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ON MENTAL ILLNESS: More About Relapse Prevention

Jack Bragen
Saturday July 14, 2018 - 03:58:00 PM

For someone with a schizophrenic diagnosis, a repeat episode of acute psychosis may begin much earlier than many people might think. Many might assume that it begins with the foolish idea of going off medication. And in some instances, that is probably so. 

However, before the decision takes place that we want to try "noncompliance," most likely, some amount of judgment and insight have eroded. This is because the illness has worsened while remaining on the same level of medication. Sometimes there are circumstances that lead to this. Some parts of one's support system could have been taken away. If we lack therapy, if a relationship isn't going well, of if there is a death, these are things that can lead to destabilization. 

Other than that, a person with schizophrenia can simply get worse while taking a consistent level of antipsychotic medication. It seems to me that the brain may gain a tolerance to the medication, and then moves more in the direction of being psychotic. My personal experience, over the past thirty-seven years of having this illness, is that over time I've needed to raise medication periodically. I currently take the "maximum" of two different antipsychotics, both of which are considered powerful. This is barely adequate to keep me stabilized. I must do a lot of insight-producing work in addition to this. 

When sleep becomes compromised, when things seem to be in a "crisis mode," or when it seems that the world is against us, these may be danger signals. It could be time to get more help. 

You could "pay now or pay later." Taking steps to avert a relapse could be inconvenient. It could involve being uncomfortable. Taking these steps may require effort, and focus. However, if you ignore and do not address increasing psychosis, the problem will be bigger, later. 

Does this apply to you? It may or it may not. A therapist or psychiatrist may have part of the answer. They seem to have methods for evaluating a person's symptoms and the severity of them. However, sometimes a psychotic person is clever enough to fool treatment professionals into thinking they are just fine. It is not necessarily hard to outsmart treatment professionals in the short term, and in the process you are short-circuiting necessary treatment. 

The mental health consumer should not take matters into one's own hands. Rather than, on our own, changing medications and/or dosages, we must run it past our psychiatrist. Otherwise, we are in the zone of misusing the medication. Also, increasing medication can bring about side effects. In extreme cases, misjudging how much medication to take can lead to permanent damage. 

There are measures that we can take on our own other than changing medications. One of them is to make sure that we are getting enough rest. Another is to do meditation. Also, we should be the nicest person we know how to be, since we may need the help of others at some point. 

There ought to be no shame in a recurrence of symptoms of a mental illness; it doesn't always indicate that we've done something wrong. Sometimes symptoms may get the better of us, no matter how cooperative we try to be with treatment, no matter how proactive we are in dealing with our condition, and no matter how good our intentions may be. 

When mental health practitioners presume we are in an infantile or less enlightened state because we have a mental health recurrence, this is wrong. Surgeons aren't condescending toward cancer patients. It should be the same way with mentally ill people. 

When we need help, we should not be afraid to ask for it, albeit with some precautions. The person you should contact for help must be either a trusted family member, or a helping professional with whom you are currently working, and with whom you are on good terms. 

If you try to ask someone for help whom you do not know very well, they may not understand you, and they may create serious problems for you. If symptoms are bad enough, the emergency department at your hospital is an option.