On Mental Illness: Psychosis or Depression, Take Your Pick

By Jack Bragen
Friday November 18, 2011 - 06:40:00 PM

Living with schizophrenic illness entails several different “catch-22’s” in which the options are limited. One of these conflicts is the choice between being overmedicated and thus depressed, versus not taking enough medication and being mildly psychotic. It seems, for me at least, there is little or no middle zone between these. 

It is useful to know that antipsychotic medications are effective probably because they slow down the brain by blocking certain neurotransmitters. This sometimes translates into medication induced low-energy, which can become depression. And depression is apparently the polar opposite of psychosis. 

There can be no argument disputing that the antipsychotic medications can be very sedating. When someone is overly sedated, once again, you end up with a depressed person. 

Depression isn’t comfortable, nor is it any fun. It seems like an eternal, magnified case of the blah-s. Constant depression makes it hard to get physical exercise, and it seems to preclude working at most jobs; because working usually requires a fair amount of energy. 

When on a lot of medication, napping during the day will happen in addition to sleeping at night. It is hard to practice meditation because it is hard to get the brain to wake up enough for that. Anxiety attacks, believe it or not, can be a symptom of depression. And when the anxiety is getting treated it may involve additional sedating medication. 

Those in charge of the mental health treatment system are not unhappy if mentally ill people live this way. If you’re snoring away the afternoon, it implies that you are not assaulting anyone. Neither are you fleeing from invisible commandos. When highly sedated, one tends to be agreeable to most things. 

When trying to rise up from medication-induced depression, I am soon at the level of being mildly psychotic. This includes some amount of belligerence, and some amount of being delusional. At this level of existence it is easy to make a few bad decisions that will have bad consequences. If mild psychosis happens frequently, it is necessary to program oneself with some type of “failsafe” that prevents carrying out actions, or even speech, when delusional; one can easily wreck one’s life circumstances and can do this in a very short time. 

I have learned not to act on a number of the thoughts I experience. Part of my consciousness seems to be aware that the thoughts are questionable. In some cases, this failsafe fails because the delusion is clever enough to convince me that it is quite accurate. In cases like that of believing in my delusions, I have been lucky not to say or do anything with results that are irreversible. 

It seems that I don’t have a “happy medium” available in which I am neither paranoid and delusional nor depressed. I can choose one or the other. I tend to fluctuate back and forth on this scale. The symptoms are mild enough that I have a pretty normal life in which I behave normally most of the time. I take both antipsychotic medications and an antidepressant. 

If I go too high on the antidepressant, it triggers delusions. If I take too much antipsychotic medication, I will experience a lot of very uncomfortable side effects, and I will also become very depressed. 

Working at a job is not really an option because the amount of energy required to be efficient or competitive at work would ultimately be enough to bring me into the psychotic zone. If I try to work while depressed, I will hate the job so much that it will be unbearable. 

The above describes an aspect of my life as a person with severe, paranoid schizophrenia. It is not something that I can make go away by making a decision of any kind; I’m stuck with it, whether I like it or not. I have no other reasonable or acceptable options but to continue muddling through this existence, which actually much of the time isn’t half bad in spite of the condition I must live with.