Roll Call 18

So as far as anxiety meds my pdoc was like are you having so much anxiety you literally can't sleep at night? That's when it needs medicine. For anxiety there is this tendency to give benzos which are super addictive and don't actually teach you to deal with the stress. You just learn that you can mute it whenever you want with a drug and never learn to deal with the underlying problem. They are supposed to be used as a short term intervention but people end up on them for years and have to keep increasing the dose. There are however other things for anxiety like Paxil and others---they aren't quite so much a quick fix though.

Personally for anxiety cbt therapy is fantastic because you deal with the underlying problems which is the way you're choosing to deal with the situation. It inserts a new layer of analysis into your cognition. Problem I'm going to start hallucinating again and hallucinating is scary so I'm scared. So you would take it apart and say OK what are the percent chances you're going to start hallucinating and I'll give you a hint its not 100%---how often am I actually hallucinating percent of time hmm only 5% that actually sounds almost tolerable---how much time am I wasting thinking about hallucinating vs actually hallucinating? If I worry about hallucinating can I actually change whether I hallucinate or not? No in fact its increases the chances as its a stressor. SO it might happen or it might not if I have no way to control it then it doesn't matter if I worry about it or not nothing will come of it. The thing is these analytical processes are very person specific what will stop her from worrying will be different than what will stop you. Knowing its not real might seem reasonable to you but in the moment you don't know its not real so that rarely works. In my opinion she needs a therapist to help her with this and people who specialize in anxiety are easy to find however finding one who will deal with anxiety of invisible things might be harder to find in this country---I admit I had a specialist but I suspect you might be able to find someone who can deal with basic stressors like friends teasing etc....the beauty of this is once you know the process you can do it with any anxiety its all equally applicable. There are also books specific for cbt for psychosis although most are directed toward professionals.

I'm not sure how much reality testing will help with anxiety---if I get an auditory after not having one for a while there is a huge startle response---its not about what the voices are saying its more like someone snuck up behind you and then yelled or it was dead quite and then a horn beeped. It doesn't matter if its real or not its just loud. There is also the stress of knowing that no matter what you do or how good you are you may not be able to stop it from happening again---kind of like chinese water torture in that sense. Sure its just a drip of water it can't hurt you but you also can't stop it even if you want to...

i noticed i am unable to post anything that is remotely helpful to people here or remotely scientific or remotely anything like that anymore. whats wrong with me? these meds did somethig to me. i believe they lowered my IQ. i used to post longg paragraphs on here and scientific stuff a loooong time ago and i dont anymore. did i get bored of that stuff? not really but these meds did something to me i think...

oMGosh. Every day I have the same conversation with her. I break it down just as you explained. I do it everyday because she forgets.

She has a therapist but the therapist doesn't seem to think there is anything she can do to help her. There are no child therapist that know how to work with schizophrenia. Very frustrating. I even mentioned to this therapist that if she could please work with Bean about reality checks but she just does not understand. She has now changed her schedule and we'll be seeing being for 1/2 hour every two weeks instead of one our each week. I'm disgusted. I'm trying to find a different therapist but they're very few of them around here.

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Bean calls it anxiety but I'm beginning to wonder if its her being paranoid and not understanding the difference between being paranoid and having a anxiety. Does that make sense?

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A bug walkingacross my desk turned into a tiny bone bird and bit me on the finger.

...so i think its going to be a long day.

i noticed i am unable to post anything that is remotely helpful to people here or remotely scientific or remotely anything like that anymore. whats wrong with me? these meds did somethig to me. i believe they lowered my IQ. i used to post longg paragraphs on here and scientific stuff a loooong time ago and i dont anymore. did i get bored of that stuff? not really but these meds did something to me i think...

Newtus---part of it is possibly not having the psychosis under control. For me I actually found in my phone a mensa app and my IQ just after being stabilized from psychosis was 106----after a couple years on the meds 130 and now 140 which is normal for me. So yeah the meds took off 10 points but the psychosis dropped 34 or possibly more while I was actively psychotic and I had to recover from that over a few years...

i AM havig psychosis right now. a bit but its becoming more and more as each day passes

Yes---I think you are...but I know you wanted some psychosis the ideas etc the problem is there is no way to pick just the good parts...I wish there was because there are some things I would go back for...

what do i do now then? i feel like im in between a rock and a hard place...

It definitely a new concept in terms of using cbt for psychosis but anyone trained in cbt should be able to break things down in the same way. I have no idea why T's don't get this kind of training it makes no sense to me they pretty much just let the pdocs handle it although there is some awareness in an organization called ISPS and they actually meet in New York but it probably takes people longer to filter out of the urban areas.

im on 4mg right now. or im prescribed 4mg but only take 2mg because i forget a lot.

whats worse the hallucinations or feeling bad from meds? idk id say the feeling bad from meds. BUT theyve changed me. the meds have changed me a little bit. STILL. im off the injection but its like its still there kinda. because my personality is still different and my energy and weight are still off. im still not as energetic and im still a little over my weight goal. well a lot. by 15-20 pounds. ANYWAY the feeling bad on meds is worse than almost being off meds but i need to find a ground i can work with

im on 4mg right now. or im prescribed 4mg but only take 2mg because i forget a lot.

whats worse the hallucinations or feeling bad from meds? idk id say the feeling bad from meds. BUT theyve changed me. the meds have changed me a little bit. STILL. im off the injection but its like its still there kinda. because my personality is still different and my energy and weight are still off. im still not as energetic and im still a little over my weight goal. well a lot. by 15-20 pounds. ANYWAY the feeling bad on meds is worse than almost being off meds but i need to find a ground i can work with

I talked to her pDoc today he is very sympathetic. He is going to make some phone calls and try to find out how he can help with a CBT. There are some big major problems going on at the mental health clinic that she goes to through our hospital. Very understaffed. Doctors and therapists are quitting. He is looking into another place where she may be able to get what she needs he also said there is a place here in upstate New York but its in Syracuse!
There is no way that I can drive her one and a half to 2 hours each way for an hour long appointment every week.
Another subject he brought up was Clozaril? He is thinking of putting her on it even though he has tried to avoid it in the past.

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Maybe making sure you take the low 4mg every day with the AD Will stablize you enough? You have to have a consistant amount in your body though to help you.
Did you take both today yet?

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That's excellent---sounds like you have great pdoc although I hope you can find a T that's closer. For the one in Syracuse could you do it once a month(in addition to seeing another non-cbt more often)? I know its not ideal for therapy but if she could learn cbt skills she could start applying them as she learns them and will slowly get better.

Clozaril---honestly she sounds sick enough that it might be worth considering---the key issue is it can kill you but it won't if you get the blood tests done every couple of weeks. Clozaril is the only AP that will work in some cases they aren't entirely sure how but it seems to block sz that is driven through NMDA and not just dopamine because it works in ketamine treated mice. There is often a lot of weight gain as well so that will have to be monitored. I know Elyn Saks is now on Clozaril and describes it as fantastic. On the plus side its one of the weakest D2 blockers so a lot of the side effects from the typicals don't happen. So honesly if I were that sick I would at this point consider it---still the weight gain for me when I was sick honestly I preferred being sick to being fat and people can gain like 80 pounds on this stuff. Not saying it will happen certainly Elyn Saks is not fat at all. The only way to find out if she can handle that med is to try it because it's possible it might be all upside can you imagine if she just didn't hallucinate anymore and went back to how she was before? I would discuss the possibilities with her so she can make and informed choice.

So while I hope its not so long a day I have to admit part of me thinks a bone bird sounds kind of neat...not the biting part but you know just seeing one...