Retrospective

A hundred years ago someone said that everything that we ever needed had already been invented. Do you ever wonder what people in the future will think when they look back at the world as it is today (in the event that a clean alternative is found for fossil fuel, so that the world doesn’t tear itself apart when supplies run low – oh and don’t forget someone discovering how to undo climate change)?

One of the things that strikes me personally is medication. I am taking the a-typical antipsychotic called Olanzapine. As far as my understanding goes antipsychotics were discovered to be effective treatments for psychosis by accident and it is not fully known why they work.

While taking it I have noticed significant changes in my emotional spectrum AS well as a reduction in psychotic thinking. Now that the dose has been lower slightly I am beginning to rediscover (sometimes overwhelmingly) my original emotional range. Unfortunately the positive symptoms appear to have grown slightly stronger too.

But is the medication a good thing? Does it treat the condition or the symptoms?

Apparently advances in genetics will have a big part to play in the future of how Schizophrenic disorders are treated and even cured. Also, the medication - such as the one that I am on - whilst alleviating the symptoms may be causing long term damage to the patient’s physiology.

Is it so difficult to picture a medical professor lecturing his pupils in the future on the archaic medicines that used to be prescribed so readily; in the same way that people now think about prefrontal lobotomies? Of course a lot of people are finding they are better off on medication as there is no alternative treatment at the moment beside psycho-socio therapy……or is there?

You could call it a conspiracy theory (and don’t worry, I’m keeping a close watch on this one) but I recently heard of a ruse by the pharmaceutical companies in America to suppress information about natural medicines that are equally effective as their counterparts – but without the unpleasant side effects – simply because they aren’t patentable and so wouldn’t make any money for their companies.

Is it true? Why would so many people testify that they are getting better naturally? And what is in it for them? Is it just me or isn’t it easier to believe that the pharmaceutical companies would choose to deny the efficacy of natural treatment because they have such a high stake in the game?

I don’t know what damage the Olanzapine is doing to my body. I read on the leaflet that comes in every box that tardive dyskinesia and diabetes can await the long term user so I’m slightly worried and eager to get my dose lowered as quickly as possible.

I’ve been on a dose of 17.5mg down from 20mg for over four months now and things are definitely better but it was not an easy period. It’s been four months of disruption and frustration and pain for me and my loved ones. Finally though things seem to have levelled out and I can start wondering how the months following the next drop will pan out?

Lowering My Antipsychotic Dose

When I was transferred to a different Community Mental Health Team a couple of years ago, the first thing my new Psychiatrist decided to do was lower my dose of Olanzapine. Unfortunately I had an immediate adverse reaction and my original dose was quickly reinstated.

I wonder now if that kind of reaction didn’t have something to do with my mind set at that particular time in my recovery. Did I see myself as heavily reliant on the medication? Was I scared that I would go back to the person I was without it? Or did I believe it validated my condition?

Two years later I decided voluntarily that I wanted to lower my dose. I told myself that I was in a much better place than before and I was ready to do without that crutch in my life.

At the time I had been studying Japanese for about five years. This was largely to enable me to focus day to day on something that was external to the confused mess of my mind. As I improved I became less reliant on the Japanese and came to see the medication in the same light; it acted as scaffolding, and I wanted to see if I could stay standing were it to be gradually taken away.

When I was first prescribed the antipsychotic medication I didn’t want to take it because I was worried about how it might change who I was. In the end what made me decide to start taking it was seeing how much pain I was bringing to the lives of the people I love. Basically, I was willing to try anything that’d put a stop to that.

I was also paranoid that what I was taking might be a placebo and that everyone – my doctor, the pharmacist, and even my parents were conspiring to trick me; so that if I got better just by taking sugar pills they’d know that there was really nothing wrong with me. I wished there wasn’t something wrong but at the same time I found solace in the knowledge that I was ill and I wasn’t just weak.

As the medication began working the paranoia subsided and those worries quickly evaporated leaving increased appetite and drowsiness in their wake. When I was first prescribed the Olanzapine I was put on the highest safe dose (20mg). It felt as though the Psychiatrist was eager to throw everything she could at me because the more I disclosed to her about my thoughts the higher she ranked up the level of medication.

I found the Olanzapine to be the most appropriate choice of medication and have been on it for about four years now. There were several reasons why I chose to lower my dosage. Firstly, I had done some research and didn’t like the sound of the long term side effects such as Tardive Dyskinesia and high cholesterol; so I was eager to avoid them if possible.

Secondly, I wanted to see what kind of person I was with the medication as low as possible. I was repeatedly told that my illness was no different from a broken leg; it was just not visible to the naked eye. I accepted this but I now doubt its validity. While reading up on my particular medication I came across the analogy of a car engine. Say a car needs its engine oil topping up; taking antipsychotic medication is basically the same as pouring oil over the entire engine so that some of it gets into the right place.

As I understand it antipsychotic medications work but it is not fully understood how they do so.

My psychiatrist told me at one of our meetings that I will be on these medications for the rest of my life. Maybe he is right; there is only one way to find out. I have been on a lower dose for over two months now and it has been an interesting and at times a terrible experience.

The first thing I noticed on the lower dose was the heightened emotional range I was capable of experiencing. Both the positive and negative emotions became more intense. You’d think it would be great to experience more intense positive emotions but at times I was so overwhelmed with excitement that I had to stop doing the things I enjoy.

The next change I noticed was the reduction of the anxiety that had been plaguing me for so long. That was a pleasant and unexpected bonus. Of course I found myself to be less drowsy and consequently less reliant on coffee to fuel my day. However over the past weeks I have been experiencing some negative symptoms.

I’ve been having feelings of distress. I’ve been feeling out of control. The noise in my head is sometimes unbearable. Seemingly insignificant things such as accidentally breaking a cup can throw me completely. I have been told that my body just needs to get used to it, which I sincerely hope is true.

For a long time I had been going along under the assumption that my brain is broken and that something isn’t right up there. But is this the case? Of course it could be but I’d rather believe that I am not damaged and that instead maybe it’s my environment that is.

That could just be wishful thinking on my part. I have now come to see that I live in an imperfect civilisation and that my brain hasn’t evolved to deal with the modern world so it’s not surprising that it struggles.

I recognise the intrusive images and words that I experience (as though they are injected into me) as part of my makeup. They can be distressing and at times I wonder if they really are my thoughts, feelings and desires. Over time I have come to realise that they are all mine – although that doesn’t mean for one second that I have to agree with them (that’s not as easy as it sounds).

I have been told not to look too far ahead; just to concentrate on the next few footsteps. I am still unable to work (even voluntarily for two hours a week) – especially now that I am dealing with my lower dose, which, as you can imagine is very frustrating. I see the people around me progressing whilst I stagnate. I have to remind myself that I am also progressing and that I shouldn’t measure myself by the rule of others.

I have been on a very long and difficult journey and it is important to keep telling myself that I have done well to get this far. I don’t know where my path will lead from now but I am hoping that the lower dose works out.

As for who I am that remains to be seen.­­­