Mental Illness and Substance Abuse

Mental illness can be triggered and worsened by taking recreational drugs, especially if you already have a genetic predisposition that you might not know of. I heard a story of a teenage boy who used to be a happy and popular high school student. He went to a party and took two pills he didn’t even know what it was. He became psychotic for the next few days. People told him to drink a lot of water in the hope that the drug would just pee out of his system. Unfortunately, after the psychosis had subsided, he fell into a depression and eventually committed suicide. Therefore, really be careful with the choices you make in life. Drugs and alcohol abuse can also worsen a mental illness. Think about it, they can mess up a healthy person’s brain; imagine the damage it could make on a mentally unhealthy person. In addition, they can also offset the effects of psychotropic medications. Therefore, if you want to recover from a mental illness, get sober first!

Questions from You

Do you have to be on medications for the rest of your life?

The short answer is Yes. I always make sure I pack my medications in two different suitcases when I travel. If I skip a dosage, I would probably know right away as the pace of my thoughts will pick up at night and I am unable to fall asleep. Without a night of sleep, my heart will beat faster and I am a little bit more emotional and neurotic the next day. But as soon as I take my medications, all will go back to normal and I am myself again.

I have developed a dependency on my medications, perhaps you can compare that to an addict who cannot live without their drugs. However, I would define mine as healthy and normal. Just like someone who is born with type I diabetes, they need to rely on Insulin for the rest of their life. Having a bipolar disorder is innate and I need to rely on something extra to keep me balanced and functional. But unlike someone who has diabetes, they have to watch what they eat and change their lifestyle accordingly, when I stay on my medications, my life is perfectly normal. Right now, I am on a minimal dosage, which doesn't give me any side effects. But as to the long term consequences, I am not worry about it at this time.

Medication --- the Right Type and the Right Dosage

A lot of mentally ill person refuses to take medication or stay on a medication, they think that they are either ineffective or they are doing even more damages. This is actually true. It is very difficult to find the right type of medication that suits a particular person. The first medication I took makes me gain 60 lbs by the time I was discharged from the hospital. It was an anti-depressant medication. Two years later, I was hospitalized again for a Manic episode. It was then that I was correctly diagnosed with Bipolar Disorder. The anti-Depressant medication was actually the trigger of my Mania.

I was prescribed with Lithium Carbonate, which is a primary treatment for Bipolar Disorder. However this medication gave me severe acne to a point that my face was disfigured. It did not do any good to my mental health.

In 2007, my psychiatrist decided to put me on Epival, it is primarily an anti-seizure medication. Amazingly, after a month, I woke up one day and felt like I was different. I couldn’t explain in what way, but I was just happier for no reason. I never felt that way in the first 22 years of my life. As I took that medication more and more, I realized I finally knew what it feels like to be a “normal” human. 

Now, my personality changed, I used to be an introvert, but I am now a very outgoing and positive person. I don’t have phobias anymore and I sleep like a baby every night. My musical and artistic ability have also enhanced. I have truly reached my potential as a person and a human being because of this medication.

Though finding the right type of medication is the key in treatment, it is still not enough. The right dosage is equally important. For instance, not every middle-age female, weighs around 160lbs should be prescribed with the same dosage of medication --- everyone has a different metabolic rate. It took me about 2 years of experiment to figure out the right amount of medication for me. There was one time, my pharmacy ran out of pills in 125mg, instead, they gave me pills in 250mg. Without knowing the difference, I mistakenly took twice the usual amount for over a month. During that month, I felt so odd. I became lazy and moody, I didn’t want to do exercise and I was hungry all the time. I gained 15lbs by the end of the month. Then, my mom discovered the mistake. Within a week being back on the right amount of meds, I was myself again. Therefore, it’s important to be on the exact amount of medication that’s custom to that particular person.

Why Is Mental Illness so Hard to Treat?

In my perspective, I think that every mentally ill person is potentially treatable. However, it is the most difficult illness to treat, for the following reasons:

1)      It is a very subjective illness. It cannot be detected by blood test, x-ray, MRI or other methods to diagnose an illness. Even the psychiatrists have a lot of limitations in knowing how each patient feels and what type of illness they actually have. Like me, I was not correctly diagnosed until 3 years after my injury.  Therefore, patients are the only ones who can access their own inner state, but most of them are too sick to even think and too easy to give up. And most importantly, they lack the knowledge and insight to help themselves.

2)      It’s hard to find the right type of medication, the right combination of medications and the right dosage. The side effects of some medications can even worsen the symptoms and make a person even more suicidal. Other side effects, such as appetite change, weight gain, acne, aloofness, etc. are big deals to most people. They could become the very cause of depression. Therefore, if one medication doesn’t work, keep on looking and trying on other types of medication. Do not give up on meds. Do not stop taking meds even if you are feeling better. My condition is treatable but I don’t think it’s curable. I’ll take my meds unconditionally every day for the rest of my life. I might compromise my chances of having my biological child, but nothing is more important than the quality of my mental health.

3)      The lack of social support is also a big problem for the mentally ill. When you are crazy and lose your mind, you really need someone to take you to a psychiatric facility and act on your behalf. But unfortunately, in many cases, when someone is mentally ill, people walk away from their life when they need social support the most. When a person lost their job, their romantic partner and other meaningful possessions during their acute state, how would they be able to feel happy again even if they are bio-chemically restored?

Questions from You

1)     Did you think of hurting an innocent person?

I did attempt to kill my dad. At that time, I was incapable of feeling love and sympathy. The illness turned me into a sociopath, literally. My nature and the basic elements of my humanity were taken away by my illness. I’d do anything to kill myself and because my parents were protecting me, I was about to kill them as well. This explains why we hear stories of mother killing their own children when they were depressed.

2)     What do you think of the school shootings in the U.S. perpetrated by people who are mentally ill?

I can’t understand their action, but I can definitely relate to their mentality. When a person is at the end of their rope, they’d feel jealous of people who are better off than they are. That’s why those shootings always take place in a school, they seldom happen in a nursing home. Secondly, killing one’s self is a huge commitment. It takes a lot of guts to do it. By committing a horrible crime, they basically leave themselves with no choice but to kill themselves, better yet, the police could do the job for them. Again, a mental illness can strip a person off their humanity. I don’t think all of them are pure evil, they are sick and they don’t believe that they are treatable. If gun control is not possible, then extensive levels of education on mental illness might be the solution to prevent more tragedies from happening.

Questions from You

Did you seek for professional help during your acute stage? And are they helpful?

I was seen by one social worker, one family doctor and two psychiatrists before my injury. They were not very helpful. The social worker and the family doctor were not specially trained in severe psychiatric conditions. Again, like everyone else they were trying to talk me out of my depression. I mean, can you talk someone out of their diabetes? They failed to understand that my condition is a medical problem. As to the two psychiatrists, one of them wrote me a note saying I am not mentally capable of completing my high school exams. The other psychiatrist prescribed me with anti-depressant and discharged me back to the community after 3 days I overdosed myself with sleeping pills. I felt like they could have explained to me what was really going on and gave me more assurance that this was a treatable condition. When the anti-depressant didn’t start working right away, I quickly lost faith on the meds, and lost faith on doctors as a whole thinking if they could not even help me, who could? I thought I would remain crazy for the rest of my life and that was my last straw. After my injury, I saw my Psychiatrist Dr. Mccullagh for the first time. He was my doctor for the next ten years. Right away, he was different from others. He was compassionate. Had I met someone like him prior to my injury, I wonder if it would have made the difference. I think a good doctor should have the heart of a parent, when they treat their patients as if they were their child, not only are they a good doctor, but they are a great human being.

Questions from You

If my love one is depressed and suicidal, what should I do for them? 
 

Take them to a psychiatric facility to prevent this person from hurting themselves and other people. I have heard so many stories of family members trying so hard to prevent their child from committing suicide. They take turns to watch the person to a point where everyone is extremely exhausted. At the end, they still could not prevent tragedies from happening. Lock a person up in a psychiatric facility is the safest place. All of those psychotropic medications take at least 3 weeks to feel the different, I don’t even mean “effective”, but it takes at least 3 weeks to kick in. During this important period, a person has to be monitored to prevent self-inflicted harm.

This might only apply to people living in countries where a psychiatric facility is an ideal place for rehabilitation. But in other less developed countries, this might not be the solution. I will write about that in another post.