Finally about to deal with myself / switching from Zyprexa / facing my problems

[sevenyearautopsy]

Hello,

First of all: I'm new to the forum, just registered. Came here by chance thru some random googling about Zyprexa and saw some kind hearted, wise and experienced souls here which was a good first impression. Thanks for listening

My story (the short version)
Seven years ago I had my first real depressive episode. I was 21 years old, lived with my then girlfriend since three years, and studied photography full time, the second year of studies. I have repressed the memories so much so I can't really say how it started, or when, but I remember being totally out of energy. I spent what felt like weeks in bed, neglecting school, and hiding away from the world. Everything seemed pointless, I was having severe doubts about my choice of career and it was increasingly obvious that my relationship was going to tank completely. My passion for photography and my girlfriend had been my two pillars of safety and now the future seemed like a big black hole.

What I think really pushed me into the depression was an photo assignment I did that autumn. Usually I made documentary style work but this was a staged photo that I eventually came to understand was about my mother. She had, to my great surprise at the time, had to be put in psychiatric ward for some time and became diagnosed with bipolar disorder back when I was about 7 years old (and then again around 13 (?)). Basically I had re-created the day when I first discovered my mom was not "right". By doing this photo, and talking to one of my teachers about it, I opened up this pandoras box of stowed away memories from my child hood years. And once opened it didn't seem to close again. I got propelled into basically a manic depressive behavior, alternating between being stuck in bed for days, and running around all over the place as if nothing had happened.

To make a long winding story short, I ended up in a psychiatric clinic for three weeks late the following spring. Before that I had: crashed my three year long relationship in the most chaotic way without even being aware of really anything, dropped out of school but still showed up every now and then to confuse everybody and act totally out of character, gotten my first tattoo, probably behaved really weird in front of most people I knew at the time, had the contract for me and my (now) x-girlfriends apartment run out = no place to live, tried a handful of pharmaceuticals (each turning me more and more into a zombie), told a lot of lies and had a lot of strange ideas.

After the clinic:
I ran away from the clinic once but got brought back by police. I only have the slightest memory of this event. Besides that I was indoors for almost three full weeks. I met some strange, beautiful and unsettling characters that in there. I remember once being let out for a walk with one of the care givers and how utterly psychadelic it was to be able to see the sky and things further away than fifty meters. I had applied in some kind of court to be let out, I was to unaware at the time to really comprehend what was happening and who these people were. When I finally got word that I was going to be set free I was so done with the place, and much more clear in the head. I stayed in bed for five days, only getting up for some meals, I was just waiting. I packed my few belongings and took the train back home to my parents place in another town.

That summer was spent in my new body, all of the sudden 15 kilos heavier, on my parents veranda, in the shade. Playing The Sims 3, trying to escape my reality and muffle the voice in my head telling me how this was the end of my life. My self-confidence was at an all time low, as was my mood. Except for my parents I and younger brother I met with friends perhaps two or three times during those months. As autumn came, for some reason, I started studying history and a local university, to pass the time and chase away thoughts. I studied, I played a MMORPG and I went to the gym. Every night I was stuck with myself. If death was not the worst thing I could imagine I probably wouldn't be alive now. In my mind I had received this diagnosis as a sentence and I believed that it meant that I would never be able to a) have close relations again b) have a "normal" life c) be independent d) trust myself e) be happy. Since I didn't want to die I was stuck in this limbo and I saw no end to it.

Fast forward to now:
I've been on Zyprexa since I got let out of the clinic. I don't have any contact with the psychiatric system what so ever. I call a number a few times a year to make sure I can access medicines but I don't even talk to a doctor. All though I was at a low dose for Zyprexa (5mg daily) it was really messing up my head and body. I moved away from home again about 9 months after having moved back to my parents. I was working as a post man then and delivering mail by bike. I remember being so tired and sluggish every morning and until I was done with work. That I even managed was by pure will. On top of that I was always hungry, everything seemed dull and uninspiring. These are the same side effects I have now. I started to mix with the dose and only took my pill every other night, and sometimes every third night.

This worked a lot better, I would get my energy back and things seemed rich and meaningful again those days when I had not taken the pill the night before. But in the end I would have trouble sleeping and I started to become too happy, and get some strange ideas. I could talk about this and the insecurites and meta-discussions it created in my head for a long time. In short I would say I still have big problems knowing what is my real self, when I am me. I have learned a huge deal about myself and I know how to manage this now, I seldom do stupid things anymore because of sudden ideas and I know the signs that tells me it is time to take the pill.

And the next day is fucked. If I take my pill at 9 PM I can feel the effects until about 5 PM the next day. First of all, I have no trouble sleeping 14 hours straight if I don't set an alarm. My body feels heavy, I feel totally uninspired, I don't want to talk to anyone, I act weird in social situations because of how shy and slow I feel, I have trouble talking because I get stuck inside my own head and perhaphs worst of all I get this strong sense of doubt. I interpret everything in the worst way, I start doubting my own feelings, I easily start believing that even my friends dislike me, any projects and fun things I usually look forward to seems boring and I want to cancel.

Now usually I take the pill every fourth or fifth day, depending on how I feel and when I can afford to have one of those days. So it's about 1/5 of my days that I feel this way because of the Zyprexa. It's still better than becoming depressed or manic of course, but it really sucks and I am fed up with it. So I am finally going to take the step and try to change my medication to something else.

I'm still very much a moody person and right now I am going through some very rough times with my girlfriend. We met a year ago and it's been really intense in both wonderful and difficult ways. (A few months ago our talks made me cry. I hadn't cried for more than 10 years. I cried again yesterday, I'm so happy I'm not a robot as I thought) I am very scared right now that because of all my problems I will destroy our relationship, if I haven't all ready. I am also afraid of how much I love her and that I will lose touch with reality again if we separate. I don't want to be so dependent on her, it makes everything very asymmetrical.

I can see in hindsight how my mild depressive and mild manic episodes (that I still experience, even though I am on the medication) along with a huge baggage of shit and dysfunctional behaviors (big part of my personality) has caused many of the bad events of my life in the past years. Especially with girls that I met during this time, but also with keeping friends and being good at socializing. And with believing in myself, both in my ability and in that I deserve to have a good life. This whole story is nothing that I talk about with people. I have a handful of close friends, but I don't really see them so often due to different reasons, and even these people don't all know my story or only small parts of it.

I feel like there is a huge stigma attached to being mentally ill, and that people will shy away from me if I tell them. I am also really scared of people judging my behavior and feelings from a perspective that I have bipolar disorder and everything is directly related to that. A huge part is related to that, but in a way that only I can come close to comprehend. I think of it as the foundation of my other thoughts of emotions rest upon, but that these in turn are complex and big enough to be their own thing. There is also the constant debate in my head about what is my personality and what is my disorder. Recently I started to look at myself in the mirror thinking that if I don't take these pills that makes me feel horrible, my body is trying to kill itself either by depression or by manic episodes that get's totally out of hand if left to grow.

Last paragraph:
Recently I have had a lot of talks with my girlfriend and realized how much of a mess I really am. And that I need to get myself sorted out. The joy I could feel some months ago about having a job, a fantastic partner, hobbies, a better self confidence and a direction in life isn't worth a lot anymore. Many things have come to the surface and I am back to not liking myself, being afraid and paralyzed. Either I lay down now and die (I wont) or I start working with myself to be better. But it's a big fucking hill to climb.

Some kind of therapy, and looking over my medication seems like crucial parts of this journey. Any help, suggestions and shared wisdom is greatly appreciated. Thank you so much for your time if you read it all. Love and light

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(For info, since it's that kind of a forum: I've never really used drugs to any extent. Two years ago I would smoke weed sometimes but made vow to only do it when I'm happy. I like weed though. Right now I don't have a easy way of getting hold of some and I think it's good, I need to be sharp. I tried MDMA three times last year and it was really good experiences that helped me on some level right then.)

 

[jammin83]

I'm not exactly sure how long you have been on zyprexa from your post but it could be part of your problem right now. Usually you can get away with taking it only once every four or five days but the shift in drug concentrations could be destabilizing you further. I'm not ignoring the rest of your post, you have obviously been through some shit, but for some people zyprexa has a pretty bad withdrawal. You could be experiencing that, it looks a lot like a return of symptoms, either schizophrenia, or bipolar, or both, even if you didn't have those before. If you want to get off of it, you really need to be careful with it.

For some people, it's not just something you can just stop taking. You need to taper off of it very slowly. If you do it too fast, it can mess you up for a long time. There a lot of ways to taper it right, and I can get into those if you want at some other point in time, but it's kind of an involved process. You can't just start cutting pills in half. Do you have any symptoms on day four or five? Can you tell me what they are? Quitting this drug has been one of the most difficult experiences of my life but I did it all wrong. You can reduce the chances of something that happened to me if you taper it right. It may not be comfortable, but highly preferred to what I have had to go through. I'm not saying you don't have some real issues, but a lot of what you are experiencing could be from the psych drugs. Have you been on other psych drugs? How fast did you switch and/or taper? Lots of doctors try and taper people way too fast and it can really mess you up if you don't do it appropriately.

Don't let anyone judge you or make you feel bad because you struggle with bipolar and depression. They don't know what they are talking about. After some years of dealing with it, it can be managed. It does take work though and you need to get to the root of your issues with or without medication. Medication is only a small piece of the puzzle if its needed at all. You didn't ask for it, it's not like you earned it, or its a result of your behavior. Sometimes doctors like to throw diagnoses at us so they can feed us different drugs they only matter so much. They are not a life sentence and you can heal from mental problems.

Don't start thinking that this is your life from now on. I've struggled with depression and bipolar a long time, I never really got much relief. I would have windows of not being depressed but I've spent more of my life depressed than not. I have been in the process of quitting zyprexa for a year now. It has been really tough for me but I know when I get back to baseline eventually I will be okay with just some depression, what I was dealing with before was nothing like this. In a way I've learned a lot from it, sometimes negative situations have more influence over us than positive ones. There is a lot of room for growth when we face difficult situations and mental states. It can be easy to just take the pain and not do anything about it but we have to look for the reasons why we are so sad and try and take action. It can be a battle, but it's a battle worth fighting. I've had to deal with way more radical emotions and mental states coming off of zyprexa than I ever had before. I am beginning to make some improvements and I know I can beat this thing that has haunted me for a long time. It takes some time and effort though.

Quitting zyprexa though isn't something you want to rush, it has the ability to make your mental health problems much worse if you do it wrong or too fast. Not everyone gets the withdrawal but you need to know it's not something you can push through if you experience it. It can last a really long time. Keep me updated and I'll help you in any way that I can.

From the olanzapine wiki:

The British National Formulary recommends a gradual withdrawal when discontinuing anti-psychotic treatment to avoid acute withdrawal syndrome or rapid relapse.^[50] Due to compensatory changes at dopamine, serotonin, adrenergic and histamine receptor sites in the central nervous system, withdrawal symptoms can occur during abrupt or over-rapid reduction in dosage. However, despite increasing demand for safe and effective antipsychotic withdrawal protocols or dose-reduction schedules, no specific guidelines with proven safety and efficacy are currently available. Support groups such as the Icarus Project, and other online forums provide resources and social support for those attempting to discontinue antipsychotics and other psychiatric medications.^[51] Withdrawal symptoms reported to occur after discontinuation of antipsychotics include nausea, vomiting, lightheadedness, diaphoresis, dyskinesia, orthostatic hypotension, tachycardia, nervousness, dizziness, headache, excessive non-stop crying, and anxiety.^[52][53] Some have argued additional somatic and psychiatric symptoms associated with dopaminergic hypersensitivity, including dyskinesia and acute psychosis, are common features of withdrawal in individuals treated with neuroleptics.^{[54][55][56][57]} Thus, some suggest the withdrawal process itself may be schizo-mimetic, producing schizophrenia-like symptoms even in previously healthy patients.^[58]

 

[sevenyearautopsy]

@jammin83

Thanks for your time, kind words and good advice!

To answer your questions first: The first 9 months when I was going through my "crisis" I felt like a guinea pig, and was prescribed a lot of different medications. I could call my therapist during the day and they'd rise the dose for some medication, and I could pick it up just hours later. I don't remember them all now. Atarax, Stilnoct are two I remember. I don't know if I had Zyprexa then all ready but I remember getting the prescription I have now of 5 mg / day a few weeks after I got out from the psychiatric ward (about 9 months after first problems)

The effects I get when I haven't taken my medication after about 3-4 days is quite hard to describe. Very seldom I go down, to a more depressed state. Usually the most depressed I feel is the morning after I've taken my pill. Instead I get sort of light manic effects. Most notably I have a harder time falling asleep and if I wake up early in the morning I'm awake. Generally my thoughts are too quick, I get impulses and ideas that are a bit more weird than the ones "I" get normally. I become more sociable, I don't care as much about how others perceive me. It's a very mild manic episode. I don't feel any physical side effects, no nausea or headaches or anything like that.

The past six years really has been an ongoing struggle of getting to know myself and think about my self, my behaviors and reactions. On the plus side I think I'm very in tune with my personality, I'm aware. On the bad side I can easily get ecocentric since every single day I am analyzing and doubting my own behavior. For as long as I can remember I've had bad confidence and felt un-easy in most social settings so maybe a lot is just an extension of that.

I think my struggle now is to learn to be kind to myself on my bad days (when I need to) but also to face the mental barriers I create for myself in relation to my illness and my medication side effects. Another part of my struggle is to take care of myself and learn what I need to be in the best mental shape: get enough sleep, avoid un-necessary and involuntary stress, have physical exercise and just in general try to strive for a happy life. And just ride the waves of being just a little sped up sometimes, and being down every 5:th day.

It's a holistic thing, so many parts working together. I'm tired of fighting it and letting it hold me back in so many ways. I feel like I've learned pretty good to live with this over the past years, there are still many issues I have with myself but I've been steadily improving in many aspects. However, once I feel better I become a bit more brave and push the borders of my comfort a bit more and find me in new scary situations where I feel inadequate. Just the idea of not letting my "handicap" restrict me puts me constantly in new challenges, often I social settings I before would have been to scared of taking part it.

In a way that's what's happening with my girlfriend right now. I haven't been this close to anyone in my life I think. It feels like I'm playing with high stakes and the fear of fucking up makes me think that I actually will fuck up, just from the stress. From second guessing myself where it would be easier to isolate myself and go back to my old ways (distracting myself from my problems and staying out of anything that could challenge me or point out my insecurities) instead of putting on the (immense) effort to face the bull by the horns. I'm a master of self deception, I can walk around all day and be distracted and a bit angry or sad, all the time "really" knowing why (for example something I thought about/experienced the day before) and feel all kinds of frustration and procrastinate for hours. Until I finally get to grips with solving that situation/replying to that text/talking to my friend about x, y or z or whatever it is that has been bothering me the whole time. And then when that is finally done, I feel relief and finally my day is good. I feel in a way I am doing that on a bigger scale now, I make up all these "fake" problems to focus on, instead of really looking into myself, have a dialogue with the me I find, have a battle/make peace and move on with my life.

Oh what a ramble. Thanks again for your advice and thoughts on my OP. I'm sure I would have left the whole thing this time too If you didn't, but now I had to relive what I wrote then and I thought about your reply for some days. So thank you for reminding me of my struggle, I was busy cleaning my apartment instead of my mind.

PS. I really should start therapy of some kind again. I just don't trust the psychiatric system, or unknown people in general. I know that in this case it's like refusing a life jacket because I don't like the material, so I am going to force myself to give it a chance

 

[jammin83]

Thanks for sharing that with me and letting me know what was going on, I appreciate that.

It honestly sounds like you have a lot going on. I can relate to a lot of the feelings that you have about yourself and we sound a lot a like. Sounds like you are a bit over-analytical. Sometimes that that can be a trap and get confusing when we over analyze things. As you pointed out, you should really try and find someone to help you with that process. You have a pretty solid grip on what is going on with you, and although I do not know you, I know that there are probably some things that are easier to see from an outside perspective. Having someone there you can relate your feelings to can help you with this. You are completely right, you need to integrate a holistic regimen of different things that will help you in your recovery. It's never just about medicine, that is only one piece, if at all. I don't mean to be that guy saying 'you need help' or anything like that, but we all do in some way or another. It's very hard to deconstruct mental barriers from the inside out. Sometimes that help can save us some time.

I can understand the way that you feel about psychiatry. I've had my trust violated before and I am not sure this medicine is the right thing for me either. With this type of medication it's not really subtle stuff. APs are powerful medicine. What you are describing could easily just be the fluctuating level of the medicine in your body. It has a very long half-life. Hypomania can also be part of the withdrawal. This isn't your typical type of withdrawal in the opioid or benzo sense. Zyprexa binds to multiple systems in your nervous system while opiods and benzos you are just dealing with one system. It effects something like 17 receptor sub types at least. Seroquel is about half of that to give you an idea.

It's not always a physically sick feeling but it can get that way if you go long enough. You should always be getting your blood checked when you are on this type of medicine too if you are not doing that. Mania is pretty common. Sleep disturbances can be pretty common. I have been off of it since January and I am still speedy and manic but not in the euphoric sense. I haven't been really able to turn my mind off. I was on a much higher dose than you though. Like 20 mg for about four years. You need to be taking care of the medicine first. Either way, on medication or off. If you are taking it, you need to be taking it the right way. You shouldn't skip days with this kind of stuff because it can destabilize you further.

If you want to get off, you need to talk to your doctor. You need to get the wafers that dissolve. They are called oradispersible wafers. Then you can use an oral syringe to precisely make small cuts in a liquid. You can't cut the pills in half or anything like that. Talk to your doctor, but it is not uncommon for them to pull you off way too fast. A proper taper can take a year or more. You may be able to do it faster, but there are some substantial risks if you go too quickly. The right type of taper will allow you to make a proper assessment of how you are when you are off without crashing and burning. Sometimes it can takes months to set in. It's called protracted withdrawal. Anyway, I can help you with that at a later point, but you need to be involved with your doctor and decide how you want to approach the medication issue. It's really important. There are some people that don't get withdrawal but there are a lot of factors at play. For some people it is really difficult though so don't underestimate it.

I know for me, when I was on the zyprexa, I didn't realize how clouded my thinking was at all. I was a foggy mess. I was having balance problems and movement issues. I was massively depressed on the medication. It just kind of turned bad on me all around. In a lot of ways I feel a lot clearer now. My mind is active again, albeit a bit too active lol. I realized I was hiding a part of myself inside of medication. I am still on some, I am still trying to get off of everything but it will take me a couple years. I have been in withdrawal already for almost a year pretty bad. I am improving though, it just has been a slow process for me.

It honestly sounds like you have some pretty significant trauma. That can cause a whole slew of problems and mood swings and everything too. I don't know, I haven't fully been able to deal with some of the stuff I have going on and I don't really know how to. I know traumatic things have happened and there is a kind of disconnect there. I don't know really what to do about it but some people say therapists have helped them in that regards. I think a lot of your self esteem and confidence issues can be traced back to that I think. When something traumatic happens, the world you thought you knew doesn't look the same anymore. It can shake you to the core leaving you questioning everything.

One thing I've noticed is that you refer to your illness as a handicap. That's simply not true. Lots of people struggle with depression and mood disorders. Everyone deals with mental health in someway. If we think we are flawed we will act in that manner. Kind of a self fulfilling prophecy in a sense. You are who you are. We have parts with imperfections but that's what makes us unique. If you can overcome this battle than you will have conquered a lot of your fears and you can get some of that confidence back. Sometimes it's not about putting the pieces back together as just deciding to move on. Find a new way of life, the old one wasn't working anyway. I think once you start making progress and put some of this behind you, you will look at things a lot differently. I am doing battle myself, when I get through this withdrawal, I will never look at my issues in the same way again. I was taking so much for granted before. Sometimes it just takes a shift in perspective and using various events in our lives as catalysts not as roadblocks.

I really think you should try and start making some steps in the right direction man and just start small. It sounds like you are on the right path just could use some guidance. I'm sure some others around here may have some things to say to you too but I think a therapist is a good place to start. Figure out the medication issue with your doctor and from there. Feel free to send me a PM if you need anything. Cheers.