Going toxic???

I feel like I have a brick in my stomach. This is about the tenth time in the last month I've felt this way. A couple of weekends ago I thought I had gastro, as I had to toilet myself to relieve the symptom. Apologies for being graphic, but there's no other way to describe it.
It comes and goes, although the past weeks it's been happening more often. Then it occurred to me; I might be having a reaction to my meds. I googled "Epilim Lithium combination side effects" and went to wikipedia (aka the bible). Apparently Epilim may well be the precursor; too much and going toxic can cause nausea, diahoerrea etc.

My doctor increased my Epilim about a month ago to deal with a potential spike in speediness. I also feel light headed and dizzy; like all the blood has rushed from my head.
I just cancelled going into work, which I'm sure won't go down too well. I called my doctor and am waiting for him to ring me back.
Geez I feel sick. I'm going to lie down :(

Fight Club and movies

That's right....when I started writing my last post I meant to comment on this DVD which I just watched tonight for the first time. The "I am Jack's Medulla Oblongata" phrase which another blogger on this site has in his title self-description. It'd alwaysed perplexed me what that phrase meant (a section of the brain which controls respiratory function and other essential things) and then I heard it tonight in fight club. Huh.

So I was watching this movie thinking When Does It Get to the Good Bit and pondering hmmm...aside from the undertones of homoeroticism and gratuitous violence I fail to see the point and then Whammo. So the protagonist is hallucinating about the Brad Pitt character. It did improve the quality of the film but all the far-fetched stuff about the explosions etc was a bit out there for me. I prefered A Beautiful Mind or the Australian film Angel Baby better.

There's still room for more stories about psychosis and mood swings. It's such a shame that hollywood will only finance those that have sellable features (eg: the fighting aspect in fight club along with the whole Fuck the Establishment side).

I had a vision the other day: in the next 5 to 10 years some bright spark willl invent software that will enable people to script, edit and direct a film with virtual characters. By 2030 Hollywood will be a bygone era; the ultranet will take over and individuals will be able to produce their own feature films (distributed freely online but aided by eg: product placement).

Maybe a wonky vision, but a vision just the same.

Solitary confinement and gaiety

I like getting lost in a good flick, as most people do. I tend to watch DVD's at home rather than see them in Cinemas; here in Australia the average film costs $15 concession ($18 full adult), compared to buying a second hand DVD from pawn shops like Cash Converters for $4. I know, I know...it's easy to download movies illegally from the net, everyone does it etc. I'm on a pissy download plan for my internet and have never learned how to download something that I could put onto a disc and watch on my telly. I did download one show once...the original Underbelly underworld crime mini series that was banned in Victoria due to certain characters still facing trial in real life. I didn't regard it as much fun to perch on my computer swivel chair and watch my computer monitor (however 'riveting' at would have been to watch Alphonse Gangitano, The Morans and Carl Williams being their devillish gangsta-ish selves)so I haven't downloaded since. The point I'm getting to is that I like to own movies to watch at my leisure in my armchair where I can put my feet up and smoke if I want to. So I do.

It's one of my solitary pusuits that I relish doing, sometimes moreso than being in good company. I caught up with a friend I've known since primary school on Wednesday, we had a nice lunch and saw "The adjustment bureau" (crap film which had interesting elements but not properly built on...based on a Philip K Dick story but I would suggest somewhat loosely). It was great to see my friend but I would have been almost as happy to be there on my ownsome.

One place where my anti-social side hinders me is at work: I can't fake congeniality. Some times I need to put on a happy face and I find it excruiciating; like when someone asks for a registered mail envelope, or a bulk mailout, or I have to do the internal mail run. Phone service I'm fine with; I can put on a warm and an "I give a shit" voice, but in person I freeze. It's mostly the eye contact thing (impossible), often it's lack of warmth and difficulty expressing myself. Like today when I asked my co-worker to explain (for the 7th or 8th time) how to do something then I got an attack of the giggles. Very embarassing.

I get a modicum of comfort in reading the wikipedia page on schizoaffective disorder;

http://en.wikipedia.org/wiki/Schizoaffective_disorder

especially when it mentions the DSM 1V criteria of affective flattening (lack or decline in emotional response). I know, it might sound bizarre to be comforted by the DSM 1V (don't yew fuckin label me...etc etc); I just mention it because I feel so inadequate to be robotic, and yet to see it written that flatness is to be expected with S/D....makes me feel like, well then I'm just behaving as much as my medicated body will let me. It's not as if I'm intending to be aloof. Can be easily misunderstood though.

I guess my tendency to have trouble communicating, whether if it's with a friend I know and trust or in the workplace will see me naturally retreating to the comfort of solitude. Mostly I distract myself with DVD's, television (I like some reality stuff like Survivor and the Amazing Race....Americans fascinate me with their intensity; also like Nurse Jackie, The Good Wife and of course AFL Football), the internet, reading (mostly biographies), housework, recently gardening and (god forbid) going for a walk, which incidentally, is the best anti-depressant I ever took (walking). I rarely get bored and lonely these days. I said to my friend last Wednesday at lunch that I could see myself being alone for the rest of my life and that it didn't bother me. That's partially true. It would be nice to meet someone, but that seems unlikely.

'Bout time I got myself a faithful hound!! :)

I accidentally overdosed on Zyprexa last week

One night last week it got to about 11pm and I thought i'd forgotten to take my nightly Zyprexa, so I took my usual dose (15mg), then went to bed at about midnight. I was half awake half asleep an hour later when I had a gag reflex; I thought I was going to be sick. At first I thought it was the big bowl of cherries I'd eaten, but my stomach wasn't sore. Then I actually was sick twice. I noticed my arms and legs were very heavy. Then I went to sleep. I didn't waken till 3pm the next day! 13++ hours straight!! I told my shrink about it a couple of days later and he said it was too much Zyprexa, not cherries. He told me to use a dosette box to avoid such things happening again. Now I know what 30mg of Zyprexa feels like: not in a hurry to do a repeat performanace. 

 So I dragged out my old dosette box; the one the hospital gave me in 2003 when I had my longest hospitalisation ever. A time when, upon discharge I had the CAT team come and give me my meds twice a day: 8am and 8pm. They did that for a few weeks; I was too spacey to care for myself. I was living in a boarding house at that stage; grimy, expensive and dank. Another story for another time. Back to the dosette: it sort of feels a bit institutionalised to use it again, but I guess I don't mind using it for now. 

Zyprexa (olanzapine) is not a popular drug; every person I know who's been on it has complained, mostly about weight gain, but here's a list of possible side-effects; As with all neuroleptic drugs, olanzapine can cause tardive dyskinesia and rare, but life-threatening, neuroleptic malignant syndrome. Other recognised side effects may include: akathisia; inability to remain still (restlessness)[21] dry mouth dizziness irritability sedation insomnia constipation urinary retention orthostatic hypotension weight gain increased appetite runny nose impaired judgment, thinking, and motor skills impaired spatial orientation impaired responses to senses seizures trouble swallowing dental problems and discoloration of teeth missed periods problems with keeping body temperature regulated apathy, lack of emotion Endocrine side effects have included hyperprolactinemia, hyperglycemia, and diabetes mellitus Brain Shivers Auditory Hallucinations. 

 I can't claim to have gone through many of these; my main ones are increased appetite, tiredness and dry mouth (I drink heaps of water and Pepsi Max, around 15 tall glasses a day). Oh and seizures; had my first of those in my sleep a couple of weeks ago. That made my doctor say to cut back to 1 1/2 tablets a day (7.5 mg dose; around 11mg a day) and to start taking magnesium capsules twice a day (apparently helps with muscle spasms). I've had a rigid neck for quite a few years now; tends to 'turn' by itself to the right; it's a subtle turn, mostly bothers me when I try to fall asleep due to head lifting off the pillow. It started happening on the older anti-psychotics I used to take; Risperdal and Solian. 

 The 1st anti-psychotic I was on was the worst: Stellazine. You had to take Cogentin along with it to stop muscle cramps. One night my head wanted to spin off its axis a-la "The Exorcist"; it was quite terrifying. All this in the name of cessation of paranoia and hearing voices; no wonder mental health patients are a downtrodden lot. I doubt very much whether the majority of the population would accept putting up with such side-effects if they were told they had to.

Enter 2011...happy new year!

So why am I nutting this out at 10.21pm on New Years Eve and not at a gathering with friends? I got invited to a good friend's house, but turned it down. Just felt like being alone, watching my box set of My Name is Earl DVD's, ripping into the Pepsi Max and fags, surfing the net. It's just another night for me, New Year's Eve. I started feeling this way about it around 5 or 6 years ago, the same time I stopped panicking about having no social engagements lined up for Friday and Saturday nights. The same time I started feeling content with being on my own and not lonely. My friend Liz said to me it's a sign of maturity. I hope that's it, and not a sign of losing touch with vitality and feeling alive.

I was watching a favourite DVD the other day: "Dracula" (the one made in the early 90's with Gary Oldman, Winona Ryder and Keanu Reeves; the latter 2 doing awful wooden performances and horrible english accents, but otherwise enjoyable). There's a scene in it where Winona comments about how she felt "so alive" when in the company of her Prince (Oldman as Dracula). It brought me back to how I felt when first watching this film in the cinema aged around 23: I felt a strong chord strike at me during the film about the wonder of sensations which I have rarely felt since age 25 when I was first diagnosed and thus medicated. I guess I'm referring to the elation that I used to feel with my unmedicated moods swirling about unfettered and how intoxicating this could feel. Looking back on these feelings, I really understand how some people with mood disorders remain non-compliant with taking medication: when you're dosed up with a mood stabiliser like Lithium or Epilim, what was once a kaliedoscopic world can suddenly become very grey and drab.

When I say grey, it's not automatically like a depression (which I describe as feeling like you view life through shit-covered filters while trying to wade out of emotional quicksand). It's just that...there's no Spark, no mojo. I saw some truly amazing ocurrances when going through undulating moods in my early 20's....I wish I could remember them all. I just had more charisma and was able to enter into conversations with strangers more confidently and fluently. An example being: I was at a friend's 21st and was going to leave early as I had a headache and was getting a bit peeved by some of her obnoxious Uni friends (they'd done a very "in-joke" speech which none of us old friends were impressed by). I talked briefly to one of these friends who invited me to a drinkies lunch they had mined up for the next day to keep the party humming at a trendy pub. I made an excuse not to go, saying I had a headache: the girl eyeballed me "Forget the headache" she spat "we'll see you at the pub tomorrow". I glared at her and said "see you there". I did turn up at the pub the next day; nobody else showed, they were all hungover. I ended up chatting to a lovely afro-american guy for a couple of hours. We went out to dinner a week later, but thereafter didn't see each other again.

My point is: I had the chutzpah to dress up, show up, not be daunted and feel ok talking to a stranger in a bar alone. I wouldn't probably do that sort of thing a few years later when medicated. Being diagnosed and medicated sort of 'extracted' my congeniality out of me. Sure, I can express things ok in a written sense, but to verbalise it is something totally different.

I'm aware that this written/verbal thing is not the exclusive domain of being medicated, and there surely must be people who do take meds who are certainly adept at conversation and many other social skills. I however, am not. I used to be.

Anyway....I've strayed from my initial line of thought: feeling 'alive'. As I type this I can hear the distant thudding bass of a party at a neighbour's house, along with erratic shrieks and shouts of those well on the way to imbibing their way into a jolly new year. I remember feeling pretty alive doing this sort of thing too in the past. These days my 'alive' moments tend to be fleeting, like the rush I get when I sit down and relax with a glass of water and a smoke having just walked for an hour. The blood is rushing around my body, my feet tingle and I feel really awake. Or the alive I get when I mix Clary Sage essential oil with massage oil and rub it into my neck and shoulders. Or if I'm watching a close and exciting football match which goes right to the wire.

It doesn't match the kaliedoscope world of unmedicated mood fluctuations, not by a longshot. I hope one day I can become less medicated, but until then I have to be content with the perceptions I have and also those I create for myself and for others.

Have a happy 2011. I certainly hope to.

Description of the onset of psychosis

Perhaps I'm wrong, but I get a feeling that many in the community fear being around people with schizophrenia or schizoaffective disorder due to a perception that such people can 'turn' psychotic in an instant and are inherently violent when in a psychosis. My experience of psychosis has been very different to this: I only develop full-blown psychosis after having a build-up of mania, which takes anything from several weeks to several days to gestate. 

 It's pretty easy to spot me (or most people, if you know them) being manic: excessively chatty, irritable, spending money I can't afford, excess energy, delusions of brilliance - pretty typical symptoms. It's only after I've been manic (fully-blown) for a few days that the paranoia creeps in. I begin by reading significance into things that have no significance; a classic example being to hold the notion that the songs on the radio are 'telling' me something, or that the television is conveying a special message for me, usually sinister. I then start being convinced of conspiracy theories, especially that people close to me have evil intentions. Finally I get external auditory hallucinations (voices) which are terrifying, nasty and mocking. By the final stages I am well onto needing to be in hospital asap. I cope with becoming unwell pretty effectively these days; because I live alone I don't infringe on other peoples wellbeing. I am aware that "it's happening" even though my grip on sanity is slipping. 

 When I start to feel like my mania is escalating out of control I ring my regional Psych triage; they have me on their files having rung them in the past. They instruct me to make an emergency appointment with my Psychiatrist, which I do at the earliest opportunity. If there is a wait to see my Psych I keep in frequent touch with the Psych triage number (which I'm sure drives them batty). If need be they fax my Psych about how I'm presenting over the phone, this can speed up seeing my Psych and if needed, getting a bed in hospital (private - as a voluntary patient). If I didn't have private heath insurance I would have to solely rely on the Psych Triage service and seeing my Doctor until (a) I got better along with adjusted meds my doctor would prescribe me or (b) my condition worsened and I totally lost the plot and needed to go to Public Psych hospital as an involuntary patient, although not all people who go in the public system are involuntary. 

 One main difference that strikes me between public and private psych hospitals is that in the public system you get more violence; both verbal and physical. In the private one you have to sign a contract upon admission saying you won't physically or verbally assault anyone during your stay. I guess what I'm trying to say is that for me psychosis is a gradual culmination of unwellness; I'm not nor would I ever be likely to just "snap" into being psychotic. There is a lead up to getting unwell, as described above. I wish people in the community would bother to learn a bit more about it, not just to assume things about psychosis from what they read/hear in the media (eg: man shot by police after wielding samuri swords and lunging at them; he was known to have schizophrenia). 

 The other thing I wish people understood is how terrifying it is to be in a psychosis; it's like a sinister nightmare, with distortions of reality lasting for days or even weeks until the antipsychotic medication has a chance to work. Then you tend to get really tired (heavy dose of meds) and put on weight (most antipsychotics really increase your appetite). Several weeks afterwards, there's post-psychotic depression, a really black place to go. Sucks, hey? 

 I wish someone with political clout had the experience of psychosis (not that I'd really want to wish it upon somebody), so that the politicians could do more than pay lip service to improving mental health care. So many people with serious psych illnesses are disenfranchised, or they slip through the cracks of the public system, never receiving adequate care and assistance. I'm fortunate; when I got really sick in 2003 I did get appropriate care for a change; the rebuilding has be slow but steady. However I know I am in a minority. 

 Housing is a major issue; I couldn't have anywhere near my current peace of mind were I still in transitional housing. Other people aren't so lucky. So.....psychosis.....yes I've strayed from the topic. If you're in the company of someone with schizoaffective disorder it's highly unlikely they would become verbally or physically agressive unless they were unwell, and that would, in my opinion be pretty obvious. I guess the point I'm making is that people don't just 'snap'; I never have. It's a build up of behaviours as described. I guess the perception that all people who have been psychotic/have the potential to be psychotic are dangerous is a sad reality. A perception based on misrepresentation and ignorance.

Why would I love being schizoaffective 2010?

Why indeed. Life has certainly taken a different trajectory to the one it was heading in, when I was a teenager, when I had my first symptoms of being unwell. I don't know the exact age my magic genie popped out it's weird and wonderful psych symptoms (was flat aged 10 soon after my parents divorce; was flat again aged 14; was majorly flat aged 18; had a minor psychosis aged 20; mood swings thereafter culminating in 1st major psychotic episode aged 25). 

 One thing I know is that when I eventually thought I had my career path sorted (aged 22; market research) and despite my undiagnosed symptoms occuring I got my business degree (25 again). I was all lined up to start my graduate traineeship with a big market research company in the city when I had my 1st psychotic episode. It lasted months. I tried to start at the company (having lied and said I had glandular faver); I lasted a few months then got the sack. Had it not been the case that I had become sick I might have had a successful career in market research. Or not. Life can have funny turns for people who don't become unwell, psychiatric or any other illness. 

 There was never a guarantee that I would be a corporate success. But there would have been a reasonable chance. So where did I go from there, the breakdown and sacking, aged 25? Too long and personal a story to do justice to in a blog. To summarise; - 1996-1999 Worked in part time blue collar jobs and felt sad, angry and lost; - Felt bored and lonely frequently along with a disposition towards depression; - 1999-2000 Got lost in drinking daily to escape my less-than-happy existence.

2000-2002 Did the rehab merry-go-round circuit combined with emergency/relief accomodation due to being unemployed and unemployable; - Had 2nd major psychosis 2002-3 (much worse than before); involuntary patient then homeless; in boarding houses; - 2003-2007 Got back on my feet via effective case management; secured a community housing bedsit; started part time work again; stayed off alcohol.

Moved to stable accomodation; retained part time employment; started being able to pay bils properly and to save; - 2009 Had 3rd psychosis; private hospital, new psychiatrist; was able to retain work; had some medication trial and error; maintained sobriety; - 2010 Work going well; fell off the water wagon but didn't go off the rails; stabilising on medication; solidifying friendships. 

I give this summary to emphasise how different a turn my life took had I not become unwell. I've seen and done things a lot of people only wonder about: a lot of them not good things. I've learned to live on a budget and to appreciate money. As I enter my 40's I'm learning that physical health is just as valuable as mental health and that it can't be taken for granted. Ok ok....so I'm sounding sanctimonious and all that. It's just that....how can I make the title of my blog ring true??? Maybe the trick is to know that often, it's said tongue in cheek. ;)