mental illness issues
I hadn’t planned on discussing my electroconvulsive therapy (ECT) experience with many people. I found it terrible, scarring, not to mention futile and immensely embarrassing; those aren’t generally feelings I like to talk about. I still find the idea of shock therapy, well, shocking. Incomprehensible. Absolutely impossible.
[Note: I am running a survey on real patients’ experiences with, and perspectives on, electroconvulsive therapy (ECT). If you’ve had ECT and want your voice heard, please take the survey here. More detailed information on the ECT survey can be found here.]
Write About What You Know — I Know ECT
The problem with being a writer is that you write what you know, and you’re driven to write what plagues you most. At least I am. I can’t write about fluffy bunnies and sparkling rainbows, because these aren’t the things that occupy my conscious mind. But ECT. Ironically it erased pieces of my brain only to seemingly permanently occupy others. I’m acutely aware of its happening and yet find it completely unbelievable.
Caffeine is the world’s most popular psychoactive substance. So many of us love it a la Starbucks, Tim Hortons or just out or our home coffee machine. Me, I love coffee and I’m a fan of caffeine too. Coffee’s the nectar of the gods and nothing will convince me otherwise.
It seems though, caffeine can actually hurt you. I know, I never thought my beloved coffee could harm me, but I suppose anything that you abuse, will abuse you back. So, here is everything you ever needed to know about caffeine, caffeine disorders and caffeine and mental illness but were afraid to ask.
I like to think I know almost all there is to know about mood disorders, but I was pretty shocked when I read this:
The Surgeon’s General Report
Mood disorders are sometimes caused by general medical conditions or medications. Classic examples include the depressive syndromes associated with dominant hemispheric strokes, hypothyroidism, Cushing’s disease, and pancreatic cancer (DSM-IV). Among medications associated with depression, antihypertensives and oral contraceptives are the most frequent examples. Transient depressive syndromes are also common during withdrawal from alcohol and various other drugs of abuse. Mania is not uncommon during high-dose systemic therapy with glucocorticoids and has been associated with intoxication by stimulant and sympathomimetic drugs and with central nervous system (CNS) lupus, CNS human immunodeficiency viral (HIV) infections, and nondominant hemispheric strokes or tumors. Together, mood disorders due to known physiological or medical causes may account for as many as 5 to 15 percent of all treated cases (Quitkin et al., 1993b). They often go unrecognized until after standard therapies have failed.
I’m shocked. No one ever mentioned anything about birth control pills to me and I’ve been on them for years. YEARS. This is yet another reason why doctors so often get on my bad side.
This quote was taken from the Mental Health: A Report of the Surgeon General. The whole report is a good read, but very long. It’s everything you wanted to know but didn’t know you needed to ask.
I’m a geek. If you know me, I deny this, but it’s actually true. Not the Star Wars-watching, video-game drenched, mother-basement living, socially awkward,virgin type, but a geek nonetheless. I do, after all, make software for a living, understand math, and make logical arguments.
A Mood Chart
So, in the vein supportive numbers, I have been charting my mood for a while. I chart depression (obviously) along with mania, anxiety, and irritation. I’ve also added trend lines for anxiety and depression (the dotted ones):
The headline is the depression is dropping while the anxiety is increasing. Looking a bit closer, you can see that Jul. 16 when I added the Zyprexa/Celexa combo, the depression dropped substantially. It’s probably the best I have felt for over a year. I don’t have the numbers to prove it, but trust me, it’s true. (I’m scared to even write that because I feel like it will be taken away from me. I feel like a higher power will reach down into my life and destroy it. I suppose a higher power will reach into my brain and start squishing it like squishing whole tomatoes for a marinara sauce. Brain sauce. Yum.)
Mood charting has two main benefits.
One, you have objective record for what is happening to you. Your doctor is going to ask you “how are you feeling?” (which is the dumbest question ever) and you have to be able to answer it. It’s harder than it sounds. Are you more anxious, or less? What side effects have you noticed? How long have they been happening? What kind of pain? How depressed are you compared to last time? Irritation? Mania? Energy level? And it would be handy if you could answer all of that in 2 minutes or less.
Seriously? Yes, seriously. You only have a few minutes with your doctor. You don’t have time to “think about it”. Mood charting can help you maintain an objective view of what is really going on. Generally, I can remember all these things because I have been doing this forever, but you may not be so “experienced”.
Two, you’ll have historic record so when you switch doctors, you know what to tell the new guy. Think your new doc will sift through the records of the old one? Well, maybe, but maybe not. It’s so much better if YOU can answer their questions and be the record for them. Then you know it’s actually accurate and right. And trust me, you won’t remember 17 drugs from now what happened with THIS antidepressant and THIS mood stabilizer combination. You just won’t. At this point, all the goddamned drugs sound the same to me. Alprozylepin. Meh. Whatever.
Try charting the numbers with drug names, dosages, side-effects, and “other pertinent info”. If every time you eat an ice cream sundae you feel super, maybe note that. Or your menstrual cycle, or whatever makes sense for you. Generally I haven’t bothered doing this because I’m so depressingly constant. I know how I am, I’m depressed. Screw off already. It just so happens that something has changed. Unbelievably. Miraculously.
See, I have the numbers to prove it.
(Child says to God, “how do I know you’re God? Show me a miracle.” God points to a tree. The child says, “that’s not a miracle, that’s a tree!”, to which God says, “let’s see you make one”.
God should have pointed to me. Let’s see you fix her.)
‘Roud these parts lots of people are smoking lots of stuff that might not entirely be legal. Very common. Good climate for that sort of thing.
I though, have always been of the opinion that marijuana makes depression worse and so stay away from the stuff. Really, if you’re crazy and on psychotropic drugs, adding extra, less predictable, street psychotropic drugs doesn’t seem like a good idea. Anecdotally, do stoners strike you as obscenely happy people? They strike me as just slow, tired, munchie-craving people. That’s not going to help me feel better. (More logically, THC from the marijuana coats the outside of your brain cells, further impeding neurotransmitters, which is bad if you already have a serotonin deficiency.)
But the nice folks at McGill university weren’t about to answer the question with conjecture, which is why I like science so much. And I was surprised. Turns out that small amount of marijuana might actually help you, but large amounts can actually increase depression and maybe cause psychosis. I copied the article below for your convenience.
MONTREAL, Oct. 24 (UPI) — A synthetic form of the active ingredient of marijuana acts as an antidepressant in low doses but in higher doses can worsen depression, a Canadian study said.
First author Dr. Gabriella Gobbi of McGill University said it has been long known that depletion of the neurotransmitter serotonin in the brain leads to depression, so antidepressants like Prozac and Celexa work by enhancing the available concentration of serotonin in the brain.
This study offers the first evidence that marijuana can also increase serotonin, at least at lower doses, but at higher doses the serotonin in the rats’ brains dropped below the level of those in the control group.
The study, published in The Journal of Neuroscience, finds excessive marijuana use in people with depression poses high risk of psychosis.
The antidepressant and intoxicating effects of marijuana are due to its chemical similarity to natural substances in the brain known as “endo-cannabinoids,” which are released under conditions of high stress or pain, Gobbi said.
Don’t rush to dial-a-dealer just yet though, because amounts are unclear, and the study was on rats. Unless you’re a rat. Then, go for it.