Tag: psychiatrists

Sanity, or Writing?

I get an idea. 

A few minutes later, the very distinct thought: I need to stop thinking about this too hard. Or I need a pen.

My fingers twitch.  

Pen.

It can’t move fast enough on the page, chaos that will be a brief note in a dated, tagged table of contents. 

Tucked in the back pocket of that notebook that is rarely far from me is a sheet of paper with emergency information about me on it. 

In a previous draft, one of the notes, the sort that’s more for psych ward intake than found unconscious in a park, noted a few topics that tend to make my condition worse. Absurdist jokes about reality; things like The Matrix or Inception; general death and gore; certain corners of politics. 

The immediately following note said that I might bring these up first—some of them even extremely frequently; I spent years talking about nothing other than gory Hunger Games fanfiction—but to tread with caution. And that I especially bring them up in writing. 

It can be hard to find a balance between reality and fiction when you have a condition that heavily blurs those lines to begin with, and the mind and overactive imagination of a writer. I have never been one to write much fluff and happy endings; I write about apocalypses and dystopia, morally gray villain protagonists, death and torture, gore to disturb horror fans, extreme mind and power games, toxic and abusive relationships, manipulation and gaslighting. The note also recommended don’t look in the notebook. More so a you’re responsible for what you find. I’ve read that such dark obsessions can be common for people with PTSD, another factor here.

Yet in reality, the stray comment that is innocently just incorrect can send me into a frantic spiral of questioning what exists. 

So, yes, I need to stop thinking about this too hard. Or I need a pen.  

Frequently, when I question whether something I do, think, or feel, is normal, there are two people I ask. One, my fiancee, who works in STEM and barely even reads fiction, is usually at one extreme of the answer spectrum, while I am at the other. In the middle is my best friend, a writer and reader in much the same genres I am. The overactive imagination of a writer gets them halfway to my end of the spectrum, but psychosis takes me the rest of the way. 

Asking about daydreams, my end of the spectrum was, “The room disappears basically entirely. I am now seeing and hearing my characters like I’m exclusively in the room they’re in, in detail. I can experience things through their senses. It may or may not be ‘pleasant’. It’s all a little bit my doing and a little bit theirs. I’m dissociating. It is frequently hard to snap out of.”  

My fiancee’s end of the spectrum was, “I am thinking about an unrealistic idea with less logic and more fancifulness.” I understood that and did that myself sometimes, but it wasn’t what I meant by daydreaming, and her version never really went further than what she described. 

In the middle was, “I kind of see a picture in picture window of my characters doing things; I can hear it; they might be doing well or bad emotionally; I basically control it. Sometimes I’m a little spacey after.” I sometimes, but less frequently, experienced that version, but again, for them it never went further, and for me, it still wasn’t what I called a daydream. 

Since I have started taking meds again, I have had an easier time slipping out of daydreams, their grip on me less tight, less emotional. The rest is still true. But for a few days as the med levels stabled out in my body, the daydreams were almost hard to stay in when I wanted to—and I found that, deeply affected by psychosis or not, they’re a very important part of my writing process and I missed them. I felt, strangely, like losing that intensity to the daydreams was to lose touch with my characters, which felt like losing touch with not only writing goals but also good friends. (Now, whether or not most of my characters are good people is a very different question).

I was glad when I was again able to stay in them, but a little more at will.

I’ve written before—and God knows I’m not the only one—about the relations between writers and creativity and mental illness. Most talked about, though, are anxiety and mood disorders, and certainly substance abuse. Psychosis, and especially schizophrenia, seem, while frequently pondered, less well factually documented. 

It’s something I’d like to look into more in the future. 

Functionality Thresholds and Medication

So I saw a psychiatrist through an online urgent care service after remembering that it was an option, and started on a new antipsychotic. 

I had a lot of mixed feelings about going back on meds. At first, I felt like it was a cynical move—the action that confirmed the thought that I wouldn’t get better without meds, that I was dependent on them again, that I was worse now than I was back when I got off of them or at any point in between. 

Then I started to look at it a little differently. 

When I got off the meds, I wasn’t working, in school, volunteering, being a great housewife, or honestly being productive at much of anything. My standards for functional were a lot lower.

I think what’s happening now is more that I’ve hit a threshold. I have a lot more things I want to do now.

I’m deep into multiple writing and other creative projects (I recently won Camp NaNoWriMo with writing over 50,000 words in July), I read several times as much, I happily handle nearly all of the domestic responsibilities, I take classes now and then, I do property management and investing, I go on walks, and when there’s not a pandemic, I volunteer at the library once a week. 

I think that if I wanted to do what I was doing when I got off of meds, I absolutely still wouldn’t need the meds. 

But I want to be doing a lot more—and I’ve hit a ceiling. I can’t do all the things I want to do now without the assistance of meds. 

It is less that my abilities are that much worse and more that they are being pushed for so much more. 

So I’ve had almost a week on the new med. It knocks me out at night; I sleep like the dead for now. I had thought my sleep had been largely okay for a while, but it seems the quality was lacking in a way I couldn’t measure, because during the day, I comparatively have so much energy now I find myself confused on what to do with it. I dissociate much less and less strongly, and haven’t had a super noticeable hallucination since I started. 

So I finished Camp NaNoWriMo, then wrote some more. I started reading several new books, including some on AirBnB management. I got back to crocheting; I socialized; I got the house in shape; I experimented with my new instant camera. 

I feel much better about the med decision. 

Knowing Your Mind Is Vulnerable, and What You Do About It

I’m writing. It’s going really well. Pages and pages of ink in my beloved dot grid Moleskine. So many pages, I think to comment to friends about my comparatively unpretentious but equally beloved Bic pen that has somehow lasted me almost sixty total pages, plus about half of my previous Moleskine, and months of Word of the Day Post It notes, mailed letters, and other miscellany. I included a picture of the inside of the front cover of my notebook, a gift from my fiancee, with that inside cover inscribed by her at the spot we met on the second anniversary of it, a callback to our first conversation—notebooks. 

I write; I take a break to clean a few things when my back complains about sitting. I end up sitting on the bed and reading Writers on Writing, a New York Times essay compilation recommended from a workshop class. I go back to writing at my desk. It flows. Something else I can’t place my finger on keeps catching my attention. I put noise canceling headphones on that I’m borrowing from my fiancee, with a bit of Harry Potter themed ASMR with splashing water and bubbles. I remember putting them on and realizing how much white noise was in my brain for the first time as hallucinations worsened. Something keeps drawing my eyes. I think it’s black—a prominent color in my most terrifying recurring hallucination, but it’s not that—yet, at least.  

Maybe it’s the cat. Our fanged black cat naps on the bed. But every time my eyes dart to her, she’s still, not eye catching. The legs of my desk, the fabric drawers, my space heater, my knee socks, my desk chair, my computer screen fully dimmed since I’m just using the device for the ASMR—something black. It keeps coming in the corner of my eye. I turn on my task lamp, also black, but hoping the light will dispel some shadows. The other cat, a tortoiseshell, naps in the rope hammock swing, encased in my white canopy and starry string lights. 

My fiancee comes and asks if I want anything downstairs while she’s going. More black in the corner of my eye at first—her usual attire. I do a double take. No, she’s there. Water, I say.  

I get the words down a little faster, not sure how much longer they’re coming for. I’m behind on words for Camp NaNoWriMo, hoping for my tenth win of 50,000 words or more in a month—one past win being the 100 pages for the sister event for scripts—and I’m not sure yet how many words are actually on the page without the convenience of a computer’s word counter, having not typed them up. There are plenty of words crossed out for better ones, and random notes about the story or about things to add to the shopping list, places my handwriting ceases to know what a space is. If I don’t write now, with the first signs of my mind fading for a while, I’m probably not going to anymore today. 

She comes back with the water and leaves. The cat goes off to explore. 

I wish my hands moved faster or my characters got to the point faster. “I’m rambling,” one of the characters confesses. Yes, you are, I think at her, hands twitching. The black cloud seems to be flashing in and out faster. I should just write down a summary of the rest of this scene in case I don’t get to it. The chapter outline lives on my computer, a picture of my whiteboard and some added notes, but it’s missing snippets of dialogue and action that have just come to me as I approach them. I add more notes; I can’t seem to hold them in my head well anyway. I sense humanoid movement, which means it’s probably heading down the PTSD road; I keep seeing it in the mirrored closet doors next to my desk; I have that distinct sense of something behind me and turning around clears it for only a moment. 

It’s strange to worry about not being able to think. Day to day, it means not holding where this scene is going only in my head, just in case my mind goes mostly out for a few hours and comes back without those ideas. It means a bit of an obsession with certain paperwork. 

To be fair, reading Five Days at Memorial would give anyone an obsession with living wills, and I’ve gone and succeeded pro se in probate court with no will recently enough to have it in mind. Those aren’t really the papers I’m worried about yet. 

Right now, it’s mostly a piece of paper in the back of my notebook, my little “SHTF” paper. The sort of things I wish I had written down before the blur of my one abrupt psych ward stay, when I’d abandoned having such a note for a while. Emergency contacts. Basics.

Cat—a black blob in the bed—no, she’s on the carpet now—the blob flickers out. I glare at where it was, mostly over knowing I can’t see my psychiatrist for over three weeks to keep it flickered out. 

I called my psychiatrist first thing Monday morning after I committed to calling, because I’m psychotic but not irresponsible—fear of irresponsibility due to my mind fading out perhaps fueling those papers and other things. 

I put the appointment on one of my multiple Google Calendars. My fiancee once said I run my life like I’m a startup CEO rather than a housewife writer with some real estate. I might just be paranoid. She agrees to drive me to the appointment, if it’s not on Zoom. I don’t drive and while I keep tossing the idea around, I don’t want to one day swerve around a dog that isn’t there, like the one that accompanied me on my walk the other day, holding an also hallucinated leash in her mouth as she trotted next to me like it was helpful, flickering and then fading entirely by the time I got halfway to my destination. 

My therapist has had no luck finding me someone who knows more about psychosis on the therapy side, while I wait on meds, and neither have I. She says the laws apparently changed, according to a coworker of hers, and she’s allowed to treat it now, but no more knowledge qualified than she was before. I’m waiting on some books, library and mail order, my finds and my therapist’s, and enjoying JSTOR’s pandemic discounts, if research is only a grab in the dark for that responsibility and control. One book I’m waiting on is My Month of Madness—a paranoid long shot for usefulness, but autoimmune has definitely been thrown around before, and after months of pain turned out to be a rare manifestation of toxic black mold poisoning once, I try to not dismiss rare diagnoses out of hand. Yet I don’t want to fall into the “letting WebMD convince you that you have a brain tumor” trap.  

So honestly, I am mostly still at waiting, which is a lot of what treatment is. You’d think I’d be better at it by now. Waiting for the black blobs to get too consuming, waiting for my appointment, waiting for books.

I have many virtues, but patience and sanity are not among them. 

On Farrah and Treatment

I swore when my shoulder cramped, which was interesting, because I’d kind of assumed I was nonverbal at the moment, based on the way my thoughts flowed, or didn’t, and a familiar feeling somewhere in my throat, though I hadn’t tested it. 

I couldn’t blame my shoulder for cramping; my disorientation at speaking came with the realization that I’d been lying on my office floor staring at the very bottom of my bookshelves again. 

Against my back, I felt Farrah, my recurring puppy hallucination, slump, and heard her whimper for attention, wet nose near my neck. The theme of the morning’s tactile hallucinations seemed to be—weight. Farrah’s dense little body in my hands, slumping against my back in the same manner the cats did, cold paws pressing at spots on my lap.  

Just to spite my saying to my therapist yesterday that the tactile and visual hallucinations didn’t line up and Farrah teleported away if I tried to get close, the hallucinations started to line up, and she started wanting to cuddle.  

She’d been clingy all morning, and while she didn’t talk, I felt or knew her thoughts in a way that was hard to explain—the way you knew the facts in dreams that were never presented in a sensory manner. She was disheartened by my therapy video chat yesterday that came to the conclusion—I might need to go back on meds. Probably, in fact. 

I’m not trying to get rid of you, was what I thought at Farrah, because this was stupid. She wasn’t real, and so wasn’t sad that I was trying to stop seeing her—and honestly, she was the least of my issues I was trying to stop seeing. Her behavior was just the manifestation of my own mixed feelings about likely going back on meds. 

My old psychiatrist’s office wasn’t open on weekends, though, and there were no calls to be made just yet. So Farrah—claws pattering on the hardwood and somersaulting clumsily down the stairs and getting stuck in the legs of my desk and trying to eat the real cats’ food—kept me company all morning and into the afternoon.  

I found myself editing a picture I’d found online that kind of looked like her, to get the image closer to right, as if trying to appease her—see, you’re not going away, you can live in a picture, I can still know what you look like, even if it’s in a healthier format. 

I also have developed a bit of an obsession with where Farrah came from. I only have two specific recurring hallucinations currently; one is straight out of a PTSD flashback; I’m very aware of where it came from. The other is Farrah. Any others are not coherent enough to be called recurring. Those little imaginary flashes of light, flips of still objects, white noise I can’t pin down. 

The only real dog I see regularly looks, sounds, feels, and acts nothing like Farrah. I can’t figure out if Farrah is my mental manifestation of dog or puppy or golden retriever or… what word my brain might have decided to attach to, that conjured this particular image. I’m not much of a dog person; that’s why my two real pets are cats. Google told me what Farrah meant—I know no real Farrahs and have no personal associations with the name, its origin in a language I don’t speak. I keep staring her down, thinking: Why are you here? 

I get at most a wag of the tail or a yip back. 

It’s a big question for a little puppy that’s not even real. 

Talking about it in therapy was strangely disheartening to me, too, because those closest to me are very used to the quirks of my physical and mental health, or at least know reacting strongly isn’t going to change it. I forget how concerning certain things sound to the average person, and I’d been out of touch with my therapist for a bit there, when I’d been doing well. 

Also disheartening was the fact that, as my psychosis spikes up again, my therapist, an MFT, is not really qualified to treat it. Therapy is not the front line treatment for schizophrenia as it is—medication is. It’s an issue we’ve discussed before. I used to have a second therapist, the psychologist who initially diagnosed me, who my therapist referred me to shortly after I started seeing her in 2015, but the psychologist sadly passed on less than a year later, and I haven’t had that second person to treat that side of my illness since. 

I can write up new medical files and go back to meditation and read more psychology books and call my psychiatrist and go to my current therapist and do some therapy workbook activities and all, and I have—but having a qualified professional to talk to is a good resource.

But, hard to find. The only name my therapist came up with off the top of her head to bring in didn’t take my insurance. I’ve had many nightmare therapists and I’ve had many who were good people who admitted they were in over their heads. The web told me that my old psychologist, the one who passed four years ago, is currently accepting new patients. 

The only real thing to do is maintain routines and wait, and wonder if it would work if I carried clumsy Farrah down the stairs.