Medication Withdrawal

One-two, buckle my shoe …

Thump, slam, crash. Scream out loud. There it goes again, and again, yet again.

Three-four, knock at the door … scream out loud.

The knocking is inside my head, in the space between the front of my skull and between my ears. It is there that the pinball machine resides.

The metal ball-bearing is rattling around inside my skull. Each time the ball-bearing strikes, it generates an electric shock. It is a mild shock, not life-threatening, or indeed life-ending; just mild. Like the sound coming from the dripping of a tap … just mild, not deafening.

Every little electric shock makes my body jerk, just a little, not wildly. Thump, slam, crash. One-two, buckle my shoe. Scream.

Optic nerves are shrinking. Every time I move my eyes, a hissing sound rushes through my ears, and a searing pain shoots through the nerves from my eyes into the bowels of my brain. This excites the ball-bearing, and it crashes around wildly … sting, sizzle, fizz goes the electric shocks. Over and over again. Scream.

Every time I move my head, even just a little, my eyes hurt and my ears hiss … Three-four, knock at the door. Scream.

Like the persistent dripping of a tap – every single drip increases in intensity. The pinball machine moves to the next level. Lips tingle and guts wrench. Every last molecule is ripped from my gut. Feet can only shuffle, and my head hangs limply.

My doctor took me off Venlafaxine; it’s a week without any antidepressant, and my body is starting to experience the horror of discontinuation syndrome.

There it goes again, and again, yet again. Scream.
Mild, yet so intense.

The Cruel Lie – You Just Need to be Strong

Mental illness is just that – it is an illness. Just as a physical illness makes you ill, mental illness does too. Illness is no stroll in the park for anyone, no matter who they are or what they are dealing with.

The thing about mental illness, though, is it carries a sting in the tail. People seem to think that if someone has a mental illness, it is as a result of some kind of weakness. Physical illness is unfortunate, but mental illness seems to be perceived around the world as of their own making, and therefore they must be weak to have ended up ill in the first place, and weak for being trapped in the illness.

It’s just not true! New discoveries are being made every month that reveal the functions within the brain, that when not working properly, results in a mental illness developing. Strength and weakness have nothing to do with it.

Living with any serious illness takes strength and courage just to get by and function on a basic level each day. Mental illness is no different, except that it comes with an additional sting in the tail – it makes you physically ill too. Nausea, exhaustion, fatigue, IBS, muscular pain, joint pain, headaches. Weight, blood pressure and blood sugar are affected too. Then there is the impact on sleep… everyone experiences different problems, so the list is endless.

When someone is in the throws of an episode, the image of them sat in in their pyjamas unable to get washed and dressed because of the debilitating mental illness, is easy to scorn. It is so easy to think they must be weak just to sit there, staring at the wall in torment. It is easy to think that they just need to be told to pull it together and be strong, and they will be able to get up and function normally again.

The truth is; they just burned up their last bit of strength to push themselves out of bed when their brain and body were screaming at them not to. There is not an ounce of energy left in the system, and no reserves in the tank – that got burned up yesterday. Washing, dressing, eating, functioning, coping and working are all physically and mentally out of the question.

Distress And SufferingThe brain and body are all burned up, and they can do nothing but exist in an empty shell and sit with the torment they are experiencing. They will use inner strength to exist from minute to minute and hour to hour. As soon as they have some energy again, believe me, they will push themselves hard just to manage basic functions. That is the way it is in an episode of mental illness. It is cruel, severe and robs people of the opportunity to engage in the world around them.

It might take days, weeks or months for recovery to start. All they have left is their courage and the memories of what they used to be able to achieve in a typical day.

So, someone with a mental illness who is crying in pain and screaming in distress is not being weak; they are dying inside because they have no strength left.

Telling them to ‘you just need to be strong, and you will get through it’, is hurting them even more.

The Downside of the Clock Change from Daylight Savings

Well, here it is. The day the clocks change and we transition from daylight savings to standard time in the UK. It is only a one-hour shift in time, so it should only be a minor blip for us to adjust to – or so one would think. The reality is, however, the change can have a significant negative impact on our mental wellbeing.

The clock change moves one hour of daylight from the late afternoon period to the early morning period. This means it will lighter in the mornings for a while until we reach the dead of winter. Most people won’t get the opportunity to be exposed to that morning light, though, because we are still sleeping or are indoors getting ready for school and work etc., and won’t get any benefit from the time shift.

The impact of this sudden one-hour reduction in light exposure causes our system to increase the amount of melatonin it produces earlier in the day. This can result in sluggishness and sleepiness happening every day from late afternoon onwards. Because it happens suddenly, it can create a shock to the system for some people and their brains don’t respond well to the change. This change can ironically cause insomnia, but in most cases, can cause excessive daytime sleepiness. For countries higher up in the Northern Hemisphere, such as the UK, this can be a serious problem.

Prolonged daytime sleepiness can have a negative impact on our mood. For people who already have a mood disorder such as major depressive disorder or bipolar disorder, there is a much greater risk of a sudden depressive episode to occur. Even without a mood disorder, the negative impact on mood caused by this change, if not improved, can lead to an episode of depression developing.

It is thought that the excessive daytime sleepiness dampens motivation, meaning the sufferer is less likely to exercise, eat well or socialise in the dark evenings. This too can have a negative impact on mood which can lead to an episode of depression in some people.

Although people suffer from depression at any time of the year, including the summer months, depression can be linked to lack of sunlight in the winter. Scientists cannot give us a definitive reason for this, but the result of many studies show that exposure to daytime light can improve mood and lessen the depressive symptoms. This type of depressive episode is known as ‘winter depression,’ or Seasonal Affective Disorder (SAD).

So, the clock change might give us an extra hour in bed, but for some people, it can cause a sudden depressive episode to occur, and for others, it can signal that their annual winter depression is on its way.

The doctor’s recommendations to combat this is easier said than done for many, and that is to get out in the daytime and get exposure to as much sunlight as possible. This is thought to stave off the production of melatonin for longer and improve excessive daytime sleepiness. Other recommendations include daily exercise and eating well-balanced meals. Go easy on the carbs! Another recommendation is to get up and go to bed at the same time, 7 days a week. This helps reset the body clock and produce hormones that will lessen daytime sleepiness. The recommendations are not particularly easy to do for many of us, which might explain why winter depressive episodes are high.

Although not linked to the clock change, another recommendation is to take vitamin D supplements, as a low level in the blood stream is also known to cause depression. Your doctor can assess whether your summer lifestyle meant you have not stored enough vitamin D for the winter period and will recommend if a supplement is needed.

So, when you change your clocks tonight, consider all the things you can do to maintain your mental wellbeing and stave off an episode of winter depression.

What is Killing Our Men?

Would you believe me if I told you, it’s suicide that is killing our men? Well, it is, and the figures are shocking. The statistics I am quoting in this blog come from The UK Office For National Statistics, for the year 2013. Statistics for later years are not available yet.

When we hear reports of ‘the leading cause of death,’ things such as cancers and heart attacks tend to come to mind. But, the truth is, our boys are dying in road traffic collisions or by suicide, and our men up until the age of 50, are dying from suicide more than any other thing. Here is what the statistics look like – these are total numbers who died in the UK, in that category during 2013:

Boys aged 5-19 
Leading cause of death was road traffic collisions – 128
Not far behind is suicide – 112
Cancer: 91

Men aged 20-34
Leading cause of death was suicide – 861
Road traffic collisions – 338
Cancer: 154

Men aged 35-49
Leading cause of death was suicide – 1,381
Cancer: 892
Road traffic collisions – 263

Men aged 50-64
Leading cause of death was cancer: 9,237
Heart disease – 5,575
Suicide – 1,075
Road traffic collision figures not listed

So, how come we don’t seem to know anything about this? Why isn’t there a public outcry? Our men are dying in their thousands, but not in the ways we think they are, because reporters are not rushing to tell us. Sure, mental health charities are screaming it from the rooftops to make their voice heard, but it never seems to make it to the news headlines. We, as a nation, need to listen to what the charities are telling us and the media need to start reporting the facts and figures.

It’s not just men who have a diagnosed mental illness who are dying by suicide; it’s also ordinary men, who appear to live otherwise normal lives. They may be hiding intense distress or serious problems from their loved ones.

So, why are we not wearing ribbons for men, shaving our heads, throwing ourselves out of aeroplanes or climbing backwards off the top of tall buildings? We don’t do 10k runs or midnight walks for men. Why not? We see so many adverts on TV, on social media or in the papers to raise awareness of various cancers that can kill men, but never anything about the real killer of men. Why not?

Maybe we should start doing these things; not just to raise awareness and start conversations, but more importantly, to raise precious funds. Let’s face it; the Government are unlikely to allocate the funds desperately needed, despite most of them being men, and many of them being in the age groups at risk.

The total number of girls and women dying by suicide is much lower. Even so, in the 20 – 34 age group, suicide is the leading cause of death. Not surprisingly, cancer tops the list in most other age categories. So we understandably do so much fundraising and run cancer awareness campaigns for our women.

For the love of men, let’s start talking about male suicide and push harder to start campaigns, raise awareness and funds because the statistics speak for themselves.

 

Where to get help:
Campaign Against Living Miserably (CALM) exists to prevent male suicide in the UK. They have a helpline staffed from 5 pm to midnight every day: 0800 58 58 58

Samaritans helpline 24 hrs a day: 08457 90 90 90

 

By Shirley Stoddart
Bio

References:

  1. Office for National Statistics 2013: http://visual.ons.gov.uk/what-are-the-top-causes-of-death-by-age-and-gender/
  2. The Guardian: https://www.theguardian.com/society/2015/feb/19/number-of-suicides-uk-increases-2013-male-rate-highest-2001

Depression and Fuzzy Thinking

Cartoon picture of a brain shaking with it's hands on the top of the brain
(c) Can Stock Photo

Fuzzy thinking is so severe at times; we could describe it as a ‘syndrome’; rather than just a single symptom of depression. It’s a collection of symptoms such as confusion, forgetfulness, inability to think properly, muddled up thoughts, lack of focus and concentration. The more severe each of these experiences is, whether suffered individually or collectively, the more distressing it can be for the sufferer.

Fuzzy Brain cartoon with warning sign of fog area in place of his head
(c) Can Stock Photo

Some people refer to fuzzy thinking as ‘brain fog.’ I call it cotton-wool-head (Other parts of the world may know cotton wool as simply cotton balls.) When I was young, cotton wool didn’t come in the form of balls, it was a packet of one big square, and you pulled off the amount needed. When pulled apart it looked and felt fuzzy. That’s what it feels like inside my brain; the cotton wool in my head is preventing normal functioning and blocking electrical circuits.

There have been various studies, but in one, in particular, they compared women with depression or bipolar disorder against healthy women. Those with depression or bipolar disorder exhibited lower levels of activity than healthy women in the right posterior parietal cortex. Other studies have found lower levels of activity in other parts of the brain too.

The right posterior parietal cortex brain region is responsible for working memory, problem-solving and reasoning, so it’s no wonder we can be so cognitively challenged by fuzzy thinking.

3d character with an empty head with big red question mark.

I think fatigue contributes to my experience of fuzzy thinking. The more physically fatigued I feel, the fuzzier the brain tends to be. Sometimes, it seems like my brain is actually buzzing or whirring; it’s quite unpleasant. At times, the only thing I can manage is to sit down and wonder which room I am in, and why I am there, or stand in a room and stare. If I wait long enough, I might remember! I did it this morning – just standing still in the kitchen staring at nothingness, unable to think, but aware I was just standing still. I was unable to think what to do next.

A simple task, such as making a cup of coffee is challenging. My jumbled up thinking means I can’t hold my focus long enough to just ‘make a cup of coffee.’ I have to break the task down into parts and make an effort to focus.

For example, I concentrate on filling the kettle, remembering to switch it on. Then, get a cup out of the cupboard. Next, I try to pay attention as I add a spoonful of coffee and a spoonful of sugar to the cup. (Making sure it is just one of each, not several, as has happened before!) I need to stay by the kettle until it has boiled, or I will forget I am making a drink. I then try to focus on pouring the boiling water into the cup without spilling or overfilling it or burning myself. Next, I need to remember to get milk from the fridge and pour it without spilling it, either. I must do it in that sequence so not to miss something out, and I need to concentrate on each step in the sequence. The only other thing, I need to remember, is to drink it! I am sure many people who want a hot drink, just make it without having to think about the individual steps required.

One day, I poured the boiling water into the sugar tin instead of the cup – destroying the only sugar I had!

Differences in brain activity from that of healthy individuals drive fuzzy thinking. It’s not something within our control or of our making, so it’s not fair to be hard on ourselves because of it. Perhaps we just need to sit down, stop trying to think and give ourselves a little break to drink that diligently made cup of coffee!

When Hyposexuality Kicks In

Silhouettes of couple not speaking
Photo Credit: (c) Can Stock Photo

Hypersexuality and manic episodes are known to go hand-in-hand, but hyposexuality (low or no sex drive) can also be present as part of the bipolar illness. It is a known side effect of bipolar medication, so identifying whether it is the illness or the medication to blame, is not so easy. However, it is also easy for the psychiatrist or doctor to just blame the medication rather than talk about it and try to help with the problem.

How do you know if it is the medication? Well, if the symptom starts not long after, even a few months after starting new meds, they likely the culprit. If the symptom starts when you have been taking your meds for some time, they are not likely the cause and further investigation will be needed to identify the issue.

Hyposexuality often occurs during depressive episodes and when you think about it; it does make sense. However, hyposexuality can also occur even when those episodes are mild or during a well period. It is rare to experience this during mania, though. When experiencing hyposexuality during a well period, meds are often blamed by the medical professionals, even when you may know it’s not the meds.

Sexuality can be difficult or even embarrassing to talk about, so often people end up suffering in silence, and this can result in relationship problems and low self-esteem.

Hard as it may be, the best place to start is talking it over with your partner if you are in a relationship. The more they understand, the less chance there is of harming your relationship. Talking about how you feel or don’t feel, as the case may be, might be a big weight off your shoulders and might improve yours and their self-esteem. Even if you are not in a relationship at the time, it can still affect your self-esteem and spoil the relationship you have with yourself, or even make you reluctant to start dating.

Bipolar Disorder - Medical Concept.

Another important thing is talking to the doctor who is treating you. They may know if it is a medication side-effect and could negotiate a different type of med for you to try. If they seem reluctant to take it seriously at first, keep pushing the issue, as it is your health, wellbeing and relationship at stake here. Your doctor might suggest counselling as an alternative to changing med, which could be a good course of action. They may also want to explore further to see if it is a medical issue causing the problem.

If you are suffering from hyposexuality, know that it is not you to blame; you are not doing anything wrong. There are some options out there for you and your doctor to consider that may improve the situation. Bipolar disorder sucks, but one consoling fact is the illness, and symptoms are episodic, and this too may pass without any intervention required.

Master of Misery

Delving into the deep, dark dungeon, depression
creeps in, clinging tightly.
You are not alone; I am with you now
I will hold you tight and won’t let go.
I will squeeze the colour from your soul
and steal the love from your heart.
I am draining your mind of happy thoughts
and replacing them with my ruminating voice.
Can you hear my criticism?
Look into my eyes,
I need to take your sparkle.
Let me hug you tight so your muscles ache
and let me weigh you down.
I will hold you back from life.
I am depression; master of misery and creator of gloom.
I laugh in the face of happiness and light
and stamp all over love and joy.
I may leave you for a while,
but I will always come back.

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