A Recovery Blog

This blog is about my continuing recovery from severe mental illness. I celebrate this recovery by continuing to write, by sharing my music and artwork and by exploring Buddhist ideas and concepts. I claim that the yin/yang symbol is representative of all of us because I have found that even in the midst of acute psychosis there is still sense, method and even a kind of balance. We are more resilient than we think. We can cross beyond the edge of the sane world and return to tell the tale. A deeper kind of balance takes hold when we get honest, when we reach out for help, when we tell our stories.

Sunday, October 31, 2010

Aspiration Practice: May I Be Of Benefit

Ozzie hasn't been dead for even a week, but I am pushing on.  A few weeks back I returned to listening to Pema Chodron teach on Buddhism in her audio program Noble Heart:  A Self-Guided Retreat On Befriending Your Obstacles.  I listened daily for nearly two weeks and then started to re-listen to it, when I decided to download one more audio program by her called Bodhisattva Mind:  Teachings to Cultivate Courage and Awareness in the Midst of Suffering. This second audio program is a bit unusual in that she is closely following the 5th chapter in a book by Shantideva, an Indian monk and scholar from the 8th century, called A Guide To The Bodhisattva Way Of Life.  She also wrote a commentary on most of the book in a book of hers called No Time To Lose in 2005.  Pema Chodron does make reference often to the teachers she's had and to some of the books she's read, but this book by Shantideva appears to be particularly important for entering into the Buddhist path.  The Dalai Lama also makes many references to this seminal work.  So what did I do?  I found that Shantideva's book was available on the Kindle for $10 and I bought it to study it more closely.  I have read through the first half of it and find that there are verses (it is a long poem of sorts) that I want to memorize and reflect upon.

A bodhisattva seeks enlightenment in order to help all sentient beings to seek and find enlightenment as well.  Pema Chodron is teaching me to cultivate the aspiration in my daily practice to be of benefit to others.  The heart of Tibetan Buddhism is to learn to place others before the self in all situations by cultivating compassion.  This is quite a challenge for me because I withdraw from much of human contact, except online.  I live in what Pema Chodron and her teacher Chogyam Trungpa call an "ego cocoon".   More than seeking to make others comfortable, I seek to make myself comfortable and thereby withdraw into my home.  But, of course, separating myself from others does not make me happy or comfortable and so I struggle each day.  I have become an alternately anxiety ridden then depressed individual.  I rarely take a walk or sit outside even though I live in the country.  I don't help my local community.  I keep the focus on myself and my brother and my cats.  This makes me think of Jesus exhorting people to "Be perfect, therefore, as your heavenly Father is perfect" by loving not just your friends and family, but your enemies as well.  He says, "If you love those who love you, what reward will you get?" and "If you greet only your brothers, what are you doing more than others?"

It's good to aspire to be a better person, but first you need to become aware of how you are failing yourself.  It might seem as if I'm getting down on myself here, but I am not.  I am waking up to what it is I do.  I have gotten to the point where I treat myself as a friend.  Talking to my therapist, my brother, myself on tape and now my dear old friend on tape has helped me to do this.  Without befriending myself I couldn't face the fact that I am a self centered individual who doesn't put herself out for anyone but her family.  My heart is becoming softer and the warmer I am to myself, the warmer I can be towards others.  Now, when I light an incense before settling into meditation or dharma study, I send out the aspiration that I be of benefit to others.  I say it aloud.  It's like making a vow to become willing to help.  It's the stage we all have to go through before we come to act on other's behalf.  What a simple thing--"May I be of benefit to others."  It's like taking a closed fist and gently, patiently opening that fist up.  Some people when they pray place their open hands face to face before their chest which to my mind is a beautiful sign of peace, love and respect towards the higher power and all others.

Quite a few months ago I joined the Awakened Heart Sangha online and began a Buddhist course called "Discovering The Heart Of Buddhism" taught by Lama Shenpen Hookham in Wales.  I learned right away that the center of the course was in the meditation practice and in cultivating a deep compassion for yourself.  At first I embraced the meditation practice and got in touch with the student teacher, my contact person, who lives in Poland and is a senior student of Lama Shenpen.  We exchanged several emails, but then my life got busy because my parents were visiting and I used that as an excuse to distance myself from the teacher and the course.  In the coursebook there was a lot of talk about exploring your heart and I wasn't yet ready to do that.  In the interim, I have moved towards being ready by studying Pema Chodron and beginning my aspiration practice along with daily meditation once again.  A few days ago, I returned to the Awakened Heart online forum giving myself a gentle push to reach out to others there.  The forum is not very active, but one of the people who had posted recently was a man who actually suffers like me from schizophrenia, but is dedicating part of his time to Tibetan Buddhist practice.  What good fortune!  I responded to his post and asked him if we could be "dharma buddies" and begin an email correspondence and he said yes, he would be very happy to try that out.  So perhaps we will be of benefit to each other along the way.

A year ago, I couldn't even consider the idea that I could in some lifetime become enlightened.  It just was out of the question.  But now, I am opening to the idea that is it okay to move towards enlightenment, to strive for it and to wish that all of us could reach some kind of liberation.  Maybe because of my isolation I feel no ill will towards anyone.  No-one gets the chance to provoke me and so I settle into a kind of general acceptance of others.  Pema Chodron would say that that is not such a good thing, that human interaction and problems create the needed challenges for a fruitful practice.  How can you practice patience and generosity without the input of other people?  She has said many times that we are all interconnected, more than that, people need people.  Even I, who keeps to myself most of the time, rely on business men to sell me their products, doctors to treat me, sanitation men to remove my garbage, postal workers to handle my mail, etc...  I also need very much the contact of my brother and my online friends.  This blog, too, is a lifeline for me, a place where for a hand full of people I am of benefit in a small way.  I'm planting a few well intentioned seeds, watering them and hoping that they will grow.

Tuesday, October 26, 2010

Rest In Peace Ozzie

Last Monday, the 18th, I brought Ozzie in to the vet because his mouth was hurting him.  The vet said he had a serious infection, but that it could be treated with antibiotics twice a day for the next 10 days; he gave the medicine to me in liquid form.  After I got home I tasted a little bit of it to see how bad tasting it was, and it was horrible.  Nonetheless, I had to give it to him and give it to him I did.  I wrapped him up in a towel and squirted the dropper full into his mouth.  I didn't get all of it into him on first try, so I would have to hold him down and try again.  Afterwards I would give him a portion of wet food which he would eat up.  This went on several times a day until Saturday morning when he stopped eating and drinking.  On Sunday he disappeared for hours and I couldn't find him.  When he did show up, he was still not eating or drinking.  Mostly he rested and slept; he was obviously weak.  Early this Monday morning I called the vet and was told to bring him right in, which I did.  They were  going to give him fluids and test his blood.  A couple of hours later I get a call from the vet's sister, who is the receptionist/nurse.  She tells me that Ozzie is very ill, that he has diabetes and several other things wrong with him and that she would like to keep him over night so that the doctor can give him some insulin to see if he responds, but that if he doesn't they will recommend that Ozzie be euthanized.  This morning I called and was told that there was no change.  I went in to the vet's office at noon and then visited with Ozzie for 25 minutes.  He cried out when he saw me.  I calmed him down by petting and kissing him and talking to him gently.  The vet's sister stayed with me for part of the time and we talked sympathetically to each other which I think also soothed Ozzie.  He drank a lot of water, but had not touched the food.  I asked the vet's sister if they would give Ozzie a pain killer first before they euthanized him.  She said that was their policy.  They would give him a mild sedative, leave him alone for 5-10 minutes and then give him his lethal injection.  I had asked before if I could bring him home to die, but was told that there was a distinct possibility that Ozzie might go through seizures because of his condition.  And so I was strongly urged to let them take over.  And so I made the decision, as I have with other cats, to follow their advice.

I had been forewarned by Ozzie himself that he would not live as long as I wanted him to because last year, after I took in 6 kittens, he lost about 4 pounds.  Then he stopped doing a good job of grooming himself and with the weight loss he was not as strong or as confident as he had been before.  I thought he was having a bad reaction to the kittens, but it appears that in actuality diabetes was the culprit.  There were several times in the last 6 months where I could have sworn that he was going to die, but miraculously he would perk up and I would feel a rush of gratitude.

I got Ozzie as a kitten in 1999 from someone I had met and befriended in a domestic violence support group.  This friend and her family were avid animal lovers and had several dogs, a bunch of cats and a cockatoo.  I was distinctly psychotic at the time, paranoid, delusional and hearing lots of voices, but I managed to hide my symptoms somewhat from the women I met at the group.  Eventually I would get another partially grown kitten to be Ozzie's playmate.  That cat, Moocher, I still have and he's in good health, knock wood.  I had other cats too from when I was with my ex-boyfriend, but gradually, one by one, they died or were euthanized.  I hoped that I would have Ozzie till he turned 14 because that's usually the age my cats have been when they've started to fail.

I have been generally fortunate with my cats healthwise, no drawn out cancers, no diabetes till now, not much in the way of having to give them medicines.  They have been a pleasure to be around and a comfort in my darkest hours.  Ozzie, in particular, was a very patient and sweet natured cat.  I felt connected to him because he was my oldest cat, besides Moocher, in a house full of youngsters.  I would make sure to pay special attention to him to let him know that he was particularly loved and he responded to my attention and caresses.

The closest I've been to the visceral quality of death has been through my cats.  I have had them die in my arms.  They are great teachers of what Buddhists call Impermanence, the fluid changing quality of life that also includes death and maybe rebirth.  The love of my pets and my love for them has been a reliable joy in my life.  So now I have seven to care for instead of eight.  Despite my deep sadness at losing Ozzie and at losing all my many cats over the years, it's been worth it all.  So farewell, sweet Ozzie, till I join you, and all the others who have gone before you, on the other side.

Saturday, October 23, 2010

On Stigma

Stig-ma --  1 a) archaic: a scar left by a hot iron: BRAND  b) : a mark of shame or discredit : STAIN  c) : an identifying mark or characteristic: a specific diagnostic sign of a disease  2  stigmata pl: bodily marks or pains resembling the wounds of the crucified Jesus and sometime accompanying religious ecstasy.  (taken from the Merriam-Webster's Collegiate Dictionary, 11th Edition)

To be branded and shamed because of having a mental illness such as schizophrenia is a form of psychic crucifixion.  Much of stigma is due to ignorance that gets fostered by the media in film and news stories.  The main stigma attached to schizophrenia sufferers is that they are at best deranged and violent and at worst all premeditated serial killers.  The flip side of ignorance, which in this day and age of internet access to information comes down to plain laziness, is fear of the unknown.  Though, really, I question that, for who hasn't acted irrationally by the time they reach adulthood out of jealousy or resentment or envy or even joy, love and happiness.  We all know what it is to be upset, to be impulsive and to trust in ideas, beliefs and people that may not be trustworthy.  People get crazy in love and out of their minds in anger and just simply mistaken about other people's motivations as the result of some complex situation.  And then there are many people who have tried one mind altering drug or another, who have temporarily crossed over into some very strange experiences.  To get drunk is to act crazy.  Even excesses of caffeine can give a person a glimpse of what mental imbalance is like.

So, on second and third thought, I'd have to say that most people know quite well enough what it is like to be mentally ill.  It's not unknown, but it is deeply disturbing.  And part of why it is so disturbing, other than the obvious reason that it is horrible to be so out of control, is because of the stigma that our culture brands people with who don't tow the line, who don't try to be respectable, "normal" and conformist.  It's the potential for unpredictable behavior that puts those "normal" people on edge.  I can understand this fear because I, too, get anxious around people who act out.  My instinct is to repress any strange impulses I have and generally I didn't act out except when I was sure that I was alone, which consisted of me talking aloud to myself, gesturing, pacing, even dancing.  I had an urgent need to express myself, but at the same time, I had an urgent need not to make other people uncomfortable.  Also, in paranoid states, I didn't want to draw people's wrath against me, so I kept a low profile.

I have been unusually fortunate:  I have not been the victim of stigma.  In my day to day activities I keep to myself and visit only my brother each week, and so I haven't given others the opportunity to label me and put me down.  I don't talk to anyone about my illness except my therapist and sometime my brother. My identity as a schizophrenia sufferer is reserved for my online presence, mainly in this blog.  The reason I started this blog was to do my part to fight the stigma.  I don't feel comfortable yet reaching out to people in my community, but I do feel comfortable sharing my world and struggles and successes with the hand full or so of people who follow or stumble upon this blog.  I also wanted to encourage those with the illness to come forward in order to show others that we, the afflicted, are not the monsters portrayed in the media, but are just as human and deserving of kind treatment as anyone.

Thanks to the internet, it is becoming more widely accepted that depression, bi-polar disorder, schizo-affective disorder and schizophrenia all have their basis in biology.  As a biological disorder it can be treated in many people (though not all) through psychiatric drugs.  The hard reality of that is that there are side-effects and because of the side-effects many people resist taking the medications consistently.  And there are other hard facts as well, such as it can take months, even years to find the right combination of medications.  Then there is the cost of these drugs and the fact that way too many people do not have health insurance.  One of the reasons why I didn't commit to taking the drugs during the first three years of acute psychosis was because of the cost and because I only had the minimum in health insurance.  If that hadn't been the case it might have saved me three years of on again/off again hell.  But a really big reason why some people do not take the medications is that they don't have insight into the fact that they have an illness in the first place.  This, too, might be due to the stigma attached to mental illness.  All too often, we who suffer, internalize the stigma and label ourselves "freaks" and "psychos".  Those who refuse to accept their diagnosis may just be trying to avoid those very labels.

Though I have met a few people face to face who suffer from bi-polar disorder or schizophrenia related disorders, most of the people I have contact with are online.  My closest friends with mental illness are almost all bloggers.  Several of them are visual artists, too.  All of them are intelligent, sensitive and creative.  None of them are "freaks".  The more people who come forward in blogs, on message boards, in YouTube videos and ultimately in the news, the more I believe much of stigma will be defeated.  Also, people have to start getting honest about either their own mental illnesses or those of their loved ones and share their stories if not publicly than with their friends and family or in support groups.  I'm a firm believer that honesty is the best policy to overcoming virtually all our problems.  Open non-violent communication might be the way of the future.  Let's all use our intelligence, sensitivity and creativity, the way my friends are doing, and take a stand against the stigma.  And while you're at it, boycott the films that are making a huge profit out of the misery of the mentally ill.

Thursday, October 21, 2010

More On Combatting Personal Isolation

The other day I got an email from someone saying that my blog had touched her life; she encouraged me to keep writing.  I thought that was very kind of her to be supportive of me.  I thanked her and told her to feel free to email me anytime.  She and my other online friends who follow this blog got me thinking that maybe I should spend a bit more time writing more blogs each month, at least once a week.  I know that I don't have a great following, but those that do follow I greatly appreciate.  This blog give me the opportunity to actually do some good in the world, if only in a small way.  So thanks everyone for reading and an especially big thank you to those that leave such great comments.

On the homefront:  still struggling with on again, off again depression and anxiety, but two things this week helped to cut through my isolation (which I believe is part of why I get depressed and anxious), I got some snail mail from Nancy and a tape from an old friend.  The snail mail was a card with a reproduction of a painting by her father, truly beautiful work.  There is something to getting a handwritten note as opposed to an email.  It's more personal and intimate.  I've begun a letter to send to Nancy and hope this is the beginning of a long correspondence.  The tape from my old friend came yesterday.  In it she talked to me honestly about her life and gave me some guidance on my life as well.  It was so good to hear her voice.  I'm hoping that our tape exchange continues, though I also want to get to the point where I give her a phone call.  She says some very wise things on the tape about the importance of having someone to confide in on a regular basis, about how this is a big factor in being happy.  Therapy helps, but it can't take the place of a deep and caring friendship.  And I can talk to myself to relieve some of my isolation, but again, it is not the same as having the warmth of human contact.

Many people take human contact for granted.  They have families of their own and see co-workers every day of the work week.  If anything, some people have to schedule some alone time into their busy lives.  It's a very different orientation from those who live in isolation due to mental illness, especially those who suffer from schizophrenia.  Why are schizophrenia sufferers so very withdrawn?  Hearing voices (though not all schizophrenia sufferers do), having delusional and paranoid thoughts and, as a consequence, usually experiencing depression and anxiety, all turn a person inward instead of outward.  The untreated illness, which is where most of us begin, quickly establishes a pattern of aversion.  At this stage we are overwhelmed by internal stimuli that seems so real and so pressing that we lose sight of what is going on in the world.  Those people who do become aggressive and confrontational are usually under the illusion that they are being attacked or abused and are acting out of the instinct for self-preservation.  More often they withdraw from human contact the way anyone who is seriously ill does in order to heal their wounds away from stressful human conflicts.  There's only so much one can deal with when one is internally attacked and confused.  Temporarily withdrawal makes sense, but as a lifestyle it does more harm than good.

My therapist has said that the key to feeling good is balance.  We all need some time alone and perhaps those with schizophrenia need proportionately more time alone, but the goal is to include some regular contact with others so that feelings of isolation don't get out of hand.  I still believe that part of the solution to the isolation of the mentally ill is quite simply access to support groups.  Unfortunately in a country as large as the US there are a lot of areas without groups.  I live in one of those areas, though there might be a meeting starting up within the next month or two.  Right now and for the last few years my brother has been my main contact with humanity.  The rest of my contact has been through the computer.  I am very fortunate in that I have a small group of online friends that I keep in touch with.  Without them, I would be in trouble.   I think part of why I've been getting into trouble lately with feelings of isolation, depression and anxiety has to do with the fact that I have been online less than in the past.  In the past, I participated in message boards and read other people's blogs and commented regularly.  I wrote more blogs.  And so I've decided to return to that pattern once again.

Writing these last two months has been good, but again, there's a definite element of isolation within the practice.  I'm basically writing by myself and for myself, unlike with the blog where I'm writing for others.  A week and a half ago I got my Kindle, which is a wonderful little computer; I have been downloading a ton of excellent free books.  I am reading a lot more because of it and reading does cut through the writer's isolation.  I'm starting to establish a sense of kinship with the writers that I've been reading.  Unfortunately because I've been reading more, I've been writing less.  So today I'm putting myself back in the saddle and will return to daily writing.  At some point, maybe soon, I will try to find an online critique group to join.  That, too, will help to cut through the isolation.

I also downloaded an audiobook by Pema Chodron called Noble Heart: A Self-Guided Retreat On Befriending Your Obstacles.  It's over nine hours of a combination of dharma talks and meditation practice that is divided into 12 forty five minutes sessions.  I listen to one once a day.  Meditating and contemplating what Pema Chodron teaches is another way I combat a sense of isolation.  I must also return to the Buddhist group I joined several months back.  I need to make myself reach out and make contact with friends and new acquaintances and with other Buddhists and writers.

I think the main way to combat isolation is, first of all, to be aware of it.  Once you see it and see what you do to cause it, then you can turn  towards some of the solutions which will invariably require you to reach out to other people.  Start a blog, comment on other people's blogs, join a mental health forum, find or start a support group, have regular contact with at least one person every week, establish email or snail mail correspondence or exchange tapes with online friends, talk to someone on the phone and also, go out and be around people even if you don't interact with them, go to a library or a coffee shop.  These are just some of the things you could try.

If all goes well, you'll be hearing more from me in this blog.  I'm going to have to start thinking of what topics I want to discuss.  If you can think of any suggestions, please let me know.

Sunday, October 10, 2010

Working Through Symptoms, Bonding With Friends

Coffee has been a partial antidote to my depression lately, but I have to be careful to stop drinking it sometime in the afternoon or else I stay up all night. Occasionally that's okay, but as a habit it invites psychosis back into the forefront, which is not something I'm willing to do. Before I became psychotic, I didn't realize how important sleep was to maintaining mental health. So if any of you are having psychological problems, be sure to focus on getting your sleep. That's why I take the generic Risperdal before bed, even though it also increases my appetite (hence I stay fat) and decreases my sex drive (hence I stay celibate). I have learned to compromise. Because I am middle-aged and have lived alone for so long, I can bear with the compromise, in a way a younger person might not be able to do so readily. Ultimately, for those with psychotic disorders, you have to choose between sanity and insanity. I chose sanity because insanity threatened to swallow me whole. But within my sanity, or relative sanity, because I still hear voices and still believe that they come from outside of me, I struggle with the negative symptoms of schizophrenia.

Except for the voices, my positive symptoms, such as hallucinations, delusions and paranoia, have all almost completely diminished. The most resistant of the three has been paranoia, but even that rarely bothers me for long. My negative symptoms, which for me are social isolation, apathy towards cleaning my house and other self-care issues have combined with healthy doses of depression and anxiety, perhaps as a result of the negative symptoms. Lately I have been trying to treat my depression and especially my anxiety by returning to meditation. But after doing a google search on negative symptoms of schizophrenia I learned that the medications I take are mainly for treating positive symptoms and not for treating negative symptoms. There is no effective medication yet for negative symptoms and so many people are turning to cognitive behavioral therapy and talk therapy.

I don't know much about cognitive behavioral therapy, though my therapist says she uses some of the techniques with me, but I do know about talk therapy. I see my therapist once every two weeks and the rest of the time I talk into my tape recorder several times a day and listen back to my recordings. I take short notes that I write on the tape sleeve that fits into the case, so that I have some idea of what's on the tape if I want to listen to it at a later date. At some point I might transcribe sections of the tape to use with my other writing, especially for my memoir.

What I've found is that talking into the tape recorder helps to ease my sense of social isolation, which is one of my negative symptoms. I equate social isolation sometimes with depression and anxiety, so talking and listening help to treat all of it. Unfortunately, it appears to do little towards helping me to clean my house, wash my clothes and brush my teeth. I wish there was a pill for that and for shedding the weight I've put on in the last 10 years. But I will take what I can get, though I am considering asking my psychiatrist for an anti-anxiety pill. I did some research on that and found most of the potent anti-anxiety pills are addictive, plain and simple, and not really worth taking, unless you have severe panic attacks, and then only temporarily. I did discover that I might be suffering from something called General Anxiety Disorder (GAD) and that there is a relatively harmless drug called Buspirone or Buspar that has been helpful for others. It is mildly sedating, has no serious drug interactions and is basically non addictive. I'm going to talk about it with my therapist and then with my psychiatrist.

In order to tackle my self-isolation I discovered a new approach this week. I asked an old friend if I could send her a tape of me talking to her. Technically I should be able to pick up the phone and give her and other friends a call, but I've developed some phone phobia. She said yes and even offered to send me a tape of herself. So I sent the tape to her, she got it on Friday and is working on a tape to send me this week. I am excited to be doing this. I have thought of doing it before with another friend, but I chickened out and never sent the tape. Now I feel ready, especially after conducting my self-talk experiment for over three years now. And I am so glad that it is this particular old friend that I'm communicating with. I worried that I got a little too personal with her on the 2nd side of the tape, but she said it just made her feel as if I really cared about her, and I do! It is special to have this connection with someone from my childhood and youth, someone from my old neighborhood. I'm blessed that she's responded to me. I am even more fortunate to have a circle of online friends who have been so good to me. Last night I picked out a bunch of small presents to give to two other friends. I will send the packages off tomorrow. And Nancy has promised to mail me an old fashioned letter very soon.

Other than this, I have hit my two month mark for writing and reading each day. Tomorrow I will celebrate, I will get a new gadget in the mail; it's called a Kindle. The Kindle is a computer the size of a paperback made for downloading and reading books, listening to audiobooks and listening to music. It also has an experimental program for surfing the internet. Books published before 1923 are mostly free to download and many others are $10 or less. I decided to buy it based on that and the portable internet connection. It can hold up to 3,500 books. I'm hoping it will reduce the pile of books around my couch. Luckily, I had an extra couple of hundred dollars this month, though normally I try not to spend too much. What this means is that I can have an entire library at my fingertips in time. I can browse through so many books and even highlight and take notes on specific pages. I can also have access to the internet wherever I travel. The Kindle is made by Amazon and Amazon pays for the internet connection through AT&T (I think). I am very excited to get it and try it out. I'll let you know if it works out well.