Psychosis © Megan Snider

"And this is not my face
And this is not my life
And there is not a single thing here
I can recognize
This is all a dream
And none of you are real
I'll give anything I'll give anything..."
--Reznor, "Head Down" (click to read)

Let’s talk about psychosis today. A psychotic person is not a psychopath. You must realize this. Write it on the back of your hand for reference. Tattoo it on your back. Remember what I tell you.

Remember!

A psychotic person is not a psychopath.

With this blog, I struggle between the use of first and third person pronouns. Should I say “I” or “she”? Sylvia Plath used “she” for “I” in The Bell Jar. She used “she” for “I” often. I hesitate between “she” and “I” simply because I don’t want to be Exhibit A in the Looney Tunes section of Ward B.

That’s how we treat mental illness, right? It’s funny. Straight jackets are funny. Padded rooms are funny. People that drool from Thorazine (Chlorpromazine) are funny, right? Paranoid Schizophrenics are funny, too, aren’t they?

It’s funny until it happens to you.

So, psychosis, let’s deal with it. Let’s look at it. If you’re scared, that’s ok; you should be. Psychosis is terrifying and can be the result of a mental disorder or can be a torture all by its lonesome self.

In the 1950s they used to stick needles behind the orbital sockets and skewer the brain like hamburger to get rid of it. The effect was permanent brain damage. Once again, thank you, mental health centers. They called it a Frontal Lobotomy. If it were the 1950s now, I would be walking around in white with half my brain shaved off. Simply because of the horrible fact that many psychiatrists cannot realize the total sum of differences between dissociation and psychosis.I actually read an article that suggested a new treatment for psychosis was to disrupt or destroy a portion of the frontal lobe to subdue psychosis. This is the rebirth of the Frontal Lobotomy. We put it in a new pair of boots and a new jacket, but it’s still the same sadism. Still the same, loving, biting, painful psychiatric care that all of us should be used to by now.

This will make you better– by the way, do you have insurance?

If you don’t have insurance, we can only destroy one section of your brain and not the whole lobe.

So what is psychosis? Simply put, it’s a break from reality. You have experienced psychosis and you probably don’t know it.

Did you ever believe something that wasn’t true?
That’s a delusion. Talk to folks with Bipolar Disorder or Schizophrenia about that.

Did you ever hear a noise when no one was there? A foot on the stairway or a knock at the door? Did you get up to answer the doorbell and there was all of nothing standing on the other side of that cherry or oak door?

Did-your-thoughts-ever-go-like-this-and-you-couldn’t-stop-them?

Di d y our thou ghts eve r go like thi s an d you coul dn’t s top the m?

Did you ever have trouble or think you didn’t fit in?

Did you ever think someone might be able to see through you and tell what you were thinking?
Were you ever scared you were paper-thin and see through and translucent?

Hey, let’s give you a pat on the back and a push through the door.

You just experienced psychosis.



Virginia Slims would say: “You’ve come a long way, baby!”

It’s not really funny, is it?



Did you laugh when that happened to you? Then why do you laugh if it happens to me or her or him?



Psychosis may be present with Bipolar Disorder, Schizophrenia, Panic Disorder, Clinical Depression, unspecified mental disorders, sleep deprivation, epilepsy, extreme trauma, brain tumors, drug abuse, severe stress, brain damage, and drug withdrawal.
Oh, man– Oh, no– That means…It could happen to anyone…Jeez…Man….Oh my God….

Yeah, that’s right, you just got a bingo on your score-card.



Psychosis is a scary term and it’s a scary problem to have.



If I had a lobotomy for every time someone told me that…

© Megan Snider

The Antipsychotic Trinity Gospel © Megan Snider

I have some things I should probably mention about antipsychotics before I let my experience with Tardive Dyskensia slide. So, I'm going to cover them today.

The first thing you should know is that as far as antipsychotics are concerned, there are three "generations."

The First Generation-- Typical Antipsychotics, 1950
The first generation came with Haldol. Haldol was the first antipsychotic developed, is the oldest, and provides the kind of psychiatric care you might read about in One Flew Over the Cuckoo's Nest. Haldol is also dirt cheap. Thanks to the Wal-Mart $5.00, prescription plan, you can buy a nice pill jar of Haldol, look in the mirror, and watch the muscles in your mouth spasm. Haldol is a strong drug and often administered in strong doses. Haldol is what they give Schizophrenics to shut them up when they can no longer provide care. They just shoot them full of Haldol injections monthly and let them jitter and spasm. Thank you, mental health centers.

DO NOT TAKE HALDOL WITHOUT AN ANTI-MUSCLE SPASM DRUG.

Even with the drug, you will still twitch.

Antipsychotics are used both to treat Schizophrenia and Bipolar Disorders. Generally speaking, these two illnesses are eerily alike. Aside from that you have Schizoaffective Disorder, Psychosis, and it continues on down the spectrum of disorders mixed with conception of reality and conception of mood and personality.

The Second Generation--Atypical Antipsychotics, 1950-1970
The second generation also began in the 1950s, but continued into the 1970s. These drugs are generally safer. I, myself, had taken Zyprexa for three years without an anti-spasm drug and had no effects. Zyprexa, at first, stopped my mind from racing and helped me get to sleep. After a while, it did nothing but make me gain weight.

The Third Generation-- Abilify and Bifeprunox, Currently being tested
The third generation of antipsychotics is still in testing, basically. Abilify has been trumpeted as the Messiah of antipsychotics, but its true effects remain to be seen. I assume the third generation is safer than the second and requires no anti-spasm medication.

Never forget, ANY antipsychotic can cause: Aranulocytosis, Tardive dyskinesia, Tardive akathisia, Tardive psychoses and Tardive dysphrenia.

That's really all I would like to mention in effect to that situation for now.

© Megan Snider

Depression Speaks © Megan Snider

"Dying Is an art, like everything else. I do it exceptionally well."
--Plath "Lady Lazarus" (click to read)


I think that Plath had her finger right on the waning pulse of depression. Depression is a cycle, mostly. It may not feel like one, but it is.

I'm going to do an experiment, since I have just been roused out of my ignorant days of happiness and hope by the punch in the jaw of the fist of reality. I've just had another handful of teeth knocked out by depression again.

Here's a quite tame expression of clinical depression for your observation.

On the surface, we have the steady throbbing emptiness of total despair that wastes away at the soul.

The threadbare linen, the white shroud that haphazardly clings to the being.

Then we have the being, the hard shell and the center that is in all actuality a whirlwind.

It does not take much to start depression back up again because it never really goes away.

A tooth pulled, a finger sliced, a black eye-- always affirmed with those everlasting aches.

The heart, bruised and tarnished with years of stains and regret and sweat-- false hope and false dreams-- finally learns to beat for no reason other than to write.

I write because I can. Everything can and will be taken away from me with time. Bluntly put, time destroys everything and somehow my touch causes empires to crumble-- not because of my power, but because of the shrug in my shoulder and the void in my eyes-- because I fail and am a failure.

I guess maybe the last thing I have is the alphabet. That is funny to say, but it is true. A word, some words, a lie, some lies-- it's all the same-- it all comes out the same way and reaches the same end-- with a gigantic accumulation of absolute nothing.

The hopes of youth, the hopes of passion, the hopes of victory-- the hope of something-- all disappear

--From my hands.

--Just give it time.


This is a tame example. It's been edited and watered down so no one gets too scared or disturbed.

Most people with Bipolar Disorder commit suicide during their manias because they know what is coming next-- the fall...and the crushed spirit and broken bones: Incapacitation.

If you understand metaphors, then you can see what I'm driving at here.

The desire to be pulled to the grave, as I related before when I quoted from "Tithonus".

Nothing is lower than this moment.

But it lasts forever.

I know why Plath put that tape on the door frame and put her head in the oven.

Do you?

© Megan Snider

Family Therapy © Megan Snider

"There is nothing wrong with me but myself."
--Franz Kafka

I think, in my opinion, Franz Kafka is the poster child for the relationship between the child with mental illness and the parent. Kafka had, it seems to me, anxiety disorders and I know for a fact that he had Clinical Depression.

When I read Kafka's diaries, sometimes it is like looking into a mirror. I mean that with no disrespect because on many occasions I have referred to Franz Kafka as my "dead boyfriend".

That's why he never calls.

Seriously, I suppose this should be done, because I've gone through similar struggles with my own parents. In one respect, I understand what Kafka says to his father and in his famous "Brief Der Vater" ("Letter to Father"), on certain days of the week, I feel ashamed that sometimes my parents may blame themselves for my condition.

Let me say this once-- aside from chemical imbalances, passed on traits, and shared attitudes-- my condition and my parents have absolutely nothing to do with each other.

Mental illness starts up in little ways-- maybe you don't notice at first or maybe you do-- when you hit 23-25, you're usually exhibiting full-blown symptoms. This is what I read and, from my point of view, it is certainly true. In my senior year of college (I had two senior years LOL) I began to really break down. Of course, various events and attitudes have helped to set me off, but that can't be helped. I have always had Panic Disorder, but when it set it again something else came with it.

As far as "dealing" with mental illness goes, NO ONE has the capacity to cure it. Parents, doctors, and even the mentally ill themselves can do similar things and gestures, but the best result is a suppression of illness-- not a remission. My own doctor gave me pills that gave me involuntary muscle spasms/rigidity/tardive dyskensia for three hours. What does that say?

I do resent, honestly, being told to be positive because I feel like the same treasures that other people find in their lives were not created for me to enjoy. I feel like I live in this fringe of society for various reasons and that my life is not entitled to joy and companionship or anything along those lines. I don't just "feel" that; I believe it.

Cycles in my life have convinced me that I am simply not going to have the things I want; that all I can hope for at best is to bury myself in pages and ink pens and web pages and pretend like being alone and being mentally ill doesn't effect me.

I think symptoms are beginning to pile up in my life. Within the last week and a half ago I completed 32 published articles. Yesterday I sat in front of the computer screen and cried. Today I felt the familiar feeling of not wanting wake up.

But that had nothing to do with my parents.

I do not blame them for my illness and I am proud of the legacy I come from. I resent the "positive attitude" talks and the "self-fulfilling prophecy" talks. I resent the fact that when I am upset, I must be having some sort of specific woman's problem or be having hormonal issues. I resent the fact that people with AIDs or cancer get to live "brave" and "noble" lives, while people with mental illnesses are just insane.

Franz Kafka said something to the effect that he felt like the point in the crack of a cup where the pressure is applied the hardest. I agree. Emily Dickinson never came out of her room. When she began to fall in love with a man whom she had been exchanging letters with, she quit writing. I have fallen in love with men and then said to myself, "It's time to stop now." And I've snapped the necks of plenty of my dreams. T.S. Eliot wrote in "The Wasteland" that he could connect nothing to nothing with his hands. I agree.

When I make comparisons between authors and my condition, sometimes people think I am claiming to be as great as they are. No, I'm not. What I'm saying is that it helps me to know that geniuses had mental illnesses, too. When they wrote, they brought their conditions-- purposely or not-- out into light and into the arena of speculation. If you can't see how I feel, then you could go read one of these authors and figure it out to a small, small degree.

Not only that, but these writers are revered. They didn't go around drooling, with red eyes, and monster claws. But, they did suffer in some way or another.

My doctor is not sharing my diagnosis with me. I specifically asked and he specifically said nothing. So, aside from Panic Disorder, Agoraphobia, and Clinical Depression with Psychotic Features, I am left to choose between two disorders to account for the rest of my diagnosis.

At the mention of those prior disorders, I have no doubt that some people reading now fear me. It's alright, I've been down that road before. I just hope that if you are one of those people, that in your hour or HOURS of need, society will also snicker and laugh softly at you, too.

But, my parents did not create these diagnostic criteria and they did not push me into them. It's like I'm in a locked closet door and they're banging on the other side. It's like we're looking at the same picture, but I am looking at the portrait upside down.

To all parents of children or "adult children" with mental illness: IT'S NOT YOUR FAULT.
To all the people who have mental illnesses: Find comfort in what you can.

Understand that you cannot understand your child and also understand that your child cannot understand you all the time. Understand? (Ha ha. Get it?-- "Understand..." Well, I'd like to see you do better...)

Anger comes from fear, sadness and regret from realization. Over time these usual feelings of doubt, pain, torture, and anger become real somehow. You begin to feel like your life will never change. You will go on loving the same people without them loving you, you will have the same conflicting desires to be seen and disappear, to yell and shut up, to cry and scream, to fantasize and to realize.

The reason your children don't believe you when you try to help is them is because they don't believe themselves. They no longer believe nor belong in their own dreams, aspirations, and fantasies. The realism of county mental hospitals, rounds of horrifying drugs PROMISED TO HELP, days of isolation of staying in bed, inabilities to find a mate, a purpose or comfort have all been bent down and formed with the weight of realization.

My mom said to me the other day in response to something, "I know what I am."

Well, I know what I am, too.

And I hate it.

That does not mean I hate you. I hate that as parents and children, we no longer understand each other.

It was once common for mental illness theories to center around mothers. That was the fifties. Those theories are now debunked and not accepted by the mainstream of psychiatry treatment practictioners.

For reference, they were called "Refrigerator Mother" theories. They were called that because they centered on a mother who was cold and did not nurture enough in the early stages of a child's development.

In reality, I have more trouble with my father than I do with my mother.

Actually, the term "Refrigerator Mother" simply makes me hungry. Refrigerators are a good thing for me-- think of all the food they have in them. That is a delicious theory.

Now I kind of wish I had a refrigerator for a mother.

But I don't.

No one does anymore , because no one did to begin with.

© Megan Snider

Tardive Dyskinesia IV: Antipsychotic Interactions © Megan Snider

This shaking keeps me steady. I should know.What falls away is always. And is near.I wake to sleep, and take my waking slow.I learn by going where I have to go.
--Roethke "The Wakening"

ALL antipsychotics can cause Tardive Dyskinesia

--Even the new, "safer" ones.

The only antipsychotic shown that has a low risk of Dyskinesia is Clozapine.

Here is a list of common antipsychotics:


Amisulpiride (Solian)

Aripiprazole (Abilify) "New" and "safer"?

Clozapine(Clozaril)

Olanzapine (Zyprexa)

Quetiapine(Seroquel)

Risperidone (Risperdal)

Zotepine (Zoleptil)

Chrlorpromazine (Largactil)

Flupenthixol (Depixol, Flupenthixol,Fluanxol)

Fluphenazine (Moditen)

Haloperidol (Serenace, Haldol) -- This is what got me.

Loxapine (Loxapac)

Pericyazine (Neulactil)

Perphenazine (Fentazine)

Pimozide (Orap)

Prochlorperazine(Stemetil)

Promazine

Sulpiride (Sulpitil, Sulpor)

Thoridazine (Melleril)

Trifluoperazine (Stelazine)

Zuclopenthixol (Clopixol)

© Megan Snider

Tardive dyskinesia III: Symptoms © Megan Snider

This shaking keeps me steady. I should know.What falls away is always. And is near.I wake to sleep, and take my waking slow.I learn by going where I have to go.
--Roethke "The Wakening"

Every case of Tardive dyskinesia looks different.

The common symptoms of Tardive dyskinesia are as follows, but please note that there may be other unique symptoms not listed here. Also note that ALL of these symptoms are painful and uncontrollable.

When the E.R. doctor asked me to rate my pain on a scale of one to ten, I said, "Eight."
I will highlight in yellow, for the sake of my memory (in case I forget), what I experienced.

Common Symptoms:
Involuntary, repetitive movements
Grimacing or "smiling" (fake facial "expressions")
Tongue protrusion
Lip smacking
Lip puckering
Pursing of the lips
Rapid eye blinking
Rapid movements of the extremities/ convulsing or jerking
Impaired movements of the fingers
Rapid movements of the fingers

Unique, Unlisted Symptoms not listed that I experienced:
Sneering (fake facial "expressions")
Grinding of the teeth
Thumb paralysis or twitching/flexing/ holding thumbs "outward"
Claw-like posture of hands
Uncontrollable blinking (see rapid blinking above)
Neck stiffness and pain
Arching and spasms of back
Extension of arms
Eyes in a locked, upward position
Impairment in speech (see tongue protrusion above)
Locked position of muscles for long periods of seconds
Contractions of muscles
Movement of brow, eyes, and eyebrows (fake facial "expressions")
Pinching, claw posture of fingers

© Megan Snider

Tardive Dyskinesia III: Causes © Megan Snider

"This shaking keeps me steady. I should know.What falls away is always. And is near.I wake to sleep, and take my waking slow. I learn by going where I have to go."
--Roethke "The Waking" (click to read)

This is the most important part of the blog for those on antipsychotics. Please, read this very carefully.

Tardive Dyskinesia is caused in two ways:

1.) AN INGESTION OF A LARGE DOSE OF ANTIPSYCHOTICS.

2.) INGESTION OF DOSAGES OF ANTIPSYCHOTICS OVER A LONG PERIOD OF TIME.

Tardive Dyskinesia can manifest itself at any time it chooses to do so.

One dose may trigger it or 2,000 may trigger it.

© Megan Snider

Even after you stop the antipsychotic it may remain permanently.

Even after you stop the antipsychotic it may recur periodically.