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.

Do You Enjoy The Darker Side of Things?

This is an inquiry piece because I’m interested in light surveys of how people with mental illness differ from people I consider “normal”. Yesterday I was interested in the different mood states that may fall outside the usual mania-depression model. Today, I’m interested in whether our minds are a little darker than others.

The inspiration for this comes from my girlfriend and our new roommate, along with the movie Hunger Games (which I desperately want to rant about, but I’ll refrain). If you don’t care to hear how this started and the anecdotal evidence that I have, you can skip to the end.

To give some background, my girlfriend has suffered from severe depression in her life at least once, if not a few times. And she and I share a very dark perspective on things. I didn’t like Schindler’s List because I thought it was too fluffy (and art-house gimmicky). We both love metal and incredibly angry music in that we find these things relaxing. And after watching a movie like The Last Circus, I was giddy with happiness and she was grinning from ear to ear. This is a movie about two murderous clowns in fascist Spain who lose their minds and enter into a bloody back and forth to woo their masochistic woman of interest. We thought the movie was great. We both enjoy the darker things in life and even have an aversion to things that are too sweet. That’s me and her.

Now our new roommate and I went to see the Hunger Games. I wasn’t expecting to like it, and the cinematography did indeed suck, but I was willing to give it a try. If you’re not familiar with it, the main idea is this: in order to punish an old uprising, the provinces are required every year to submit two children, male and female, between the ages of 12 and 18, to compete to the death against all the other “tributes”. Only one will survive and will be declared the winner. Sounds deliciously dark in a Battle Royale kind of way (by the way, that’s a great Japanese comedy about children killing each other). But, and this is a spoiler alert so don’t read any further if you really want to see it (but it’s not a big spoiler), the main character never kills anyone with intent.

My new roommate and I got into a disagreement over this in that she liked that the main character didn’t have to really kill anyone. The way that I saw it, it was a cop out. In a life or death situation where people are hunting you to kill you and will not cease until they find you or you kill them, chances are you’re going to commit some degree of premeditated killing. And the movie would have been the better for it. It would have been darker and gotten into the psychology of what these games do to people. It would have made the spectacle of it, even the idea of us watching it, something closer to perverse. But that’s not what my roommate wanted, she wanted something lighter.

And this I’ve noticed in other members of my family. None of them have that much of a dark side. And while some do like darker things, like preferring the Empire Strikes Back over New Hope, there isn’t that cold relishing of the darker things that my girlfriend and I appear to have.

So the question is quite clear, hopefully, at this point. And it applies to anyone with a mental illness because I’m interested in it across the board. The question(s) are: do you enjoy darker things more than other people you know,

if you had to choose between a movie that was dark and one that was fluffier which would you pick,

do movies/books/music that make these leaps into darker material not only please you but excite you,

and finally, have you noticed a divide between tastes in people who are mentally ill and those without a mental illness?

Living With Someone New

This August I’ll be moving in with a second roommate. She’s a very nice person and we lived together at the co-op for a while before. I believe that she’s vaguely aware of my mental health, but since the last time that I saw her, it’s become more pronounced. My mood swings are much more apparent and I have psychotic episodes. And there lies the question, just how much should I tell her and what sort of responsibilities should be forced on her? I’ll explain more of what I mean by these two things.

I have no problems with telling her the details of my current health. I’ve gotten used to the idea that I need to inform some people of the goings on in my head so that they don’t take everything I do seriously. Personally, I think that it would be a very good idea to tell her so that she doesn’t take my irritable moods seriously. I’m fairly good at controlling them with medication, but that’s never 100%, it only takes off the edge. In that sense, I’m in favor of informing her of some of the details just so she doesn’t get caught up in my bizarre swings and why I can seem like several different people in the same day. So in that sense, I think that informing her about my mood swings would be very good.

But then there’s the other aspect that she doesn’t know about, my psychotic episodes. To the best of our knowledge, they’re under control, so there is less of a need to inform her. Still, they might erupt out of nowhere and she should know what could happen. It could also make an episode far less frightening if she knows what is going on and that this is almost “normal” for me. The hesitation that I have with this is that psychotic episodes are perceived by and large differently than extreme moods. Even though I find that psychotic episodes are no more scary than something like a dysphoric mania. In fact, I’d rather have a psychotic episode than a dysphoric mania as my psychotic episodes seem comparatively kind and complacent. But back to the point, revealing the psychotic side of myself might make things uncomfortable in our friendship.

The other aspect to this is something that is sadly obvious but never talked about. It’s that living with someone new means that I’ll force a certain set of responsibilities on my new roommate. It isn’t that much, but little things, like having my psychiatrist’s phone number on file in case something goes wrong. Telling me to take some of my medications if I’m starting to act out of character. For instance, if I’m becoming very manic and becoming very bothersome, it does us both good to tell me to take my klonopin. But things get more iffy with psychotic episodes. I need to take certain medications but not twice (as I seem to try to do). It’s also a great responsibility to deal with someone completely delusional for the 2 hours until the medication works. There are other things that need to be done as well. Keeping me away from all medications and knives, and possibly ledges (we’ll be on a second floor), are some of the things that just need to be done when I’m in those moods.

In all fairness and likelihood, I’d like to be told by my roommate if she had such circumstances, so I’ll tell her. It would be much worse if the event would arise that I did have a psychotic episode and she was unprepared for it. And I don’t need to reveal every last detail of it. I need only tell her that I can become delusional and hallucinate, and that I’m safe to be around as far as is known. The only danger that is present is me taking my pills twice or cutting myself early on. And that my medication takes care of the problem very quickly. And as for the manias and depressions, if I start to seem hyper and irritable, tell me and I’ll take some medication. And if I’m depressed and things need to be done, just give me one task to do so I don’t get overwhelmed and get nothing done.

Amnesia and Psychotic Episodes

I went to see my psychologist the yesterday and we talked a bit about my psychotic episode.

As I suspected, he was rather freaked out that I was hallucinating. Even more so that I could communicate with them. It doesn’t appear that alcohol is the only factor in these things. Partly because I’ve had drinks before and this has never happened. It was definitely a trigger for the event and as a result I’m staying away from drinking too much from now on. What also caught his eye was that this was unlike the previous psychotic episode. That time I just thought I was being watched by invisible people and had to make them stop looking. No voices or anything with that one. He explained that in many psychotic episodes, there is continuity between them, so in future episodes I might hear The Council again. But that’s for another time.

The amnesia though was possibly a good thing. At first I thought it was bad and I hated not being able to know what went on in my mind. There’s no information to learn from or be able to predict when other psychotic episodes will occur. It’s frustrating. However, given the magnitude of the event, he said that it might be a good thing for me in terms of living in an unaltered reality. Apparently, psychosis can be isolated in these events, but gradually bleed through into reality. Causing disturbances and undermining the grasp on reality. Not remembering anything might be a blessing in disguise in that my normal reality will not be impacted at all from it.

He did praise me for one thing though. In both my psychotic episodes, I recognized that something is wrong. In the very first one, half way through cutting up the cardboard boxes to put up in the windows, I thought something was wrong and I should call my psychiatrist. I couldn’t exactly tell what was wrong or why it was wrong, I just knew that it was off. I told Dr. A that people were watching me and I couldn’t see them (though I didn’t know why that was wrong) but he did and then began my escapade into half a dozen medications at the same time. This time around, I didn’t have the impulse to call, but I had another one that I had engrained in me, it was to take my medication. I had horrible memory so I tried to take it more than once, which would have screwed me up really badly and endangered my life. But it was a persistent idea that I had to take it. And in taking it, I literally woke up the next morning as normal as one would be after a night of drinking. He emphasized that this wasn’t just because I had formed a habit and had to take my medication on a regular basis. That might have been strong enough to come through in such an episode (though I was manic at the time so probably not). Rather, the reason that it came through is because I have a very strong attachment to my medication as something important. In actuality, it’s one of the most important things. My view of my medications as life saving devices is probably what made me think of it. So now I’m very happy that I have that impulse and attachment, because it could have probably gotten really ugly if I didn’t.

Went to the Psychiatrist Today

As the title subtly suggests, I went to see my psychiatrist today. I told her about all the things that went on and the reaction was not what I expected. From my past psychiatrist and current psychologist, I’ve come to assume that all mental health professionals have a degree of unflappability. Even from Dr. M I noticed that she seems relatively unflappable when I was describing my suicidal gestures. She didn’t miss a beat and calmly but forcibly suggested that I should check myself in, but was almost ok with me waiting a day or two. It seemed relatively common place in her book to work with someone suicidal. That’s very reassuring to be on the other end of since it reduces what is scary and unknown to commonplace and manageable.

I didn’t quite get that this day. Rather, I saw some shock on her face. Not a whole lot, but enough that I picked up that this was not a common thing and that something big had blown up in my head. What really seemed to throw her was that I didn’t just hear voices, but that there was an interactive council involved that decided what I would do. I didn’t press the issue further than that. What I drew from our discussion is that this was lurking in the background the entire time as part of the intensification of my illness, alcohol just provided the catalyst for it to appear. Yay… So there is definitely no more alcohol in my future for the next few months. Partly because of the episode, also because the change in medication was a moderate dose of klonopin (though this time I’m enjoying it more).

As for the blacking out, she doesn’t think it had anything to do with the alcohol. If it was the alcohol, then I would have bumbled about a bit and gone to bed. I wouldn’t have spent an hour and a half out of my mind and swinging between moods. Rather, as Inchlabel pointed out, the state of mind that I was in was so alien to my normal mindset that I cannot remember it at all. I’m still scared by that reality. That I can be so radically altered that I have no recollection of what happened. Moreover, it’s been plaguing me that I was incredibly lucky that I made it home before this happened. If I was lose on the streets, I would be a hallucinating mess supercharged by manic energy that punched through a wall several times. Or worse yet, I could have been paranoid while like that. I could have seriously injured someone and then never known about it.

Obviously, I’m treading more carefully around any substances. I had already written pretty much everything off, but now I’m just sticking with low amounts of caffeine, nicotine, and maybe 1 beer once in a while (but not for a while). Before this happened, my responsibilities were solely focused on me being productive and accomplishing the things that I wanted done. However, after this event, I now realize that I need to do it for other people as well. I don’t want to terrify my girlfriend ever again and I especially do not want to get into a situation where I might harm someone without having the slightest clue as to what I am doing. As such, this has really globalized what I am doing and that I need to keep control to protect myself and others.

I must have a word though for those who might be casual readers or do not know much about mental illness. As you can see from above and the previous post, I was in a very dangerous state. I could make mince meat out of a wall and feel no pain as I did it. Coupled with a paranoid and psychotic state, that could have been very dangerous. But there is a flip side to all of that. After taking my prescribed medication, the next morning I woke up, sore from sleeping on the couch, and was calm and back to normal. That’s just the way that it is with mental illness. I have my prescriptions dialed in and after I take them, I go back to normal. Then I see a psychiatrist and we form a game plan to make sure it doesn’t happen again. It’s no different than someone drinking angrily and losing control, except that I have pills to stop me before I do anything stupid.

A Very Big Psychotic Episode

I did something really stupid that led to an even more terrifying episode than I could have imagined. A while back I was helping clean up the music venue that I co-own and I brought over some beers to make the night a little less dull. I brought enough for three beers for each of us, and they were light beers. So, I thought, there wasn’t much of a problem with getting drunk. By the end of the night, and I double checked this with the people who were there, I had five light beers over the course of about six hours. I haven’t had that much in quite a while, but gauging from my past tolerance and the fact that that’s a little more than two really good beers that I would normally drink, it shouldn’t have fucked me up like it did. But it did. It made me increasingly manic and delusional along with some frightening strength. For instance, while tearing down a wall I decided to see if I could punch through it. I did, three times in a row. Then I went home.

I can remember the night fairly clearly since I did not drink all that much and by the time I went home I had stopped drinking for about an hour. The alcohol should have been leaving my body by that stage, but instead my mania started to really ratchet up. I don’t remember making it home, but my girlfriend does. There’s a good hour and a half that I have no recollection of, it’s a complete black out. I’m unsure of whether it was the alcohol or not, but I’ve never ever blacked out from alcohol before in my life and in past years when I was drinking heavily while manic, I would drink what I did that night in an hour. Which makes it all the more frightening, I hope I blacked out from the alcohol even if that means that I was incredibly stupid in drinking beyond my current tolerance.

The reason why I hope that is because I want to know what I did and what I need to watch out for. If I cannot remember my episode or other episodes, I cannot grow or learn from it. So, I’m hoping it’s a one time thing.

The morning after, I woke up on the couch. I didn’t know how I got there at all. The bedroom was locked, my lithium was missing, and all the knives were gone. After my girlfriend woke up, she filled me in on what details she remembered. When I got home, she initially was mad at me because I half-planned an evening with her and broke it. But after that, I started making very little sense. I must have begun hallucinating fairly early on and my moods must have been cycling insanely fast. When talking with her, apparently my voice would change every few minutes and I would exhibit different personalities. Not in the multiple personality kind of way, they were all me to some degree, but it sounds like I was changing very fast. Then came what were definitely auditory and visual hallucinations.

While I was smart enough at that time to take my pills, I forgot about them 15 minutes later and tried to retake them. My girlfriend took them all to the bedroom along with knives and pretty much anything that I might hurt myself with. In the meantime, I was talking to people who were not there. And this must have been a fairly complex hallucination because the voices were not individual, but collective. At some point in the evening, while I was resisting the idea of her protecting me, I “consulted with the council” by talking to them. This council apparently was more rational than me at the time and I said to her that they “ruled in [her] favor”. It got creepier, I was also talking backwards at times.

There was also a delusional manic side of it. I believed that I would become a great screenwriter some day. I kept reassuring her that I would always write her into it because I loved her. And apparently I’m really handsy too.

I’m still processing this emotionally. Like I said above, I really hope that I had a black out due to alcohol and that it isn’t a normal function of my psychotic episodes. I also feel incredibly stupid and guilty for drinking when I know that I shouldn’t. The really scary thing is that I have had that level of alcohol recently and not only was not that drunk but it cleared up fairly quickly. The fact that this was lurking in the background the entire time is frightening. I’m also devastated that in my stupidity I put her through what must have been frightening as well as blowing her off. I could make excuses and say that I clearly was not myself that evening, but that doesn’t help that I brought it on. Good news is that I’m not violent when like that, and I’m reasonably complacent. My voices don’t seem to tell me horrible things or feed my paranoia. The other good news is that they cleared up by morning after taking my medication.

Yet, hearing about it has shaken things up. The fact remains that I don’t know what those voices were saying, so I can’t tell anything about what they are or their motivation. Not to mention that it’s really frightening to hear about how far gone I was without any ability to remember it. As a result, I’ve just turtled emotionally since then and read comic books trying to escape for a little bit. After all, it’s not every day that you wake up and find out that you have visual and auditory hallucinations with paranoia on the side. It’s just left me feeling completely disconnected from the human race. But, that’s starting to come back. It was a good move that I took the semester off.