Monday, October 8, 2012

Crisis postponed

Thanks to everyone who sent me encouraging words and helpful comments. I changed the original title of this post from "crisis averted" to "crisis postponed" because the crisis did, in fact, happen, and there is always the possibility of a new crisis somewhere in the future.  Such is life. Due to the events of the last few days, I'm trying to be more philosophical about the need for Chris to be back on a medication. We had to grab an additional weapon that might stand a chance of stopping his growing anxiety, emotionalism and negative self-image. I've seen in the past where this can lead, and it was the hospital.

Not that I have changed my mind and think that the drugs are safe or particularly effective, but, they can work in a pinch, and often they do work to shut down the symptoms I described above.  (I'll not go into the side effects in this post. We all know them, and the first visible one, even at a low dose, is usually weight gain.) Vigilance is needed on everyone's part  (especially Dr. Stern's) to maintain the drug at the lowest dose for the shortest period while continuing to find other ways of making Chris even more resilient the next time a crisis looms.

I think it's important to point out that a supportive family and intensive psychotherapy didn't stop the crisis from happening, and based on my past experience, won't necessarily prevent it from getting worse. But, with all the holistic interventions Chris has undergone in the past eight years, he's in a much better position to not prolong this latest crisis. Ian and I acted quite business as usual with Chris and did not aggravate the situation by over-reacting.

Chris agreed to the resumption of Abilify, and seemed back to whatever his normal is the following day. He's keeping up with his musical theater practices and finally bought himself a cell phone so he could keep better track of his appointments and his growing group of friends. Ian and I picked up where we left off with him, and are no longer walking around in a state of fear.

Some people may think about the medication, well, what's the big deal? Everybody knows that low dose is best. Well, that's not exactly the way the doctors presented this to me eight years ago. Eight years ago nobody I spoke with mentioned low dose or a single medication only. I had to do my own homework, and was treated like an idiot who didn't understand the problem. Now, lowest possible dose and fewest drugs are on everybody's lips. To get Chris to a low dose of one drug only, took a lot of arguing and willingness to change doctors on my part. Leonard Cohen's crack of light getting in, at least where psychiatry is concerned, is largely thanks to the growing stridency of the psychiatric survivor movement.


  1. anxiety and low self-esteem play a big role in people's breakdowns and yet I wonder why isn't there another way but psychitric meds to deal with them. I suffered from panic attacks in my youth and benefited greatly from breathing and relaxation exercises. I used also valerian tablets now and then which are not addictive and did a great job in my case.

  2. I totally agree that there should be more than psych meds handle this. My son was been practicing Transcendental Meditation for a year, but even that was not enough enough avert the crisis. It may be coincidental that the psych med seems to have stopped this latest crisis from continuing.

  3. Rossa,

    My recollection is that you were suspicious about the vitamins and the others orthomolecular products, saying something such as that you wouldn´t like that a patient be dependent on vitamins, as well as you wouldn´t like a patient be dependent of the neuroleptics. Well, I would prefer be dependent of the vitamins with no adverse side effects even if I must be in a low dose of neuroleptic with virtually no side sffects. The number of products that an orthomolecular doctor can prescribe could be high and it is necessary an effort to take control of the situation.

    I think that orthomolecular therapy is a good one. Dr. Carl Pfeiffer Ph.D. M.D. books like "Nutrition and Mental Illness An Orthomolecular Approach to Balancing Body Chemistry" are good examples. This therapy is a help, a reinforcement that probably make that you don´t have to depend too much in other more or less psychological therapies.

    This is what recently Dr. Bonnie Camo MD wrote in her Facebook page, (Dr. Bonnie Camo MD, Natural Medicine & Homeopathy, she worked with Dr. Pfeiffer in the Princeton Brain Bio Center
    M.D. · From 1978 to 1995 · Princeton):

    "Shortly after Hoffer and Osmond’s study, the first neuroleptic tranquilizer, Thorazine™, was introduced to North America in 1953, and promoted aggressively by psychiatrists and pharmaceutical companies. These antipsychotic drugs work by blocking dopamine, an excess of which may cause paranoia. Conventional neuroleptics also block dopamine in the basal ganglia, resulting in incurable tardive dyskinesia. Unknown to conventional psychiatrists, TD can be prevented by certain vitamins and minerals, including DMAE, a form of choline, and the mineral manganese. In thirty years of treating schizophrenic patients with megavitamins, I never had anyone develop tardive dyskinesia, even if they were also on neuroleptic tranquilizers".

    "The new generation “atypical” antipsychotics, such as Clozaril™, Zyprexa™, Seroquel™, and Risperdal™, are less likely to produce movement disorders, but they cause other problem, including obesity and diabetes. Since these drugs rarely produce tardive dyskinesia, psychiatrists are lulled into believing that they are relatively harmless to the brain, and give them in higher and higher doses. They may cause tardive dementia and tardive psychosis - symptoms persist and even get worse when the drug is withdrawn. It is very difficult to withdraw patients from these drugs, yet their mental functions may be deteriorating the longer they stay on them".

    "According to Eva Edelman, Natural Healing for Schizophrenia, “Psychiatric drugs have the potential to induce a supersensitivity psychosis in the world’s sanest human, forcing the individual into a lifelong drug dependency.” Blocked dopamine synapses become hypersensitive, so when the drug is withdrawn, paranoia and hallucinations become worse than ever. Once the patient is on orthomolecular therapy, an attempt can be made to withdraw the drugs very gradually, but many patients will need to stay on a small dose, as the brain has become dependent on it. The natural psychosis has become a “tranquilizer psychosis”, as Dr. Hoffer calls it."

    Other recently commentary of Dr. Bonnie Camo MD: "Pfeiffer's law: Whatever a drug can do, a nutrient can be found to do it better - and without side effect. I worked for many years with Dr Carl Pfeiffer, founder of the Brain Bio Center in Princeton. We treated people for schizophrenia, bipolar etc with megavitamins and orthomolecular psychiatry. We tested and prescribed the nutrients their individual brain needed to function properly, without drugs - which don't cure anything, just suppress symptoms and turn an acute problem into a chronic illness"

    1. Anonymous,

      This is a bit of a ramble, but your e-mail has provoked lots of thoughts on my side.

      I couldn't agree more about vitamins and supplements being way preferable to meds. And I agree that nutrients (often administered in high doses which makes them drugs - my emphasis) perform better than drugs. I just don't feel that nutrients are the whole picture, based on my experience trying to get my son back to a state of total health.

      What is scary, and what may be happening with Chris, is in your quote from Eva Edelman:

      "Once the patient is on orthomolecular therapy, an attempt can be made to withdraw the drugs very gradually, but many patients will need to stay on a small dose, as the brain has become dependent on it. The natural psychosis has become a “tranquilizer psychosis”, as Dr. Hoffer calls it."

      I really "hope" this isn't the case. Dr. Hoffer had no time for psychiatry or the concept of trauma in psychosis, so he may only have seen the part of the picture that suited his professional interests. Nothing is black and white, and I have to hope (for Chris's sake) that Dr. Hoffer and Eva Edelman haven't entirely unlocked "schizophrenia's" mystery. They are a good part of the picture, just not the whole picture.

      You also write: "The number of products that an orthomolecular doctor can prescribe could be high and it is necessary an effort to take control of the situation."

      My son spent three years with an orthomolecular doctor, who administered a mind-boggling array of nutrients in addition to helping him with visualizations. (She did this concurrent with his meds, and gradually got him off the meds entirely while continuing with the supplements. He eventually ended up back in the hospital with the same symptoms that got him hospitalized and on meds in the first place. He wasn't on meds when he first went psychotic. (Had I known about Dr. Hoffer when he was aged 16, and had I known he was going to go psychotic, I would have started him on high dose niacin therapy.)

      Unfortunately, access is limited for most people to orthomolecular treatment combined with time out in therapeutic caring environment when a crisis is looming.

      So, yes, I totally believe in orthomolecular, and would choose it any day of the week over being on a med. I'm on Dr. Hoffer's niacin combo therapy and it works wonders for me. Chris's problems are more complex. I really hope that he will eventually get off the medication completely. Here's the rub: As long as he continues to see a psychiatrist, the prescription pad will be used when he starts to look shaky. To paraphrase Peter Breggin: "Your psychiatrist may be your problem." (But, I can't afford not to put eggs in that particular basekt, either.)

      The ideal (for me) would be a system in place at the national level that treats mental illness in a holistic way, emphasizing orthomolecular, but also incorporating psychological treatments, shamanic approaches, and energy medicine, and that has access to respite centers in every community.

    2. Rossa,

      Well, I remember you commented that probably some of the suplements that your son was taken were finish and that he doesn´t replace. It is my believe that if your son miss some of the important vitamins, minerals or aminoacids the relapse could happen, in a certain way like the drugs.

      With these therapy, besides all you say about psychological treatments, shamanics approaches, and energy medicine I think it is important to follow a healthy diet, be careful of food allergies and other allergies, a program of regular physical exercise, a prodromes daily record to prevent relapses, no drugs, no alcohol and so on.

      I think that people who suffers a psychotic break, whatever the cause, make them vulnerable to others breaks if they don´t sleep well (for example less than three hours) and had strong reactions to particular stressors. All these could be complicated with drugs. It is like inside the brain there is a jungle and then a clear path is open, when you return to this place the most probably way the neurones would follow is the clear path already open and this could be the result many times.

      You write about psychiatrists and prescription pad, I know you are in Switzerland, well near Zurich is Dr Roman Lietha (, I think), he is a Swiss medecin that worked with Dr. Pfeiffer and lives in Meilen, near Zurich and if you want you can contact him.

    3. Dear Anonymous,
      Thanks very much for the name of the doctor in Rapperswill. I came across his clinic a few years ago, but my son was already working with someone who took an orthomolecular approach, so I didn't pursue it. Right now, my son has resumed taking supplements, but nowhere near the amount he was taking four years ago. If my son was a biochemical deficiency somewhere that is related to the diagnosis of schizophrenia, so far we don't know what it is. He has recently been working with a color therapist who says that he has cleared his traumas, but is puzzled by the fact that he still sees by way of brain scans, that he has an energy blockage. We still don't know what causes it or better yet, how to fix it. I am hoping to write more about this in a future post. So, while it was disappointing that Chris went back on a small dose of medication, we are still working on finding other ways of helping him that may ultimately make the medication unnecessary.

  4. Ms. Forbes,

    I've been taking an atypical antipsychotic for several years now. I did experience weight gain as a side effect and I began taking a diabetes drug called metformin (aka glucophage)in addition to going on a diet and taking up an exercise regimen.

    You don't need to be diabetic to take metformin for this purpose. This is an entirely different use of the drug.

    I wrote to you about metformin elsewhere a very long time ago when you mentioned that Chris was struggling with his weight and you told me that you didn't think that it was a good idea to take one drug to combat the side effects of another.

    I can understand why you might feel that way, but I wish that you would broach the subject with Chris and let him decide for himself whether or not he would like to talk to his doctor about this option.

    Weight gain might sound like a trivial thing to be concerned about, but my self-image was badly affected by the change in my appearance and the my antipsychotic can cause high blood sugar. Type 2 diabetes and obesity are rampant in my mother's side of the family and the weight gain on top of my medication put me at a higher risk than usual.

    I know you and your readers would not approve of many of my medical decisions, but one thing I can say for sure is that I am very, very physically healthy, despite having been diagnosed 12 years ago and having subjected my body to a barrage of different drugs before finding a combination that has helped me and that I am sticking to.

    (I don't look half-bad, either, if I do say so myself!)

    If or when Chris stops taking the Abilify, he won't need the metformin anymore.

    I feel a bit anxious about posting this message because you and your readers are largely anti-drug and I was once taken to task here for saying that mine had helped me. But I'm going to post it anyway beause I really do want to help and you and Chris are certainly free to reject the idea if you wish.

    I don't know whether or not it will matter to you or Chris that metformin is not a psychiatric drug and that its worst side effect (for me, anyway) was an intermittent upset stomach that went away after two weeks, give or take a few days.

    Please just float the idea past Chris and see what he thinks of it, okay?

    Whatever he diecides to do, I wish him the best. After all he's been through, he is probably far more resilient than he knows or gives himself credit for and he will get through this. Please remind him of that when he feels sad and down about himself...I have a wonderful mother who does that for me and sometimes you remind me of her.

    I wish you the best, too. Try not to worry too much. This is just a bump in the road and it sounds like things are already getting better.

    1. Thank you for your kind words and encouragement. I remember your mentioning the weight loss medication quite a while ago, but you didn't mention the name, if I recall. I'll see what Chris thinks. If the truth be told, it's probably ME who is more upset about the weight he will gain back than he is. The most weight he ever gained was about 50 pounds, a few few years back. That no doubt was upsetting to him, not only to me. On one medication at a low dose, he gains, I'm guessing, 10 pounds, not great, but not the end of the world. His doctor believes in low medication, ideally no medication, so we'll see how long she feels the latest medication may be necessary. I really appreciate your taking the time to reconnect with me, despite our occasional past tussling over the value of meds. And, you are right. It's so far a bump in the road and things are getting better!

  5. Ms. Forbes,

    This is not the first time that I've posted here since we "tussled." I'm the one who suggested that Chris might like to finish college with other adults rather than kids.

    I have deliberately refrained from posting about medication here too often because I know where you and your readers stand and I want to respect that.

    I've come to realize that there is much, much more to life than the question of whether or not to take medication and I would like to apologize (belatedly) for having quarrelled with you before--matters pertaining to my illness and treatment made me feel frightened and insecure and the more insecure I felt, the more strident I became.

    My medication got rid of my voices but it didn't get rid of my thoughts or my feelings. The other lady I argued with here suggested that childhood abuse had caused my illness and that also made me feel frightened and insecure--not to mention angry!

    I really was sexually abused at a very young age by someone who was supposed to be taking care of me, but I just wanted to forget about it.

    I don't know what caused my illness (no one really does, though there are a lot of different theories), but I found it much easier to cope with the idea that I was physically defective in some way than to believe that one loathesome excuse for a human being could inflict such lasting harm.

    It made me feel small and weak. And very, very frightened.

    I have recently read that being abused can affect the pathways formed in a child's brain on a physical level.

    I don't want to believe that might have happened to me but my not wanting to believe it doesn't necessarily make it untrue.

    I still have a lot to work out...things are not as cut and dried as I wanted to believe when I first encountered you, your blog or the other reader I argued with.

    (Marion, if you are reading this, I aplogize. I was frightened by the things you said because they hit too close to home but that is no excuse for having been so rude and argumentative. I really am sorry.)

    I have learned a lot more about you, Chris, and supplemental therapies from reading your blog than I knew when I first encountered you. I didn't fully understand where you were coming from--I just felt like you were criticizing me for taking medication and and as I said, I felt frightened and insecure.

    I felt like I needed to justify myself to you and everybody else. I am trying hard to break that habit but it's tough. I've been that way since I was a child.

    I'm glad that things are going well and it has been great to read about Chris' progress and even his occasional setbacks because they are a part of life and I have them, too.

    Most people with my diagnosis whose treatments are successful hide it, so life can feel very isolating for someone like me. I don't hear voices anymore but I am still struggling with my moods and my memories and I am still struggling to live my life to the best of my abilities.

    You and Chris have been helping me for a long time now and I thank you both for it.

    1. The good news about trauma, I am learning, is that it can and does heal. I feel that you are right, in that one never really knows what caused the psychosis. All we can do is to face up to our fears, and examine our preferred coping mechanisms, as you seem to be doing. Still, there are no quick fixes, but all we can do is keep an open mind and try whatever we think works best. Thanks for your thoughtful comment!


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