Trip to the Mental Health Center

Earlier today I was sitting in the waiting room of the mental health center. My psychiatrist came to get me, and brought me back to her office. We sat down, and she poured over my file with a serious demeanor, trying to determine the best treatment options for me. After discussing how I've been doing, we decided to stick with the Abilify and Wellbutrin, as they seem to be working well for me.

"Do you feel like your old self again?" she asked. "Or do you still feel different from before the episode?"

"I still feel kinda different."

"How so?" she inquired further.

"Hmmm..." I had to think about it. "I don't have the confidence that I used to... the confidence socially, and the confidence to get things done. I'm still not as active, and don't feel as motivated as before. I used to just go out and do things."

"That can be a symptom of the illness- not being as motivated." she replied. "Although you don't feel as motivated, you have still done some things, like take the GRE and submit a volunteer application. Hopefully you will build upon these things, and gain some momentum."

I like Dr. L. She takes her job seriously, and gives me the attention and time necessary to work out the best treatment plan. I can be honest with her, and I feel she respects me as an individual who is able to make his own decisions. She works with me, instead of simply dictating what medication I will take. I know this is not always the case with psychiatrists, and I value the relationship we have.

The Silence of Stigma

I was having a conversation with David yesterday, and he mentioned that he had been reading about schizophrenia. He said, "I read that one percent of America's population has schizophrenia?"

"That's the statistic that I always hear," I replied.

"That sounds like a high number!" he exclaimed.

"Yeah, it's amazing that that many people have schizophrenia, and you never hear about it."

I explained that, in comparison, about one in six-hundred people have Crohn's disease. Yet when I tell people I have Crohn's disease, I'm always hearing that they know someone with the disease.

I continued, "It shows how little people talk about schizophrenia, because of the risk of stigma. If people were able to about it openly, everyone would realize that they know someone with the condition, and people would understand it better."

This evening David left to drive down to his girlfriend's house to celebrate her birthday. He will go straight back to college after that.

After he had left, I said to Mom, "It was nice having David home for winter break."

"Yeah, it was," she replied. "You must really miss him when he leaves. He's your peer, you have a lot to talk about and share."

"I do miss him when he goes."

I feel sad that he won't be around the house to laugh with and talk to. Still, I'm happy to see him return to his college life with all his friends, where he is building his future.

Where My Dreams May Lead...

We had a poker game to celebrate last night. After all my relatives had left, I laid down on the couch at two a.m., and soon drifted off to sleep.

In my first dream of the new year, I was spending time with an old high school friend. In the dream, we felt great affection for each other, and we started kissing passionately- the kind of kisses that take your breath away.

As I started to wake up, I felt sad to leave her lips and the deep feelings of affection I had for her.

Wow, I thought, it has been a long time since I've been in the arms of a woman...

I felt part of me reawakening...

I felt a longing for the companionship of another...

I felt good, but lonely...

I started to evaluate my life.

I have made progress over the last year. No longer do I lay on the couch all day. I am more talkative, more engaged. But what lies beyond my small circle of comfort?

Nascent thoughts began to form in my mind: maybe it is time to step beyond myself... to push myself further out into the game of life. A job. An apartment. A girlfriend. For a long time it was too overwhelming to even consider striving for these goals. And in a way, it still is. But now I am almost able to desire these things, to imagine myself attaining them.

All this stirred up by the lips of a woman in a dream. It was more than a kiss, though. To me, it was a symbol of stepping back into the flow of life. My subconscious saying, don't forget what is out there... don't forget what possibilities life holds.

Morning Therapy

I woke up to my alarm at 8:30 this morning, rolled out of bed and went downstairs to make some coffee. After eating breakfast, I drove through snow-covered roads to the mental health center. I checked in, waited for a few minutes, then my therapist Jeannine came and brought me back to her office.

We talked about what has been happening in my life.

"How is the librarian stuff going?" she asked.

"OK. I should start looking at schools soon. I'm still a bit ambivalent about it though. Looking ahead at the coming year, I think I may want to start working at some point, and I don't know if I'll need to go through an adjustment period before I start taking classes as well."

"That makes sense. Have you inquired about volunteering yet?"

"Yes! I finally called and talked to the volunteer coordinator."

"Good for you, Mike!"

"Thanks. I picked up a volunteer application and now I need to fill it out and return it."

"So this is still something that you want to do?"

"Yeah, I guess so. I'm not exactly looking forward to it intensely, but I think it will be good for me to get out and have more of a routine. Plus it will be a step toward getting back to work."

Later she asked, "How is the overeating going?"

"Ummm, not so good."

"Has it decreased at all?"

"No, not really."

"Do you have a sense of what is causing it?"

"I'm not sure. Sometimes it may be stress, but other times it just seems like a habit."

"I think that you need to come up with a plan," she said, "something that you do whenever you get cravings. Tell yourself that you will do it, say, three times. You may still end up overeating, but you will begin forming good habits as well. Also, some people find that if they get in a good routine, their overeating decreases. Perhaps volunteering will do that for you."

"I hope so." I replied. "I do feel like I have excess mental and physical energy that may make my cravings more intense. Being busier may improve things."

Soon time was up, and we scheduled an appointment for next month.

Now that I'm home, I need to clean the bathroom, because we are having relatives over for a New Year's Eve poker game.

I want to wish everyone a wonderful night, and a new year full of hope and promise.

Hopes and Burdens

I've been listening to some old mix tapes I made when I was in high school. They take me back to a different time in my life. A time when I was so sure of myself. I had a good group of friends nearby, a girlfriend, the soccer team. I was a leader in Boy Scouts, and a writer and editor for the school newspaper. But my nostalgia is tempered by the fact that I was also depressed and full of angst and anger toward what seemed to be an unjust society.

Since then I've had much happen that I would have never dreamed of. I moved out to California. I was diagnosed with Crohn's disease. Had a few different girlfriends. Lived in Tijuana, Mexico for six months. Moved back to San Diego near the beach, made new friends and learned to surf. Eventually I had a psychotic episode, was diagnosed with schizophrenia, and ended up back in New Hampshire, living at home again. Life has come full circle, yet I am a much different person than I was back in high school.

There is little that I regret, yet much that I may never accomplish. I always assumed that I would have a successful career, buy a house, get married, and have two or three children. Over the past year I have come to terms with the fact that all this may not be in the cards for me. It no longer frustrates or angers me. Que sera, sera.

I do still have some hopes and dreams though. I still want to get married someday; I feel having a partner to share life's ups and downs with would eventually be important to me. Right now, however, I feel it is enough to sort out my own life, without dealing with someone else's psyche.

Also, I think that some sort of gratifying work would be good for me in the long term. Work seems to give people a sense of purpose and satisfaction.

But I am no longer jealous of my friends that have career track jobs with stock options and a 401K. That is great for them, but may never materialize for me. It is my own life, and I need to set my own goals and try not to compare myself to others.

We all have our own burdens to carry. And I must do the best I can with what I have been given.

The Holiday Season Continues...

We went to the Christmas party for Roby's side of the family last night, at his daughter Jackie's house. Roby has eight children, so with the wedding my family suddenly became much bigger, adding many step-brothers and sisters. It is funny to think of them that way, though, because most of them are much older than me. Roby is about fourteen years older than my Mom, resulting in a large gap between the age of their children.

At the party, David was talking about his plans for winter break, saying "No, I won't be working, but I'll be productive through..."

"Define productive," Mom said, giving him a hard time

"Well, I've been exercising, and I'm working on a business plan."

"So what you're saying," Jackie interjected playfully, "Is my fifteen year old son will be working more than you will during vacation?"

"Haha, yeah, I guess so."

They did not say anything to me, but I felt embarrassed about my own unemployment. Much of society's definition of a productive individual relies on gainful employment. At times, not having a job brings on feelings of inadequacy. Perhaps I am not pushing myself hard enough? Some of the symptoms of schizophrenia are lack of motivation, apathy, and social withdrawal. But how do I separate these symptoms from normal feelings of self doubt, fear and laziness? Since I was diagnosed with schizophrenia, I have tried to take things slow, so I would not become overwhelmed. But have I let myself coast instead of climbing the path of recovery?

"So what do you plan on doing next summer?" Mom asked David.

"Well, I'm starting to apply to internships. I'm hoping to get one in Boston or New York."

Boston or New York... that's when I realized that David may not return home for the summer. Small pangs of sorrow rose in my chest. I will miss him if he doesn't come home after next semester.

The party continued, and overall it was pretty good. David and I hovered near the food tables and ate until we were stuffed. Roby's family members are all personable and friendly, so it is easy enough to get along with them. It was a good way for us to get to know our new side of the family better, even if I felt awkward and nervous at times.

The holiday season continues, with one more party down.

No, Not Yet...

There is a new study out, reported by schizophrenia.com, saying that people with schizophrenia are less likely to get cancer, despite the fact that many of them eat poorly and smoke. Heart disease- that's a whole different issue- we have plenty of that. Not so much cancer.

Turns out, there is a genetic link between cancer and schizophrenia. While in cancer these genes cause their cells to multiply out of control, in schizophrenia the same genes slow them down, seemingly preventing cancer. Interesting.

Anyway... yesterday one of my Aunts asked me if I was working, and I had to answer, "No, not yet." This came to mind today as I was trying to convince myself to call the library to ask about volunteer opportunities. I have been wanting to volunteer for a few months now, and I put it off and put it off... but now I am out of excuses. I need to find the motivation to do it. I almost feel guilty for not working or volunteering.

I have read some people say that working was an important part of their recovery from mental illness, that it gave them the purpose and discipline that they needed. Why would I think that it will be any different for me? I guess I just have bad associations with work because of previous jobs I have had, and I am cautious about how I would react mentally to all the stress and activity of a job.

This is why I consider it important to start volunteering first- so I can ease into it and develop a healthy mindset for working. If only I would pick up the phone and call...

At the Bank

This afternoon I was sitting in the lobby of my bank, waiting for Eric. I had some money saved up from the last job I worked before developing schizophrenia, and since my expenses are low because I live at home, I had a little extra to put into an IRA retirement account. I had to meet with Eric to decide how to allocate the money. Within a few minutes he arrived, and took me into his office.

Eric is probably in his mid-fifties, with graying hair and a professional demeanor. He needed to know my financial situation, to make sure I would not need to take any money out of the account. So naturally, he asked the question: "Where do you work?"

I do not disclose that I have schizophrenia to people I have just met, because I feel stigma is still common when it comes to mental illness. So instead of being explicit about why I'm not working, I said, "I've been between jobs for a while because of health problems."

"Is your health OK?" he asked, showing some concern.

"Yeah, I'm OK. It's getting better."

"Where was the last place you worked?"

"At the Journal of the American College of Cardiology, as an editorial assistant," I replied.

"Oh, you have a medical background?"

"No, I have an English degree, so it was more for the editorial work."

"Do you have any sources of income?"

"I am on disability, so I have some money coming in from that."

Satisfied that I would not be withdrawing money out of the retirement account, he left it at that. He did not pry, nor ask any further questions about my health. I noticed that my face was hot, and I realized I was probably blushing from nervous energy. Although this sort of conversation makes me uncomfortable, it was good for me to have practice discussing this type of thing.

He spent almost an hour talking to me about the different mutual funds I could put my money into, until I made a decision I was happy with. I appreciate him taking his time with me, considering the modest amount of money I was putting in.

I left feeling good about the appointment, but happy to have it behind me.

Sushi and the Supermarket

Without my mother here, the food supply has been steadily dwindling down. So today I finally decided to go food shopping. When I entered the store, I noticed that my heart rate was up, and I was feeling slightly anxious. Public places are not always a problem for me, but the supermarket in particular makes me nervous. It is there that I am most likely to bump into people I am acquainted with.

Despite some social anxiety, I made my way through the store picking up items on the list. I was looking for something easy for dinner, and I stumbled across a sushi display. I love everything about sushi- the seaweed wrap covered in rice, the wasabi and soy sauce, the ginger, the chop sticks- everything, except- the raw fish. Problem solved: I picked out a vegetable roll that contained cucumber, avocado and shredded carrots. I think of it as sushi for beginners.

Sushi in cart, I weaved through the rest of the store, picking up what I needed.

When I found the last item on the list, Chap Stick, I started to move toward the checkout and finally ran into someone I knew. I was relieved to see that it was Mrs. C, one of my mother's friends.

"Is that you Mike? I'm not good at picking up faces when people have baseball hats on."

"Hi, Mrs. C, how are you?"

Her son, who is about my age, has bi-polar and also lives at home with his parents. Although I do not know them very well, I feel a connection to their family, since they are dealing with some similar mental health issues.

"Did your mother get married last weekend as planned?" she asked.

"Yeah, it was a nice ceremony. Everything went well."

"Oh, good to hear. You know, you guys are being so good about the whole thing. I know it must be difficult having someone new come into the picture, but it sounds like you and your brothers have been really supportive of your mother, and that's great. Roby really means a lot to her."

"I know," I said. "It's good to see her happy with someone."

"Now, did I hear that you're planning on going back to school for library science?"

"Well, it's not definite yet, but I'm thinking about it."

"I hope whatever you decide to do works out for the best."

"Thank you."

We said goodbye, and our conversation was over. As usual, the chance encounter that I had feared was not nearly as difficult as anticipated.

After getting through the check out line, I pushed my cart outside to the car, and loaded up the trunk with groceries. Mission accomplished.

And my sushi dinner was delicious.

Waiting Rooms and Therapy

"Hi, I'm here to see Jeannine at one o'clock," I said to the receptionist at the local mental health center.

"Great, she's running a little late, but she'll be with you shortly."

I walked across the waiting room and took my seat against the opposite wall. I sat still, except for an occasional foot tap in sync with the U2 song being played over the sound system. I always feel pretty awkward sitting in waiting rooms. It would be easier if I would pick up a magazine and try to engage myself in some reading, but I consider magazines in public places off limits because of how many germs I imagine lurking throughout the pages.

I thought back to when I first started coming to the mental health center, sitting in the waiting room looking around at the other patients for some sign of sanity, some hope that mental illness isn't the end of the world. And although there were some sullen faces, I would also be amazed at some of the patients who seemed to be holding up just fine, engaging each other in lively conversation.

It wasn't too long before Jeannine appeared and led me back to her little windowless room. As I followed her I stole a few glances at her face, and noticed how tired she looked. She was also sniffling, as if she had a cold. Tough day to be a therapist, I thought to myself. When I see therapists, I always wonder how they are doing. That doesn't usually come up in our conversations though.

Despite the apparent fatigue and cold, Jeannine was still fairly cheerful and attentive. After checking in with the normal happenings of my life, she asked, "So is there anything else on your mind?"

"Well, my mother's wedding is coming up this week."

"How are you doing with that?"

"I feel OK with it. It's been such a gradual progression- first having Roby stop by occasionally, and getting to know him a little, then eventually seeing him often, and then having him move in with us- that I've become accustomed to the whole thing. Plus he's a good guy, so I do approve. But I'm waiting for the moment when it hits me that they are really getting married... and my father is really not around anymore."

"It's good you're aware that you may have some moments, even days, when it hits you emotionally."

"Yeah, I think it will be OK."

When the hour was about up, she pulled out her appointment book and penciled me in for next month. I left, feeling good about the visit, and looking forward to the rest of my day.

Pangs from an Old Addiction

I went downtown today, to go to a smoke shop to buy incense and rolling tobacco.

As I entered the smoke shop I walked past hookahs, Buddha heads and psychedelic images on the walls. I surveyed the merchandise placed underneath glass counters: bongs, knives, pipes, and flasks. Welcome to New Hampshire's counterculture.

I felt little pangs of desire as I visually examined the multicolored, glass-blown pipes. It's been almost one year and eight months since I last smoked marijuana, yet there is still a part of me that wishes I could buy a glass piece, take it home and sit back and smoke a little nug of weed. I'll just do it on occasion, I tell myself, but the plea is short lived. I know myself better than that. I wasn't a casual smoker, and I doubt I ever could be. When I smoked, I smoked up all the time. Before work, after work, before dinner, after dinner, before hanging out with friends, while hanging out with friends, before bed... all the time.

That's how it was, and then I stopped, cold turkey. I have not smoked marijuana since the day I was admitted to the mental hospital in San Diego. From the hospital I came back east with my mother, leaving my California life behind me.

Had I stayed in Cali, it would have been incredibly hard to quit; it was part of my routine and my social life. Back home in New England, I was divorced from all the elements that would have drawn me back to the drug. Sure I craved it and longed for it... and I still have moments of nostalgia for my favorite herb... but I know keeping clean is the best decision: research has shown that those who have schizophrenia and smoke marijuana are more prone to relapses. I don't want to put my mental health in jeopardy.

My thoughts were wisped away with a pleasant, "What can I help you with?" I looked up, and saw a young, attractive woman with plenty of piercings peering back at me from behind the register. "I'll take these," I said, placing three small boxes of Nag Champa incense on the counter, "And I need some rolling tobacco."

I left the store satisfied with my purchase: sweet scented sticks and my second favorite plant to roll up and smoke. Sure, someday I'll need to quit that as well, but for now I'm just happy to be sober.

My Secret: A Serious Snacking Problem

"See you later," I say as my mother closes the door. She's off to run some errands, and I have the house to myself. As soon as her car pulls out of the driveway, I take up my position in front of the food closet, scan the contents, and decide where to start.

I rustle through the various packages and boxes, eating with impetuous desire. I eat and eat and eat, while being sure not to consume too much of any one item, so my habit will go unnoticed by my family.

This has been going on for months. I've gained 40 pounds because of it. I euphemistically call it my "serious snacking problem." If I'm honest with myself, I have to admit that I have the tendencies of a compulsive overeater.

I do have hope that the problem could spontaneously resolve itself. I developed a similar eating pattern in college, and after some time I was able to leave it behind me, without much conscious effort: senior year I stopped overeating when I had a really busy schedule. Perhaps a major shift in my schedule could have the same effect.

Regardless, I'm rather ashamed of the whole thing. It's something that I want to brush under the carpet and pretend doesn't exist. However, it is a part of my emotional and mental life that I battle with every day. Perhaps writing about it from time to time will help me confront it and get serious about overcoming the habit.

A River of Peace

"How was the NAMI meeting?" I ask my mother as she takes off her jacket and puts down her purse. She had just returned from a support group for friends and family of people with mental illness.

"Good, I'm glad I went. It was good to see everyone again. Such sad stories though. I think that's why I stopped going after a while- it can get kinda depressing. Most of the people there are having a lot of trouble with their loved one and they need to vent and support each other. It's a really good group for them, I just don't feel like I fit in. You're just so easy to live with."

I smile. I feel fortunate to have such a loving, understanding mother. I know she is glad that I take the medicine that allows me to think clearly. Without the meds, there's no telling what state of mind I would be in.

"You know," I say, "from the schizophrenia recovery stories I've read, many of these people had really tough times, hit rock bottom, and eventually turn things around and end up being OK."

"Do you think it's the meds that does it for them?"

"Well, it's not the only thing, I think it takes more than that... but medicine is often the foundation for everything else. Medicine... and hope."

Having her go out to the NAMI meeting takes me back to when I first was diagnosed. I would lie on the couch in the living room, feeling so sad and depressed and I'd wait anxiously for her to get back from the meeting, hoping she'd bring some good news about my condition, some bit of hope. It makes me emotional to think of that time, wandering through the dark woods of a new, frightening diagnosis, desperately seeking a glint of light.

And I still remember a night later on when I was lying on my bed staring off at the ceiling, and spontaneously I started visualizing myself merging into a flowing body of water- a river of peace, a river that washed away all worry, that gave the strength to deal with anything that could possibly happen, including death.

I thought to myself, "this must be what hope feels like."

And suddenly, by the grace of God, I had something to hang on to.

Smokin' in My Little Room

I fired up the heater in the little room my father built in the garage for smoking cigars in the last few years before he died. I now use it in the winter for smoking cigarettes- as I live at home with my mother and soon-to-be step-father, I cannot smoke inside, and my little smoke room is the next best thing. It reminds me of where I was at mentally when I last smoked in there, at the end of last winter.

I was just starting to come out of my idle days of laying on the couch and staring off at the ceiling or at the pictures on the wall. I had been sleeping at least 12 hours a day, had completely lost my sex drive, and had no energy, stamina, or motivation, and generally just didn't feel like "myself." I was experiencing what is considered to be the negative symptoms of schizophrenia, such as lethargy, apathy, lack of motivation, and lack of emotion, causing me to become much more withdrawn and reticent.

When I was in the hospital in California, they started me on a medication called Risperdal. Fortunately this drug quickly eliminated the positive symptoms I was having (the paranoia, delusions and hearing voices), enabling me to be discharged and taken back to New Hampshire to live with my mother. However, I suffered from the negative symptoms of schizophrenia, in addition to dealing with the side effects of the medication- which are actually hard to distinguish from the illness.

Finally, near the end of last winter my new psychiatrist (who I am very grateful to have in my life) weaned me off of the Risperdal and started me on a medication called Abilify. After some time the new drug started to assuage the negative symptoms and I started having more energy, my sex drive came back (although still being without a sex life) and I started reading and reading and reading. I would read for eight hours a day, punctuated by trips out to my smoke room. Sure, I was still sitting around the house all day, but my mind was starting to become more active, I grew more talkative, and laughter and smiles came back into my life.

Thoughts of all this came back to me as I sat smoking a cig in the little room.

Tomorrow I Step Up

I slept in this morning- I’m trying to have a nice relaxing Sunday, as it is my day off from GRE (the test they make you take to get into graduate school) studying. I’ve been studying consistently 6 days a week in order to prepare for the test. If for no other reason, the responsibility of studying has forced me into a routine that gives some structure to my days, which I think is healthy for me, seeing as how I’m on disability and don’t work.

Tomorrow I’m hoping to take a step in the direction of getting back to work by calling the library and seeing if I can start volunteering for them. It’s something that I’ve thought about doing for a couple months but I just haven’t worked up the courage to call. It’s a bit intimidating for me to think of getting back out there in the world doing work amongst strangers that I don’t know, in a public place where I may run into old acquaintances from my high school days. I really haven’t been that active since my episode in the spring of last year.

But as I work towards recovery from my mental illness, I believe this is an important step to take. As my councilor/ social worker Janeanne pointed out, one can’t always wait to be full of confidence before starting a new activity- sometimes you need to take the plunge, take what comes, and build the confidence as you go. Tomorrow I hope to step up, get my feet wet by making the phone call to the library, and get ready for the dive.