A Recovery Blog

This blog is about my continuing recovery from severe mental illness and addiction. I celebrate this recovery by continuing to write, by sharing my music and artwork and by exploring Buddhist and 12 Step 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, August 19, 2012

Change Of Diagnosis And A Response To Michael Moore's film "SICKO"

Several months ago at my psychiatrist's office they changed several things.  Now one must pay the copay upfront, prescriptions are no longer written out but called into one's pharmacy and each patient gets a print out that lists the diagnosis and current medications.  I noticed that my diagnosis was no longer schizophrenia, but schizo-affective disorder.  Just when my psychiatrist changed my diagnosis I do not know, but he never informed me of it and so far I haven't talked to him about it.  I've been so used to labeling myself a schizophrenia sufferer that it has taken me these several months to re-name my condition.  The truth is that schizophrenia, schizoaffective disorder and bipolar disorder are all related, but for some reason doctors seem to need to separate us.  Just about all my online friends suffer from schizoaffective disorder and several of them said that they thought I might suffer from the same thing because I've struggled with a lot of depression.  It's not so clear to me.  Many schizophrenia sufferers also suffer from depression, so what is the big difference?  Many professionals are not so sure and often misdiagnose patients or, as is true in my case, see a change from one condition to another very related condition.

So what is the difference between schizophrenia, bipolar and schizoaffective disorders?  Schizophrenia is considered a thought disorder, bipolar is considered a mood disorder and schizoaffective is considered a combination of a thought disorder and a mood disorder.  I'm not sure if I've got my statistics exactly correct, but generally speaking bipolar disorder is the most prevalent disorder out of the three affecting perhaps 3% of the population; schizophrenia affects about 1% and schizoaffective about .5% of the population.  Despite people with schizoaffective suffering from the worst of both schizophrenia and bipolar, it also appears to have a better longterm prognosis.  Not sure why.  Maybe there is more of a chance for balance instead of being stuck in one camp or another.

I've also read that anxiety disorders are fairly common for people with schizoaffective disorder.  The irony for me is that my problems with anxiety seem to stem from my high dose of the anti-psychotic Abilify.  Did I become schizoaffective because I began ingesting this medication?  Do medications, depending on their dosages, actually cause mental illnesses instead of preventing them??  This is an issue that Karen has also been exploring as she lowers her medications because she's seen that she is much healthier and productive on a lower dose of the anti-psychotic.  And since I lowered my dose of Abilify, I have had similar results.  Sometimes I wonder about conspiracy theories about pharmaceutical companies misleading so-called "consumers", which by the way is a horrible word for people who suffer from mental illness I think.  But that's just how they must see us and so that is what they call us.  I often wonder too about the Republican orientation towards glorifying business and the potential riches that come to mere individuals from doing business.  Business at the expense of morality is not business, it is swindling.

My brother gave me the documentary by Michael Moore called SICKO.  I saw it several years ago when it came out and watched it last night again.  I'm thinking of lending it to my friend Richard, who dodges calling himself a Republican, but who, in his views, really is Republican.  I have some hopes that some of what's in this critical, but also funny, documentary might make him pause and reflect and perhaps change his opinion.  He is after all a rehabilitative VA nurse.  He knows up close about how people suffer and die.  We have agreed several times that euthanasia should be a legal choice for people who are slowly dying while in pain.  Of course, he can't say that openly, but to me he sees the compassion of an overdose of morphine in certain cases.  I want the right to end my life if I so choose if I come down with something incurable and if that is denied to me in the future, I will find a way on my own, but it would be nice to go with a certain amount of dignity and in the company of family and/or friends.

If you haven't seen SICKO, do try to see it.  Yes, Mr. Moore's point of view is definitely left of center, but he interviews real people both in this country and in Canada, England, France and Cuba, countries that have successful universal care, that is government run healthcare for all.  I know the United States is a much larger country in the literal expanse of the land and in population and that that may make the changeover to universal care more complicated, but I still believe in time that it can and will be successful and stop all the unnecessary deaths and illnesses and heartache of too many Americans.  I have health insurance (at over $1000 a month), but this film shows me that this does not mean that I have security if I come down with a more serious health condition.  Right now, I have access to my medications, as does my brother, who suffers from Type 2 diabetes, but I can't be sure that I will always be covered, unless the Affordable Care Act goes into effect in 2014.

Mr. Moore's film has its funny moments certainly, but underneath it all it is very serious.  I think the humor is the sugar that makes the medicine go down more easily.  Humor is a bridge between opposing camps, at least sometimes.  Mr. Moore does mock the idea that the right holds onto like a dog with a bone that socialism is the anathema of democracy and capitalism.  He points out that we already have socialized institutions in place with the fire department, libraries, the police department, the postal service, etc... and our country has not fallen apart because of these public services.  If anything, we are more likely to fall apart without them.  Does the government need to be held accountable for infractions?  Yes, definitely, but so do private citizens who abuse their business privileges.  Health care for all should be a right and not a privilege for all people and without moral judgment against those deemed somehow unworthy.  Fact:  we are all going to die, many of us from sicknesses if not accidents and we must be compassionate about our eventual destiny and treat each other with dignity.  And yes, this does mean that those who have a great deal must contribute to those who don't.  The idea that people are superior because they are rich is to my mind a sick perspective.  They are not superior, they are damned lucky, no matter how hard they have worked.  People work very hard all over and most don't get a fraction in comparison.  This is not justice for all.  This is justice for some and that just doesn't cut it.

One Englishman that Mr. Moore interviewed said that the difference between his country and ours is that the English government is afraid when people protest, which English people have done over time with a fair amount of success.  He says poor Americans are disillusioned and instead of fighting back they are rather cowed into submission.  Many, too many, refuse to vote (like my friend Richard) because they've concluded that all politicians and people in government are corrupt.  And a lot are.  But that is not a very good reason to give up.  Maybe, with the advent of the internet and social networking, that is changing.  I really hope so.  The American frontier and farmer mentality of being the self made American and doing it on your own is outdated at best.  At worst, it degenerates into the ugly American view that many other countries have of us.  We can't do it on our own.  We are interdependent and have to care for each other, especially if we've been fortunate financially or otherwise.  Greed is a very ugly trait to encourage and develop and extol.

1 comment:

Karen May Sorensen said...

Hi Kate!

I think in terms of your diagnosis, you should think back to the time before you went on medication. You are unique because you lived with your illness for a long while before it was treated medically.

Were you depressed? Were you suicidal? Were you ever manic? Or were you just delusional and hearing voices? In essence, was there emotional disturbance, highs or lows, that went along with the positive or negative symptoms of your schizophrenia?

Having schizophrenia itself is difficult to endure especially if you are intelligent and have self awareness of the disease. There are reasons to be depressed if you are simply disabled, for any reason, from the fact of being different from others and loss of functioning. I think that some schizophrenics become depressed because of situational difficulties and the difficulty of accepting a self that is different from the norm in population. I had a friend who committed suicide who was paranoid schizophrenic and suicide was always a big issue with him, but I don't think he needed a new diagnosis. He was tormented by his illness, and eventually found it too difficult to continue with life. And yes, he took medication. I knew him quite well when he was on the suicide hotline everyday, and he didn't seem depressed other then having to deal with an illness that was placing him in poverty and seemed to be obstructing his path in life. (He became ill in high school).

For me, I tried to commit suicide once when I was young and on very little medication because I felt like such a failure and a freak. That situation, and I think like my friend, was probably not medication induced. (I believe that depression is present in all suicides). In my history, all upping of antipsychotic medication was always because I would get suicidal on very little medication.

Now it seems that too much medication makes me suicidal too. I no longer have the self esteem problem in degree that I had when I was younger and made my suicide attempt, I accept that I am different from the rest of the population and to a degree, disabled. Light medication for me has freed me of depression, due mostly to the fact I think that I am on antidepressants and have a strong focus and motivation in life. I have great reasons to live, and lots of positives in my life, a condition that was present on larger doses of medication but that because of the drugs I apparently could not appreciate.

I don't know yet if depression or mania will return. But I remember that both were present before I ever got medical treatment and antipsychotic medication. So I was comfortable with the schizoaffective label. However, I was very young when I had emotional difficulty and suffered the nervous breakdown that got me the diagnosis of schizoaffective. I suspect that I have healed a great deal from that early life crisis, and that it was probably triggered by years of emotional abuse at the hands of my father. Depression is natural after years of emotional abuse. Happily, as an independent older adult who has a loving husband and a lots of therapy, my sense of self is rather good these days. I wonder now what the interplay was between having PTSD and schizophrenia.

I still am on antipsychotic medication, and my case has not yet played itself out. There is still time for symptoms of my illness to return, and lower doses of medication to trial test. Can one heal from schizophrenia? All I know is that some have.

Some of my fate rests in my hands, but a lot of it is beyond my control. I merely am a passenger on the ship that is taking me on a voyage. Steer the vessel as much as I can, but nature is mighty, the sea is brutal and unforgiving, and I know that I exist due to the blessing from a higher power.

All my love,
Karen