Tag Archives: antipsychotic

We Need To Talk About… Psychosis

Psychosis! What do you think it means? Does it mean schizophrenia? Does it mean being locked up? Does it mean there is no hope? These things are things I thought before I experienced psychosis and I know many still think this way. This is why we need to talk about psychosis.

So what is psychosis?

Psychosis is made up of many different symptoms. Some people will have many, some only one. They include:

  • Hallucinations (these may be visual, auditory, tactile or related to smell and taste)
  • Delusions (having strong beliefs not shared by others, for example, people are going to hurt you)

Does everyone with psychosis have schizophrenia?

It’s a common assumption that the only people that experience psychosis are those with schizophrenia. This simply isn’t the case. Many mental illnesses may cause a person to experience psychosis. These include bipolar, depression and BPD (Borderline Personality Disorder). Psychosis can also be a result of physical illness or trauma.

Will someone with psychosis recover?

There is hope for those with psychosis. Many people will only have one episode of psychosis. Psychosis can also be managed with medication. There is a variety of antipsychotics. Of course as with any medication there can be side effects but these often are often outweighed by the benefits. It can also be a process of finding what works for you. Sometimes, when the psychosis is caused by trauma, psychosis can be helped by therapy.

What does someone with psychosis look like?

There is no specific way that someone who experiences psychosis looks. The term “psychotic look” which is often used to describe a way someone is looking is a work of fiction. Those with psychosis look like everyone else. The signs are more likely to be in their behaviour.

A last thought

People with psychosis experience extreme stigma. We are made out to be “crazy” and someone to be feared. In fact we are more likely to be a danger to ourselves or be at risk from others. It can be scary to see someone dealing with psychosis but remember they are probably scared too.

For more information about psychosis click here.

To share your experience feel free to use the comments or Twitter, Facebook or Instagram.

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I Need It Out

Please be aware this post may contain content that is triggering. It includes talk of suicide and swearing. Please take care.

Currently listening to the voice being a constant negative monologue in my ear. It’s been pretty bad lately and the hours I’ve spent having to hear it are numerous. Today I just need it out and the thoughts that go along with it. It may not make much sense so apologies in advance.

(Italic = voice, bold = me)

You’re vile. Why would anyone want you?

I’m not. I don’t know.

You are vile. No one wants you. You’re a burden.

I know. I’m sorry.

You should die. Everyone wants you dead.

Leave me alone.

Why would anyone want you? You’re nothing.

Come on you should be dead. Why aren’t you dead?

But it’s not easy.

You should just do it. You’re weak. You’ve always been weak. That’s why no one likes you.

But they say they like me. They’re not liars.

They’re just being nice. They put up with you. They’re better than you. They have more worth than you. You’re nothing.

But…

You are nothing. You should be dead. Why can’t you just die? That’s what everyone wants. That’s what everyone needs.

Why?

Because you’re bad. You know you’re bad. You know how evil you are. You deserved everything that happened. You make people hurt you.

I know.

If you know why are you still here? Just do it. Just do it. Just do it.

I can’t.

For fucks sake just do it. You’re weak and pathetic. No one wants you. They all wish you died. They’re just too nice to say it. Just do it.

I can’t.

This is why people hate you. Can’t you see how much you annoy everyone. Why do you even open your mouth? No one wants to hear it. No one cares. You just annoy everyone. They hate you.

But I’m trying to make things better.

All you do is hurt everyone. You should die. Why don’t you just die?

I’m not talking to you anymore. I don’t need you.

You should be grateful for me. I tell you the truth. They want you dead but are too nice to tell you. Don’t talk anymore. They don’t need you, you’ll see. You’ll see how much better they are without you. Then you can do it knowing its the right thing. You’re weak. Too weak. Dying would be the best thing for you. You just get in the way. You’re worthless and a waste of space. You should just die. If you’re not going to talk to me I’ll keep telling you everything. You should just die though. You’re a fuck up. Why can’t you see it?!

That’s just an extract of what seems to be pretty constant to me. Replying isn’t easy. I don’t often know what to say to it. I feel powerless most of the time. Distractions have not been helping lately but I am aware they help a lot of people. This isn’t really an advice post. More a me getting it out and hoping to feel less alone post. The voice is isolating. It can be hard to fight. It can be hard to ignore. But I’m trying.

Please don’t feel alone and feel free to connect via the comments or on Twitter, Facebook or Instagram.

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Murder Not Mental Illness

I wouldn’t normally comment on things that happen in America as it is not my country. But this is an issue that comes up again and again with regards to mass shootings in America. The common rhetoric is to claim the perpetrator is mentally ill. Now it is possible that they do have a mental illness but for the number of mass shootings that happen each year in America, that is a lot of mentally ill people with access to guns.

The truth is that these mass shootings are murder. Even terrorism. Often racism is at the core. This isn’t mental illness. Racism isn’t a mental illness. It’s a societal issue. Also America is not the only place where people are mentally ill, yet the number of mass shootings that occur there is disproportionately high. Surely this points to a deeper issue (*coughs* gun laws).

Here is the reality. People with a mental illness are more likely to be victims of violence than perpetrators. I only have access to British statistics but this paragraph from Time to Change’s website shows the rate of murder caused by someone acting as part of their mental illness:

“According to the British Crime Survey, almost half (47 per cent) of the victims of violent crimes believed that their offender was under the influence of alcohol and about 17 per cent believed that the offender was under the influence of drugs. Another survey suggested that about 30 per cent of victims believed that the offender attacked them because they were under the influence of drugs or alcohol. In contrast, only 1 per cent of victims believed that the violent incident happened because the offender had a mental illness.” Time to Change (Accessed August 2019).

It shows that while mental illness can cause someone to become violent, the chances are you’re more likely to be killed by someone drinking or on drugs. Yet this is never given as a possible explanation to those carrying out mass shootings. They also forget to mention that those with a mental illness are more of a risk to themselves than others.

It’s too easy to blame mental illness. To take something that people already fear and stigmatise against and use it to “explain” something so scary. People don’t want to think that someone who is a neurotypical person can be capable of causing so much death and destruction. But that is the case. Their brain may have been warped but it is not by mental illness, it is by racist ideologies (most of the time).

I know there will be many who won’t accept that mental illness is not to blame in the majority of cases. The thing is, even if a person is mentally ill, there are many other things that contribute to these situations. You need to look at your treatment of those with mental illnesses. You need to look at the ease of access to guns. It is not simply “this person was mentally ill and so there was nothing we could do”. Even when a person with a mental illness is violent, there are things that can be done to reduce this risk as there are often signs that this may happen.

So there we have it. Think before you say that a perpetrator is/was mentally ill. You are adding to the stigma. Maybe think what could be changed to prevent this ever happening again. What could of prevented it. What was the real motive. It is more than likely much deeper than “they were mentally ill”. Think. Yes, I’m looking at you Mr. President.

If you have any thoughts feel free to share in the comments or on Twitter, Facebook or Instagram.

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BPD Q&A

There is a lot of misinformation out there about BPD and many people don’t have a good understanding of the illness. It can be very confusing, even for those of us who are dealing with the disorder. Therefore I thought I would answer some common(ish) questions. Obviously I only have my experiences to draw on but I hope it is still helpful.

What is BPD?

BPD stands for Borderline Personality Disorder. It may also be known by the name EUPD or Emotionally Unstable Personality Disorder. It is a mental illness classified in the DSM-V (the manual of all mental illnesses). There are a variety of symptoms including relationship difficulties, fear of abandonment, suicidal ideation, self harm, impulsive behaviour, lack of a sense of self and extreme emotions which switch rapidly. To be diagnosed with BPD you need to match five points of a criteria of nine. This means that everyone with BPD is unique as each criteria is also on a spectrum.

What causes BPD?

There are many different theories as to what causes BPD. It is widely agreed that trauma in childhood is a big cause but not everyone who has BPD experiences trauma. There has also been research into changes in brain structure and genetics. However nothing has been conclusive.

What does having BPD feel like?

Everyone with BPD is different so I can only talk about what BPD is like from my point of view. Personally it feels like I’m an alien in this world that seems to be out of my control. And the lack of control reaches even inside me. I also feel constantly scared that people won’t like me or will leave me. I also feel like everything is too much.

What treatment is there for BPD?

The main treatment for BPD is Dialectical Behavioural Therapy (DBT). This is a therapy that is mindfulness based and proper DBT consists of both group and individual therapy to learn skills to deal with distress, relationships and emotions. However it is not always available. People with BPD may also take medication though no medication is suggested for BPD. It can however help with symptoms and other illnesses that people with BPD are likely to have.

What is BPD rage?

BPD rage is the extreme anger that some people with BPD feel. Like all our emotions it is incredibly intense. It can also last a long time after the triggering event is over and when other people have forgotten about it. It also may seem disproportionate to the triggering event. Sometimes we turn the rage inwards and this can lead to self harm and suicidal behaviour.

Can people with BPD get psychosis?

Yes. It is a lesser known symptom of BPD but it can happen. It is more common in times of stress but can be there long term too.

Is BPD serious?

Yes there BPD is serious. It has a suicide rate of 10%. 70% of people with BPD attempt suicide. Self harm is common. Alcohol and substance abuse are also common. It effects everyday life.

Are people with BPD dangerous?

No people with BPD are not dangerous. In fact people with BPD are more likely to be victims of abuse than perpetrators. We are also more likely to hurt ourselves than other people.

So that is a few questions about BPD. I hope it helps with some understanding of the illness. For more information on BPD check out the Mind website. Feel free to share your experiences in the comments or on Twitter, Facebook or Instagram.

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The Lesser Known Symptom Of BPD

As some of you may know there is a criteria of 9 symptoms which are considered when diagnosing BPD (Borderline Personality Disorder or Emotionally Unstable Personality Disorder (EUPD)). To gain a diagnosis of BPD you need to meet at least 5 of the 9 criteria but each criteria can be met to different degrees. This means there are many different combinations of the criteria and therefore everyone who has the diagnosis is unique.

One of the lesser known criteria is hallucinations and psychosis in times of stress. This has been described below as mentioned on the NHS website.

“Brief episodes of strange experiences – such as hearing voices outside your head for minutes at a time. These may often feel like instructions to harm yourself or others. You may or may not be certain whether these are real.” (NHS website)

This lesser known symptom of BPD can be devastating but it is often overlooked by others. Most people focus on the difficulty with relationships and self harm. These of course are very serious symptoms of BPD but so is psychosis.

Often when you tell someone you hear a voice people will assume you have schizophrenia but it can be a part of many different illnesses, BPD being one of them. It means that an already stigmatised diagnosis (BPD) is even more stigmatised. This can be from others with the same diagnosis as well as mental health professionals.

It took a long time for me to tell my mental health team about the voice I hear. I thought that they would write me off as crazy and didnt realise it was part of my BPD diagnosis. I wasn’t informed that it was a part of BPD until years later, as different mental health professionals didn’t inform me that it was.

In fact I came up against stigma from some. They didn’t seem to take my symptoms seriously and dismissed me to begin with because I knew that the voice was in my head. They made out that it wasn’t a big deal even though it was still distressing. It took some time to persuade them to give me treatment. In fact one professional told me that because the psychosis was part of BPD I would never be able to get help with it. This was untrue as my current psychiatrist believes it can be helped by medication and I just haven’t found the right one yet that doesn’t cause me side effects.

Of course not everyone who has a BPD diagnosis experiences psychosis but it is part of the criteria so many who have it will suffer. How many suffer in silence? I want to talk about this lesser known symptom and end the stigma.

Have you had an experience of psychosis because of BPD? Feel free to share in the comments or on Twitter, Facebook or Instagram.

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Medication and Mental Health

Disclaimer: I am not a medical professional. All that I am writing is my own experience with medication. Every person is different and will react differently to each medication. If you are having issues with your medication please speak to a doctor.

I first started on medication for my mental health when I was 19 and it has been a huge journey full of trial and error. I’m still not even sure I have found the correct combination nine years on. This doesn’t mean it will be the same for you. Some people find the first medication they try works for them.

My current medications for my mental health are Sulpiride (an antipsychotic), Sodium Valproate (a mood stabiliser), Venlafaxine and Mirtazapine (both antidepressants). I have also tried Citalopram, Fluoxetine, Sertraline, Risperidone, Aripiprazole, Lorazepam and Diazepam. Here I plan to discuss my experience and journey with medication.

When I first went to the doctors, seeking help for my mental health, I was reluctant to try medication as I had heard negative things about it. So my doctor decided to get me to try counselling first but I continued to struggle and it was eventually decided to put me on an antidepressant. The drug of choice was Citalopram. I was started off on a low dose and had it gradually increased over time but, for me, it was not very helpful and didn’t make a dent in my depression. I was also lucky in that I didn’t get any side effects from it. I was on it for quite a while.

Then I was changed to Sertraline, another antidepressant. Again it was started at a low dose and increased. This time I felt a small benefit from it but I also felt disconnected from the world and like my creativity had gone. So I stopped it without discussing it with a doctor. This is something I would never advise and it ended badly for me with me becoming more unwell until it was restarted.

Eventually it was decided that Sertraline wasn’t right for me and I was switched to Fluoxetine. This is where I began to run into problems quite quickly. Fluoxetine, for me, was the worst medication. I quickly descended into a crisis and became extremely suicidal. My depression was at it’s worst with me being unable to get out of bed.

Me medication was quickly changed and I was put on Venlafaxine and Mirtazapine. These two drugs really helped me. Mirtazapine sorted out my sleep and I remain on it. I think this is the one drug I’d be reluctant to stop as sleep is important to keeping me well.

As for Venlafaxine it was also helpful but was decided I would stop it as the withdrawal from missing a dose was awful and I was always anxious I’d be ill and unable to take it. It took 6 months to come off and I was off it for several years before it , recently, was decided it should be added back in at a low dose. It is helping me slightly again.

These are all the antidepressants I have tried. I am also on a mood stabiliser and an antipsychotic. The mood stabiliser I am on is Sodium Valproate and its the only one I’ve tried though the dose has been played around with. It is currently working for me and stops, to an extent, the rapid mood swings of BPD. It has weight gain and acne as side effects and these are things I’ve struggled with. But the benefits outweigh these at the moment.

The first antipsychotic I tried was Risperidone and it worked for me. The voice I hear was reduced. I, however, couldn’t stay on it as a blood test showed it was effecting my kidney function and hormone levels. It was stopped and for a while I was without an antipsychotic.

After a while my symptoms were not improving so it was decided to try a new antipsychotic; this time Aripiprazole. Aripiprazole didn’t help me. It didn’t touch the voice and caused my anxiety to sky rocket. I also felt more like a zombie on it and even my parents noticed I wasn’t with it.

In the end I decided I needed to come off Aripiprazole and so with a doctors help I did and was put onto Sulpiride instead. This I am currently still on and I am not sure how much it helps me. It has had an effect on my hormone levels but it seems the benefits outweigh this. We shall see how it goes.

I have also tried Lorazepam and Diazepam to help with anxiety and have found them useful in the short term. I have not used them enough to go into detail though.

So this is my experience of medication. It has been a rocky journey but my current view is that medication can be a useful tool to manage symptoms. It may take a while to find the right one or it may not be right for you but it is a valid option. Noone should feel ashamed of taking medication for their mental health.

Please feel free to share your experiences of medication in the comments. Everyone is unique so I am sure many of you have different experiences.

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