Catatonia

I sit on the ground, my breath rhythmic and steady. My breath is my sole attention, as I watch the world go by around me. My thoughts go by immeasurably slow. My breath is the only thing I can focus on. I am aware that there is a world outside myself, but it does not feel like a real world, I am withdrawn into myself like a hermit crab into its shell. My limbs are statues. All I am is breath.

The above describes my first catatonic stupor. A state of immobility or repetitive movements that can last anywhere from hours to years. I do not know how long it lasted, but based on the length of my other episodes I would suspect it was at least an hour. I would later be officially diagnosed with psychosis NOS, an inherently varying disease that includes many symptoms of schizophrenia. I have experienced auditory and visual hallucinations, depersonalization and derealization, and lack of focus to the point where I could not read a book, but the catatonia is still what frightens me the most.

What is Catatonia?

As mentioned previously, catatonia is an elongated period of immobility or repetitive movement. While catatonia is extremely debilitating, it is not, in itself, a disorder, rather, it is a symptom of an overlying disorder, often schizophrenia. People in a catatonic state may not react to external stimuli, or may suddenly become agitated or react to no stimuli at all. They may also maintain positions that they are put in, a trait called waxy flexibility, while others resist all efforts to be moved, called rigidity.

Catatonic Schizophrenia

Although removed as a diagnosis in the DSM V, the “Bible” of mental health, some people with schizophrenia acutely display catatonic symptoms. Formerly, these people were diagnosed not just with schizophrenia, but with catatonic schizophrenia. Note that not only do these people qualify for a diagnosis of schizophrenia (hallucinations, delusions, etc.), but they also have catatonic symptoms as described above.

Treatments

Catatonia can usually be treated successfully with anti-psychotics, and in some cases benzodiazepines. Most people respond well to these drugs and will quickly come out of a catatonic state within a few days. Some people may require ECT (Electro-Convulsive Therapy), and may even require regular rounds of ECT to stay out of catatonia. It is to be noted that ECT is not the horrible torture that movies often make it out to be. It is painless, and the movements seen during old time ECT is simply due to involuntary movements. During current ECT procedures, the patient is given a muscle relaxant to cease the movements.

Prognosis

Unfortunately, the prognosis for people with catatonia, in general, is not a good one. This is why I fear it most out of all my symptoms. According to one study, 14 of the 36 participants were in need of “continuous psychiatric care”, take from that what you will.

Conclusion

While I may have catatonic symptoms, which studies show makes my prognosis rather poor, and while my symptoms, as we speak, may be getting worse, I have not given up hope, and neither, I believe, should anyone else who has psychotic and/or catatonic symptoms. Life isn’t over till it’s over, and every life is worth living all the way through, even if the part of the path you’re on right now is in a scary forest with wolves all around you. One day after walking (or running) down that path for long enough you’ll come out to a field full of bright tulips, and the sun will shine.

 

 

Relapse

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Sometimes, despite our best efforts, things do not work out. Sometimes it’s something small, like not getting through that light coming up. Sometimes it’s something big, like breaking up with a long-time partner. Sometimes, despite taking medicine and going to therapy religiously, our mental health continues to deteriorate.

In the past week, symptoms have slowly begun creeping back into my life. The auditory hallucinations are worsening, and I’m now starting to see things as well. My cognitive symptoms are also returning, and I’m having small bouts of catatonia. So far, it is not as bad as my initial breakdown, but I fear it may become worse as time goes on.

My fear stems from two corners. In one corner, I am terrified of becoming sick again, and, more specifically, staying sick. In the other corner, I’m scared of going to the hospital. So great is my fear that I am planning to  suicide if it gets to that point.

I don’t want to write about this, and I’m sure most of you don’t want to read it, but this is my week to write an article and dammit I’m going to write one. I’d like to write about something nice, something to educate you or make you feel better about yourself, but I can’t do that this week. This is the only thing I can think about, and hence, it’s what this article must be about.

Tomorrow I see my therapist. After much deliberation, I have decided to tell her about my plans to kill myself. I’m not sure what’s going to happen after that, but I have a strong suspicion. That suspicion is the reason I am posting this on today rather than the usual Friday, before I go to my therapy appointment. If I don’t post my article week after next, you’ll know where I am.

I know I’m not the only one in this boat. I know there are more of you out there who are terrified of reaching out for help, or deathly afraid of the hospital like I am. I wish I could give you some uplifting pep talk, but I know from experience that there are no magical words that make everything better.

All I can tell you is that right now you are pulling a heavy wagon up a steep hill. The only way to get to the top is to get help pulling. Getting  down  that mountain won’t be a cakewalk either, with rocks and pitfalls along the way, but as long as someone’s next to you pulling, you have a chance.

I want to sincerely thank all of you who have, and continue, to read my articles. It really means a lot to me that you find it worth your time. I hope to write many more for you in the future. Thank you.

 

Joy

To begin this article, I would like to wish everyone that celebrates it a merry Christmas, and to everyone else, happy Holidays. This time of year is one filled with joy, wonder, and wishes. December itself is enveloped by this sentiment. I believe joy is something that is vital to all of our lives, and for not just one month, but for all of them. Joy is unbridled happiness, it is not hindered by logic or reality, in that moment, when you are joyous, nothing else but that emotion matters. Joy is pure.

I had an early Christmas present this year. It came in the form of a 37 pound black, white, and brown, bundle of energy named Jack. Jack was a shelter dog and had been there, much to our surprise (because of how sweet he is) for over 3 months. We immediately fell in love and brought him home. I bring up the story of Jack, which I’m sure must strike most of you as completely unrelated, because, as all dog owners know, there is nary a purer, more unadulterated source of joy than a dog. As a favorite show of mine (Limmy’s Show for those interested) said in one episode, a dog does not overthink things, he does not sit in a car going 70 miles an hour thinking “how is this possible?”, he just sticks his head out the window and enjoys the wind blowing in his face. That is joy.

Jack does not think about the 3 months he spent at the Humane society, in what surely must have been a terrifying experience. He does not think about the time he spent in a high kill out-of-state shelter, which I’m sure was much worse. He doesn’t think of the heartbreak he had to have experienced when he was adopted out for a week and then brought back because the owner “didn’t have time”. No, Jack does not think about any of that, Jack just runs around our half acre yard at full speed, trips, sending him somersaulted across the yard, gets back up, and keeps running like nothing happened with a huge grin on his face.

Jack is joy, and I think we could all learn something from him.

 

What is Ego Death?

While speaking with a friend earlier this week, we came upon a topic that I found very interesting – perhaps a topic that not many have heard before, called “ego death”. When ego death occurs, it is considered the loss of subjective ego, a person’s sense of self-esteem, self-importance and self-identity. In Psychology, ego death may be called a psychic death, a term coined by Carl Jung, the man behind Jungian psychology.

Ego death is often referred to as an enlightening, yet potentially terrifying experience which may be brought forward in many different ways. More often than not, it is considered a spiritual experience, one where you experience the cessation of sense and feeling of control living your life. The feeling of being in control is replaced by feelings of being helpless or powerless as you go about the motions of life, with a sense that the thoughts you’re experiencing are somehow being inserted into your mind. While it sounds like a terrifying experience, many individuals who experience it often regard it as a very humbling transition into the next stage of their life, allowing them to harmonize with things they were unable to harmonize with before.

In Jungian psychology, ego death is often referred to as the death of consciousness, which may be accompanied by panic. Jungian psychology refers to ego death as psychic death, and goes on to explain it as a “shift back to the existential position of the natural self”. It is thought that after one experiences the death of consciousness, the consciousness is then resurrected. Carl Jung called this process the “the transcendent function”, which he believed led to a more “inclusive and synthetic consciousness”. It is believed that this process is a fundamental transformation of the psyche as it allows individuals to develop further understanding and peace of mind with the world and its inhabitants.

While ego death may be experienced through spirituality or rigorous introspection, it may also be experienced through the use of psychedelic drugs, such as LSD. Individuals who experience ego death through this method often are looking to experience what lies in the recesses of the human mind or to experience spiritual liberation. The early stages of ego death induced by a psychedelic may be terrifying, but those who experience it say that it is a liberating feeling, one that gives them a feeling of unity with other individuals, nature, the universe and God.

While the experience itself seems quite foreign and terrifying, it is something that I, coming from a mindful perspective, whole-heartedly believe is beneficial for personal development. Putting aside one’s subjective views is an important skill – one that allows individuals to view the themselves and the world around them objectively. We are all characters in this world we inhabit, and as such, we should try and make the world and our characters better each and every day.

If you would like to read more about ego death, I suggest checking out this page for more information.

 

 

Understanding Psychosis

The word “psychotic” is perhaps one of the most misunderstood words in the mental health repertoire. To the public, who are used to hearing it in movies and other media to refer to a violent, remorseless, person, attribute it’s meaning to just that. Someone who is psychotic, by this definition, may be violent, violently “crazy”, or simply lacking empathy and remorse, capable of any wrong and evil doing. But, as so often is the case, Hollywood and the media have gotten it wrong, and in the case of psychosis, they’ve gotten it completely and dangerously wrong. This incorrect usage has led to irreparable stigma for those suffering from actual psychosis, the sufferers of which are far more likely to be victims than perpetrators of violent crime. In this article I will tell you, dear reader, about the real story of psychosis.

According to NAMI, psychosis occurs in about 3% of the population. Psychosis is a debilitating mental condition that affects the way we perceive reality. In a way, people undergoing a psychotic episode live in an “alternate reality”, different from what healthy people experience. They may believe, perceive, and understand things that are not actually in existence, to the sufferer however, this “alternate reality” is as real as the ground beneath our feet.

What is Psychosis?

Psychosis is often called a “break from reality” due to the reasons I described above. There are hallmark symptoms of psychosis that healthcare providers look for when diagnosing a person, such as…

Hallucinations: Seeing, feeling, tasting, and especially hearing things that are not actually there. The most common hallucination is auditory hallucinations, or “voices”. The voices may tell a person to harm themselves and say other negative things.

Delusions: Strong beliefs that do not change despite opposing evidence. For example, a person may believe that someone is stealing their thoughts, that they are being watched or followed, or that they are God.

Causes

Psychosis, like so many things having to do with the mind, is  hard to pin down to a single cause. There are several, intermingling factors that affect someone’s likelihood of developing psychosis.

Drugs: Psychedelic drugs, or even lighter drugs like marijuana, have been shown to trigger or worsen psychotic episodes.

Genetics: Many studies have been carried out that link psychosis and other mental illnesses to genetics. If your parents, family, or siblings have experienced psychosis, you are more likely to experience it.

Illness: Some illnesses and diseases, such as brain cancer, can cause psychosis, or what appears to be psychosis, in a person.

Stress: Stress and trauma can bring on or worsen psychosis.

Warning Signs

There are several early warning signs for psychosis which can be noticed by others, they include the following…

  • Difficulty in school or work
  • Isolation from others
  • Decline in personal hygiene
  • Lack of clear or coherent thoughts

Psychosis and Mental Illness

Psychosis itself is not a mental illness. It is, however, a component, or possible component, of many mental illnesses. It should then, be seen as a symptom rather than an illness. Many illnesses can include psychosis, including post traumatic stress disorder, depression, bipolar disorder, and schizophrenia, the last of which has psychosis as a hallmark symptom.

Treatments

Treatment is paramount for those suffering from an acute psychotic episode. There are a variety of treatments for psychosis, some of which I shall list  below.

Hospitalization: For someone undergoing an acute psychotic episode, the hospital may be the best option. The goal of any psychiatric hospital is to stabilize and rehabilitate enough so that a person may undergo further treatment after discharge.

Cognitive Behavioral Therapy (CBT): CBT is used in a variety of disorders to identify and change thought patterns. In psychosis, CBT can help a person identify triggers, manage symptoms, and identify strategies for getting through it all.

Medication: Medication for psychosis is referred to as antipsychotics, these drugs work by reducing dopamine (a neurotransmitter involved in psychosis) in the brain. While often effective, they can have detrimental side effects. Newer antipsychotics however, called atypical, have less side effects and are more tolerable to take than older drugs.

To Wrap it Up…

Psychosis is a serious mental condition that requires care as soon as possible. Unfortunately, it is also one of the most misunderstood mental conditions in our society today. This makes reaching out for help difficult for those who suffer, the stigma is real and is felt by sufferers every time they turn on the TV to a headline of “psychotic killer”. As someone who has experienced psychosis first-hand, I can tell you that getting help is possible, and it does help…it saved my life.

If you believe you or someone you know is undergoing a psychotic episode, please reach out for professional help, it will improve your life tenfold, and may just save it. Some crisis numbers can be found here.