Rico: Zyprexa tapering

December 21, 2017

Hi all,

Here is an update on what's been happening - last night 21/12/2017.

Yesterday, I took the lithium 750mg in the morning and 750mg in the evening.

After the evening dose, I felt quite nauseous and generally sick. I drank lots of water, and felt better.

However, in trying to get to sleep last night, my thoughts were all over the place and mind was racing. I became quite anxious to the point where I really felt like admitting myself to hospital - the racing thoughts/anxiety and panic were pretty bad.

I know that this is not advocated on this site, but in desperation last night I took 10mg of Valium and 1 Temazepam (sleeping pill) to get some relief.

My key issues at the moment is that I am highly anxious - I am worried about everything, regretting the past, I feel like a failure, I am overwhelmed by even all the information on this site and not sure what doctor I should trust or even what my diagnosis is - it's very, very hard. I am overwhelmed by life in general and I am literally taking it one moment at a time.

My tolerance to stress is extremely low and I feel my brain is completely damaged. I am scared of being disabled for life and at the mercy of mental health people all my life. This is incredibly difficult.

Would love to hear from you,

Rico

December 22, 2017

You seem like a very strong person.. You have much more to overcome than me. However, I am also sharing your fears. Especially the brain damage part. I am actually afraid to take a measly little 50 mg trazadone because I woke up and had a horrible night last night. It’s difficult living in fear. You sound young and pretty determined. I feel for you. Hang in there.

December 22, 2017

Hi Again Rico,

7 hours ago, Rico said:

Yesterday, I took the lithium 750mg in the morning and 750mg in the evening.

After the evening dose, I felt quite nauseous and generally sick. I drank lots of water, and felt better.

I'm a little concerned about this. I'm not sure if your doctor is aware you increased the dose or if you have been having blood tests for lithium levels? If your doctor is not aware of this increase they would not have the opportunity to send you for another test. Lithium toxicity can present in many ways, including nausea. I'm speaking from experience. Please be careful and get a blood test....K

December 23, 2017

Hey Rico -

It sounds like you started tapering the lithium too close to your end of Zyprexa.

Your Zyprexa was a fast taper and you may still be feeling side effects from that. Additionally dropping your lithium in half right away - precipitated a crisis which ended in multiple hospitalizations.

Looking at that - less than 6 months ago - your symptoms are quite normal.

Yes, it's the lithium kicking you around, but I reckon you weren't stable when you decreased it last time.

My first suggestion to you is to drink plenty of water. It only takes one dehydration event to land you in dialysis. Should I say that again? It only takes one dehydration event to land you in dialysis!

You have complained of dehydration at night, which probably means you are not getting enough water during the daytime.

In addition to drinking plenty of water, you should be getting good electrolytes. I remember when my brother played high school sports, they always kept salt tablets ready for dehydration events. We've learned quite a bit since the 1970's, and table salt is not the solution.

There are products available at the chemist - the main brand is Pedialyte, but there are others. I recently found a form of a fizzy tablet that you drop in your drink and it adds electrolytes to your drink (and makes it fizzy, too). I found these tablets were great for travelling.

My kidneys are damaged from lithium. So I have dehydration events and symptoms of diabetes insipidus (fancy words for I have to pee a lot). After years of struggling with this, I've learned to tell when my kidneys are irritable, and I offer them Himalayan salt (another way to get electrolytes - can also include Australian lake salt, or Celtic sea salt), electrolyte drinks, and barley water.

Here's my recipe for barley water. I have found that barley water is soothing to irritated kidneys, and actually seems to heal them somewhat. Kidneys don't heal as well as the liver (or even the brain, for that matter) - so the magic of barley water is a completely unknown factor. I know that if my kidneys are irritated, and I have a barley water drink (I don't drink it straight, I dilute it with water or juice), the kidneys settle down.

Okay - once you get the dehydration in control, it's time to look at tapering.

2x a day is fine. It doesn't matter if the lithium is extended or immediate release. Your doctor wants to keep you on it forever (more than likely). If you complain to him that you are having dehydration issues, he will rip you off so fast and put you on valproate and your head will be spinning.

Let's see if we can manage your dehydration, and taper you down.

Lithium is not like other psych drugs. It has a muffling effect, rather than a twiddling effect. (these are technical terms! ) So you might be able to get away with quicker 10% tapers.

You still should taper by 10% but with any luck, you can maybe even shorten the taper time to 2-3 weeks instead of a month.

I did dry cutting of my lithium. Over the course of my taper, I ran a smaller morning dose and a larger evening dose. Because of your dehydration at night, you may want to reverse this.

Your first taper will be a whopping 150 mg! This should help immensely! I had 2 sizes of pills to choose from - 450 mg (extended release) and 250 mg (immediate release). Once you cut the pills it's all immediate release.

Are the only tablets you have the 750 mg? Do you have any other size tablets around the house?

To get 150 mg taper, you will remove 1/5 of ONE tablet (perhaps the nighttime one).

Your dose is 1350 - which would be 3 x 450 mg tablets (no pill cutting required).

Let me know what questions you have - and maybe fire me a PM when you've posted, as I'm not around the site very much right now.

I hope you see the Sun today, and have a great holiday!

Edited December 23, 2017 by JanCarol

December 23, 2017

Hey Rico -

If you can get 3 x 450 from your doctor, complaining of dehydration events - I would suggest that you take 2 in the am, and 1 in the PM.

And drink lots of water!!!!

LOTS of water!!!!

And remember those electrolytes!

December 23, 2017

Thank you so much JanCarol!

How much water should i be drinking?

Also, i would love some assurancr here. Right now, i am feeling very depressed and just out of it. I went to the shops with my partner and could barely concentrate on anything and i am getting pains in my head.

I feel brain damaged to be honest. Should i get a CT scan or MRI? Or is this just the effects of the extreme stress from the last two weeks?

Thank you and Merry Christmas everyone.

Rico

December 23, 2017

Moderator note: These calculations were based on 1800 mg lithium, I didn't have the correct amount of 1500 mg per day at the time.

Oh Rico!

I felt like lithium made me so sluggish. Like - I would tell my foot to move, and it took 6 seconds for the signal to get to my foot. It made karate an interesting challenge, and I'm still learning how to move my body. The lithium put a big, damp wet blanket over everything - so - being depressed is normal.

I know that's not super assuring, but it might help you to realize - it's not your depression, it's the drug.

How much water? Start paying attention to your pee. How much pee is there? Is it dark and strong, or thin and watery? Strive to keep your pee on the clearer side, and when you start drinking water - the first few days will be a lot of peeing, but your body will adapt to more water after about 3 days. You want to feel a full bladder before you pee, and you want that pee to be pale in colour.

I am hesitant to say "drink 2 litres a day" because - when you are compromised by lithium, you might need more, and if you are getting good electrolytes, you might need less. Start by paying attention to your body.

I still take lithium, but I only take amounts which are equivalent to what you would find in "natural lithium water." When I studied lithium water, a light bulb came on. That ratio was a gift from Mother Earth = 0.2 mg / litre is a natural amount of the mineral. So if I take 0.4 mg elemental lithium (the actual amount of elemental lithium in my 1.67 mg of lithium orotate), then I only need 2 litres of water a day for it to be a natural amount. I reckon my kidneys will not take more, and I know I can drink 2 litres of water a day.

You are on 1800 mg (please update your signature) of lithium carbonate, which is 95.75 mg elemental lithium. 95.75/0.2 mg/litre = 478 litres of water! In order to match the amount of lithium you are taking you would have to drink 478 litres of San Pellagrino water per day. Or - conversely - in order to convert your lithium into a healthy amount for your kidneys, you would have to drink 478 litres of water with your current dose. I don't believe that 478 litres is humanly possible at the dose you are on. (and I'm not going to mention what lithium does to your thyroid. I lost mine.)

The electrolytes are vital, too - my mom, after she lost a kidney, had to drink a lot of Gatorade. But the Pedialyte dissolving tablets are better (less sugar, kidneys don't like sugar, either).

You will feel better once you can start to get the toxins out of your system. I know you say you are not ready to taper, but the symptoms you are complaining of are symptoms of too much lithium.

Maybe consider a taper in the New Year?

I hope you see the sun today (it was too hot here!)

Edited January 3, 2018 by JanCarol

December 23, 2017

Rico, it might be a good idea for you to think of minimizing the lithium, rather than going off it completely. You've made the mistake at least twice of quitting it too fast.

You may wish to carefully taper down, as JanCarol advised, but not go off completely at the end -- stabilize on maybe 150mg twice a day (or whatever minimal dosage keeps you calm) for maybe 6 months or so. (Still, get regular kidney function tests.) Then, very, very slowly taper lower towards "natural" dosages, as JanCarol suggests.

It's important for you to take care of yourself by maintaining good behavior and keeping yourself out of the hospital. People who are susceptible to symptoms identified as psychotic might get such symptoms as part of withdrawal when they go off the drugs too fast. You want to be especially carefully to keep your nervous system stable, getting plenty of sleep, avoiding alcohol and recreational drugs, etc. -- don't take risks, live very moderately.

December 23, 2017

Thank you Alto for replying, i really appreciate your help. I am struggling a lot right now with depression - its quite severe. I just took my night dose of lithium and feel even more depressed. I'm not sure what's causing what at the moment as I have been depressed ever since the hell of last week.

Also, no one is supporting me anymore with tapering etc. I have pressure from my family and girlfriend to "take your medication" and wait till I see my doctor on the 9th January. This is the same doctor who helped me get off zyprexa in the private hospital.

I was very close in the last hospitalisation to be put on community treatment order and be foribly injected with Abilify. My family and i stood beside me and assured the doctors that i will be ok on just lithium. And during hospital, i was ok. I still dont understand why it started making me feel so sick after discharge.

I am too scared right now to make any changes. My stress tolerance is close to 0 and the smallest thing can depress me.

Sorry if i have repeated stuff here, but am writing this while i am severely depressed.

Thank you for your suggestion and time.

Rico

December 23, 2017

Rico, doctors are often more receptive to the idea of minimizing the dosage, rather than going off completely.

Since you have had some success in maintaining your behavior at low dosages, perhaps your doctor would be receptive to a plan to lower very slowly to 150mg twice a day.

If you present this to the doctor, be very calm and business-like. Any sign of emotion makes them nervous. I would explain the side effects you feel and suggest you might do fine at a slightly lower dose to begin with.

Is the idea of being on lithium at all depressing to you?

December 23, 2017

Hi Alto,

Yes, the idea of being on lithium does depress me because of the long term effects on my body. I am also quite confused because i have had so much different advice from different doctors.

The doctor i will be seeing on the 9th of January has already told me in the past that he wants to keep the lithium at the therapeutic level. I doubt that since i have had many hospitalisations since the last time i saw him in May that he will be receptive to me being on a lower dose. The therapeutic range for me usually means at least 1350mg of slow release lithium.

I have a lot of fear too because i have literally being on every drug for bipolar. I have lost credibility with everyone and I need to make sure from now on that any changes are blessed by my doctor AND i have private health insurance active - which is not until mid February.

Unfortunately, i just need to ride this out until 9th of January or find a new psychiatrist who is willing to help. So far, all everyone around me sees is that without medication, I end up in hospital. No one though, seems to be listening to how I feel.

On a lower dose of lithium, i was able to work and start functioning again. Unfortunately, the job was mega stressful and the reduction in lithium was too fast.

My memory is shocking right now. I dont even remember what happened. It was however a very bad psyhotic episode. I am surprised that i even recovered that quickly.

I have learnt something important though, rapid reductions if lithium send the nervous system into a mess. I felt safe making a rapid reduction only because the doctor advised me to. In the past, my body handled rapid reductions, but now my CNS is much more fragile.

Thanks to this site, i will make sure that any reductions suggested by a doctor will follow the 10% rule.

Thank you for your help.

Rico

December 23, 2017

Hi Rico

I am sorry if my last post caused you any additional stress on top of all the stress you already have. I should have been a lot more gentle and reassuring, I'm sorry I wasn't.

I have a similar history to yours- I was put on nearly every anti psychotic drug including the very old "first generation" ones like thorazine and stelazine (forcibly, not by choice, so I totally understand the fear of being forced to take meds) I was on high doses of lithium for years and went off cold turkey, and it was not good. It took me a year to get straightened out after that- I also became psychotic. I ended up committed but was able to recover quickly, just as you noticed. I think that means that the psychosis was from the rapid withdrawal and NOT part of any underlying "mental illness".

I was put back on a lower dose of lithium and did experience some depression but I've found that every single time I've had any kind of "nervous breakdown" that the drs labelled a 'psychotic episode" or a "manic episode' or even a 'mixed episode'- all of those were followed by a short period of depression. I used to think of it as my body/brains' way of taking a break after all that upheaval.

Like you, I've also been on lots drugs: antidepressants, mood stabilizers, anti psychotics, sleep meds and benzos (haldol, depakote, zyprexa, very high doses of seroquel- I came off all of these cold turkey; also a long list of antidepressants, from elavil to celexa to zoloft to massive doses of lexapro) I was on cocktails of drugs with rapid switches in meds and dosages. The drs had no concept of how damaging this was/is to our brains. :/

The reason I tell you this is that I am now almost 62 yrs old. I was on one or more psych drugs since I was 18yrs old (1974!!).

I just finished a less than perfect taper off of lexapro and am now psych drug free.

It was a rough journey for sure, but I am recovering and am very very close to being almost totally healed.

I know we are all different, but I am not an especially strong person. I don't think I'm an usual case or anything like that. But I always believed that I would heal and I have and continue to heal.

I am not brain damaged. I truly believe that you are not brain damaged either.

Our brains and bodies are always working towards healing.

I really believe you are going to recover as well.

You are going to get better, and this part of your journey will be behind you. I really firmly believe that healing is possible for all of us, and that it's practically inevitable if we just allow it and support it.

You are very strong to have gone thru all that you have so far. Do what you believe is in your best interest, given the pressure you have of possibly being forced to take meds against your will.

Soon, the drs will lose interest in your case and you can likely lower your dose without them giving you a hard time. I routinely took less lithium than I was supposed to, and found ways to get out of the blood testing (while knowing that my level was going to show up as lower than therapeutic, if I was concerned about dehydration I would have gone for the testing) You can work out a way to decrease your dose when things are more settled, I think.

again sorry if I came on too strong in my previous post. Wishing you a quick transition out of the depression. You've got a great attitude for someone going thru so much.

all the best to you in your recovery

December 23, 2017

Thank you for this encouraging post.

I sort of need urgent help from anyone right now....this is what is happening:

I am finding it hard to stay asleep and i am mentally exhausted. I slept for a few hours last night and woke up anxious. Its not deep or restorative sleep either. When i close my eyes, it feels like my brain is all "mushy" and the thoughts just wont stop.

I did some breathing exercise and managed to get back to "sleep".

I havr woken up now feeling anxious, tired. I am jusy mentally completely exhausted. I want to go back to sleep, but i cant.

The stress and anxiety of the last two weeks was extreme. I can still feel the physical effects of it in my brain. I feel like i cant do anything at all. I have absoluyely zero energy.

I keep thinking that i should go to hospital before i deteriorate, but i really don't want to go to the public system. I feel that tired and exhausted that i dont care if i get more drugged up, i just want relief - does that make sense?

What can i do to get better and avoid hospital? My brain doesnt "wind down" like it used to. I am exhausted, but my brain will simply not turn off. Can you relate to this level of exhaustion/anxieyy?

What helped you? I am even too tired to search the self help section of this site.

Thank you

December 23, 2017

hi Rico

what you are describing is incredibly common for withdrawal from all types of psych meds unfortunately. the feelings you describe - I've had them all, and so have many of us going thru this. you are not alone in this. these are common experiences of withdrawal, not fun, but not at all unusual. You can get thru this, as we have too. try not to fight it, try to just accept that this is the way it is FOR NOW. I can assure you, it will NOT be like this forever, it will change and you WILL feel better. Your brain is busy doing some work on healing right now, and unfortunately, that healing can feel bad, but it is a good thing.

I know that's small consolation right now, but it means soon you are going to be feeling BETTER. ok?

Sleep disturbance is quite distressing but it's NOT dangerous. I recently read a book that put a lot of my fears to rest, about getting "enough" sleep. We all sleep, whether it feels like we do or not. I agree, feeling as if you have not slept is disturbing, and not being able to shut off your mind is also distressing.

but it's not dangerous and it's not going to harm you long term to be like this.

so hopefully that will help reduce your anxiety even if it's only a tiny bit.

I understand totally the wish to be drugged out of this uncomfortable state of being. It's entirely up to you whether or not you go that route

However, if you have become sensitized to medications, as many of us have, the drugs they give you for sleep may not work, or they may in fact make things worse. You can have what is called a paradoxical effect, where you get the opposite of the desired effect.

there's no way to know in advance if you'll have a "good" reaction and get some sleep, or if you'll have a bad reaction. One way to limit the potential bad effect is to take as tiny a dose as you can get.... which usually is not an option in a hospital setting.

When I got like this and was feeling like I might be a danger to myself, I got an RX for a med from the ER and then brought that home and took a TINY TINY TINY bit of it, to see what it would do. Initially, it did give me a bit of sleep, but not very much, and each time I took a bit more, the good effect was less, and the bad effects were greater, til It was just making things worse.

that's one person's experience, however. we are all so different, there's no way to know if this would be a good thing for you.

as far as getting your mind to shut off, There are a few things you can try- you may get at least some temporary relief.
I found that reading something I was intensely interested in, tricked my mind into relaxing and I could fall asleep for a bit

Or watching a TV show that I really wanted to see thru to the end- nine times out of ten, If i wanted to see what happened, I'd fall asleep and miss the ending!! if I am watching something I'm not interested in, I don't fall asleep.

so the trick is to distract your mind with something that truly holds your interest

when you're going thru the rough patches, sometimes the only thing that interests you is reading this forum and searching for ways to find relief, and there's nothing wrong with that. Just keep it in the back of your mind to check in with yourself- if reading something here adds to your distress, go and find something else that does not increase your anxiety.

try different things to see what works for you. for some people that might be soothing music, for others, yoga or meditation

Get up and do something that's not physically taxing, even though you are tired, it may help distract you enough to put you in the frame of mind where when you do lay down, you'll be able to sleep. Even if you dont fall asleep, try to enjoy just resting. Tell yourself that resting is good for your body, nearly as good as actual sleep. Even when it does not feel restful, your body IS getting a benefit from it.

try to focus on anything that feels good or ok right now. In what ways is your body feeling ok? are you in any pain? I hope not! if there's no pain, you can tell yourself, ok this part of recovery is hard but I don't have any pain, so that is GOOD.

this is all I can think of, off the top of my head but I'll come back if I remember anything else that might help

in the meantime, do you have any epsom salts? or can you get some? a nice relaxing bath in epsom salts can help you feel better.

you might wish to try that.

December 23, 2017

I'm really sorry you're experiencing insomnia, Rico. It could be that your system still needs to settle down from your recent round of going off and on drugs.

You might find a little melatonin to be helpful for sleep, take at nightfall and turn off the lights. See Melatonin for sleep

Since you're 1350mg lithium for now, there's not much you can do about the dosage. I don't know what you mean by "therapeutic dosage"; it seems to me that adverse effect indicate the dosage is too high. "Therapeutic dosage" has to be individual.

Here is an interesting article about low-dose lithium http://www.psychiatrictimes.com/bipolar-disorder/low-dose-lithium-different-important-tool/page/0/1

FYI Tips for tapering off lithium

December 23, 2017

Thank you both Happy2heal and Alto for this helpful advice.

If i can just add one more concern - it feels like my whole nervous system is struggling. Its not just that i am depressed and having insomnia - it feels there is something wrong neurologically. I am feeling pains in my head, sometines tingling sensations in my head and arms and just trying to think and remember is hard. I keep asking my girlfriend to take me to ER so that i can get a brain scan but she keeps telling me theres nothing wrong.

Is this just something thats going to take time or should i prepare myself for the worst?

December 23, 2017

it's just going to take time Rico. Seriously. as strange and as disturbing as your symptoms are, they are all common symptoms of dosing changes in psych meds

a brain scan will almost certainly show that your brain is normal. Trouble thinking, tingling sensations, this is all part of making changes in your meds.

you will stabilize and start to feel better. It will happen but it's going to take a bit of time for things to settle.

as hard as this is, try not to think about the odd sensations and focus instead on things that you like, things that make you feel good, or just neutral things, if you can't think of anything good.

For good things, it's good that you are able to come here and clearly write about what is going on with you. In spite of having trouble thinking and remembering, you are doing just great in expressing yourself and your concerns

You may not feel like you are doing well, and that's just part of the way the drugs act in your brain, but you are really doing a lot better than you know.

I know you don't feel that way and I'm not trying to minimize your feelings.

Your girlfriend is there with you...? perhaps ask her to , I don't know, play a board game or card game with you, or watch a funny movie, or something like that? something to distract you from the uncomfortable feelings and worries.

You are going to be ok. I am glad you've got people around you to help you thru this difficult time

that is really all it is, though, a hard time, that WILL end. One thing I've learned in my 60+ years on the planet, things always change!! things may be rough now but they *are* going to get better.

December 23, 2017

Thank you so much for your help. This is probably the worst I have ever been. Thank you

December 23, 2017

6 minutes ago, Rico said:

Thank you so much for your help. This is probably the worst I have ever been. Thank you

I'm so sorry you're going thru such a rough time. Hang in there, it is going to get better

December 24, 2017

Hi everyone,

Thought I would give you an update. I had a warm bath and a bit of sleep afterwards and woke up anxious and all over the place.

I had some lunch with my girlfriend and drank lots of water and did feel a bit better afterwards. I would say i am bout 5% better than i was before, and wanted to thank all of you for your encouragement and support.

It has been an absolute lifesaver to read positive comments when all thats going through my head is doom and gloom.

Thank you, I will keep fighting despite that voice in the back of my head telling me thats its not worth living anymore.

I hope I can make it to my appointment on the 9th without ending up in hospital. The public system is terrible and although they have many services here in Australia to reach out to, there's just way too much anxiety for me in reaching out to them because of the fear of being forcibly drugged and not listened to.

It sucks that i have lost faith in psychiatry in a way. A big part of my anxiety is that i have tried pretty much all the drugs and the public health system often give zyprexa out like lollies - which would be my worst fear being realised.

The private hospital that i was at last had horrible beds too. It was like sleeping on yoga mats. Just thinking about all this causes me to have suicidal thoughts.

Surely, there's a doctor out there who is underatanding and compassionate I think - but there doesn't seem to be any.

Thanks everyone

Rico

December 24, 2017

hi Rico,

I am so glad that you are noticing feeling a little bit better. Even though it's a small amount, believe me, it will continue to grow.

It helps to keep going back in your mind to those times that felt better. It's not easy when your mind keeps wanting to slip into a dark place, but you can do it.

when those dark thoughts are very strong, the next best thing is to distract yourself as much as possible.

I understand wanting to find a compassionate doctor, I do. however I honestly feel that you'll get better care, kindness and compassionate from friends, trusted family members and others who understand what you are going thru, then you'll ever get from anyone in the medical system.

and, what's more, you can give YOURSELF the care that you're looking for; you're doing that already by taking the warm bath, by reaching out here for support and encouragement, and by fighting the dark thoughts.

While it's disturbing to find out that you can't trust modern psychiatry, it's empowering to know that you can trust yourself. You can trust yourself to know what helps you and to seek those things out. In trying to get off psych meds, we look to finding tools and learning skills instead of reaching for a bottle of pills. It's a big transition but it's a good one. You are already doing this and you're doing great!!

You will find your confidence in yourself grow over time and eventually you will feel the strength that you already have and be able to access it in difficult times easily.

I hope that you have a place to sleep in your home that is just the way you like it, and that you are surrounded by loved ones as you go thru this hard time. Please keep taking good care of yourself.

You're going to be seeing more and more glimpses of good things in the days ahead. Look for them. They will remind you that you are on your way to feeling even better.

I am so impressed with how well you've been keeping yourself together, and not giving in to the dark thoughts.

You're doing some hard work and you need to give yourself a lot of credit for that, I think!
:)

December 25, 2017

Thank you for your reply.

I am doing better now but still a bit all over the place. My girlfriend has been extremely supportive and caring, I am so lucky. She is also not allowing me to wallow in self-pity and is pushing me to do the things like walking to the shops etc.

There is so much going on in my mind. I feel a lot of guilt about the past. I blame myself for tapering the lithium earlier this year. Although, when I did taper it, I mamaged to get a job and feel better - but the job was really stressful and I got greedy with the tapering and ended up breaking down. I can't even remember now what exactly happened other than I was doing really well at work and felt like I had my brain back.

My plan this time is to get everything in order health-wise before attempting any tapering. I would like to lose weight, stop smoking and work on all the outstanding stressors in life first. I have lots of outstanding debt and a lot of personality issues to address to.

My other concern is that I would like to work with a psychiatrist who will support me in the process. The psychiatrist I am seeing on January 9 has already told me that he wants me on lithium for the rest of my life - at the therapeutic level, or go find someone else.

And because I have had multiple hospitalisations with a diagnosis of Bipolar 1, if anything were to go wrong with because i have taken matters into my own hands, I would almost certainly end up on a community treatment order.

So, the plan is to learn to live on the current dose of lithium (1350mg) and get everything else in order before attempting any further reductions.

In a way, this is a good opportunity to learn how to look after myself and become healthy. Ironically, I am more overweight now than when i was taking the old lithium/epilim/zyprexa cocktail which my first psychiatrist had prescribed.

I am also still waking up early in the morning freaking out and wanting to go to hospital. My girlfriend talked me through how i was feeling and i went back to sleep. I am not too sure if this is anxiety or feeling sick from the lithium overnight. I took the lithium at 8pm last night and my mood crashed afterwards and I just felt quite "off". The same happened this morning when I took the lithium - i become depressed / confused.

I feel much better though taking the slow release form as opposed to the fast release one.

Thank you all for your help during this really tough time. I was so close to admitting myself into a hospital.

Merry Christmas,

Rico

December 26, 2017

Hi all,

I would like to give an update on how I am doing and thank those who supported me through my recent crisis.

I am slowly getting better and the early morning panic of wanting to go to hospital has shifted to just waking up confused and ringing up lifeline instead to talk to someone.

My brain seems to be very busy trying to process a lot of memories or trauma. I’m not sure what to call it really, but there’s a lot of confusion about the past.

I honeslty find it hard to make sense of my past. My first cruel psychiatrist could probably have an explanation for it, but he not only damaged me with drugs but reduced my entire being to a series of symptoms.

So, I am both trying to make sense of the past and struggling to understand who I am. I know in my heart that I can one day heal as a person and never have to take medications. I also know though, that I am an impatient person and lack discipline. There’s a couple of things I am sure of!

The experiences of the last couple of weeks and the support I have had from this site have really helped me to take responsibility for myself and not just abandon myself to the medical profession.

For the first time in my life - I am 38 years old - I am learning to take care of myself and manage symptoms without rushing to a hospital. I have been lucky though that my girlfriend has been here to support me. I would have definitely ended up in hospital had I tried to go through this at home living with mum.

I am still not 100% independent, but my aim is to get there eventually. I have a lot to sort out in my life that is not related to any illness or medication.

My current symptoms are hard to describe. My brain feels “different” and my concentration is pretty bad. There’s always something playing in the background of my mind and I am finding it hard to be present.

My eyes are still quite sore, but I attribute that to my brain being fatigued. My brain is constantly occupied with either trying to understand the past or worrying about how to heal.

I must admit that I have for a long time being a selfish and self-absorbed person, so I can’t really blame this entirely on withdrawal / recovery.

In fact, the massive ego I once had as an 18 year old combined with a very selfish and self-absorbed nature is partly responsible for why I had my first breakdown.

The recent breakdown has humbled me also and there are important lessons for me to learn - not just blame it all on doctors and medications.

I have a long way to go as a person, and withdrawal from the old self and destructive behaviours is probably the hardest thing I wil ever face.

I don’t believe that healing will come from simply tapering lithium slowly. If my behavioural patterns and outlook doesn’t change, then it will only take one stressful event to break again and be back on drugs.

There’s lots of work to do and I am prepared to do it.

I have complete respect now for the gradual tapering of medications and thank you all for your support.

Please bear with me as i also taper these inner demons and replace them with more positive and constructive behaviours.

Thanks,

Rico

December 26, 2017

wow Rico, that's a lot to deal with all at once, and you're working so hard. I hope you'll remember to cut yourself a break... not one of is perfect, everyone has their own "stuff" to deal with, and so many never make the step of taking responsibility for ourselves. It took me a very long time to realize that the only person who could make positive changes in my life was *me*. I'm embarrassed to say, I was a bit older than 38 when I came to that realization. But hey, better late than never, right? :/

*You* are doing absolutely wonderfully.

I hope your mind will settle soon so you can get some good rest. I think that's part of the med adjustments up and down, the brain that doesn't shut off. I think it will calm down in time.

While you are going thru all this, you may wish to take a break from figuring out your past- afterall, you can't change it, and just work on getting thru each day. I understand you want to see what you could do differently now, so that means focusing somewhat on things in the past, but don't let it consume you, ok.

Your girlfriend sounds like a lovely person, so glad she's helping you thru this.

December 27, 2017

I am having another crisis and I am very tempted to go to hospital.

I only managed a few hours sleep last night and woke up panicking and wanting to go to hospital. My brain physically felt sore.

i stayed awake throughout the day and had a lie down next to my girlfriend. Again, I woke up feeling like my mind is in fire and it will not switch off.

I am really, really tempted to go to the emergency department and just let them do whatever they need to.

i know I can write ok, but my brain will not switch off.

It’s like my brain is too scared to relax and wind down. I have been staying over at my girlfriend’s place, but sleeping next to her has been too hard.

i think I will return home where I can sleep in my own bed.

I am not sure...I just feel DESPERATE for relief and I honestly don’t know how to help myself right now.

What is going through my head is “this is mind racing because you have bipolar and you need extra medication because the lithium is not working”.

i can see my girlfriend getting more and more frustrated with me and that is stressing me too.

This is tough as again

December 27, 2017

Rico, whether you go to the hospital is your decision. You know what the results might be.

If you want to stay out of the hospital, you will need to find some way to cope with your symptoms, including not adding to whatever drug effects you might have with self-blame and imagining the worst. You are the only person who can make this happen.

December 27, 2017

Thanks Alto.

My girlfriend took me to accupuncture and the anxiety settled a fair bit.

When I was lying on the table with the needles poking me, my mind was just playing a whole range of memories from the past and I could feel a lot of fear in my body.

The amxiety gets gets worse when I start thinking that I am brain damaged and I’ll never recover.

I find that I don’t have much control when I wake up with this type of anxiety. I seem to want to run to hospital and it takes some time for me to snap out of the idea.

I don’t know if it’s neuro-emotions, brain damage or PTSD (I hate psych labels) or whatever. My mind though is playing back a lot of the past and it’s all over the place, and unhappy / confusing memories. One memory in particular was being in the seclusion room of a hospital going completely nuts because I was terrified. I have been in seclusion rooms lots of times unfortunately.

Thank you for your reply, I haven’t gone to hospital and I hope tonight is better.

I have also also noticed that smoking cigarettes (I smoke about a pack a day) stresses my body a lot at the moment.

I am going to cut back and my girlfriend and I are going for a walk right now.

I apologise for my last message that I wrote in a highly anxious state. I am starting to learn that there are other strategies. I am trying really hard. Thank you for being there for me.

The therapist also provided me with a psychiatrist who apparently doesn’t like medications. I’ll investigate this later.

Thank you much.

December 27, 2017

hi Rico

I totally understand feeling desperate for relief. this is when it can be helpful to remember, heck, no, don't count on your memory- WRITE down when you are feeling better and what it was that helped to calm you or helped you to feel better, even if it was just a distraction while you were not feeling well.

Uncomfortable feelings happen to all of us. They don't last. You are learning to wait them out.

You are not brain damaged, and you are going to recover.

Maybe when your mind is playing those memories, try to think of them as a movie, of someone else's life, even. You are not the same person you were in these past memories; you've grown and changed and learned new things. Try to put some distance between you and the memories, maybe. Let them play out like scenes that you are detached from, that are no longer relevant to you life now.
I have some PTSD type memories that plague me from time to time, and when they do, I literally will write up a note to stick on my fridge and around my house, that says "The past can't hurt me" "Memories can't hurt me"

or things like "feelings are not facts"

If I'm feeling a bit stronger I'll remind myself that I survived what happened in the past and am doing great now.

when you are feeling the fear, try very hard to stay in the present and take stock of what is actually happening. For instance, you were having acupuncture and you felt fear, but was there anything to be afraid of? were you in any real danger? Take stock of all the things that were not scary: you were with people you could trust, you could leave at any time if you felt like it, you were not in any danger. The fear and anxiety, they are just feelings.

It's ok to feel them, and then let them pass, as they always do. They are not going to hurt you. They are unpleasant but not dangerous.

For today, maybe think of all the things that are going well in your life. Think about how strong you are that you resisted the urge to go to the hospital.

Maybe put aside some time to think ahead to how you will handle tomorrow if you wake up feeling the way you did today.
Mornings are often the hardest for many of us who have gone off or made adjustments to psych meds, but as the day goes on, we start to feel better and stronger.

If you have a rough night, or wake up feeling poorly, remind yourself that in a relatively short period of time, you are going to be feeling a lot better.

While it's good to think positively, it's also good to plan for those times that don't go as well as we hoped.

make notes of what is working for you, and then add more ideas, look around the forum here, esp the self care sections, and try out different strategies to see what works for you

You're doing great. You've got this!!

December 28, 2017

Hi everyone,

Thank you for all your support over the last week, I am doing much better now and not writing this from a hospital.

I returned home last night and managed to get a few hours of quality sleep.

I attribute this forward step in recovery to the help I have received from this forum, my wonderful partner who sacrificed so much to help me, calling life line, prayer, and ultimately a change in my attitude.

My history is full of experiences and adventures and I have had lots of doctors, labels, and psychiatric drugs. I have also had a lot of spiritual experiences and dealt with my pain through various addictions (not illicit drugs or alcohol, though I have tried marijuana a handful of times and found that it is really bad for me).

It is unfortunate that experiences which were special to me at the time and meant something were dismissed by doctors as "psychosis" or "mania" or whatever they wrote down.

It is also very unfortunate and distressing that treatment under Australia's mental health system (especially the public system) is not pleasant and very drug orientated.

The distrust in the mental health system, and the scars it has left in me (especially the local hospital in my area - it is a shocker!), made my anxiety worse because I felt absolutely helpless in a time of distress. Since I had recently been discharged, another admission would have more than likely resulted in a Community Treatment Order (CTO). I was nearly placed on one in the most recent admission, and experienced a lot of anxiety in the process of fighting against it. I also believe that use of Ativan (Lorazepam) during my admission had a lot to do with my symptoms after discharge (the lorazepam was ceased a week before discharge upon my request because, thanks to this forum, I was educated on the effects of withdrawal and the potential for addiction). I did however, take 2mg of Ativan the night before discharge because I was excited about being released and thought "what the heck, let's just get knocked out so I get an awesome sleep, I am going home tomorrow anyway". Bad idea, right?

That's not the full story, and I don't believe that my meltdown after discharge can be solely blamed on drug withdrawal. And if there is something that I have learnt over the last couple of weeks, is that there are no black and white answers to any of this. In fact, I am starting to accept that nothing is black and white or perfect. Life is indeed a mystery, and much of my anxiety has to do with wanting to know everything perfectly and be 100% sure about everything. The desire to be right and be perfect, has caused a lot of issues in my life (and so have many other defects too).

So the "triggers" (I don't even like that word or psychiatric labels, but it will do for now) for what happened after discharge has all to do with my behaviour.

I have always been used to blaming everything and everyone around me and relying on everyone to fix my problems for me and then resenting them when they can't. Shep, in a previous post once commented about my "learned helplessness". Even on this forum, there is so much evidence of me being so needy and not taking responsibility for myself.

Thank you so much Happy2Heal for telling me in your first post to try and seek answers inside of myself. You were not harsh at all in saying that. I didn't fully comprehend it at the time, but I am starting to now. I also heard on a YouTube clip about stress that every breakdown is an opportunity for growth.

Thanks to you guys and those who sacrificed themselves to help me (especially my girlfriend), I am back on the right road now.

As much as I dislike my diagnosis and in my heart know that healing is possible, there is a LOT I need to do before even worrying about reducing the Lithium. I also need to respect the laws and customs where I live which take "non-compliance" very seriously. I can only pray, that either my doctor or another doctor in the future can share my dream of healing and living without drugs. Although I am not legally bound to take any drug, the consequences of ending up in hospital involuntarily would definitely result in a legally upheld injection of an antipsychotic drug that would most likely make me very sick and the withdrawal of parts of my freedom as a citizen would be very distressing also.

If I do have Bipolar 1, BPD or nothing at all, I will only make changes to medications (and there's just one) under the guidance of a registered psychiatrist who will be willing to take responsibility for my treatment. In saying that, I will also make sure that changes are made in the context of the 10% tapering rule advocated here. The days of "psychiatrist must be right" are long gone.

I have been holding a belief that therapy would be useless whilst I am on lithium because I have "no emotions". I am not too sure if this is true or not, but I am not in a position to change it myself, so I will just have to keep moving forward regardless.

My current symptoms are: not the best sleep, selfishness, intellectual pride. defiance, ungrateful, lack consideration for other's feeling and their lives, not accepting life on life's terms, not listening to good advice (especially when my gut feeling that is right), blaming others for past mistakes (not forgiving), beating myself up and focusing on problems rather than solutions, impatience (huge problem), not trusting God or practicing my faith properly, not looking after myself or having healthy boundaries, smoking way too much even though I know that it adds to my body feeling stressed, trying to work everything out that's happened in my past even though there's nothing I can do to change it, not bearing with other's faults even though I have plenty myself, not exercising, making up excuses for not doing what is right and good, being dishonest to others - especially myself. I have told myself so many lies that I have believed a whole bunch of crap that doesn't even make sense (and then wonder why i am "confused" later, unhealthy addictions like sex, pornography and gambling (I also had some alcohol for after discharge from hospital because I had a "who cares mentality", ungrateful for the things I DO have. It was my dream to get off zyprexa (which I was on for almost 16 years).

My solutions are: to get the help I need professionally (therapy) and do the things I can to help myself, and accept that there is no "perfect" treatment where I will come out the other side healthy, happy, and living in a perfect state forever after. I have personally found that 12 Step Programs (like AA) are a great place to explore my life honestly and deal with the insanity that resides in my head. One of the steps is understanding "character defects", which I look forward to, because for a long time I used the symptoms of bipolar as an excuse for my behaviour. And in saying that, maybe such a process will reveal that I do have an underlying mental illness after all....who knows? I certainly don't right now!

Ultimately, for me personally, I need to practice my faith (I'm Catholic btw). I have been very lucky in my life with this gift of faith which I received after being discharged from my first hospitalisation. I recall saying to my mother "how can there be a God if all this has happened to me?". Up until that point, although baptised a Catholic, my sister and I grew up in a home where my parents had two different faiths (dad being muslim, mum being Catholic (although technically, dad converted to catholics just so that he could marry my mother, but he always identified as being muslim - never practised it though). My mum's assurance that God would one day heal me etc gave me hope. This hope led to discovering my true faith and involved a lot of miracles that I would be happy to discuss personally ...but never to a shrink!). I am also conscious of not offending anyone here by mentioning this, because it is something very personal. It is a major part of my story though, and the reason why I am still here today.

Irrespective of my personal faith journey, I have not being a good Catholic or Christian and have consistently done the opposite of what even good, non-religious people do. Even the simplest "treat others the way you would like to be treated" is something I have failed to do - and this is a common theme in any religion or life practice.

I have a long way to go. Although you may be thinking that I am being hard on myself, but I don't think so. My behaviour has been ridiculous and I need to change it so that I can grow up and stop being a big kid. I appreciate that others in true medication withdrawal are having different experiences, but I can honestly see (and so can you if you read previous posts), that my issues are not purely medication or withdrawal related. And as much as it is tempting to go back to why I had my first breakdown and trace it all the way back to childhood, abuse and neglect, it serves me no purpose at all now in having to take responsibility for the future. I will of course discuss these issues with a therapist, but hopefully in a constructive manner where the focus is to forgive and let go and not walk around like a nuclear bomb of resentments that is then labelled as psychotic because the overwhelming emotions lead to reckless behaviour.

Thank you again for all your support. I will keep you updated.

PS. I have attached a photo from 2012 that I am quite proud of (I am quite fatter now). I may get paranoid and ask an admin to remove it, but I wanted to share something personal with you and also show-off like I usually do!).

January 3, 2018

Hey Rico!

Great to see you with your motorbike!

I like Alto's idea of minimising your doses. I understand what you are saying when the doc says:

On 23/12/2017 at 9:08 PM, Rico said:

he wants to keep the lithium at the therapeutic level

Oh, dear. I understand. Unlike with other drugs, they have determined an actual "therapeutic window" with lithium. The range at which it is most effective, however, is very close to the dose at which it is toxic. (usually "therapeutic levels" is something determined by a drug company - but in the case of lithium, it has been around for so long, that they have determined levels below which it no longer controls mood and behaviour.)

I remember when I came to Oz, and got put on Lithium, my GP from the USA said: "Oh dear." and the words she used were "Narrow therapeutic window." This means that - the dose they want to keep you on is not far from the amount which is toxic, especially in the long term.

I got past this by making all kinds of promises to my p-doc. She said I could go lower than therapeutic if:

1. I made a contract with my husband, that he would intervene if my behaviour got extreme.

2. I made a contract with my psychologist/therapist, that she would report on me if I was too extreme.

3. I made a contract with the p-doc that I would continue in therapy during my reduction, and I would see her monthly until the process was complete.

4. I made a contract with my p-doc that I would take a 10 minute walk in sunlight every day as early as possible in the day to manage my mood. (this might help with your insomnia)

My husband, my p-doc and I made some really clear definitions, and wrote them down on paper, as to what constituted "extreme." I don't remember the paper now - it's filed away somewhere deep. But these definitions included: not sleeping for days, agitation, outbursts in public (hubby gets easily embarrassed, so that is an easy one for him), "nerves" that are sticky (as in, I get upset and cannot calm down by myself).

I also, privately made an agreement with hubby that these would have to continue for long enough to survive withdrawal symptoms (which the p-doc did not recognise) so that I wouldn't be re-drugged for withdrawal. I gave it a month. If I'm messed up for more than a month, he is allowed to get help for me.

And of course, I've always had the agreement with myself to NEVER GET CAUGHT. That means no yelling at bus drivers, no behaviour in public that could get police, ambulance called on me. If that means I don't go out in public, then that's what it means.

At a taper as close to 10% as I could keep it, and with this agreement - I survived, and you can, too.

Of course, the p-doc didn't care what I did, once the lithium levels were below "therapeutic." She thought that once it was below "therapeutic" it wasn't "doing anything." That is a lie. I still take tiny amounts of lithium, because I was so afraid that I would destroy the life I've built for myself. I will go off it when I run out of the last bottle of natural supplement, and I am no longer afraid. I have learned that only I can really adjust my own moods. If I cannot control my own mood and behaviour, then who or what can? It is up to me to do so.

I understand your desire to have:

On 23/12/2017 at 9:08 PM, Rico said:

any changes are blessed by my doctor

but remember (is this the doctor who fast-tapered you off of Zyprexa?)

On 23/12/2017 at 9:08 PM, Rico said:

I felt safe making a rapid reduction only because the doctor advised me to.

The doctor did not understand tapering or withdrawal.

You state:

On 23/12/2017 at 9:08 PM, Rico said:

i will make sure that any reductions suggested by a doctor will follow the 10% rule.

Rico no doctor that I know of will suggest 10% tapering. Not even the great Aussie doctors like Rob Purssey and Yolanda Lucire will do so. They taper faster than we do. Why? Because they are still believing the drug companies - or - in the case of these 2 doctors, they believe that getting off the drugs is more important than doing it safely. Someone who has never used or been hooked on these drugs would ever understand.

Your Zyprexa taper was too fast. So when a doctor suggests anything (it will be more than 10% , I promise. To them, 25% is considered "conservative.") - it is up to you to ask: Can I go slower? Can I taper smaller amounts?

You are suffering lithium side effects. Now, in this week before you meet with your doctor, is a good time to plan what you will say. How will you report these lithium side effects to your doctor? When was the last time you got blood tests?

If it were me, I would complain of feeling dehydrated, and ask for a small reduction, while requesting blood tests to make sure everything is okay. My kidney damage did not show up on the blood tests, but your doctor may not believe that. They love their numbers.

Are you in therapy, too? That can be a huge advantage when negotiating with psychiatrists. "I'm in counselling" holds a lot of weight with them, and as you improve, your therapist can report to your p-doc that you are doing better, which helps you taper, too.

This post is too long, so I'm going to stop here, and come back in a bit.

I hope you see the sun today!

January 3, 2018

Hey Rico!

Alto's link about low dose lithium is excellent! If I'd had that when I was going to my p-doc, she might have accepted it as evidence that "non-therapeutic levels" of lithium are still therapeutic! Print it out and keep it in your back pocket. Show it to your p-doc when you are ready to taper.

On 24/12/2017 at 6:12 AM, Rico said:

I am finding it hard to stay asleep and i am mentally exhausted.

This is more about your stress levels than it is the lithium.

Lithium is more on the sedation side of things. It's not exactly a tranquiliser, but it is not a stimulant, either. It's more of a numbing agent.

The middle of the night awakening might be cortisol spikes: http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

ALL of these drugs mess with adrenals and cortisol, and cortisol awakening is very common. If you are jolted awake, you can say to yourself: It is just cortisol. If you need to get up until you settle down (I find an hour reading something really dull helps), then fine. Go back to bed when you get tired again.

Alto suggested the melatonin. There are other strategies, too. My 10 minute walk in sunlight was key to helping reset my body clock and help me sleep at night. It also made sure I got a little zap of Vitamin D. Take that 10 minute walk in sunlight as early in the day as possible, to help set your brain up to sleep better.

Here are some more strategies for sleeping well:
http://survivingantidepressants.org/index.php?/topic/53-sleep-problems-that-awful-withdrawal-insomnia/

and

http://survivingantidepressants.org/index.php?/topic/348-what-is-the-sleep-cycle/

and

http://survivingantidepressants.org/index.php?/topic/6122-guided-meditations-calming-videos-sleep-hypnosis/

On 24/12/2017 at 6:12 AM, Rico said:

my brain will simply not turn off. Can you relate to this level of exhaustion/anxieyy?

What helped you? I am even too tired to search the self help section of this site.

Mindfulness.

Here's one:

Jon Kabat-Zinn Body Scan (I have never made it to the end of this without falling asleep!)

and look - I found this:

Shep's Guide to Guided Meditations for Mindfulness, Relaxation and Sleep

Happy2Heal says:

On 24/12/2017 at 7:21 AM, Happy2Heal said:

Sleep disturbance is quite distressing but it's NOT dangerous. I recently read a book that put a lot of my fears to rest, about getting "enough" sleep. We all sleep, whether it feels like we do or not. I agree, feeling as if you have not slept is disturbing, and not being able to shut off your mind is also distressing.

but it's not dangerous and it's not going to harm you long term to be like this.

and mostly I agree, but with one exception: Getting caught.

I have friends (and I used to, too) who experience "manic," and if you feel you are ramping up into an extreme, out-of-control state - that state is dangerous. Not because of your health, but because of your behaviour when you are in a ramped up state. It is up to you to catch your own restlessness and channel it into something - like a heavy workout - that will calm you down.

I'm not a naturopath or a doctor, but a lot of people with these mood difficulties have achieved excellent benefits with high dose niacin. Abram Hoffer, one of the founders of orthomolecular psychiatry, recommends inositol hexanicotinate as an effective no-flush form of niacin. He recommended up to 20 grams per day in extreme states, closer to 5 grams per day for maintenance. I am currently maintaining on much less than that, 1 gram per day, and you might be well on 1-2 grams yourself. Consider it. There is a little more information here: http://survivingantidepressants.org/topic/43-vitamin-b3-niacin-niacinamide/

I know that the orthomolecular people swear by it, and I have found it to be helpful too.

On 24/12/2017 at 7:21 AM, Happy2Heal said:

in the meantime, do you have any epsom salts? or can you get some? a nice relaxing bath in epsom salts can help you feel better.

you might wish to try that

That's another excellent suggestion!

On 24/12/2017 at 8:21 AM, Rico said:

If i can just add one more concern - it feels like my whole nervous system is struggling. Its not just that i am depressed and having insomnia - it feels there is something wrong neurologically. I am feeling pains in my head, sometines tingling sensations in my head and arms and just trying to think and remember is hard. I keep asking my girlfriend to take me to ER so that i can get a brain scan but she keeps telling me theres nothing wrong.

Rico, please review the list of withdrawal symptoms. When you have new symptoms, look at the list, and say - ah. Yes. It's just withdrawal: Dr. Joseph Glenmullen's Most Common symptoms of Withdrawal

Symptoms can occur 6-12 months after withdrawal - remember that Delayed Onset of Withdrawal Symptoms

You're expending a lot of energy - and creating a lot of stress - by secondary fear. You are afraid of the fear. Moderator Brassmonkey talks about this with Anger: Dealing with Emotional Spirals but it can apply to fear, anxiety, any emotion, really.

On 24/12/2017 at 2:35 PM, Rico said:

I hope I can make it to my appointment on the 9th without ending up in hospital. The public system is terrible and although they have many services here in Australia to reach out to, there's just way too much anxiety for me in reaching out to them because of the fear of being forcibly drugged and not listened to.

There's the inner you, and the outer you.

The inner you can be bouncing off the wall, anxious, sweating, jumpy, nervous, with wild ideas, even delusions.

As long as the outer you is calm and smiling.

That calm and smiling exterior will go a long way towards not being caught.

Perhaps you would benefit from an Inner Smile Meditation:

When you can achieve the Inner Smile, then you are more able to project a calm exterior when dealing with medical professionals!

I'll be back one more time...

Remember. Sun. Today!

January 3, 2018

Hey Rico!

On 26/12/2017 at 10:14 PM, Rico said:

My brain seems to be very busy trying to process a lot of memories or trauma. I’m not sure what to call it really, but there’s a lot of confusion about the past

This, too, is common in withdrawal!

Some of it is Neuroemotions which are real emotions, amplified by withdrawal. Sometimes it's Neuro-OCD, where you brain gets stuck on a loop and has difficulty shifting into a new thought or emotion - again - amplified by drugs and withdrawal.

Sometimes it's real trauma. I can't remember - do you have a therapist or counsellor? If it's real trauma, I recommend that. It's not necessarily about dredging up old trauma, instead, it should be about finding ways to move forward.

It's said in recovery circles that when someone checks into Emergency for a mental/emotional distress, that we shouldn't ask, "What's wrong with you?" Instead, we should ask, "What happened to you?"

Sadly, the answer to that takes too much time, and there's no quick fix (e.g. drug) for that. So our medical model for trauma, distress, and extreme states is seriously broken.

On 26/12/2017 at 10:14 PM, Rico said:

For the first time in my life - I am 38 years old - I am learning to take care of myself and manage symptoms without rushing to a hospital. I have been lucky though that my girlfriend has been here to support me. I would have definitely ended up in hospital had I tried to go through this at home living with mum.

This is great news! That's the ticket. I think that's something that I have learned in yoga class. In yoga, we spend a lot of time in uncomfortable postures, and there's not much grace in it. Learning to relax, let go, and just let the uncomfortableness wash over and through me - has been a great gift. It sounds like you - and your girlfriend (hooray! you got a good one!) are getting strong and experienced in this.

On 26/12/2017 at 10:14 PM, Rico said:

My eyes are still quite sore

This can be a symptom of dehydration. Please get soothing saline for your eyes. Dry-eye can cause problems later. Most over-the-counter eye drops contain a chemical which, when used in the long term, exacerbates dry-eye (just like any drug - it fixes it short term, but exacts a price long term). . But plain saline is good.

Also, make sure you are drinking enough water. Headache is another symptom of dehydration.

On 26/12/2017 at 10:14 PM, Rico said:

I must admit that I have for a long time being a selfish and self-absorbed person, so I can’t really blame this entirely on withdrawal / recovery.

In fact, the massive ego I once had as an 18 year old combined with a very selfish and self-absorbed nature is partly responsible for why I had my first breakdown.

This is excellent insight! Me, too. I was my own worst enemy, and it was around your age that I started to take responsibility for my life - you are ahead of me, as it was another 10 years before I started to understand how to manage that responsibility!

On 26/12/2017 at 10:14 PM, Rico said:

I don’t believe that healing will come from simply tapering lithium slowly. If my behavioural patterns and outlook doesn’t change, then it will only take one stressful event to break again and be back on drugs.

YES!!!!! This is the one. This is what will keep you from getting caught, and it puts you in the driver's seat for your own moods, your own healing. You got this!!!!

On 27/12/2017 at 3:42 PM, Rico said:

woke up feeling like my mind is in fire

Oh wow, tough one!

Shep is always telling me about the difference between "brain" and "mind."

I would like to suggest that it might be your brain that is on fire, not your mind. It is your brain's job to receive/create thoughts. But it is your mind which said, "My brain is on fire"

What is the part of you which observes the way that you feel? Eckhart Tolle had enlightenment on a park bench. He was homeless, depressed, and he said to himself: "I don't like myself."

It was in that moment that he realised there was a difference between "I" and "Myself" in that statement, that there was a part of him being judged and a part of him judging. In meditation, this part of ourselves is called the Observer or the Witness. A part of ourselves which is objective, which observes things like "thoughts" and "feelings" and sensations, but it is something beyond those thoughts and feelings and sensations.

I am not as eloquent as Eckhart Tolle, but I would suggest to you that - you might be able to say, "This is a symptom, these are only symptoms - or sensations." If you can approach these sensations with curiosity instead of fear, or better yet - objective observation - they might teach you something.

On 27/12/2017 at 7:24 PM, Rico said:

The amxiety gets gets worse when I start thinking that I am brain damaged and I’ll never recover.

This is understandable, and common. Really common. Dirt common. Go outside and look around. See any dirt? That's how common it is.

I was a zombie for 10 years. I was volatile for another 20. But during the zombie years, I gave up all hope, all ambition, all dreams, all beliefs, all motivation, even relationships didn't mean anything to me. It was anhedonia big time.

And here I am - coming up on 2 years drug free, and I'm trying to re-engage my relationships, I have dreams and ambitions, desires and motivation, and I'm recovering my faith, too. My brain is not what it was - I was a genius when I was 17, now I'm just ordinary, and that's okay. Sometimes being "special" has its own price.

Here are some things I wrote about tobacco, here and here (the second post also has a story about my husbands brain damage from a stroke which might be helpful to you):

Quote

Tobacco.

You know many hospitals in the US have banned tobacco? Jails, too? That is, you get checked in with florid psychosis (or a "public event gets you caught") and the first thing they do is take away your ciggies and give you a patch? And then they don't provide anything to do other than TV (which you cannot control) or lame games in the Day Room? (in jail, they smoke "jail-garettes" - which is coffee grounds rolled up in a nicotine patch, and smoked. So maybe a normal cigarette doesn't sound so bad?)

Most of my friends on neuroleptics smoke. I smoked for 10 years (it was the first drug I quit, because I thought I was dying - then I found out that the statins and the PPIs and the lithium could make me feel awful, too!). That was all I did. It kind of kept me alive during a difficult time - because even when I could not do anything else - I could always smoke. And I did.

I used cigarettes to put barriers between me and people - if I got uncomfortable at groups, I could always slip outside for a smoke. I used cigarettes to fill time. I used cigarettes for "slow suicide," because I mean, why extend my life, if I was that unhappy?

The cigarettes may help mediate some of the receptors hit by the neuroleptics. I think that's why many people on psych drugs smoke. Also, it's my understanding that they can be a tiny, instant serotonin "hit." Regardless of which receptors they hit - they do give you a tiny, instant "something." And for me, that "something" was enough to keep me alive until the next "something" (which was often another cigarette).

My rule for here at SA is this: which feels more cruel? To smoke? Or not to smoke?

Follow your kindness. If it is kinder for your brain, emotions, spirit to smoke, then smoke. If not, then work on smoking less until it doesn't feel cruel anymore (that may be totally tobacco free, or perhaps you will be like Hassan i-Sabbah, who kept a cigarette case which only held 2 cigarettes. Daily he filled it, and took one cigarette upon rising, and one after dinner. That's discipline!)

Before I go on, I will tell a story. In herbal medicine, tobacco has had a number of uses over the years. The indigenous Americans had it in their herbal medicine cabinet, but it wasn't remedy specific. Instead, the use was more spiritual. When Man was created, all of the plants and animals and stones had medicine, but Man had none. So Great Spirit took pity on Man, and gave him Tobacco. Tobacco, He said, will connect man to ALL of the healing properties of all of the plants and all of the animals and all of the stones. So, when white folk came to North America, the natives shared tobacco with them as their highest and most sacred gift. It was used for prayer, healing, communing with nature and socially.

Unfortunately, what white man did with tobacco was become addicted to it. Native Americans rarely smoked it pure, instead mixing it in herbal mixtures called "kinnickinnick." These herbs would soften the tobacco, and tobacco would amplify the healing herbs. But white man took the pure tobacco, and it became "fashionable," in snuff, pipes, cigars, and eventually, cigarettes.

The modern cigarette bears little resemblance to the sacred herb of tribal times. It's mostly toxic chemicals and additives meant to increase addiction and sales. There are a number of strategies you can use to purify your tobacco use.

1. Use rollies. They are additive free. (I can't roll to save my life, but you're a bloke and can probably do so with one hand!)

2. Be conscious of each cigarette you smoke. Acknowledge what it is, and offer it as a breath, a prayer, a connection between yourself and Spirit (whatever that may be).

3. Notice your patterns: Do you like to smoke around people or away from them? This place or that one? (my 2 places were at the Pokies - OMG - and on my back veranda with a book)

4. Put fences around it. "I will only smoke out-of-doors" (that was a challenge in cold, rainy, snowy Indiana!), or "I will not smoke while on the computer" or "I will smoke when I'm reading a book," and "I will not smoke while watching TV." Be creative: "I will keep the cigarettes in the freezer, so that I have to pay attention and smoke mindfully" "I will do something constructive before I have another cigarette", "I will earn my next cigarette by taking a walk in the park, lifting some weights, or after 5 levels on this game." You see how these fences and rules discourage "mindless smoking?"

and follow your kindness.

When I was ready to quit I bought a carton. Then, I told myself I would never ever buy another cigarette again. Ever. I had a whole carton. Then, I went to all of my favourite smoking places and shared a cigarette with myself there. I didn't tell a soul what I was doing, not even hubby. As my carton ran out, I began to savour them more, and take them less often. So it turned into a gentle 2 month taper. I think I had 10 cigarettes in my last week (like Hassan i-Sabbah!). I do not remember where I smoked my last cigarette.

My oath was to never buy them again - which meant that, if I wanted to, I could bum one. With friends who smoked, it would have been easy to bum one. I think in the first 6 months, I did bum one cig. But I would never, ever walk up to a stranger and bum a cig. So that was how I quit. It also felt good to NOT smoke as I watched my friends smoking - a bit of moral superiority gave me a "hit" of "something" too! I smoked my last one over 5 years ago, and only in the past month have I noticed that the smell of them is - not "oooh, cigarette!" but "yuck!"

I was cigarette free for 2 weeks before I told hubby "have you noticed anything different?". It was a great Christmas present! (Plus, that was about $3000 a year back in the budget!)

But that may not be how you do it, if you do it, or when you do it. For now, just pay attention to it, start finding gentle fences for it (and if the fences seem cruel, then they are not the right fences!)

What do you think?

and

Quote

So - "it is cruel to quit smoking" still? Okay. Let go, and don't beat yourself up for it. When you feel better, you will want this again.

You sound like you are in a wave - you wanted to "get better" before, so you will want it again.

Remember healing happens in Waves and Windows

I would ask that you honour the spirit medicine of tobacco, and maybe make a ritual for it. Something like this:

Rolling (put a pinch of tobacco on the earth to share your smoke): I am alive, I want to live. Tobacco connects me to the spirits of the Earth. Tobacco is the highest, most sacred plant medicine, a gift to humans to keep us connected to Earth Medicine.

Lighting: I dedicate this smoke to healing, to learning more about myself.

Smoking: silence (do nothing else).

Like with so many other things which have happened in this world to destroy native traditions, the "marketing of addictive tobacco" is one of the most universally harmful. Use a prayer (make up your own, if you like, mine is only an example) to free yourself from British Tobacco or whatever brand you are smoking, and connect to the earth, the spiritual medicine which is in the tobacco.

On 29/12/2017 at 5:18 AM, Rico said:

Life is indeed a mystery, and much of my anxiety has to do with wanting to know everything perfectly and be 100% sure about everything.

This is awesome insight! I don't know the exact studies, or who said it - but there is a strong link between perfectionism and anxiety. It makes sense - you want "perfect" which is impossible, but when you fall short - you get anxious - which is like - all the time, because - nobody's "perfect," and what the heck is "perfect," anyway?

On 29/12/2017 at 5:18 AM, Rico said:

every breakdown is an opportunity for growth.

It's not a Breakdown

On 29/12/2017 at 5:18 AM, Rico said:

I have been holding a belief that therapy would be useless whilst I am on lithium because I have "no emotions".

Actually, therapy can still be useful, even when you are anhedonic, to help keep you taking good care of yourself. Therapy can involve diet suggestions, self care, Cognitive Behavioural stuff (like - how to not beat yourself up all the time, or how to be responsible for your moods), or just a good place to talk about the things you are struggling with. I've always had therapists who make suggestions, like - instead of doing all the laundry in one day, just do a load a day until it is done. I still do this! It was a simple, practical suggestion that made my life easier. I remember one therapist who listened to me for 45 minutes, guiding me to describe the things I was struggling with. Then the last 10 minutes of the session were "plan of action," and she always addressed everything I brought up in the first 45 minutes. I left feeling like a giant with a plan! She was extra good.

One of the current symptoms that you did not address - is the self awareness you are forming which enables you to see some of the "symptoms" (or behaviours) that you listed. You are waking up, and it is beautiful to see! You are showing the sort of self-reflection that is essential for healing and escaping the drugs.

All of us got put on the drugs for something. For many of us, it was inability to self-regulate our moods, trauma, or behaviours. It was for me - and I'm still no saint. I'll never be a "good" person by the definition of any faith. But I can, as a Native American taught me, "be the best Human I can be." Sometimes our best is all we've got - and - though you may not believe it - you have been doing your best. Some of your best has been counterproductive - but - you are learning from it. And that's what is important!

Sorry this was so long - I was just going to drop by today to see how you were going. LOL. I'm too long winded, but I don't know when I'll be back next.

Please let us know how your visit goes on the 9th, and hang in there!

January 10, 2018

Hey Rico,

is it a Yamaha R1? Nice bike man, I'm into sport cars.I've driven a 430 scuderia and a 360 stradale. In my country bikers behave on the streets as if the road is theirs, overtake from the right lane, speeding 300km/h, that's why I don't like them but I make an exception for you because I like your attitude and you seem an honest guy.

January 10, 2018

On 12/29/2017 at 12:48 AM, Rico said:

My current symptoms are: not the best sleep, selfishness, intellectual pride. defiance, ungrateful, lack consideration for other's feeling and their lives, not accepting life on life's terms, not listening to good advice (especially when my gut feeling that is right), blaming others for past mistakes (not forgiving), beating myself up and focusing on problems rather than solutions, impatience (huge problem), not trusting God or practicing my faith properly

Rico,

You just described most of my mental state.. Anger , anhedonia and occasional rage are additions.

I was always a God loving guy, atleast valued my family beliefs. But now i dunno past actions and reasons for doing same. I just cannot do.

I still believe its some mental blockage, wdl or stress created.

On 1/3/2018 at 9:31 PM, JanCarol said:

.

On 12/27/2017 at 2:54 PM, Rico said:

The amxiety gets gets worse when I start thinking that I am brain damaged and I’ll never recover.

This is understandable, and common. Really common. Dirt common. Go outside and look around. See any dirt? That's how common it is.

JanC, how well said.

January 10, 2018

Hey Miko,

How are you ?

January 17, 2018

On 1/10/2018 at 7:33 PM, bhasski said:

Hey Miko,

How are you ?

I have flu-like symptoms , I can function but I have difficulty. I have seen some improvement but not much while doing mindfullness meditation, I have no idea how to get to grips with that? I'm thinking of going to a neuroligist to get a opinion/ view about it. Or CT?

In conversation I sometimes find it difficult to say the right word. I currently facing an ongoing issue.What about u ?

You were on olanzapine for 6 months, on signature.How were you when you quit Ct? Did you have any sleep problems insomnia , any concetration problems. What dose were you on?

Rico: Zyprexa tapering

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