[Tower_Tusk]

Hi all,

In December I had a psychotic episode which lasted about a week or two (with some residual delusions lasting for a month or so.) It was a pretty painful time, and my recovery has been alright although I'm still struggling with depression. My question has to do with fatigue. Lately I've been feeling really REALLY tired all day, both mentally and physically. I hung out with friends once or twice since I've gotten back to normal, and it's tough because I feel like I have nothing to say. One friend said I seemed to be kind of dulled or flatlined, and I couldn't argue with him. My question I guess is how long I can expect to be like this. In some ways this episode has been helpful in making me clarify some questions about what I want to do with my life (nothing like a little bit of psychosis to bring some urgency into your life), but in other ways I miss the energy I used to have and worry it might never come back. I used to consider myself a creative person but I wonder if I haven't burned out in that respect. Also in terms of meds I'm on 1 mg of abilify (have been tapering down from 3.) Thanks in advance for the help

[Sometimes psychotic]

Hi and welcome! Have they given you any sort if diagnosis yet...brief psychotic disorder...bipolar, psychotic depression? Wow that's a super low dose of abilify normally it's starts at 10mg for psychosis...abilify for me made me seem like I had no emotions and it really helped me connect with people once I finally got off it entirely although I seemed like my old self by the time I got down to 2.5mg but everybody responds to meds differntly. Here is my question did you start feeling tired when you started tapering the abilify? Abilify tends to be activating you kind of have this push and need to go out and do things....it's also got that add on antidepressant quality so if you are depressed it may have been helping you. Are you tapering off on your own or with a doc? My pdoc would not even think of letting me taper off for at least 6 months but I had 1.5 months of psychosis prior to getting an effective drug. I'm just wondering if you might be tapering off too early and that's why you're experiencing mood symptoms....

[Tower_Tusk]

Originally Posted by Sometimes psychotic

Hi and welcome! Have they given you any sort if diagnosis yet...brief psychotic disorder...bipolar, psychotic depression? Wow that's a super low dose of abilify normally it's starts at 10mg for psychosis...abilify for me made me seem like I had no emotions and it really helped me connect with people once I finally got off it entirely although I seemed like my old self by the time I got down to 2.5mg but everybody responds to meds differntly. Here is my question did you start feeling tired when you started tapering the abilify? Abilify tends to be activating you kind of have this push and need to go out and do things....it's also got that add on antidepressant quality so if you are depressed it may have been helping you. Are you tapering off on your own or with a doc? My pdoc would not even think of letting me taper off for at least 6 months but I had 1.5 months of psychosis prior to getting an effective drug. I'm just wondering if you might be tapering off too early and that's why you're experiencing mood symptoms....

Hey. Thanks for the quick response. I don't have a diagnosis per se that we've discussed, but I guess at this point I'm leaning towards brief psychotic disorder (caused by copious marijuana intake.) I think my pdoc's thinking was that the psychosis would blow over on its own (which it did for the most part) and he didn't want to get me too deep into these powerful meds. I had been tapering off with the hope that I could get on a standard anti-depressant after I got back to normal a bit.

I started tapering little over a week ago and had been feeling tired before that yes. An additional factor might be the fact that I was going through benzo withdrawal a couple of weeks ago in mid february. I'm hesitant to consider this as a root cause though just because I wasn't taking benzos for very long. I've felt the symptoms of that go away and have had some pretty good days since then. This feels more like a static lack of mental and physical energy.

[Sometimes psychotic]

So you can use a standard antidepressant alongside an antipsychotic especially abilify since that's routinely done...there is no benefit in waiting until you are off the AP. I'm also wondering how often you smoked pot...there is some evidence that use of that pot causes lack of motivation etc over time...it's kinda the classic stereo type of someone who uses...I'm not sure if it's permanent or not but there is also something called post acute withdrawl syndrome that can last like a year as can the discontinuation syndrome with benzos as in there are ups and downs as your brain readjusts. Have you talked with your doc about how you feel he should be more aware of the possibilities for you as it may have nothing to do with your recovery from psychosis.

[Tower_Tusk]

Originally Posted by Sometimes psychotic

So you can use a standard antidepressant alongside an antipsychotic especially abilify since that's routinely done...there is no benefit in waiting until you are off the AP. I'm also wondering how often you smoked pot...there is some evidence that use of that pot causes lack of motivation etc over time...it's kinda the classic stereo type of someone who uses...I'm not sure if it's permanent or not but there is also something called post acute withdrawl syndrome that can last like a year as can the discontinuation syndrome with benzos as in there are ups and downs as your brain readjusts. Have you talked with your doc about how you feel he should be more aware of the possibilities for you as it may have nothing to do with your recovery from psychosis.

Hmm. Well I did smoke a lot of pot (maybe a few times a day starting when I got out of class at 5), but I remember how I felt right before the psychotic episode began. I was a very curious individual who loved learning and always enjoyed thinking abstractly. There always seemed to be a joke or observation on the tip of my tongue, and I was usually contemplating all kinds of things on and off. Now the intellectual side of things seems kind of useless and empty, like I've been shut off from that place. But it's more than that. I just feel so burned out, like my mind is reaching for thoughts or observations and just doesn't have enough energy to get there. When I'm with people the flow of conversation (which I seem to have no intuitive grasp on anymore) seems to be stilted and when I'm alone I just feel spent and useless.

I think the thought when it came to not being on multiple meds at once was just that it would be easier to identify a bad reaction if I was just on one drug at a time. Anyways we both seem to have a less is more approach to the situation. I don't want to load up on multiple meds because what happened to me seems like a one-off thing. I have talked to my doc about my situation and he seems to be attributing it to a kind of "burnout" phase that happens after psychosis, which he says can last a while.

[Sometimes psychotic]

Ok I doubt it would happen that fast then if you were ok before...one of the things I was doing when I was initially well was cognitive remediation. So I used brain age and lumosity as brain training I also visited a lot of museums and the tried to learn guitar and ukelele as well as trying to learn a filtering language. I also did logic puzzles crosswords word searches etc. They are kind of different than what you do in class because they often use something called working memory which can be decreased by psychosis. Also psychosis will potentially cause a temporary loss of like 10-15 IQ points so you really might not be as sharp right now. This is a totally different thing than non motivated which is kind of dipping a toe into the depression pool. Anyway you should look into neuroplasticity...it's the idea that you can sort if retrain your brain to deal with any damage that might have occurred. I think of it as replacing the wiring on any circuits that might have gotten fried. In short you can get it all back but the time frame is differnt for everyone some people just sit around and watch TV for six months after a break and they seem to need that to heal.

[Tower_Tusk]

Haha. That's funny you should mention neuroplasticity, as one of the ideas central to my psychosis was the idea that I was an evolving human being who had 100% control of his brain through the use of neuroplasticity. That said I recognize your point. I have perhaps been doing too much sitting around waiting to get better and not enough working on the problem. I've gotten this advice directly or indirectly from a number of people and maybe today would be a good day to put it in practice. Part of what holds me back I think is just that I've never been good at cumulative work that you learn a little bit at a time. I've always been kind of a procrastinator who excelled at that last-minute stroke of genius. Ah well. Time to turn over a new leaf I suppose.