#szsll:help

[szspectrumlife]

L Shana Tovah u’metukah to my fellow Jews!

Just a reminder: if you are Jewish and on the sz spectrum (or any kind of mentally/physically ill and Jewish) it OKAY to take your meds on Yom Kippour and it is okay to need to take water with them. If you have to eat a certain amount for the meds, you must do so. The point of the fast is not to kill you. Your life is important and following the fast as you can is completely valid and correct.

Gmar chatimah tovah!

[szspectrumlife]

Constipation and Antidepressants

So a side effect that a lot of people don’t talk about of antidepressants is constipation. Constipation can make life extremely uncomfortable and is the unfortunate side effect of many antidepressants and mood stabilisers.

When you’re on antipsychotics and a mood stabiliser/antidepressant or just on an antidepressant, constipation can make mood improvement difficult. You might constantly feel sick, uncomfortable, or very unhappy.

To deal with constipation caused by antidepressants, it is recommended that you:

Drink lots of water--at least the recommended amount per day. 

It has to be water. Some other drinks, like coffee, alcohol, and sodas actually dehydrate you. 

Eat foods that are high in fibre.

Spinach, whole grains, fruits, and veg.

Regular exercise.

This doesn’t have to be super intense. Walking around town is more than enough. Try to walk 5 miles in a day, but even walking 1 mile will make a big difference.

Take fibre supplements.

Some of these, like Metamucil, are actually rather tasty so it’s not the worst thing.

Laxatives or stool softeners, if all else fails.

Find the one that works for you, because you might have a bad reaction to some of them. I’m allergic to pretty much all of them except “Ex Lax”, which seems to work for me. Proceed with caution and don’t take laxatives more than twice a week. Also, continue doing all of the above when you take them--these things work best when they’re supported.

sources: [link] [link] [link]

[szspectrumlife]

Recovery*/Remission and Sz-Spectrum

[* I’m using recovery here not to mean the absolute cessation of all psychotic or mood symptoms, but merely to mean that progress has been made to the point where the individual has significant control over their life and feels well]

I have been struggling a lot with my schizoaffective disorder for the past few years. I was finally diagnosed last year after being in therapy for a long time and began seeking psychiatric treatment. Getting on the right meds also took me forever. Now, almost a year from the time of my diagnosis, I think I can safely say that what I’m living right now looks a lot like what people think of when they say “recovery”. I’ve made a lot of progress, and I’m really really proud of that.

Here’s some observations of my own about what recovery looks like for someone on the sz-spectrum or with a psychotic disorder.

Most of my actions that ultimately have led to my recovery did not begin as a conscious effort of trying to take care of myself, but out of boredom.

I’ve written previously about my self care routine [link] for the morning. This routine, which has played a huge role in my recovery, emerged not out of my self-love or a realisation I needed to take care of myself... it emerged because I was bored and wanted to fill the time. 

Don’t think that to practise self-care you need to actually care about yourself. This is patently false. Caring about yourself will emerge from self-care, not the other way around. Take care of yourself because it’s something to do and you may as well--the self love will come later.

Recovery doesn’t mean an end to psychotic symptoms or mood issues and you need to watch your triggers.

I’m on an antipsychotic, a mood-stabiliser/antidepressant, and a bunch of vitamins and stuff. These meds have meant that generally I do not experience much in the way of psychotic symptoms or severe mood episodes. However, certain things can still set me off, in spite of the meds.

For example, today I accidentally over-did it with caffeine (I had three cups of coffee in the morning and then a doubleshot of espresso). I otherwise had a really good day but for about an hour after the espresso I was talking to myself and arguing with myself in public. This was embarrassing, but it didn’t last forever and eventually it passed.

Keeping track of your triggers is necessary even if you’re largely recovered. They will still set you off and you will still need to avoid them. 

You won’t stop feeling sad because you’re recovered, but you won’t experience mood issues in the same way.

One thing that I find really hard to deal with even with where I am now is this: sometimes you just have bad days. Even when everything’s “coming up Milhouse” as it were, you can still have bad days. Largely my mood is stable but every now and then something bad will happen that will leave me insecure or hurt and crying. 

The thing is, crying actually helps. 

When I would be in a depressive episode... it didn’t matter how much I cried, I could never overcome the sadness and bleakness of my life. My pain was so deep that there was no healing it and there could be no release. 

Now, when I have a bad day, if I cry or express my feelings in some way, I feel better and am able to move on. It’s extremely different and something I’m not sure I’ve experienced since my childhood.

Weird things will change in your life, and that’s okay and that’s good.

Right now I’m exercising every day and reading books. These are two things I haven’t consistently done since my childhood--well, the exercise. I was never a big reader. Now that I’ve found meds that work for me, for the first time in my life, I’m able to read for fun. It is incredibly weird but also completely great.

You’ll start to discover things about yourself that were latent or that you didn’t know of. You’ll find that you’re good at some things. You’ll find yourself proud of that. You’ll start being okay with being you. You might even start to like it. 

You might get a job or be able to do school.

YMMV on this one, but recently I’ve been able to acquire a job. It’s not very high stress and it’s part time, but it’s a step. I actually enjoy working and having an income. 

Since my diagnosis I was essentially unable to work. I finished up at my last position at university and then... couldn’t do anything. I made excuses, but I was also incredibly vulnerable and hurt. I was depressed. I was scared. I was all over the place from meds that didn’t work with me... I couldn’t have worked if I’d wanted to.

However, now that my life has started to stabilise, I’m getting my feet wet again. I advise starting out with part time and slowly working towards more hours and maybe even full time. I recommend this for work and school. Don’t make yourself stressed out--that could trigger a relapse. Take the amount of work you know you can do. Don’t overdo it.

You’ll begin enjoying yourself and other people more.

Since my recovery has become more solid I’ve become much more socially comfortable. I’m taking risks, I’m opening up to people, and... it’s actually working out wonderfully. I’m connecting to people. I’m feeling heard. I don’t feel like a lonely freak anymore.

You can reach out to people... and this is an essential step to recovery.

My recovery seriously began when my mother discovered I was in a severe depressive episode with suicidal tendencies as a side effect of my antipsychotic. I wasn’t going to do anything. I was just going to try to die. My mother discovered what was going on, listened to me talk, and rang my psychiatric nurse for me who put me on a mood stabiliser. 

Since getting on the mood stabiliser, everything has improved, but it’s not just that. My mother made sure to make herself available to me and I have been able to confide in her and seek comfort from her.

You might not be so fortunate with your parents, but try to be with someone you can trust during your recovery process. If this means moving in with a family friend, godparent, or distant relative, or friend from school... so be it. Support is essential to successful recovery.

You’ll relapse a lot, but the relapses will become less and less severe...

As I mentioned above, sometimes I still have mood problems and psychotic problems. I hallucinate. I become paranoid. I cry. I cry. I scratch my skin off. Etc. This stuff does still sometimes happen.

When my recovery was first really starting I’d relapse a lot. I’d lots of days where I would be so upset that I’d cry alone in my room for hours. I’d days where I despised myself and wanted myself dead more than anything. I’d days where I lashed out. I’d days where I was disorientated and days where I got jumped up from psychotic symptoms. There were days of mania.

There was a lot of that. And honestly, sometimes it really sucked. The thing is, it does keep happening, even when you’re doing really well... it will just stop being so shitty.

You’re going to reach a point where you have a psychotic symptom--like hallucinate something, say--and are just kind of like “okay” and can move on. You’re going to reach a point where you have a despairing emotion and are just like “I should distract myself”... and it will work. 

Your symptoms likely won’t ever fully leave, but you’ll find coping with them is possible.

You’re going to reach a point where you actually feel really good about life and about yourself--all of yourself.

About a week ago I was walking through the park en route to library and I saw a bluebird in a tree and my feet hurt from walking so much in sandals. I realised that for the first time since before I hit puberty that... I actually liked being alive. I actually liked being me and felt like maybe I was a decent person. For the first time, since before puberty, the quiet voice in the back of my head telling me to kill myself and that death is always the answer was absolutely silent. Not ominously silent, just silent. It had moved on and so had I. 

I was convinced for some time that I should have died in January of 2014 or 2015. I was absolutely convinced of this. Every minute I lived beyond that felt as if it oughtn’t’ve happened. I felt as if I were living in a dream that was irrelevant. I’d nothing to contribute. I was just existing past my expiration date.

When I was walking through that park I thought about that and I realised for the first time that I was glad that I didn’t die in 2014 or 2015. I realised that I was glad that I’d reached that moment. I was suddenly grateful for being. I was suddenly proud of the progress I’d made. For the first time since I was eight years old, I didn’t feel actively suicidal.

Recovery is not a finish line, it’s a continuous process.

You will never not be recovering once you start. Like I said, you relapse, it happens. You have successes, it’s awesome. 

You’re not going to reach a moment where you’re like “that’s it, I’ve recovered”... but you will have lots of small moments of minor successes that will eventually become more and more frequent until the bad moments are the anomalies. 

Recovery is hard, especially at the beginning, but it starts getting easy after a little bit. Eventually what used to be difficult self-care will become just a normal and fun part of your day. What used to be impossible self-love will become you catching a glimpse of yourself in a window and thinking “that is me and I look nice”. You’ll still have some hard moments, of course, but eventually they will be drowned out by all the good moments you’re having.

I know that recovery can seem extremely daunting for those of us on the schizophrenia-spectrum. I know that, compared to a lot of other mental illnesses, recovery isn’t even discussed for schizophrenia. I know that the stigma surrounding our mental illness makes it feel like things can never get better.

Here’s the thing: all that stuff I just wrote is based on my personal experiences. That is all real. That is all stuff that happened. I’m living it. Recovery is real and recovery is possible.

[szspectrumlife]

Schizophrenia Signs and Symptoms in Children and Teenagers

Schizophrenia develops at different times for different people. Some of us develop symptoms at a very young age, whilst others develop symptoms in early adulthood. Some of us are diagnosed in adulthood but began developing symptoms at an early age. All of us are different. 

Here is a list of some signs and symptoms that can be early signs of schizophrenia in children and teens. Sources are Mayo Clinic [x] and SchizLife [x].

Early Childhood:

Language delays

Late speaking, trouble learning to speak

Late or unusual crawling, late walking

There is a usual progression of crawling and learning to walk for children and disturbances in this could be an indication

Rocking, arm flapping

Stimming can be a quality of multiple developmental disorders, like ASD, so this could also be an indication of that.

Teen Years:

Social withdrawal and isolation

Avoiding friends and family, withdrawing from friends with whom they’ve previously been engaged, isolating themselves from other’s company 

Problems at school, a decline in marks

A sudden change in school performance can be an indicator

Trouble sleeping

Disordered sleep can often come along with schizophrenia

Irritability and depression

Avolition, anhedonia

Unusual behaviour

This is honestly hard to determine, especially if most people in the family are neurodivergent in some way

Teenagers are less prone to delusions but more prone to visual hallucinations

Childhood symptoms tend to accumulate, eventually accumulating the common adult symptoms as well. Schizophrenia is somewhat heritable so if there is a family history it would be wise to be attentive to the development of these symptoms.

[szspectrumlife]

Some Information about Coffee + Schizophrenia

This isn’t something that’s widely discussed but ask most schizophrenic/sz-spectrum people whether coffee or excessive caffeine effects them differently than it effects NT people and they will respond with an affirmative. If you’ve recently been diagnosed with schizophrenia you might not have realised the extent of this relationship yet. Here is some information about the effect that excessive amount of caffeine can have on people with schizophrenia.

The relationship between coffee and exacerbating schizophrenic symptoms has been observed since the 70s. Even though it’s not widely discussed, this is certainly an observed phenomenon. Increased amounts of caffeine have been found to set off mania and psychotic symptoms. [link]

Large amounts of coffee, combined with stress, have been found to cause hallucinations in NT people. For some people this leads to the onset of schizophrenia, for others it’s just kind of a one off thing, but I think it’s somewhat comforting to know that excessive caffeine consumption can cause psychotic symptoms in everyone and not just us. [link {tw for the link: ableist language, ableist ideas}].

Caffeine increases the effects of dopamine--worsening positive symptoms--and can worsen tardive dyskinesia. However, it doesn’t tend to cause anxiety in sz-spectrum people. Eliminating caffeine from the diet doesn’t seem to have a positive or negative effect, so I think the upshot is basically just don’t consume too much and if you don’t like coffee don’t start now. [link]

Anecdotally, reactions seem to be mixed. Some people’s psychosis is worsened by increased caffeine consumption, some people’s psychosis is not. I think it’s best to be cautious, but here is a link to a forum thread discussing this. [link]

Personally, I’m a big fan of coffee and love drinking it. However, I have a very strong reaction to it. I have to be very careful how much coffee I consume because even going a little bit over (like 4 cups instead of 3) can instantly cause very distressing manic and psychotic symptoms in me. Here is how I’ve gone about limiting my caffeine intake:

Consuming coffee with milk and sugar. Generally, if I have even one cup of black coffee, I get set off. This stinks because I like my coffee black. However, taking coffee with milk or cream seems to significantly decrease its psychoactive effects on me. I believe that this may be because it gives the body something to digest at the same time as all the caffeine. I am not sure exactly, but I haven’t had any black coffee for months and only had trouble when I consumed too much coffee, otherwise I’ve been fine.

Switching to decaf in the afternoon. I know this feels weak and hateful but sometimes you have to do what’s best for you. If caffeine has a really significant effect on you, you may wish to switch to decaf for the entire day. There is still some caffeine in decaf coffee, but significantly less than in normal coffee. Btw, you can still get any coffee drink you please at Starbucks with decaf coffee (this includes espresso drinks). Decaf cappuccinos taste just as good as regular ones.

Finding a substitute. Green tea has some caffeine in it but it does not have as much as coffee or black tea (which still has less than coffee). Find a substitute drink that you can enjoy but that can replace some of the role that coffee filled in your life. 

Avoid energy drinks, especially artificial ones. Some natural energy drinks, like Yerba Mate/Club Mate are not so bad for you, but should probably still be consumed with caution. However, the artificial ones, like Red Bull and Monster and, G-d forbid, 5-hour energy... avoid those. They’ve been known to have fatal effects on NT people. They really, really are not good for you and can make your caffeine tolerance so high that you have to consume extremely high quantities of caffeine to get the same “fix”. Avoid them like the plague.

If anyone else has any advice, feel free to add onto this post!

[szspectrumlife]

If you think you might be developing schizophrenia/be at risk for developing schizophrenia

Life goes on. With new methods of treatment, schizophrenics are able to live happier, more peaceful, and more productive lives. You will find love. You deserve to be loved. I know because there's so much stigma this can seem impossible. I know that Google searching "schizophrenia + romance" certainly doesn't encourage...but this is simply not true. Many of the schizophrenics I know have stable and happy relationships. I have wonderful, dear friends. The diagnosis is not a death sentence. You will keep living; things will be different but they always would have been. It is never too early to start seeking treatment. I began therapy because of suicidal tendencies and came out with a diagnosis of schizoaffective disorder. Because I started therapy when my problems were just beginning, I have never been hospitalised and have developed strong methods to control my condition. You can have children if you want. There's nothing wrong with this. People who tell you otherwise are eugenicists. I know if I ever have a child who is sz I will be able to help them and guide them. Your thoughts, feelings, and fears are valid. Being sz won't be the end of your life. It will just be a new part of it.

[szspectrumlife]

Meditation and Schizophrenia Spectrum

If you’ve been diagnosed or self dx’d with a sz spectrum disorder then you know what people will recommend. “Have you tried yoga?”, “I heard that meditation can cure that”, or even “That’s just a lack of mindfulness”. Of course, none of these useless and ill-informed suggestions are actually cures for schizophrenia or related disorders. There is no cure for sz. There are treatments and methods to manage symptoms and some people even make full recoveries, but there is no cure.

As annoying as those suggestions can be, schizophrenic people can actually benefit from meditation and mindfulness exercises. These methods work best in combination with more traditional treatment methods, such as medication and therapy, and are not recommended as a sole method of treatment. However, developing a healthy lifestyle whilst schizophrenic means improving your life in every way possible to best ameliorate your symptoms.

Huffington Post on the benefits of meditation for sz people and autistic people.

HealthCentral on meditation’s benefits to mental plasticity and stress levels.

MindfulnessBell.org: one man’s perspective on meditation and schizophrenia.

Schizophrenic.com: Meditation may offer conscious control over sz.

MentalHealthAmerica.net: Benefits of Meditation for people with psych disorders.

So how does one go about meditating and integrating meditation into their life? I know that a lot of us are concerned about “cultural appropriation” and overstepping sensitive cultural boundaries. For many of us in the west, meditation is linked specifically with eastern religious practises and we may struggle to see how we can effectively engage with meditation in a way that is not disrespectful to these cultures but that is also healthy for our brains.

Here are some important things to know:

Meditative practises exist across cultures and throughout the world and in different religious disciplines. Recently I purchased Aryeh Kaplan’s book Jewish Meditation: A Practical Guide and Kaplan has written many books about meditation in Judaism. There are many guides out there for meditation in Christianity, books and websites. Meditation also plays an important role in Islam and there are many guides online for how to practise it. Meditation also need not have a religious basis if you are not a religious person. There are many resources for secular, atheist, agnostic, or non-religious peoples. Seek out guides for meditation for your specific religious persuasion.

You can do guided meditations at home. With the help of some of the aforementioned resources or the numerous websites online, you don’t need to go to a class to begin practising meditation. You can do it comfortably from your own home. Find a quiet space, a comfortable position, turn up your speakers, relax, and begin listening. Here are some websites: [link], [link].

Your smartphone can help you. There are many apps out there that can help you with your meditations and mindfulness. Here are some articles about them: [link], [link], [link], [link]

Hopefully this can help get you started on what can be an extremely healthy and life-improving technique! I plan to start meditating soon and I’ll let you know how it works out for me. Best of luck!

[szspectrumlife]

SchizLife’s advice for navigating a Psychotic Break

I would definitely recommend SchizLife as an excellent resource for people on the sz spectrum. SchizLife deals with all aspects of living with schizophrenia, including diet, exercise, spirituality, community, etc. 

I recommend reading the full-article [link], because it also has some great advice and information about understanding psychotic breaks in context and in the context of history and spirituality. 

I’m going to cover the basic advice given by the article and describe some of my own experiences as well so that applying them can be easy and accessible. Again, I definitely recommend reading the full article. SchizLife is a very positive, helpful source.

Keep Quiet and Private: As the article points out, sometimes articulating your delusions or hallucinations to the wrong person can attract unwanted medical attention. I advise speaking to someone who knows about your condition and who you can trust. This person will also be able to determine whether your delusions or hallucinations are actively posing a threat to you or other people. Having one person in the loop can be very important. Generally, however, try not to make your hallucinations or delusions publicly known. There is a lot of stigma attached to these symptoms and articulating them could have a negative impact on your life, unfortunately.

Abstain from Drugs, Nicotine, Alcohol, Sugar, and Caffeine: Yes, all of those things can exacerbate your condition. For me, caffeine is the worst. Under normal circumstances I cannot drink coffee black because caffeine (without anything else to digest with it) can trigger an episode for me. Cannabis, though extremely popular, has been known to trigger episodes and even the onset of schizophrenia. You know yourself and you know which of these things bother you (for example, sugar doesn’t trigger me at all). Try to avoid using any of these materials as something to rely on or as a way of self-medicating. Substance abuse problems + schizophrenia can be a difficult mixture.

Relationships: This was an interesting point that the article makes and one I’d not given much thought to, but it certainly makes sense. Being appreciative of the people around you, reaching out to them, and looking after animals can be extremely therapeutic. This is true both when you are and when you are not experiencing symptoms. It can also help ground you. Petting a dog or a cat or feeding them can soothe you and help you to ground yourself through tactile experience. Observe the animals and people around you and take in exactly what they are doing. Try to understand them better.

Control Cognitive Behaviour: Don’t ruminate. Don’t allow negative thoughts. Don’t constantly repeat prayers or mantras. I know this is a difficult one. This is actually one of the hardest for me. Prayer is a way that I cope with most of what happens with me and I feel extreme feels of shame and guilt when I’m having an episode. The idea here is to control for these thoughts, acknowledge them, and let them pass. A good way to also avoid ruminating or negative thinking is to keep yourself busy doing things. The routine that I posted about a while ago started when I was toward the end of a depressive episode (I didn’t know I was near the end at the time). I started the routine not because I particularly liked myself or wanted to care for myself but simply so I could be doing something and not just lying on my bed crying. It blossomed into a routine that’s made my mornings something to look forward to. 

Big Picture: Trying to place yourself in context in space and time. The article discusses this someone theoretically but I would actually advise a specific exercise (or series of exercises for this). Viola Spolin’s book Theater Games for the Lone Actor actually has lot of exercises that are good for this. Many of them involve laying down and acknowledging each part of your body and experiencing each part of your body. This is a very physical kind of meditation and it helps you to be aware of your own body and of your physical surroundings. I would definitely recommend this book for actors and non-actors alike. Sometimes when I am overwhelmed the exercises in Spolin’s book help to ground me. 

Break the Cycle: Deny negativity from your life, as it can create a cycle of unending negativity. Avoid negative people and entertainment. Treat yourself positively, even when you are not feeling it. Positive actions lead to positive feelings. Create a routine for yourself and stick with it.

Take meds if you have them or if you need them: Don’t deny yourself medication if you think you could actually benefit from it. Seeking help does not make you weak. If anything, it makes you incredibly strong.