Friday, July 15, 2011

More notes on psychosis

I started the Electro-Convulsive Therapy (ECT) in the first place because I was growing more desperate to end my life.  I went in-patient because we thought it would get the treatments started faster.  I remember being incredibly hungry because I wasn't allowed to eat or drink before my treatment, and one day they didn't get to me until 11am.  I said I would give ECT 2 weeks and if it didn't help I would kill myself.  
Since ECT induces a seizure I had to stop taking my regular gabapentin and Klonopin because they inhibit seizures.  Instead they put me on Requip to control my restless legs.  Requip is a dopamine agonist, meaning it stimulates the dopamine receptor, which probably contributed to my psychosis.  The also put me on Doxepin, which is a tricyclic antidepressant that has a sedating side effect, but it may have been activating in my case.  It makes you sleepy, and can make one delirious.
I got dehydrated from vomiting, which could have concentrated the levels of the medications in my blood and contributed to the problem.

  • I thought i was dreaming, but the dream was taking way too long.  I kept waiting to wake up, kept trying to wake myself up.  Thinking you are in a dream is a psychotic symptom. 
  • When the doctor determined I was psychotic and needed to be in the hospital I couldn't control my hands well enough to connect my pen to the paper to admit myself voluntarily, but they admitted me anway. 
  • I opened my eyes and could only see a sliver of the scene, having my focus caught between my hands in front of me and the scene beyond - I couldn't adjust the focus of my eyes for depth perception.  My family reports I had my eyes half-closed for several days. I thought it was night when it was day.
  • I was caught in a non-responsive catatonia.  "Catatonic disorders are a group of symptoms characterized by disturbances in motor (muscular movement) behavior that may have either a psychological or a physiological basis. The best-known of these symptoms is immobility, which is a rigid positioning of the body held for a considerable length of time. Patients diagnosed with a catatonic disorder may maintain their body position for hours, days, weeks or even months at a time. Alternately, catatonic symptoms may look like agitated, purposeless movements that are seemingly unrelated to the person's environment. The condition itself is called catatonia .
    A less extreme symptom of catatonic disorder is slowed-down motor activity. Often, the body position or posture of a catatonic person is unusual or inappropriate; in addition, he or she may hold a position if placed in it by someone else."
  • They gave me some medication in applesauce, from a spoon, and I became more animated.  My brother the psychiatrist says my thoughts were racing too fast to be expressed, and the medication slowed them down.   Once I started getting treatment with Klonopin (Clonazepam) I started to be able to feed myself.  When it wore off I went catatonic again.  They had to titrate the Klonopin at a higher level - 0.5mg three times a day - it was a lot.  
  •  I moved my hands quickly in circles, then clasped them to show I felt stuck.
  • Whenever Otto came I would get more alert and happy.   He played music for me on the iPod, and got me dancing and singing, even though I couldn't speak.
  • I couldn't use the restroom alone.  My  mom had pull down my pants and sit me down on the toilet.  They turned on the water to get me to pee.  
  • I emitted high-pitched giggles that were apparently quite disturbing.  
  • I held my hands stiff in front of me.    I exhibited 'waxy flexibility,' remaining in positions other people put me in.
  • I drew a maze and wrote 'what am i doing here?'
  • I couldn't pass a basic mental status exam - I couldn't keep track of where I was, the date, the season, or the time.
  • Nurses kept asking me how I was, and I couldn't answer.  I couldn't make any words come out.  I would nod yes or no but somehow it came out in reverse, like:  Jessica, do you want to go outside?  Me:  thinking yes, but shaking my head no.  
  • I kept sliding down in the chair, almost falling out, then would push myself back in, so my father put his knee in front of my knee to give me a guide.  My glasses also kept sliding down my nose.  I couldn't coordinate enough to feed myself for a few days.  I couldn't walk in a straight line either.  I remember rubbing my thighs and not having full sense of feeling in my fingers or my feet.  Standing up was a trick, as was sitting down.  I kept getting hair in my mouth.
  • I sought ways to tether myself to reality, to prove I was alive by associating with things I could recall as familiar from the real world.  Things like ordering sandwiches from the restaurant Bread and Cie, or eating sushi, or thai food - the familiarity of the food helped me orient. 
  •  I used my email and web pages to prove to myself that I was alive - I was catatonic, but was able to remember my gmail name and password!  Email ritual habit cuts through psychosis.  Then I remembered my website  (!  I had external proof I existed!  I did research on myself - watched all my videos, looked and my postings, and 'got to know myself' again from the outside.  I wanted to wake up and get back to life because it looked like I had some interesting things to do - I got notice I was invited to a residency, and I wanted to make sure it was real.
  • Once I started to suspect I was NOT dreaming, I had to find ways to prove I was alive, in the world, that things were happening, or that I could control what was happening, in which case it would be lucid dreaming.  I thought I was in a boring version of the movie Inception - instead of explosives and folding over skylines I was trying to manipulate what kind of dessert I would get served. 
  •   The only ways I felt alive were to be in motion, to walk in cirlces, to kiss Otto, or to pee.  They had me pee in cups and funnels a lot.  They kept wanting reports on my bowel movements.  
  • I vomited at REI, perhaps from food poisoning, perhaps from a virus.  
  • There were things I thought were dreams that apparently were real.  For instance, a man with a plastic bladder and catheter coming out of his zipper, just sitting in public as it filled up.  There was a very round large young woman with short hair who was constantly yelling - I pictured her like the Queen in Alice in Wonderland.  Apparently she was real too.  Yelling about her parents being mean to her.
  • "We're going to get you good medicine.  You're safe"  my brother tried to reassure me.  He got me transferred 'against medical advice' from one hospital to another, because the doctor wasn't adequately treating my psychosis and catatonia.   

Thursday, July 14, 2011


I am having a crisis of emptiness
of lack of creativity
the faucet that used to be always flowing with ideas and images has been
turned off
and I can't get it to open up again
I feel stuck inside myself
Dried out
But not like a raisin, which has become something else with flavor and character
more like an empty seed pod that can
recollect a time when it used to hold a seed
a seed that could grow in a million different ways
but now is just
Earlier today Otto tried to help me get started again
He put me to work with some empty plastic bottles,
started recording my audio and taking pictures
I felt impotent
I couldn't bring myself to do anything besides
crush the bottles
Then he told me to get in the bathtub
He sprayed me with shaving cream and dumped
'clean' garbage on my head
I yelled in disgust and anger
He didn't make me want to make anything creative
He just made me mad
So now I've spent the rest of the day
depressed and stinking of shaving cream