“I Did X, Chucked My Meds, Now I Feel Great”

I really need to stop this trolling habit, but it’s so addicting. Yesterday it was trolling for stories on bipolar disorder. This time it was alternative health. Right there I should have known the amount of BS that I would encounter. I’m not a spiritual person by any means, at best, I’d convert to reformed Judaism because I get along with the Jewish culture very well. But spiritual healing is something I rank with homeopathy as criminal enterprises that should be shut down and prosecuted. Why so extreme? After all, they’re just practicing their beliefs. However, those beliefs kill. And peddling beliefs that jeopardize other people’s lives is in my opinion, criminal. Just like refusing insulin to a diabetic child because your beliefs don’t allow it. There are facts in the world, and medicine holds claim to some of those facts, and I believe that laws should be based on fact first, especially if you claim to be able to cure people without facts.

The most entertaining ones are Reiki and things dealing with chakras. It’s difficult to even get past the bizarre color analysis and then the sometimes suggested “looking at colors” to alter moods. As far as I know, and I grew up in an orange-red painted room, colors don’t influence my manias or depressions. But what is scary is the anecdotal support for these things. Hence the title of this article. Someone with a mental illness chucked their pills and voila, the world opened up. This is a meme that is carried over into boards like CrazyMeds. People adopt some behavioral/nutritional pattern, chuck their meds, and now they’re fine.

For the record, I haven’t come across anyone who was schizophrenic that did this and now feels fine. Probably because the disease is so marked by psychosis that it’s easy to identify when something is working or not. But I did encounter it a lot with people who were depressed or bipolar. Also, for the record, I did not find anyone who was severely depressed who made these claims. Again, that might be because that too is very clearly marked in its mental state. That isn’t to say that there are not people who make claims like the title who have severe depression or schizophrenia, but in my limited search capacity along small blogs and CrazyMeds, I did not find them.

For depression, it’s understandable that getting rid of medication might help. There is a growing debate over the efficacy of antidepressants for anything but severe depression. In some cases it might make things worse. This happened to both my sister and my sister-in-law. Antidepressants didn’t help them and actually made my sister suicidal for years until taken off of the drugs. Antidepressants can have these paradoxical effects. Just like opiates don’t sedate me, but up me and can induce a mild hypomania. The effects are probabilistic, which means that there is a chance that something else happens. In the case of the miraculous recoveries after leaving antidepressants, it very well could be that they fall into the slim margin of paradoxical effects. It’s even happened to me, where bupropion (Welbutrin) pushed me from feeling horribly depressed to trying to kill myself just to escape the depression. I don’t fault “western” medicine for this, I simply realize that there are risks as well as rewards for every medication out there. The brain is unique and complex, bizarre side effects are bound to happen in some people.

So yes, sometimes getting rid of these drugs is a good idea, especially if they are not helping or the side effects are intolerable. But to move from “it didn’t work for me and X number of people” to “no one should take these and adopt my specific regimin” is a horrible induction. First, it sees a small population as a representative for a larger one, dismissing the reality that a larger number of people are helped than harmed by the drug. Secondly, it demonstrates a narrow understanding of the mind by saying that a specific avenue of action is appropriate for everyone. In reality, to get these drugs to work, it isn’t a set and forget system. Constant updates with a psychiatrist or an internal medicine doctor are required to make sure that it is working or if something else will work.

With bipolar, it gets even more scary because of the lack of knowledge about the disorder. For starters, ridding yourself of mood stabilizers, especially lithium, provokes manias. Obviously you’ll think that it was a smart move because you’re flying high on the world. It’s scary, but mildy amusing, to read some of the posters because it’s clear that they are manic just by the disorganized nature of their writing. It’s the kind of thing where after reading it you think to yourself “someone’s off their meds”. As testimonials go, these are not exactly the best endorsements for people who are bipolar or know people with bipolar because the signs are so bluntly obvious. These are short term endorsements and most testimonials don’t disclose how long they’ve been off of them.

But there’s another kind of bipolar testimonial. The “I’ve done X, gotten rid of my meds, and Y years later I feel great”. It sounds very convincing. It’s not the short term mania that happens after withdrawing from lithium or other mood stabilizers. In fact, it sounds like they’re on to something. After all, these people have been off meds for years, they must know something we don’t. This is wrong again and even more dangerous than the above experiment that will lead to a very quick crash after the mania wears off. It’s dangerous because they’ve mistaken a few years without a mood cycle for being cured. They’re not cured, they’re in “remission” for lack of a better word. This happens with people who are bipolar, they can go for extended periods of time with no mood disturbance. A classic case is Kay Jamison’s autobiography The Unquiet Mind, where she had mood disturbances in college, but made it through grad school without a problem. It’s not a disorder that is present 24/7 for some people. It comes, it goes, it can be triggered. And by not taking a med like lithium, which has very manageable side effects and is quite cheap, they’re setting themselves up to fail with no safety net to catch them.

To me, this is the most saddening portrait that I’ve come across. The short term withdrawer will have a psychiatrist set up and after the impending crash, will likely go on meds again. This is a classic see-saw of going on meds and coming off of them. But the long term withdrawer will lose psychiatric contact and if some major stressor brings the swings back, there is no medication or psychiatric safety net to catch them and help them. And nothing is worse than finding a psychiatrist while depressed or having to wait the weeks to see them and get the proper meds.

Most of what I’ve seen is due to a reaction to the zombiefication that psych meds can induce. Drugs like Seroquel and risperidone have this effect as well as drowsiness. But being mentally ill means you have to be an advocate for yourself. Setting up weekly or every other week appointments with a psychiatrist when going on a new drug is crucial to getting the dose or the drug right. And being forceful and not tolerating the side effects is key to not becoming zombied. And the energy spent on integrating a whole new life style, be it gluten free, reiki, or anything else, that energy could be put to use in finding a proper medication. You don’t have to be a zombie or accept being a zombie, there are a lot of pathways to try. And those pathways are less likely to set you up to fail than dismissing them all.

Klonopin Withdrawal – 2 Weeks In

I’ve had to take a step back in my titration off klonopin. I was supposed to be off of it in 4 weeks, now it’s 6 weeks. The change was just too sudden and the complications were too many.

At first, it was the usual physical symptoms of shakiness and anxiety. Those I could deal with. I even had some mild paranoia, again, that’s fine with me. It might sound strange to some readers that having a constant feeling of an impending panic attack is manageable, but it is. There’s something about cycling several times in a day that makes anxiety seem more of an afterthought than as a present danger. I obviously took breaks and kept a relatively stress free lifestyle to manage these symptoms. I’m relatively lucky as a student to have this summer vacation where I can relax. But I also think that being bipolar (or schizophrenic or other serious mental illness) has a hardening power. Where two years ago, anxiety was high on my list of problems, but now psychosis has replaced it and anxiety just seems like something I’d rather not do. It’s like going to work an 8 hour shift while sick. Unpleasant, yes, but no longer in the “worst things to go through” file.

Part of it also comes with the shift in psychologists. I’ve gone from mindfulness to social rhythm therapy and cognitive behavioral therapy. That change has produce massive results. The rhythms set up by SRT helps keep my moods in check and alerts me to any changes. And the CBT has me constantly challenging my thoughts. So rather than just letting the anxiety pass as an afterthought, I assault it, question it, and it often dies down to a certain level. But even if I don’t use CBT, the anxiety just no longer bothers me as a symptom that I really care about. I’d rather be off klonopin.

What’s getting to me is the pain. For a while I was very uncomfortable in general. My skin crawled and was hypersensitive, so everything was painful. I was shaky and weak like I hadn’t eating in two days. And then on top of it came the migraines and the leg pain.

When I was younger, I had chronic migraines. As in, I would have a migraine about 5 times a week and an underlying low grade headache 24/7. I no longer vomit or dry heave with migraines, I just go comatose. I lay without moving and my eyes are fixed in a position where they cause me the least amount of pain. That’s when it’s bad. If I really need to do something though, I can still get it done. 10 years of experience with them has increased my immunity to them. Still, they are horrific and feels like someone is drilling into my eye with a blazing hot drill. And that is not an exaggeration. While a bike mechanic, I had the unfortunate experience of a bike chainring (the large gear in the middle of the bike) stab into my back and then rip a 4 inch gash down my back. I’ll take that any day over a migraine. Migraines also make me into a very un-chummy person. I don’t snap at people, I don’t have the energy to do that. I just bitch and everything annoys me. I also look like a drug addict since hot or cold showers (and in between), feel horrible. So my appearance is pretty bad. I can’t exactly look for jobs looking like that.

The other thing that it’s brought back is my old leg pain. I’ve had it since high school and it went away. But it’s incredibly painful. I had a little bit of it before withdrawal, but I’ve noticed that the frequency has increased. It’s not pressure sensitive, so walking or relaxing doesn’t change the pain level. It’s just insane swelling that puts pressure on my nerves causing them to fire constantly. And the swelling used to be immense, I have stretch marks on my knees where my knees swelled up to the size of grapefruits. Now it’s not so prominent, but the pain still is. The only thing that I can imagine that would hurt more is if someone was using bolt cutters to take off my leg. And withdrawal has magnified that to an unbelievable level.

There are also cognitive deficiencies. It’s a problem that philosophers call updating a belief. I’ll believe that it is tuesday, when in fact it is wednesday. And even using my phone to remind me of the day, and even doing things in sequence that are supposed to happen on that day. I will remain surprised that it is in fact wednesday and not tuesday. I have a belief that it is tuesday, and no matter how much data is thrown at it, I won’t update the belief to the belief that is wednesday. As such, I’ve had to rely heavily on my phone to get basic things done on time. The problem is also not something that happened on klonopin. While on it, I would become confused about the day or time, but if I concentrated, I could update my belief. That doesn’t happen anymore. The information comes in and goes out.

All that said, the pain, the cognitive problems, I am much more myself. My girlfriend has noticed it and I have noticed it. I’m more interesting again and interested in other things again. It’s like a veil has been lifted and I can see and think again. The powers of my cognition run into problems with the pain, but you’d be amazed at just how well you can think while unable to move lest you find an uncomfortable position. In addition to that, on good days where I’m not in pain, my powers of creativity are back in full force. I was initially afraid of taking an art metals class because I wouldn’t know what to create. But in the past week, I don’t even have to think hard about it and have 4 ideas of what I want to do, all marrying the art of metal with mathematics. It’s that wonderful world of sub-mania thinking, where there are no blank sheets of paper. Just possibilities and you have to choose one.

Hopefully, the slower progress will decrease the incidence and level of pain. I’ll give it a week. If not, I’m hunting down something and trying it. Nothing too strong, just enough to take the edge off. Surprisingly though, the pain has done nothing to impact my moods. Same with the withdrawal. I’m at a very comfortable and happy 8-9 days up with 1 day down. That’s a ratio I can get behind.

Hidden Complications of Medications

Withdrawal has not been that kind to me lately. I’ve been going through approximately a migraine a day. On top of that is leg pain. It’s an old leg pain that I’ve had since high school and it largely went away as I got older. It would flare up now and again, but it was manageable. And by pain, I mean crippling pain that shoots through all my joints from the knee and below. My toes even hurt.

Before, it wasn’t a problem. I would take prescription levels of ibuprofen and that would take the edge off of it. Granted, it would tank my stomach and I would feel sick and have a lot of heartburn. But at least I wouldn’t be in crippling pain. And after my back injury, I was introduced to another NSAID called Ketoprofen. That stuff is wonderful. It took care of severe back pain, sciatica, and my leg pain. Also, for migraines, I could take excedrin. It wasn’t perfect, but it took the edge off and I could function again. I can no longer take these drugs. Any of them.

The reason for these is lithium. I cannot take ibuprofen, aspirin, or naproxen (aleve) because they will increase the serum levels of lithium and push me toward toxicity. In fact, besides tylenol, there are no over the counter pain killers that I can take that does not mess with lithium. But it gets worse. All NSAID class drugs do this. So no COX-2 drugs either. What I’m left with are anticonvulsants and antidepressants (and opiates).

However, anticonvulsants are not a reality because of possible complications with lamotrigine (lamictal). All of them score a moderate interaction on the Drugs.com interaction checker. Worse yet, the best ones not only take a while to work, but can decrease the amount of lamictal in my system. That could have devastating mood impacts. So anticonvulsants are pretty much out because they are slow and interact with another one of my drugs.

Finally, there are tricyclic antidepressants and SNRIs (like welbutrin). There are two problems with this. SNRIs make me suicidal and a little homicidal. Even at low doses they destabilize me. So no matter how effective they are, I simply cannot take them. As for tricyclics, like amitriptyline, they too are antidepressants with a risk of mania. This effect is exacerbated by taking olanzepine.

And there’s one other. A low level opiate, tramadol, also interacts with both olanzepine and lithium causing increased risk of seizure. This is because it acts on both the D2 and D3 receptors in the brain. So even low level opiates are off the table because of the medication cocktail that I’m on. Which is disappointing because tramadol is the least likely to get me hooked on another narcotic.

This just reveals the hidden complications of medication. Drugs like lithium and olanzepine interact with nearly everything. And once you throw in lamictal, everything goes out the window. And adding in bipolar disorder helps clear away the remaining drugs. The only things left for intermittent moderate to severe pain are powerful narcotics like hydrocodone and oxycodone. To some, that might sound nice. But after withdrawing from one drug, I’d rather not do it with another. They are also sedating, which is something I desperately want to get away from after taking clonazepam for so long.

However, I don’t advocate dismissing these drugs because of the complete lack of access to no nonsense pain killers. It would seem strange to jeopardize one’s mental health because you can’t take ibuprofen anymore. And I’m definitely not going to stop taking these drugs simply because I have days of pain. Even if right now I’m very badly medicating myself with a little alcohol and tylenol. What it means, in my opinion, is that if you have severe pain that isn’t handled by tylenol, get to a general practitioner and find out a medication right away that you can take. I was stupid and didn’t set up a primary care physician and am now in the lurch for not doing so. Instead, I’ll have to rely on my psychiatrist for pain meds until I can get into my July appointment, and that’s a position that I don’t want to put her in.

It’s also a very good reminder to double check every interaction with every drug because even common and safe drugs like ibuprofen can have relatively devastating effects. Drugs.com has a good one that lists the severity of the interactions and what it does. Also, talk with your pharmacist about these things. I’ve found several good ones and they know off the cuff what can’t be done or what little tricks can be taken to work around complications. It’s their job, and my psychologist informed me that there is a strong movement amongst pharmacists to demonstrate that they are more knowledgable than doctors about medication. Ask questions, they are more than happy to inform you about the latest research that they have read. Plus, and this is just me speculating, I think that they like the sexier drug cocktails that pose complex interactions. It’s a stretch to figure it all out. It’s like my experience with the university health clinic, where my doctor was more than willing to act as primary care after finding out that I had a herniated disk. I think it’s a break from the norm, which is always more interesting to intelligent educated individuals.

New To Bipolar? – My Ever Changing Views on Meds

The longer that I’m on medications and the more that I’ve had to experiment with them, the less straightforward it appears. It should be a normal course for anyone, that experience heightens the nuance of someone’s view on a particular subject. It’s good, it’s healthy, and it’s natural.

Earlier this morning I was thinking about whether I would recommend trying medication to new people or even to my old self given all that I’ve been through. I’ve had a rough year and a half with about 6 months of it in complete sedation and obliteration. These drugs are powerful and going slightly overboard with them can be devastating. It’s enough to make one think that the cure is worse than the disease at times. But that’s a snap judgment about the short term.

One the one hand, without knowing that zyprexa is such an effective medication, I would have stayed in a mental ward for a long time during my severe winter depression. And while it initially stripped me of emotions at a higher dose, it led to the discovery that a very small dose can control even my most severe psychotic states. It’s a long term realization from a short term loss.

Same thing goes for klonopin. I’ve been on it twice, and I should have learned from the first time on it to get off of it fast. But I didn’t. And now I know. It clearly works for controlling depression, anxiety, and mania and is cheap and effective. Granted, it took a while to find out all that it does, but it’s part of my armament against dangerously extreme moods and anxiety.

Then there are all the other psych meds that I’ve been on. The horrific experience of going on abilify, the failures of seroquel and risperidone. They all cost me time, money, and energy. One would think that after a while I should just give up. Or if you’re starting out, that the energy that it takes to try all these meds is worse than the energy it takes to manage the moods on their own.

I reject those ideas. I’ve always been on the side of finding a minimum level of dosing to help stabilize me and then allow psychology to help with managing the rest of the ups and downs. And that takes a lot of energy even with the meds. But the energy that I invested in finding the meds that work for me will pay off. One can think of it in terms of net gains. While in the short term I might have spent a lot of energy finding the correct medication, that energy will be saved in managing the severity of my moods. It’s restoring me to a functional level. It might have taken a bad year to figure it out, but I’m talking about the rest of my life as well. And that life will likely be longer because of drugs like zyprexa helping me out during severe depressions that will ultimately crop up a few times in my future.

I’ve also written about mood cycling before (though I cannot remember the post’s name) where as time goes on, they become easier to trigger and grow in how extreme they are. I might have been functional at one point in my life with the mood swings, but as time went on, the highs went higher and the lows went deeper, landing me in a psychiatrist’s office with suicidal thoughts. And when I went off of medication in a drug holiday, I went from a psychiatrist’s office to a mental ward. It’s best to think of bipolar disorder as a progressive disease. It doesn’t stand still and stay the same. It gets worse. It’s similar to epilepsy in many ways. So locking it down and controlling it quickly is for the best. This bad year has ultimately succeeded in getting my moods in a safe confined range where I still go up and down, but never reach anything dangerous.

Furthermore, it might be strange to think of it this way, but trying drugs that failed is a learning experience beyond just learning that drug X didn’t work. These drugs push your mood and brain around in ways that you never experience in ordinary life except for extreme circumstances. As a result of being over medicated and the feelings attached to that, I have developed a hyper sensitivity to where my mood is at any given time. Seeing what it is like to not have manic or depressed thoughts, and be rather normal, has shown me what sort of dialogue I should expect with each one. And just based upon a quick categorization of desires, motivations, and a few minutes of internal dialogue, I can tell exactly where I am and how severe my mood is. All these failures have taught me more about my mind by showing me alternative states of mind.

It’s kind of like when I had migraines every few days. The triggers were plentiful and over time I learned to avoid them. They were mainly food triggers and smells. Getting the meds right was on par with finding all the triggers for my migraines. It’s a lot of trial and error and with error comes horrific pain or zombie like states. But it pays off in the end. And in terms of migraines, I developed a sort of six sense for triggers. From just smelling something, I can accurately predict whether it’s a trigger. Took 10 years to get that, but it’s saved me from a lot of migraines. What it took was a lot of sniffing and letting my brain correlate the smell with what I ate. Just like now I have an intuition about what is going on inside my mind at any given moment. I just naturally catalog what is important and I constantly check it.

I’m never going to say to anyone that finding the right medications is easy, fun, or quick. I was lucky and did it relatively quickly and I don’t know how people go on for longer. But it’s not only worth it in terms of getting the stabilization and the energy saved from that, it’s also worth it in terms of learning more about one’s mind and how it operates.

Benzo Withdrawal and Contentment

Going off klonopin is a beast. It’s going to take 4 weeks to ease me off of it, and that’s a rather moderate addiction to it. Benzodiazepines are a class of drug that is powerful, wonderful for what it can do, and over long stretches of time, quite dangerous in terms of addiction. The speed of which I’m being taken off of it is relatively fast too. If I can’t handle the withdrawal, then it’ll take somewhere around 6 to 8 weeks. It is a drug that you never want to stop cold turkey. Not only could it be destabilizing, but the withdrawal would be horrific.

I’ve already written about how my first day off of it produced some major aggressive thoughts and a general seething hatred for people. And it’s just hate, unlike mania, where you despise people or see them as beneath you and therefore dislike their existence. This was just hatred.

But that’s just the change in mood that comes from it. There’s also everything else that has come along. For starters, as much as I do not like the drug, I now have times that I crave taking it, especially at night where I’m approaching my next dose. And it’s not just desiring to have it, it’s the bare thought “I need it” that comes up. This is likely because the withdrawal symptoms are things that I would usually take the drug for. So the addiction is not only chemical dependency, but psychological dependency. And the symptoms are not very pleasant. I have much higher anxiety than usual after 10pm. I feel anxious for no reason and have a lot of tightness in my chest. It feels like I’m going to have a panic attack in the near future. But that never comes, so I’m stuck in the waiting room expecting the worst and resisting the urge to take the drug. There are also skin sensations associated with this. I feel everything and can experience pain very quickly. Pricking my finger on a knife goes from a silly mishap to a lightning bolt traveling up my arm. If I didn’t have the baby dose to take every night, I would be in hell after a few days. They say quitting cigarettes is hard, that’s not even close to this. With cigarettes, you have cravings that can become intense and you can get moody. You don’t want to scream and shout at random people or feel like you’ve just watched the scariest movie in your entire life and now can’t sit in a room alone.

Thankfully, klonopin acts rather fast, so after my nightly dose, it all goes away and I can sleep. Still, the only thing I can do in those times is watch TV since I don’t have the attention span to really appreciate a movie. But the kind of TV that I watch can help. Sitcoms are a no go unless they’re absolutely surreal, like Spaced. Sitcoms are also very loud and fast. And by loud I literally mean the way that they are mixed. It’s a normalized and compressed sound to make everything sound even and easy to hear. But it lacks realism in that voices don’t wander in and out of volume levels. It’s quite unnatural and more like commercials than like real sound. The best choice I’ve found is Wire In The Blood, which is a british crime show. The darkness of it soothes my aggression and the slower pace over 90 minutes keeps me on track. It’s very much like The Wire and Prime Suspect in its involvement and development.

It’s all rather unpleasant for those few hours every day, but the upside is that I’m much clearer during the day. I forget less and do more without constantly putting it off. And I think I have a theory for why that is. Klonopin makes me too content when I take it.

It’s like Brave New World in that klonopin is a mood. It’s contentment with how things are. That’s brilliant if I’m anxious, depressed, manic, any sort of heightened state where I’m no longer functioning properly. It tones things down. It makes me content. And that’s perfect for handling the extremes of moods. But in everyday life, that’s a bad thing. Being too content with things means that I don’t feel anything when I procrastinate. There’s no anxiety or anything and I don’t feel bad about doing it. I just pass it along. It also means that I don’t see as much need to get things done in general. As I said in another post, klonopin shifts me into neutral. My brain can be whirring along, but I can’t connect to it to do anything. It placates me into oblivion and I have to struggle to do anything. Not to mention the obligatory naps 2 hours after taking it.

And now that I’m cycling again, I can see the difference in starker contrast. During my ups and downs, I’m never fully content with anything. I always see room for improvement and desire to improve it. That was lost when I did not cycle. And the drive from that perception of things not being in their right place makes me do the things that I do. It makes me rework things and be creative. It’s necessary for me to do things. Klonopin took all that away and made me ok with how things are. It doesn’t make me happy with how things are, just ok. And being off of it for the past few days, I’ve noticed it more. I’m trying new things, new movies, new kinds of music, I’m adventurous again in my tastes rather than being satisfied with what I already had. So for that, I’m grateful to finally be tapering off of it. Just in time for the summer mania season to hit too.

Beyond Medicine, How Being Simply Scientific Keeps Me Stable

I’m a huge fan of science. So much so that I study it as a subject of philosophy as well as reading things like the Feynman Lectures for fun. Science is a part of my life. Some would call it a religion, in that I “believe in” science. That is, that I believe that it holds all the answers. Short answer to that is that I do not believe it holds all the answers. In fact, most any scientist that you ask that question to will provide the same answer, science is incomplete.

But it is not the end product of science that I hold on to. Which is where the religion question gets things wrong, as do other critiques. The current product of science has the possibility of error always built into it. It could be wrong. Now that might seem to be a problem in itself, and then warrants skepticism about science, but thinking that way would be wrong too. Just because something can be wrong, doesn’t mean that it is wrong. Nor does the possibility of something being wrong warrant skepticism in the opposite direction. One must have grounds for being skeptical.

So what does this have to do with moods, and in particular, psychosis? A lot actually. Obviously, we turn to science for meds to help with our mood swings and psychosis. It’s not a precise science, but it works well enough to get the job done. It has in my case. But we can also use the systematizing nature of science to our advantage. Plotting moods along many different points and charting them to gauge how well a drug is doing and how fast is it working. I need to form a new charting system, but the old one works well enough. But what it does is transform what is a bundle of subjective feelings into a more precise and organizable data set that we can look back on and see if progress has been made in the right way. It’s not rocket science. In fact, it’s done automatically by google charts and spreadsheets. But it’s turning a scientific eye to what is going on in my head and keeping track of the things that I care about. It’s also a recognition that my memory is faulty and remembering subjective moods when you are no longer in them is difficult. It’s the escape from the subjective to the objective, and that is part of what a scientific enterprise is about.

The skepticism and scientific format also helps with things like paranoia. I often get paranoid thoughts when my meds are getting low. I’ve written about them before, but they are mainly cabals of individuals working against me or trying to harm me. These thoughts pop up like a flash and I instantly believe them. It’s taken practice to even identify when these thoughts happen. The way to deal with them is quite scientific. It’s an element of Cognitive Behavioral Therapy to identify the thought, then ask whether you have evidence for it, then whether there are alternative explanations, and finally whether one does not know. After going through these three things, it’s fairly easy to dismiss the thoughts. Yet, it’s a very scientific approach to psychosis. All that’s being done is hypothesis testing. There is nothing fancy about alleviating paranoia, other than simple hypothesis testing and the right medication.

It still goes deeper than this. And a lot of people do it without thinking about it. But there is a strong distrust of one’s own subjective feelings. For me, it could be in a mood state and I have to distrust my reactions to things. Or it could be a psychotic state and I have to distrust my own thoughts. Finally, I put a significant amount of trust in other people to tell me what to do, e.g. my psychiatrist, girlfriend, and parents. Part of being scientific in one’s enterprise is not believing everything that comes in. In fact, that’s very dangerous for those of us who are mentally ill. Yet, remote corroboration is always necessary in scientific testing. It’s old fashioned, but it’s a corner stone.

It actually irks me when I talk with other people who are rather new age-y and believe that the subjective experience is everything. It completely neglects the reality of mental illness, where that is not a privilege. Rather, it’s the opposite. Without thinking that hard about it, we rely heavily on other people to live properly and function as a normal(ish) human being.

This does not mean that we immediately reduce to a materialistic metaphysics, but it does suggest that practicing simple scientific steps has plenty to offer in terms of remaining stable. It’s not hard to do these things, and it’s probably rather obvious once they’re pointed out. But just because it’s obvious after the fact doesn’t mean it’s not going on or shouldn’t be continued or honed into something better. And personally, knowing that I’m mentally ill, I know that I cannot take the world at first glance. I always need to be skeptical of what is going on and whether something in my brain is influencing me in a certain direction. This could be said of everyone, but the general populous isn’t concerned with equalizing their mood cycle like I am. Maybe it’s a perverted gift that I’ve been given to know how my brain is influencing me in certain directions; but I know it, and I control it through simple scientific operations.