ON MENTAL ILLNESS: Antidepressants May Not Mix Well with Antipsychotics

Jack Bragen
Sunday September 09, 2018 - 05:31:00 PM

In this week's column, please note that I am not offering you a professional opinion. I am sharing my experiences, and if you have questions about medications, you must consult with a medical and/or psychiatric practitioner.

My mental health and my behavior improved following discontinuation of antidepressants, which I took in addition to antipsychotics. Antidepressants do not do the exact opposite of antipsychotics. However, the combination of these two categories of drugs can be bad from a medical-physical standpoint, and it can cause people with psychotic tendencies to become ill. I suggest that readers do research about this on the web, and/or by discussing it with doctors.

A person taking antipsychotics will often feel depressed. Antipsychotic medications can cause depression. However, life circumstances can also cause depression. It is not always easy to know if one's depression is caused by antipsychotics, by difficult life circumstances, or by the brain condition itself. 

I was told at one point that there is such a thing as "post-psychotic depression." This is probably the brain rebounding from psychosis, and is the brain trying to repair itself, as soon as the owner of the brain becomes stabilized on antipsychotics. 

A test to see if a schizophrenic person is depressed due to bad life circumstances could be to give the person some form of gratification, and see if the person is still depressed. Gratification is often efficacious. For some reason, it seems that treatment practitioners do not want to offer us any gratification. This is in keeping with the concept that we need to be punished, and that is supposed to make us well.  

A "meaningful relationship" is a desire of many mentally ill people. Some, however, aren't ready to handle this, even though they may badly want it. In this case, gratification can be sought in other areas of life. Obtaining employment and earning money is an example of this. Or, sometimes, a game of ping-pong, watching a movie one wants to see, or going out to dinner, are things that can get a person outside of their "shell" and outside of oneself, and this can relieve depression. 

However, my main point in this week's column is to say that antidepressants often aren't good for people who suffer from psychosis. They can counteract antipsychotics, and/or they can worsen the condition. I don't know a lot about "Serotonin Syndrome." However, it seems to be caused by a bad mix of medication. Apparently, it involves a buildup of serotonin, which is potentially fatal. I suggest that the reader research that, or ask their treatment practitioner about it. 

The depression caused by antipsychotics can be addressed in other ways. A cup of coffee or tea in the morning is helpful--although I do not advise an excessive amount of caffeine. Physical movement (I am not going to call it "exercise" since the word brings up negative thoughts for some people) is helpful. Washing a sink full of dirty dishes can be therapeutic. Taking a shower, brushing your teeth, and so on, can improve mood. Mental activity, such as reading, doing a crossword puzzle, or playing a game of Monopoly, or Scrabble, can help. 

Depression that follows a psychotic episode may be temporary, and may dissipate over a period of a few months. Depression due to life circumstances can be addressed by taking actions to make circumstances better. In this case, antidepressants will only mask the problem. 

Some people must have an antidepressant, and I do not dispute that. However, antidepressants for someone subject to psychosis, some of the time, can make problems worse. Again, these are not professional opinions; and if you are in doubt, talk to your treatment professional.