #AtoZChallenge didn’t work out. I knew it would be tough writing about autism and related disorders when myself undergoing re-assessment for autism. It didn’t help that, from the E-mail I received on the day I posted my theme reveal, it became clear that I will not have an answer before the end of April. That wasn’t the reason I haven’t written at all since April 1 though. The real reason was my mental health.

Like I mentioned, I have been rather anxious and depressed lately. It however got extreme over the past two weeks. This likely isn’t a worsening of my depression as much as it is emotional dysregulation. That doesn’t make it less real though.

About two weeks ago, I started being more irritable and having more dark, death-related and suicidal thoughts than I had before. I had had almost-daily dark thoughts for a few months, but now they became more than daily. I also started making more concrete plans for a final step. Before then, there had been bizarre images in my head of how I’d die by crucifying myself over the staircase at home and such. These had appeared a bit laughable even to my twisted mind. Now, I started making plans and the before then bizarre-sounding thoughts didn’t seem that ridiculous anymore.

I wandered out of the house at home last week Saturday. Thankfully, my husband came back from where he’d been within aobut fifteen minutes and I was fine. Then on Sunday I had a very bad argument with my named nurse that ended in me melting down.

On Monday, I decided I’d stop taking my medication. I didn’t take my morning meds other than birth conrol and vitamin D (because I wanted to take birth control and couldn’t tell the two apart) on Tuesday. I spiraled out of control that same afternoon. This, for your information, can’t have been from withdrawal yet.

The reason I quit taking my medication was that I’d been having these dark thoughts for a while already and yet I felt I was too drugged up to express them. I don’t mean that I wanted to tell the world, like I’m doing now, but I wanted to be able to cry. And cry I did. I also felt like maybe, if I stopped taking my meds, I’d feel some kind of motivation again. I take a high dose of an antipsychotic, which admittedly the psychiatrist says can’t cause flat affect. I also take an antidepressant, but I’d forgotten why I’d been prescribed it (in 2010!) and it had never been reviewed.

Admittedly, there was also a part in me that wanted to signal to my staff that I wasn’t coping. That didn’t really work. My psychologist said that, if I wanted to be taken seriously about my mood, I needed to take my meds. Not that she’s ever taken me seriously about my mood, unless writing depression NOS into my diagnosis counts, which I don’t feel it does. She also told me that I sabotage the independent assessment if I don’t take my meds. I don’t like to admit it but that was one reason I started taking them again on Saturday. I hate to admit I give in to authoritarian manipulation, but I do.

on Wednesday, I started experiencing what I believe are brain zaps – a kind of weird dizzy spell caused by antidepressant withdrawal. I at first thought they were a side effect of a failed attempt at an overdose. They weren’t. By Friday, they occurred about every minute. I was then ready to start my antidepressant again, but wasn’t sure I could safely go back on it after five days. The nurses had to ask the on-duty doctor or some kind of head nurse or whoever and I didn’t get an answer till Saturday afternoon. Now I feel so stupid for havng bothered the nurses with this question on a week-end. I am glad for no more brain zaps though. I did also start back on the anitpsychotic. Not because I want to be on it, but because it seems I need to.

Since late Thursday evening, I’ve felt relatively well. I still experience anxiety and depression, but my emotions aren’t as out-of-control as they were before. Some things that helped were one nurse taking me on walks and allowing me to use her boxing equipment to blow off some steam. It sucks that I can’t do this at home.

A Thank You Letter to a Bus Driver

This is getting old, but I have been extremely uninspired lately. It’s like everytime I try to do blogging in Dutch again, I neglect this blog. It wasn’t even so much that I didn’t want to write, but I didn’t kow what to write about. A few days ago, however, I saw a blog post in which a person wrote a thank you letter to their genetic counselor. Other people were invited to write thank you letters to people you wouldn’t expect they’d be thankful for. This got me thinking. At first, I wanted to write a thank you letter to the psychiatrist who admitted me to hospital in 2007. While writing this letter, however, I thought of another person who was important to me that night: the bus driver who overheard me make a suicidal threat and called the police. I am writing a letter to him today.

Dear bus driver,

You may have forgotten about me. At least, I hope you have. Thhat’d mean you didn’t experience too much stress from what I did while on your bus. I haven’t forgotten about you. I don’t know your name, but I want to thank you anyway.

I was the person who threatened to kill herself while sitting on your bus on the evening of November 2, 2007. I told someone’s voicemail the details of my suicide plan. You overheard me, although a fellow passenger said you merely heard me cry. She probably just said that to quiet my mind. I heard you tell the police that you would be at the train station by 8:15 PM. By that, I judged I’d got onto the 8:01 bus at the bus stop near the training home I used to reside in. You dropped me off at the train station and the police took over and took me to the police station, where I was seen by the mental health crisis service.

I want you to know that I’m well now. I’m not fully recovered from my mental illness, but I’m a lot better than I was back then. I remembered you for years, which was causing me to find it hard to travel the bus in your city. I feared I’d run into you. Now, I know that you did your job and you did it well.

I could bore you with a long story of my mental illness and recovery, but that would probably stress you out. In case you’re wondering, however, I want you to be assured that I’m happy that I didn’t kill myself that evening. Now I know that, somewhere between the bus and where I wanted to kill myself, someone probably would’ve stepped in before I would actually be dead. However, you happened to be that person to step in. Thank you for that.

Astrid

A College Memory

Last week or the week before, one of the prompts from Mama’s Losin’ It was to write about a college memory. Since just yesterday I shared on my Dutch website about studying with a mental illness, I thought i’d write about it here too. It’s been 8 1/2 years since I dropped out of university, of course. For this post, I’d like to share about my first day of university.

My first day of university was September 3, 2007. I took a ParaTransit taxi to the building where I’d have my first class. As I approached what turned out to be a large lecture hall, I was immediately overwhelmed by the huge number of students. Until that day, my idea of a large group of students was my psychology class at college, where about 35 students were in the room. I had expected the same number of students in my university classes, because only about fifteen to twenty students enroll in the linguistics program each year. Turned out the class was a combined linguitics, business communications and language and cultural studies class and there were over 200 students in attendance. I had the most spectacular meltdown right there and ran off. I don’t remember much of what happened next. I think I called my home support worker, because the team manager, who also acted as my support worker, came to pick me up. She drove me to the office of the organization I received care from. This was the first time I was in such major crisis that the team manager decided to call mental health services. She later told me I was “not crazy enough” to be admitted.

I must say here that a meltdown whilst in a lecture hall is of course not in itself a reason for a mental admission. In this sense, the mental health agency was right that I was “not crazy enough”. Maybe if they’d knwon that I had meltdown after meltdown almost on a daiy basis, they could’ve offered some help. Now back in the day my only options were an admission or no help. Today, most mental health crisis services offer more varied help.

The professor for my first class – the only class I even attempted to go to that first day – was by the way one of the most supportive people in the university. He offered to have me listen to the lectures in a room attached to the lecture hall that is often used for recording lectures. I was able to attend his classes up to the moment I landed in my final psychiatric crisis in late October. His class was also the only one I took an exam for – three days before my hospitalization. This professor was the first to notice I wasn’t at university anymore and I don’t think it was solely because he was the professor for my Mondaya morning class. The director of studies E-mailed me the Monday after midterm that said professor had been missing me in his class, so had I quit my sutdies? I didn’t read this E-mail till I was home on a visit the next month.

I don’t have the greatest experiences with accommodations for me as a mentally ill, multiply-disabled student at university. I remember being told a number of times that I had a bad attitude and “we’re not a therapy center”. Though this is true, I badly did want to continue my studies for as long as I could. This one professor was, without even talking much to me, one of a few people who kept me going. He instilled a continuing interest in language composition and univesal grammar in me.

In Between Mental Illness and Wellness

I have often talked about recovery on this blog. Particularly, I have talked about recovery from my disordered eating habits and to a lesser degree self-injury. I wanted to get rid of my binge eating and stop self-injuring. Today, as I gave this some more thought, I took recovery one step further. So what if I stop bingeing and self-injuring? Would that then mean I’d be cured of my mental illness?

Of course, strictly speaking it wouldn’t. However, what if it did? What if I were cured of my mental illnness? After all, I exhibit far fewer destructive and aggressive behaviors than I did years ago. If I were to check mysel finto a mental hospital just as I am now, with no history of acute mental illness, the registrar would laugh at me. I wonder even if I’d be sick enough for outpatient mental health care if I presented with jut the symptoms I’ve been having lately. My overeating may or may not meet the criteria for binge eating disorder or eating disorder NOS. My self-harm does meet the criteria for non-suicidal self-injury, but then again these crteria are quite vague. My mood does not meet the criteria for a disorder. Heck, even when I was suicidal in 2007 and was clearly in need of acute psychiatric care, the only diagnosis the psychiatrist could come up with was adjustment disorder. Adjustment disorder is no longer covered by health insurance. In other words, under DSM-IV, which doesn’t include binge eating or self-injury as diagnoses, I would hardly if at all qualify for psychiatric care.

Of course, I do have borderline personality disorder and Asperger’s Syndrome – I still meet the criteria for these. However, no general practitioner would come up with the idea that I’d have these if I asked them to refer me to mental health services, and the vague referral letter my GP wrote in 2007 would not be enough now. So if I’m not sick enough at first sight for mental health care, am I then recovered? I don’t think so.

Mental health care has in recent years been more and more reduced to mere crisis intervention or other interventions directed at averting people becoming a pain in the neck. Now I won’t say I can’t be a pain in the neck, but a GP writing my referral letter from scratch now would not know. If you aren’t a danger to yourself or others, you most likely won’t get mental health services paid for through insurance. As such, mental health treatment is focused on curing the symptoms of severe mental illness (which is in most cases impossible), whereas recovery is more than that. Recovery, after all, is getting your life back on track.

As a long-term institution patient, I struggle with this. I am relatively well mentally speaking – probably not as well as I describe in the above paragraphs, but still -, but I don’t have a life. When I was admitted to the mental hospital in 2007, I was a university freshman in a new city. Now I’m nearly 30 and have little that could fulfill my life. I have my blog, but that’s about it. It makes me depressed. Not suicidal-type depressed (or should I say “adjustment-disordered”), but it does definitely make me slightly depressed. If I am not sick enough for mental health services and not well enough to get my life back on track without help, then where do I find help in recovering my life?

I hope that outpatient mental health services aren’t really as bad as I now think they are. I can only hope the recovery model still hasn’t been killed by the push for budget cuts. It however makes me sad to read in memoirs of mental health consumers about the recovery model and using mental health services to get your life back on track. After all, I’m afraid you can’t get mental health care for that now even if you’re severely mentally ill like myself.

Z – #AtoZChallenge on Mental Health

Welcome to the last day in the #AtoZChalleng eon mental health, dedicated to the letter Z. I am just in time to publish my post, as I was at my parents’ two hours way all day. I did take my computer, so don’t worry, this post was not my reason to leave. Anyway, today’s words are all on a common theme. Here goes.

Z-Drugs

Z-drugs are a few medications, most of whose generic names start with Z, eg. zaleplon, zopiclone and zolpidem. Besides the letter they start with, they have in common that they work similarly to benzodiazapines but are not benzos. There are three subgroups of Z-drugs, all of which are GABAA agonists, meaning they increase the availability of this neurotransmitter. Z-drugs are used in the treatment of insomnia. Some have advantages over benzdiazepine sleeping pills.

Zombie

Many psychiatric patients, especially those on long-term units, seem a bit zombielike to outsiders. I discussed this when discussing lethargy in my letter L post too. Negative symptoms of schizophrenia and other psychotic disorders may cause people to act like “zombies”, but so do many psychiatric medications, including antipsychotics, anti-anxiety medications and certain antidepressants.

ZZZ

Last year, I discussed sleep in my post on the letter Z for ZZZ. To finish off this year’s challenge, I am going to discuss the same topic. Sleep disorders are common among people with mental illness and of course can be a mental illness themselves.

There are two forms of sleep disorders. Dyssomnias are disorders in the quantity, quality or timing of sleep, such as insomnia or hypersomnia. Parasomnias are characterized by unusual physiological or behavioral events that limit sleep, interfere with certain stages of sleep or with the transition from sleeping to waking. Sleepwalking is an example of a parasomnia.

Like I said, sleep disorders can occur on their own but can also be part of another mental illness. For example, many people with clinical depression experience insomnia, usually waking up way too early in the morning. Some people with depression conversely experience hypersoomnia, sleeping far too much.

Y – #AtoZChallenge on Mental Health

Welcoe to the letter Y post in the #AtoZChallenge on mental health. This was definitely the hardest letter of all. In fact, I cheated a little, because I have only one word and it’s practcally unrelated to mental health. I use it to talk about an important topic in mental health though. Here goes.

Ypsilon

Ypsilon is of course the Greek letter from which the Latin Y is derived. However, it is also the Dutch organization for family members of people with schizophrenia and other psychotic disorders. Like I said, it’s a little out of left field, but I want to use this word to discuss the importance family plays in severe mental illness and recovery from it.

A few years ago, there was some debate that revolved around the question whether organizations of families of patients should receive government funding, or whether it should only be organizations of patients themselves. Ypsilon spoke up, saying that people with severe mental illness cannot necessarily advocate for themselves. Never mind that there’s an organization for people with schizophrenia and related disorders too, called Anoiksis.

Some other organizations, like the Association of Manic-Depressives and Relatives (that’s the literal translation of the Dutch name), allow both patients and family to be active members in the organization. I don’t know how each group is represented on the board of directors. However, this organization makes it clear that patients and family should really work together towards a common goal. Note that bipolar disorder is often as severe a mental illness as schizophrenia, so Ypsilon’s argument that people with severe mental illness can’t advocate for themselves, holds no ground.

Family are, of course, important in people’s mental health recovery. However, it’s still the patients who have the first-hand experience of mental illness. As such, they should always be at the center of their recovery process. Ypsilon is an okay’ish organization in this sense, often cooperating with Anoiksis and having destigmatization as a goal. Other organizations, however, often do not value patients’ input.

X – #AtoZChallenge on Mental Health

Welcome to the letter X post in the #AtoZChallenge on mental health. I have two words for you today, so this is a short post. Here goes.

(E)X-Patient

I have said this when discussing “survivor” in my letter S post, but many patients have endured traumatic experiences while in psychiatric care. As such, many are happy to be freed from psychiatry. There is a movement called the C/S/X movement. The C stands for “consumer”, ie. those still in psychiatric care. The S stands for “survivor”. Once consumers/survivors have completely freed themselves from psychiatry, many feel comfortable only with the label “ex-patient”, which signifies they are no longer involved with psychiatric care.

Xanax

Xanax, the brand name for alprazolam, is one of the strongest benzodiazepine tranquilizers. Xanax is commonly used to treat anxiety or panic. Other benzodiazepines are also used as sleeping pills, but I’ve never heard Xanax being used for this purpose.

Benzodiazepines are highly controversial drugs because they are often overused and they can become addictive. In the Netherlands, for this reason, people can only get benzodiazepines covered by insurance if they have epilepsy, an anxiety disorder for which they’ve tried at least two antidepressants, or if they have severe mental illness requiring high doses of benzodiazepines (for chemical restraint). On this last ground, many severely mentally ill people take benzos on a daily basis. Worse yet, people without mental illness can get only one prescription for ten sleeping pills, to be used over the course of ten weeks, and even then they have to pay for them out of pocket. People in the psychiatric hospital almost always take sleeping pills much more frequently and many take them everyday. When patients are in the psychiatric hospital, benzos are paid for by insurance. I wonder whether I’ll get my benzodiazepines covered once I leave the institution. Depends on whether my condition is seen as a severe mental illness requiring high doses of benzodiazepines.

W – #AtoZChallenge on Mental Health

Welcome to the Letter W post in the #AtoZChallenge on mental health. This was a hard letter. In fact, up till a few days ago, I could only think of one word for it. I have however managed to think of a few more words.

Wellness Recovery Action Plan® (WRAP®)

The Wellness Recovery Action Plan® is a plan that people with mental illness use to regain their wellness if they’ve endured a distressing experience that might otherwise destabilize them. WRAP® was developed in the United States by Mary Ellen Copeland, who herself suffered from severe mental illness. It is rooted in the recovery model of mental illness. WRAP® focuses on people’s strengths rather than their deficits. However, it does include a crisis plan too. This crisis plan or advance directive is written by the patient themself and lets others know when they need to take responsibility for the patient’s care. This allows the patient to stay in control even when they can no longer make decisions for themself. I found the interesting part was also the post-crisis plan, which is meant to reflect on ways to regain wellness and prevent another crisis. In traditional crisis plans, people are not taken care of after crises and their original plan is not revised.

Willpower

Of course, mental illness is not a choice. However, recovery is. It is often believed that willpower is the power to get over all one’s emotional or behavioral struggles, to be cured of one’s mental illness or addiction. I discussed willpower from a spiritual perspective a few months ago. In this light, willpower is the will to turn over one’s life to God (or another power greater than oneself). In the recovery movement, willpower is the will to take back control over one’s life in spite of mental illness. This might seem completely contradictory to the twelve-step view of willpower, ie. turning one’s life over to God. I see the two as peacefully co-existing. Allowing God to guide us on our journey, after all, does not mean we are not as humans responsible for the decsions we make.

Work-Out

Exercise is often thougth to greatly help with mental health. People who are depressed often benefit from getting moving. People with severe mental illness might use exercise, even if it does not cure their illness, to get into a daily or weekly rhythm.

V – #AtoZChallenge on Mental Health

Welcome to the letter V post in the #AtoZChallenge on mental health. Pfew, we’ve arrived at the last week and I’m looking forward to writing regular posts once again. This letter wasn’t too hard though. Here goes.

Visiting Hours

Mental hospitals, like most hospitals, have visiting hours. The difference is that they are particularly meant for patients from other units. Family often can come when they want.

Vitamins

Many mental institution patients take one or more vitamins or minerals. The reason is that many don’t have the healthiest diets and hence run a risk of vitamin deficiency. However, it is also thought that vitamin deficiencies may contribute to people’s mental illness. For example, depression may be associated with vitamin D deficiency.

Voice-Hearing

Many people with severe mental illnesses hear voices. Many people without severe mental illness do too, but they can function in spite of their voice-hearing. As such, voice-hearing itself does not indicate severe mental illness, even though until recently, you could be diagnosed with schizophrenia by merely hearing voices.

There is an international movement of voice-hearers. The most well-known organization supporting this movement is Intervoice in the UK. Intervoice aims to support people who hear voices, whether they’ve been diagnosed with a mental illness such as schizophrenia or not.

Core values of the hearing voices movement are:


  • Hearing voices, seeing visions and related phenomena are meaningful experiences that can be understood in many ways.

  • Hearing voices is not, in itself, an indication of illness, though difficulty coping with voices can lead to great distress.

  • When people are overwhelmed by their experiences, support should be based on respect, empathy, informed choice and an understanding of the personal meaning of this person’s voice-hearing.

Volunteers

Many mental hospitals and support organizations for people with severe mental illness employ volunteers. Volunteers might be visiting buddies, visiting the patient every so often. They may also help paid staff during day activities. My institution isn’t keen on employing volunteers. There was this staff member who would be laid off due to budget cuts and she offered to come back as a volunteer. The management said “No”, because volunteers cost some money too.

U – #AtoZChallenge on Mental Health

Welcome to the letter U post in the #AtoZChallenge on mental health. This was a hard letter once again and hence my post is very short. I have two words for you and they’re pretty irrelevant, but well. Here goes.

Unstable

People use the word “unstable” to describe the state of not feeling well mentally. In the description of care packages allocated to people, often the word “unstable” is used to describe someone’s psychological state. Of course, if a person is chronically depressed, for instance, they are not truly unstable in the literal sense of the word.

Unusual Experiences

“Unusual” is a word used to describe the experience of mental illness from an inclusive point of view. It sees mental illness as merely an experience that is uncommon. Everyone has unusual experiences at some point. For instance, many people experience totally benign hallucinations at times, for example when drifting off to sleep. As such, the experience of being mentally ill is merely an exaggerated form of ordinary human experience.