Sunday, May 31, 2015

Pills against the ageless ills - Part VI: Sweet dreams

Currently I am in a clinic doing long-term therapy for anxiety, and aside from the great opportunity it presents for getting my life in order, it also gives me a lot of ideas for what to write for this blog. There was for example a conversation with a fellow patient about how intense and memorable his dreams have become since starting on antidepressants that made me think that's actually something I know a lot about. If there's one common side-effect that majorly affected my life in the past years, it's that. The success of medications in what they're supposed to do varied a lot for me, but what was there since day one and remained throughout numerous changes is how my dreams were altered by the drugs. 

It's pretty much any psychoactive medication you can take that can have such side-effects. For me, I think it is chlorprothixene that does it. Some medications are known for it more than others. Mirtazapine is the one with the highest reputation for intense dreams, and I can say from my own experience that it is quite effective in doing it. This is not to be confused with another common side-effect, a much more unpleasant one, frequent nightmares. I think an entirely different part of the brain is affected for that side-effect and entirely different meds do it. The intense dreams I am talking about are rarely unpleasant and even more rarely nightmares. 

It's some really weird stuff you get in your dream phase. Just last night I dreamt I was in a sequel to the movie The Thing, and in the dream the thing was a brilliant tactician that perfectly planned out who to take over at what time for the maximum tactical gain. The goal was to frighten me, because I was the prize it wanted to take over for some reason, but it could only take me over if I was scared. At one point it took the form of Cthulhu, but it was sort of a 50s James Dean Cthulhu with a leather jacket and smoking a cigarette. It was destroying things and killing people but it looked ridiculous. I could go on, but I think you get the idea. Now imagine I get dreams like that every single night, and they're always extremely vivid and I remember them for hours. It's what everyone who likes dreaming would wish for, if it didn't involve taking pills. 

I think it is up to everyone for him- or herself whether or not you see this as a blessing, a curse, or something you just don't give a damn about. For myself, I see it as a bit of a gift, because I've had many creative ideas from my dreams, and I wrote down or permanently memorised some of the best ones with the intention of making them part of a book some time in the future. But I can see how to some people this intense dreaming may be annoying or unsettling. I can only recommend it as a conversation starter at the very least. A lot of people love to dream and might envy us psychoactive medication consumers if they knew we have some of the best dreams you can get every night. 

For many people, the question probably is whether there could be therapeutical potential in this type of dreaming. Does traditional dream interpretation work with dreams clearly influenced by chemicals? That's provided dream interpretation works at all, it's not without controversy. But it's an interesting question, whether there is important information about ourselves in these dreams, and whether by amplifying them and making them more memorable, meds make our dreams and thereby our subconscious more accessible. At one point I should write down everything I dream and read up on some dream interpretation to see if there's any useful information in it at all. Mental health professionals feel free to give some insight in the comments. 

In the end, to me it's mostly a pleasant diversion to think about the dreams while I am awake, and sometimes an inspiration for creative writing. But in my dream phase, while my brain is coming up with all that stuff, I can't help but think it's the most awesome side-effect any medication could have.

Friday, May 29, 2015

Life with an anxiety disorder - Part VII: Obsessive-compulsive disorder

Last in the collection of anxiety issues I have personal experience with is obsessive-compulsive disorder. It is not nearly as pronounced or bothersome as my social anxiety or my somatoform autonomic dysfunction, but it is still a key puzzle piece of the big picture of what goes on in my mind, anxiety-wise. Perhaps some of you are familiar with some of it through various media, including that film with Jack Nicholson, but reality is often different from popular perception. 

As the name implies, OCD is split into two main components: Obsessive thoughts and compulsive actions. The latter is what you'll find popularised in mainstream depiction. People suffering from that component of the disorder are forced to constantly repeat certain rituals individual to the afflicted. This may include washing your hands after every time they are used, or checking whether the door is locked a particular number of times, or locking it a particular number of times, or arranging your silverware a particular way before eating, and so forth. This is generally for the afflicted to feel safe from whatever impending doom he associates with that ritual happening.  Psychologists call it "magical thinking", if I recall correctly, meaning there's a certain magical effect associated with the rituals. And that only performing them correctly and every time will allow the magic to work. 

Personally I don't really deal with any of that sort of stuff. I'm an obsessive thoughts kind of guy. Most OCD people have both types of symptoms, one more than the other, but for me the obsessive part absolutely dominates. It's some of the most bizarre stuff that goes on in my head, and the only reason I don't consider it a major issue is how relatively rarely it happens and how easily it goes away when it occurs. 

Obsessive thoughts aren't really what you'd think at first when hearing the term, having certain thoughts that you obsess over for extended periods of time. That would be ruminating. They're thoughts that just shoot into your head and kind of force themselves into you against your will. It pretty much always is deeply disturbing stuff. It goes against all your moral values, everything you stand for in a profound way. A psychiatrist once told me obsessive thoughts are pretty much the exact opposite of what the person experiencing them actually believes, and it seems quite true to me. 

Examples of obsessive thoughts include situations in which I ride my bicycle and a truck comes the other way and suddenly I have the thought of steering my bike (and myself) in front of the truck. Or jumping when I'm in a high place. Those are self-harm related thoughts. I also get a lot about harming others, such as the thought of kicking a child in the face when I see one. It gets a lot darker and more disturbing than that, but I'm not comfortable putting that in public. There are thoughts about taking off all my clothes and/or jacking off in public as well. All kinds of thoughts that just force themselves into your head against your will and make you think you're some sick, crazy sociopath. 

It's often not easy to talk about, because this stuff is so disturbing, and what gets you in particular is the nagging feeling that they are manifestations of someone you really are subconsciously. But as I said, they are not. They're the exact opposite. That's OCD. Someone has yet to explain to me what exactly causes these thoughts. Because it has never been a major issue to me I have never researched it. But I do know that obsessive thoughts in no way represent you as a person, and that technically, if you have them, you shouldn't think of yourself as the new Jack the Ripper, or whatever your thoughts are. 

I say "technically" because it isn't easy. For a long time I was deeply concerned about this stuff going on inside my head, and every time one of these obsessive thoughts occurred I used to grimace and try to force it out of my head. And there was a lot of shame about what kind of monster I thought I was. It wasn't until I got a little more information on what OCD is and how common it is that the shame started to subside a little. More so over time. I still hated the thoughts and tried everything to make them go away, which was an extremely stressful situation and only seemed to make it worse. 

In the end, a psychotherapist told me that trying to force obsessive thoughts to stop indeed makes them worse, because it gives your brain the information that these thoughts are extremely important and the neural connections for them need to be maintained and strengthened because they are so important. What actually does help is what some of you have learned or will learn in mindfulness exercises: Let the thoughts come, let them happen, know what they are, don't judge them or assign value to them, and just let them pass. May seem like an impossible task at first, but it's really very easy, and I can attest to that helping a lot in reducing frequency and especially severity of obsessive thoughts. Simple psychological trick that worked miracles for me. 

Yes, these thoughts can still be bothersome and disturbing sometimes, and there are still moments when I think I'm some kind of monster, but it really improved a lot, to the point that I consider OCD the least of my worries. But it's still up there and still a part of myself, probably interacting with my other issues to some degree. Will be interesting to see if I can ever fully get rid of it.

Monday, May 18, 2015

Alcoholism: A love story - Part VIII: Sober

At this point I have written so much about the dark side of alcoholism, I think it's time I mention "the other side" that I've come to know recently. After detox in August 2009 I stayed sober for two and a half years. It was a pretty shitty time because there's some sort of post-alcoholic depression that I don't know whether it's something semi-official doctors know about or just my bad luck or my brain's way of punishing me. Symptoms of my anxiety disorders were going rampant, couldn't leave the house, felt like crap all day every day.

I was however in psychiatric treatment, and though I went through many false diagnoses - mainly schizophrenia - and thus went through the wrong types of treatment for a long time, through trial and error, doctors eventually found ways to alleviate some symptoms. More and more of them over time. This is turn made me more social and I generally found myself doing a little more, which helped, too. Anxiety disorder and depression were still a big issue, but I had some slight relief in some areas.

Eventually I felt comfortable enough to have a few drinks here and then. It was never a big deal to me because I was never convinced that you'd relapse from drinking once, you'd have to drink over a longer period of time for addiction to kick in again. And I was right. Drinking occasionally was no issue at all. In fact, doctors told me that it really isn't that much of an issue as long as I pace myself and don't overdo it. It did however become more of an issue every now and then, there were times when I would drink several days in a row, or when I'd drink regularly every week. Those times were usually associated with a general feeling crappy. A lot of depression usually means I am more prone to drinking not entirely out of control, but with less than full control. I did have to do one smaller detox in December 2014, not in any way comparable to the big detox in 2009, but it was something I had to do at the hospital because I had overdone things a little and my body told me it was not amused. After that I was still fine with drinking occasionally, but I still had periods when I couldn't fully handle it.

So about a month ago I decided that's it, I'm going to stay sober for the time being. Things have changed since the last time I stayed sober. As you can see in the first post of my "Pills..."-series, I got new stuff called ziprasidone which helps a lot with my depression and anxiety. Had it since February 2015. With that stuff in my system, sobriety really is an amazing experience I haven't felt in a very long time. All of a sudden there's all sorts of stuff I find myself being able to do. Just look at the amount of posts on this blog I have written recently. I've also been working on a lot of music (I'm a musician, guess the genre), been working on drawing band logos which I think I am quite good at, have been starting to get into learning to code (website stuff, as in html, css, php, javascript), and there's a ton of other things I want to get into. I've even been starting on my idea of writing a novel. I have a lot of creative energy and with the new med and the extended period (by my standards) of sobriety so far I have a lot of drive and ambition to put all my ideas into action, make everything a reality.

Whether or not I will eventually get myself two sixpacks of some nice German beer eventually and have a little party with myself or friends I do not know. Tomorrow I start a long-term inpatient anxiety therapy at a very high profile clinic, which could be around three months, obviously no drinking there. But after that I do not know. What I do know is that right now, being sober works miracles for my disposition. I feel great. I feel better than I have in a long time. It's something every drinker should do sometimes, take an extended/open-ended break, live your life a little. A few years ago, "yolo" aka "you only live once" has been a popular slogan among morons to justify doing some total shit with your life. For me, "you only live once" means that you should use as much of that one life you have to make an impression on the world people will remember. Do something good, or at least something you think is good. Being wasted can be great, but spending most of your time not being wasted leads to something even greater. Something like a rewarding, fulfilling life.

Not trying to preach here, and I certainly didn't turn anti-alcohol. Just enjoying this extended/open-ended break a lot. I'll likely have a couple drinks again some time in the future, but after my current experience with sobriety, I'm going to make long, productive periods my focus in life. It's the true "yolo." And it's awesome.

Alcoholism: A love story - Part VII: Believe in yourself - say "No!" to AA

This is a subject that is very close to home for me. Those of you who have known me before reading this blog know that I have a long history of addiction, with many ups and downs, good choices and poor choices and a lot of stories to tell. Being an addict is not something that is easy to deal with, and in most cases you need help. The problem is that a lot of people who offer you help do not have your best interest in mind. There are some really shady groups out there, and chances are that if you have dealt with alcohol abuse in your life, there's one you will inevitably have come across.

What I would like to talk about are the lies perpetuated by Alcoholics Anonymous and its subgroups (Gamblers Anonymous, Smokers Anonymous, Foot Fetishists Anonymous and a thousand others devoted to just about everything you can develop an addiction to) and an alternative solution to the problems it deceitfully proposes to solve through shady methods. Basically two very different ways to go: Their way, or the right way (one that I and others I have met with similar experiences went.)

First of all, there is their way: The Twelve Steps:
  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
 Let us examine everything that is wrong with these steps, one by one, shall we?

The first is the worst. Admitting to be powerless is the worst thing you can do as an addict. This is what I would counter with an attitude of "addicts' empowerment" to address the issue properly. You are never powerless. It was you who got you into that mess and it is you and no one (or nothing) else who can get you out of it again. You didn't become an addict as the result of some disease or demons or whatever they have you believe in, you made the choice to go down that road, and you can make a choice to go a different way. You have the power. Never let anyone tell you otherwise. Believe me, I know what it is like when one's life becomes unmanageable as a result of one's addiction. There is only one solution: Take control, make a cut, and start back from square one.

Then comes number two. I know from U.S. TV shows that people in the United States refer to taking a dump as "number two", and it seems very appropriate for the AA's second step. First of all there is the matter of addiction and sanity. Yes, insanity can be the reason for addiction: For example, a lot of my meanest drinking habits could be attributed to myself attempting to use alcohol to suppress panic attacks that were the result - I did not know back then, the diagnosis came years after I quit - of obsessive-compulsive disorder. However, addiction is not a form of insanity by itself. It is, in almost every case, a symptom of a deeper problem, be it insanity or other deeply entrenched psychological issues. And it should be treated as a symptom. Direct and rapid treatment, read: detox, in the case of alcohol it is over in one week and the symptom is dealt with, works like a nasal spray or cough syrup. Once you have eliminated the symptom, and only then, can you deal with the underlying issue. And here you do not need "a power greater than yourself", in fact that might even do more harm than good because belief in something immaterial might bring some short-term relief but distract you from actively dealing with the problem that led you to addiction. No, I am afraid there is no quick fix. In most cases, that being almost all, you will need proper treatment. How involved this is can be your choice. You can see a doctor once a month or you can commit yourself to an in-patient institution, usually rehab, to work on your problem intensively. But the minimum requirement is a proper diagnosis, from a doctor, not WebMD, research into proper solutions, with the help of your doctor and through research of your own (unlike with the diagnosis, here you can freely search the internet for pointers), and the will to work hard to overcome whatever underlying problem led you to addiction. It's going to be a rough ride, but you want to get out of the mess you got into, no? Toughen up and bite your way through. "Greater power" my shiny metal ass.

Does it get worse than step two? Oh yes, the Twelve Steps have the unique ability to surprise you with yet more revolting and misguided "advice" with each new step. I already quoted it above, but let me repeat step three once more, in all caps for emphasis: "(WE) MADE A DECISION TO TURN OUR WILL AND OUR LIVES OVER TO THE CARE OF GOD AS WE UNDERSTOOD HIM." (Love the italics on the last four words. Tacky attempt at suckering people from other faiths into the true path™.) This one makes me furious! First of all: You made a decision? Thought you were powerless. But that's just nitpicking. It's not even the bit about "God" that infuriates me, it is the eight words after "decision": "To turn our will and our lives over." No! You don't turn your life over to anyone or anything! Nothing good will ever come from that. And your will? Are you serious? Turn over your will? Then you lose everything that makes you a human being. I hear Nietzsche rotating in his grave as I type this. What you do with your will and your life is the exact opposite, take control back over them. Adjust them to a new purpose: Beating the burden that bogs down your life and fucks you up in a way you hate more than anything. Your will and your life are what you depend on the most at this point, they are your only hope to get out of this in one piece. Hang on to them, they are of the essence to your recovery. Hand them over to anyone or anything and you have already lost. You, like other AA drones, may stop drinking, smoking, gambling, injecting, snorting or watching porn for a while, but you are running away from the hard road to recovery by refusing to take responsibility of your life.

Step four gets into morality. You have read the exact quote above, and you will have noticed how it is deliberately vague. Okay, so you are looking into which times you have done well morally and which times you fucked up. That's not a bad thing to do per se, on the contrary, it's something every addict just as much as every non-addict should do occasionally. The implications of the context of the Twelve Step Program are of course a little more sinister, since it just spent the previous three steps blathering about God and greater powers. So it's not your own moral guidelines they want you to examine yourself by, it's theirs. That's a load of bull. If you want to quit whatever you're into right now, religious rules are the last thing you need to screw up your bearings. But even if there wasn't the shady context of the first three steps, examining every time you fucked up is not something you should concern yourself with in the immediate process of getting out of the addiction, it is something to do when you go through therapy to take care of the underlying problems for your addiction, because these underlying problems are likely the true root of your screw-ups. Basically, what step four is trying to tell you is that you should blame your addiction for the times you screwed up. Prime example: Beat up your wife and kids while drunk? It's the alcohol's fault! Reality check: Nope, it isn't. Alcohol was a catalyst for something seriously wrong inside your head and when you remove the alcohol something is still seriously wrong inside your head (you beat your wife and kids, should be self-evident), you are just less likely to act on it. In the example I just named, you need some SERIOUS therapy. No seeing a doc once a month, this is the stuff for prolonged in-patient rehab. No way around it. And it's going to take a long-ass time. And you have to face the fact that it might be better if your wife and kids ditched you, and if you are serious about making a searching and fearless moral inventory of yourself you will have to present them this option and let them know you would be okay with it if they left, otherwise you would be, pardon my French, an asshole. That is just one example, there are many other ways you can screw up in ways that are amplified by your addiction BUT NOT CAUSED BY IT, but they all only have one solution: You have to make a serious commitment to fixing this. No scapegoats, no blame game, no greater power, get off your rotten ass and do it.

You may have noticed that step four did not mention God by name. Fear not, he's back with a vengeance. I don't know what else to say about this fifth step that I haven't already said in my paragraph about the fourth step, except for the fact that step five is, well, pretty pointless. Yes, once you reach the point in your road to recovery that it is time to examine your screw-ups as detailed in the previous paragraph, you must of course accept them yourself and, God aside, seek an outside perspective, preferably from a professional. Shouldn't this be self-evident?

The sixth one just gives me a headache. Yeah, that's gonna work just beautifully. Ten Hail Marys and *poof* your defects of character are gone. Do I really need to get into how this is a load of nonsense? You obviously got to work on your flaws yourself. I'm afraid magic tricks from supernatural entities won't get you very far. Quite frankly, provided you believe in God the way Christianity teaches him, and you assume that he created you, and you go to him saying "Hey God, thanks for creating me (and the universe and everything else), but you screwed up here and there, would you mind fixing that?", how do you think he'd feel hearing this, being an all-powerful, all-knowing entity who makes no mistakes, and certainly none a mere human could spot and know how to fix? That doesn't make much sense from a theological perspective, is frankly quite rude towards the guy who created the universe and everything in it, and is most likely just a way for AA to sucker you into becoming more and more deeply entangled in their cult, because if God isn't fixing your character, surely you gotta pray more or something? Go to church more often, empty your wallet, there are still defects in your character you bum!

Step seven is just an addendum to step six. Yeah, God's gotta get rid of those shortcomings for you, too. Because shortcomings are obviously not included in "defects", so they gotta be an additional step.

The eighth step is something that if you went to a psychiatrist or therapist or anyone with proper training in the field and told him a group advised you to do that, they would ask you what the hell kind of purpose that is supposed to serve? I mean, yeah, people close to you, obviously, such as your spouse, your children, your family, closest friends, if you put them through a hard time, you gotta try your best to make it better, especially if they remained loyal to you throughout the years, you owe them. But AA wants you to make a list of all people you have ever harmed. What for? Don't you have enough to worry about without making a list of people on whose mailbox you peed twelve years ago? Nah, you gotta focus on what's important. First, get yourself in order, then get your life in order, then get the lives of those around you in order. Focus your energy on these three things instead of spending weeks trying to find the name and address of the guy you punched in the nose during a bar fight in 1997. Focus on your life and the life of those you love and who love you. AA is just trying to overwhelm you so you offer less resistance to their proselytising. Don't give them a chance to make a mess of your head and turn it inside out, you made a mess of it already, and your goal is to make it less of a mess, not more.

Next two steps are pointless filler again like the seventh, just repeating what was said in previous steps.

What the hell is wrong with the people who wrote the eleventh step is inexplicable to me. No one can be that far gone. This is basically "pray the gay away" for alcoholics. In fact, this is literally "pray the gay away" for alcoholics. It's not going to work. It's never going to work. In the United States, people are told by courts to either go to AA or go to jail. And thanks to the poor appeal of U.S. jails, this is what people end up with. This type of shit is not a treatment or help for anything, they are literally saying outright that their only purpose is to convert you to Christianity, and sending you to jail as an alternative is the exact same thing Islamic State is doing to religious minorities in Iraq and Syria right now. That's the kind of thing we want to be like? Joining a cult has never done anything good for anyone. What you want is therapy. You want to work on your problems. You want to get yourself in a position in which you can deal with all your problems without resorting to alcohol or whatever else you may be addicted to. This is hard work, and it requires help from trained professionals who base their work on hard science and decades of experience in how to properly deal with addiction. You can't "pray the gay away", you can't if you're gay, and you certainly can't if you're an alcoholic. Fuck this shit, seriously, it pisses me off to no end.

Last but not least, once we're fully brainwashed into this creepy little cult - at least that's their goal, the smarter ones of us never gave them the satisfaction - we spread the word to anyone we can get our hands on. At this point their intentions become obvious even to those so blind that they could not see them in the first eleven steps. This is an organisation to promote Christianity, and to get people to forego proper therapy in order to maintain their underlying illnesses, keep the relapse potential high so AA can always be sure they will keep coming back. In short, they are deliberately keeping people ill so they can maintain a dependency on the organisation. It's disgusting as shit. How it can even be legal in a civilised society in way beyond me. They are deliberately inflicting harm by preventing treatment of serious mental conditions, all in order to maintain permanent control over the person. And then they openly urge their subject to lure in other people who are at their weakest point in life, increase the flock of submissive drones, brainwashed into believing they are powerless and only the ways of the cult can keep them alive. I repeat, this is enforced as the only alternative to jail in the world's leading superpower. And offshoots of this sickening sect exist in every other Western society and exact a good deal of power there. If that doesn't make you a little nauseous, you have a higher tolerance for modern barbarism than I do.

You are not going to be helped by any of these steps or anything this organisation does. A lot of people say it has helped them, but it is always short-term relief. Since they actively prevent you from seeking proper treatment for your underlying problems, these problems are always going to be there to steer you on the road to relapse. And the numbers are obvious: Do a little Google search on the relapse rate of people going to AA compared to people seeking proper medical/psychiatric treatment. It's horrifying. And this is still done in 2015. Always remember that we live in the 21st century, not the early 20th. Shit like AA should not exist in the world in which we have such great medical advances as we do. It should not exist in any world.

What should exist, and I can't say this often enough, is a mindset that you are in power of your life, that it is up to you to take control back over your life, that you are the one making the decisions, that it is you who is going to work on your issues, that you are going to work hard and not be distracted or deterred, that you are the one who holds the cards and decides your future. You are not powerless. Nobody is powerless because of addiction. You may feel that way sometimes when you lose all control over what happens, but control is not power. Power is something you will always have. And with that power, control is something you can regain just as well as you could lose it. It's up to you to exercise your power to MAKE A DECISION. You decide that you want no more of your addiction in your life, that you want to be in control of your life, and you decide that it's time to stop letting an addiction run your life, that it's time to do something about it, and that you will do the right thing about it. You will not hand over your will and your life and pray the gay away, you will take charge and seek the professional help that you need. Never let anyone tell you you are powerless. You got into this mess, you can get out. Fuck AA. Believe in yourself.

Pills against the ageless ills - Part V: Alternative medicine

Alternative medicine is something I've been guilty of a lot. I no longer do it, but for years I took all sorts of stuff. Used to spend a lot of time on Wikipedia searching for cures for my various illnesses and looking into things that have had one or two scientific studies into whether they might be effective. Usually the control group tests with a small sample size. Not much to go on. But for me it was enough to try a lot of different things. And of course I never consulted my doctor, no self-respecting consumer of alternative medicine would talk to a trained professional about it, that would be preposterous. If the internet says it could work, that's good enough for me!

Thinking back, it really is kind of ridiculous. What went through my mind when I got myself some of that stuff I got and took it? With no real scientific evidence to back it up? Possibly with interactions with some of my actual medication, that just aren't researched yet? There basically two people who do this sort of stuff. Those who see alternative medicine as sort of a way of life, such as hippies, hipsters and other nutjobs. You know the type. And people who are really desperate. People like me. Suffering so badly from your afflictions and seeing no way out, proper medications not helping, we seek out anything that promises relief with however shady half-facts to back it up. It really seems like a ridiculous thing to do when you think about it, but when you're in a really, really bad situation and all you want is some relief, you'll do almost anything that you think can make things better. Does any of it actually work? To give you an idea, let me think of some of the stuff I tried out while acting on my vague hopes.

Of course the first thing anyone will get into is vitamin supplements. Minerals, too, but vitamins are the first thing. Vitamins are of course very important to human biology, and we all need them to function properly. Easily done when you eat properly. Of course we are all told that we don't get enough. Go to a doctor and have your blood examined for deficiencies, test comes out negative, and you still believe you're not getting enough of anything. There's a whole industry around telling people that. Now I can't speak for everyone, some people really do need to take supplements because they don't get enough of one thing for a variety of reasons. But for most of us, if we eat like we should, vitamin deficiencies are not something we should naturally worry about. Being in an awful situation with mental illness and looking into what you can do to help, it's the first thing you think of, though. B-vitamins in particular are praised just around every corner as a cure-all and B-vitamin complex capsules or tablets are a huge market targeting people like us, showering their product with all sorts of praise about what it can do for mental health. So that's something I really ate up. Quite literally. Don't think it did any harm, but much to everyone's surprise it turned out to be a dead end as far as improving mental health was concerned. Could have thought of that considering I did the aforementioned blood test at my doctor and had no deficiencies, and also am a vegetable nut who surely can't complain about a lack of  vitamin intake. Had to try it anyway.

Next came a whole array of things I stumbled upon in various Wikipedia articles. Usually reading an article about the illness of choice and the treatment section. There'd always be bits about how the university of wherever had done a study on whatever substance and it tested well against a control group. Usually only a single study done on it, always with a small sample size. For me, in my situation, that was always good enough to think "awesome, scientific evidence!" and see it as a very promising lead, conjuring up all sorts of hopeful scenarios to the point that I told myself I could be cured if I tried this.

The very first thing I came up with was L-tryptophan. It's what your body needs to synthesise serotonin, the stuff a lot of science-y guys tell you make you calm and happy. So the story goes that if you take L-tryptophan, you get a lot of serotonin and everything works out for the better. Aaaactually it doesn't quite work that way biologically, and what really happens is that you end up shitting out a lot of tryptophan that your body didn't know what to do with. L-lysine is another one that promises miracles in making you calm on the internet. It's another thing that certainly is a nice chemical to have in the food you're eating, but which as a supplement is pretty useless, because the human body just didn't evolve to absorb these things from supplements. Pretty much goes straight through your digestive tract and out the other way virtually unchanged. Money well-spent. Another chemical that's great to have in food, but dubious as a supplement is inositol. I mean, things are a little better here. Your body does absorb some of it, and several scientific studies have shown a beneficial effect for afflictions usually treated with SSRIs (depression and obsessive-compulsive disorder, mainly.) You need a whole tablespoon of it at least, but that's okay. Thing is, the positive effect is pretty much comparable to an SSRI at a very low dosage. And that's a type of med that with depression and/or an anxiety disorder (such as OCD) you are already taking. At a medium dosage at least. Basically compare it to taking one quarter of the smallest type of paracetamol pills along with your max dosage ibuprofen for pain. The ridiculously low amount of paracetamol is going to make all the difference, right? Nah, forget about inositol, not much use for it.

At one point came acetylcysteine, the miracle cure for obsessive-compulsive disorder. Again there were one or two scientific studies into its effect, and they yielded very positive results, but they were also on a very small scale. The results showed signifiant improvement in some of their small samples. They said it was due to it affecting the neurotransmitter glutamate, which supposedly plays a role in OCD. This was a very promising lead. Bought a lot, took the dosage recommended by the study, kept it up for weeks. Can't really give you a scientific reason as to why, because I am not a scientist, but it really did absolutely nothing for me. No effect of any kind. Further research might give us some insight into the workings of this substance, maybe lead to improvements to make it useful for patients, but as is, I can't really say it was something worth spending my time and money on. Not to mention that the extent to which I was starting to test chemicals on myself without consulting a doctor was starting to get really worrying at that point.

The one thing there really is solid scientific evidence on is fish oil. Most of you will have heard about it, and there's a very strong case for its effectiveness in a number of areas. It's no substitute for proper medication, and it can interact with some, but in some cases it is even recommended by doctors as a therapy aid. Of course this is also the one "alternative" medication I can't take, the capsules are about the size of a phone booth and there's no way I can get them down. I tried many times, I just can't get myself to swallow those things. It's a shame, there might actually have been some benefit to it. What interests me at this point is that a friend of mine who is into nutrition a lot told me once that fish don't produce the active ingredients in their oil themselves, they get it from their food, and you'd be just as well off taking algae tablets such as spirulina. That could be interesting for a number of reasons. Getting the active ingredients of fish oil, getting a complete protein with all essential amino acids (spirulina is one such rare protein), having tablets that are easy for me to swallow, and last but not least getting to be more serious about my vegan lifestyle choice. If my friend is actually right, and I unfortunately have no science available to back up that he is, it would be the perfect alternative, and something I could talk to my doctor about trying out.

There are a few more minor things I gave a try at some point, but I don't think they need specific mention. I ended up really liking turmeric (curcuma) as a spice after trying it out based on something said about possible benefits, and use it a lot now for its taste. But really, the whole idea of self-medication just doesn't work for me anymore. I want something that had some real, extensive scientific work put into it, with solid proof of its effectiveness. And I want everything I take to be discussed with and sanctioned by my doctor, who is a very smart man and someone I trust to know a hell of a lot more than an article on the internet written by whoever. Alternative medicine has never done anything for me, and the only semi-positive thing I got out of it is that at least it didn't do any harm. My recommendation is that no matter how desperate you are, and I know how desperate one can be, the best address for proper treatment is always trained professionals. Get off the internet and see your doctor. Just trust me on that one.

Sunday, May 17, 2015

Ten of the best metal albums of all time - Part VIII: Morpheus Descends - Ritual of Infinity

Since this "best metal albums"-series is starting to appear a little lopsided towards more well-known albums again, I think the timing is perfect to throw another bit of a curve ball since "best" does not always mean "most famous" or vice versa. Morpheus Descends is not a band that is entirely unknown, or known only to die-hard tape traders from the early 90s, especially now that they've been picked up by Dark Descent Records. However, they never were and still aren't a band that achieved anything near noticeable fame. In fact I doubt they are known at all outside the circles of those curious about what the New York death metal scene has to offer besides the big names and those curious about hidden gems in old school death metal, and both those groups are limited in number. To this day you are more likely to have heard of Incantation knock-off #74553 than this band - a band which ironically is pretty much on par with the Incantation original quality-wise - though not all that similar in style.

The type of death metal Morpheus Descends play is actually not that straight-forward to define, since you could group them in either old school death metal or brutal death metal, and yet they are not really all the way on either side of the fence. They're generally more brutal than the average old school death metal band, but also generally more old school than the average brutal death metal band. It's not like they mix elements of both in a way that'd be the most obvious to imagine, as in first an old school death metal part, then a brutal death metal part, and so on. Rather it can be described in the way that a child does not look half like its father and half like its mother, but rather a perfect intermingling of elements from both, with a distinct identity of its own. It's a unique product of the New York scene in the early 90s, something you could only possibly find right there, right then.

If I was forced to draw comparisons, the Immolation debut would be the closest match I can think of, but Morpheus Descends were far, far ahead of what Immolation were doing at the time. It's Dawn of Possession not only on steroids but an array of stimulants as well. Where Immolation at the time played pretty simple stuff (compared to what they would later win acclaim for), Morpheus Descends crammed as much material into the tight space of a few minutes per song as possible. Dark, menacing riffs of the unique New York death metal variety follow each other in quick succession, riff after riff, they don't let up, and every riff is better than the last. And to spice things up they often bridge two riffs with a technical but commanding half-riff that only lasts for a few notes. There's something going on constantly, they never give things time to settle down. There is a commanding presence to the dominance of riffs that won't let you escape, you are sucked in relentlessly, powerless to the primal yet complex force these songs command.

It's impossible to get over just how good this band was, especially for 1992 when technical leanings were still in their infancy. I would not call Morpheus Descends a technical death metal bands by any means, they are too much of a cavernous old school act in essence for that, but the complexity and precision of the instrumentation makes drawing comparisons to the technical side of the death metal genre inevitable. And what makes it so good is that everything has substance. They don't string up random notes, everything has well thought-out progressions that set moods and create atmosphere, it's all highest quality stuff that is both incredible catchy and incredibly intelligent. For the nutjobs who compare death metal to classical music, Ritual of Infinity might actually be a good candidate, because it has that perfect combination of drawing the listener into another world created by the music, while at the same time keeping the listener's mind busy with the perfectly crafted complexity of its songwriting. Morpheus Descends certainly knew how to turn the dark and malevolent riffing and song structuring of New York death metal into an experience.

But that isn't all. Aside from the complexity and intelligence of the material, those of us who don't delude ourselves into thinking we're listening to the new Prokofiev, those of us who want something to profanely bang our heads to, Ritual of Infinity also gives us all we need. With all the aforementioned elements in the mix, the songwriting on this album is also incredibly catchy, with a commanding (using that word a lot and it really applies) intensity urging us to swing our hair windmill-style. The sheer amount of quality of its riffs and the amazing songwriting contrasting these riffs with each other creating tension and release on a relentless level, it pumps your body full of adrenaline and gives you a real rush of undirected fury for which there is no other release but to raise your fist, throw the horns, flail your head around like a madman.

This is really death metal at its best: Dark, menacing, complex, intelligent and fucking awesome to rock out with your cock out to. It unites all the qualities you could desire from a death metal album. That this album does not get the recognition it deserves is a crime against art. Best thing to do for the moment is to get the new Dark Descent compilation immediately, skip the awful new songs and go straight to this album, and prepare yourself for an onslaught of every quality of greatness death metal offers at its highest level.

Life with an anxiety disorder - Part VI: Social anxiety

Oh finally I get to the interesting part, huh? Yep, we're going straight to the core of my issues here. Social anxiety: The devil of the mind. Let's face it, the fewest of us can live happy lives living alone in a cabin in the woods writing manifestos and sending letter bombs to politicians. Humans are social animals, we need other humans around to function, to be content, to be happy. Look at any study any scientist has done over the past century on what isolation from other humans does to the human mind. We can't handle being without others of our kind. It's one of the things that are at the core of our being.

Social anxiety messes all that up. You still want to be around others, but you fear any situation in which others are around. Remember the Greek myth of Tantalus? The punishment of wanting something, needing something, but whenever you reach for it, you can't get near. This is social anxiety, the fear of a thing that you need to be a human being.

Many people with an anxiety disorder have issues with social anxiety. In fact it is a common companion of most mental illnesses. Aside from depression, it might be the most wide-spread issue in the psychiatric field. And it is so god damn troublesome. It takes away one of the things most essential to life. I think if you were to dissect the issue, there would be many reasons for social anxiety among different people, and many different ways it manifests itself. It ranges from discomfort to an outright phobia. Some hide it well and somehow cope with situations, others react to the sight of another human the same way I would to a huge spider. (see previous post)

For me, the issue is that I am incredibly socially awkward, just react to people in ways that are weird to most, and I am incredibly self-conscious about it. The latter is where my anxiety stems from, the constant fear of screwing up around people, making an ass of myself, looking ridiculous, embarrassing myself. Every time I feel I do or say something that looks or sounds weird to people who see or hear it, I get the typical issues with trouble breathing and the high pulse, symptoms of a panic attack. I am so incredibly scared of what my social awkwardness looks like to other people. It doesn't matter if it's in a conversation and I say something I feel was stupid, which I then think about over and over while freaking out inside, or if it's something as simple as riding my bicycle and people see me, and I feel I hold my arm in a way that might look weird or something. I have this massive fear of what people might think when they see me or hear me talk. That's why any situation involving any other human beings causes huge amounts of anxiety, and why I came to avoid such situations as much as I can.

What begins there is a vicious cycle. For one, isolation makes you more socially inept. Social interaction is something that requires constant practice, and the more you get out of the loop, the more you unlearn it, the worse you get at it. And to add to that is that the anxiety puts you so on edge that you are more likely to make mistakes, or what you consider mistakes, and the more the anxiety increases. More anxiety leads to more isolation, more isolation leads to more anxiety. More anxiety leads to more social ineptness, more social ineptness leads to more anxiety. It's a hellish conundrum that once you're in it, you can't go anywhere but sink deeper, and getting out or even getting better is nearly impossible. And like I said, it is depriving you of something you need, something you want and desire, but like Tantalus it is impossible for you to reach it. Your social anxiety pushes you deeper into isolation for every attempt you make to get out. And with isolation comes depression, to the point of despondency. You are in a prison from which you cannot escape, and it is one of the most desolate prisons imaginable.

There are ways out. I've been out once in my life when I did a day clinic type of thing in 2012. It requires social situations you can't avoid for one thing. The next thing it requires is that the social situations are with people who share or at least understand your problem. So either other socially anxious people or people with a related illness who can imagine what it's like. Another point that is important is that they are what I call "good-hearted people", people who mean well and care about you feeling well in a social situation as much as they care about their own situation. That point really comes down to luck, unfortunately. Of course another point is that you always have to have a therapist handy to guide you, explain problems to you and reassure you. And finally the most important point: Once you have all the aforementioned factors together in one place and have these social situations with that type of people, repeat it. Repeat it all day, every day, for at least weeks, ideally months. You have a lot of catching up to do in terms of practicing social situations, so cram as much into whatever time you have as possible. Repeat it, repeat it, repeat it. That's how you eventually learn to get comfortable and handle social situations well, eventually not just in the safe circle of the clinic people but in daily life as well. It's not a failsafe method and probably won't work in a hundred percent of all cases, but for the majority of people that's the best shot.

Unfortunately after the day clinic I slipped right back to where I was because nobody cared to give me a follow-up thing to do. What's important is that after therapy to get out of the social anxiety problem, you continue to be in and seek out social situations. You gotta keep your practice up. That's really the big issue with social anxiety. It comes back instantly the moment you allow it to. There's no "oh, I'll spend a week alone to relax" for someone with social anxiety, you don't have that option, no matter how appealing the thought is, because you are inviting the illness right back into your life. Staying social is the only way to keep these torments of Tantalus out of your life. Stay in frequent contact and interaction with other people, or relapse all the way back into the deepest depths of isolation. Social anxiety is one torturous illness, so if you suffer from it, seek therapy, find a safe environment to relearn social interaction, then, for the sake of whatever values you believe in, do everything to keep it from coming back into your life.

Life with an anxiety disorder - Part V: Four legs gooood, eight legs baaaad

As I am typing this, a big fat crane fly is sitting on the wall next to me. I am not bothered by it in any way. It is basically the same size as a house spider. The body is basically the same size as a house spider's. The legs are the same length and thickness as a house spider's. It just has two fewer, and a set of wings instead. Other than that, very similar in appearance to a house spider. It just doesn't bother me that this crane fly is sitting on the wall right next to me. If it was a house spider, however...

Well, if it actually was a house spider, I wouldn't sit here typing. I'd have jumped up, possibly yelping, fled to a bit of a distance and stared at it in mortal terror. My pulse would be going through the roof. I'd take short, flat breaths. I'd be sweating. Cold sweat. I'd be in a state of fear as intense as if I were facing death. It's fight or flight. It's my apartment, so flight is not an option, so I can't go and wait until the spider leaves by itself. What do I do? I can't get closer than two meters to it, too terrified. I could call my mother, who leaves nearby, but that would be pathetic. It's got to be the vacuum cleaner with the long pipe. Poor animal, some would say, but it's it or me. I am dying a little inside as I approach to the length of the pipe and am mortified at the thought of it escaping the suction and getting under the couch or behind a cabinet where I can't get it. I succeed. The terror does not subside. The rest of the day I'll be a nervous wreck scanning the walls for spiders with my eyes.

That's right, today's topic is phobias. Because what would an anxiety disorder be without a good old fashioned phobia to mess it up even more? It's spiders for me, but many people have a phobia. Many people who are otherwise completely healthy as well. But what's really interesting in the context of this series of posts is how phobias interact with an anxiety disorder. If you are anxious all day every day already, how does the prospect of mortal terror being literally around every corner ready to hit at any moment without warning sound to you?

One defining factor of an anxiety disorder is what therapists in Germany call "the fear of the fear": The idea that your anxiety is not just focused on high states of anxiety itself or panic attacks in particular, but that these states are actually so horrible to you that you spend your whole time fearing their next occurence. "There is nothing to fear but fear itself" gets a whole new meaning for those suffering from this illness. Fear is literally the worst thing to fear. And then you add one or more phobias to the mix and you're in a permanent condition of fear of what will happen one minute from any given moment, or even one second. They can really kill it all. You can have a good day, have your normal fears under control, can go to the grocery store without a panic attack, can talk to people without your social anxiety giving you much trouble, generally feel it's one of your better days, then a big house spider decides to explore your apartment and everything is fucked. It doesn't matter anymore how well you were dealing with your normal problems that day, everything is ruined. Imagine scientists announcing CO² emissions are at an all time low and global temperatures are stabilising, and half an hour later Putin launches nuclear missiles on half the planet. That's pretty much what a phobia does when you're dealing with an anxiety disorder. It's the "terminate all"-button that doesn't care how you're dealing with your life that moment otherwise.

So you always have that in the back of your head. And the feeling that no matter how well you do with dealing with your main illness, "something is out there that can ruin it all" just puts an impossible strain on your confidence in your coping with your daily life. It puts you on edge automatically, because you can never feel entirely free or relaxed and enjoy a moment of your anxiety disorder letting up in intensity, because you  know there's something out there that can change the situation to the worst any given moment. So fear always remains part of your thinking no matter what happens. And I put animal phobia as one of the worst type of phobias to interact with anxiety disorder, because it is one of the phobias that is hardest to control or avoid. A claustrophobic can avoid enclosed spaces, an agoraphobic open places, but you never know where a spider or other animal you fear is coming along. Not saying animal phobia is the only type of phobia with such an issue of lack of control, it is one of a group of phobias that occupy a special circle of the hell that is phobia as a whole. Phobias where you can't predict when or where you are confronted with them, and have no way to prevent that situation from occuring. Like a constant dark cloud hanging threateningly above your life.

Anxiety disorder and phobia are a very bad mix, because they interact in a very bad way, amplifying each other constantly to unbearable levels. The good news is that you can do something about it, and phobias are generally much easier to treat than anxiety disorder, with a much higher rate of success. For me, of course that would involve being in a room full of huge spiders with the guidance of a therapist, eventually taking a few in my hand and letting them crawl on me. I'm sorry, but fuck off. Or in more polite terms, I am not ready to do that yet. It's literally the least desirable thing in the world to me. Waterboard me instead. But to end on a positive note, once I conquer my weaker self, it really is a pretty easy treatment. Hang around some spiders until it doesn't bother me anymore. And it's something anyone suffering from a similar problem should consider: It really is quite simple stuff, you just need to get yourself to do it. And you can be damn well certain that it would take an enormous weight off your shoulders.

Saturday, May 16, 2015

My thoughts on Pagan Altar - R.I.P. Terry Jones

Yesterday, Pagan Altar singer Terry Jones died age 69 after a long battle against cancer. I'd like to make a post talking about my feelings for his work as sort of a personal memorial service. It's sad to see the man go at what is really still a young age, considering what he has given to the world. My condolensces go to his family, friends and bandmates. It's never easy to deal with the death of a loved one, but what's important is to keep the memory alive, and Terry Jones certainly is a man who will never be forgotten. Not for his personality, of which I have heard account from many people who have met him in person, and certainly not for his creative work.

Pagan Altar is actually a band I don't really listen to anymore. My tastes have shifted a lot in recent years. Those who have known me for a while that what I reviewed in my series of best metal albums is not something I would have rated so highly two, five or ten years ago. Pagan Altar kind of drifted out of my field of interest as I moved into much darker territories. But it is a band that I was once so passionate about that I still almost remember every note of their albums. I have nothing but infinite respect for the band's output, and no matter how much my tastes shifted, they still have a special place in my heart just for how unique and emotionally intense their sound is.

Playing doom metal correctly is something almost every band in existence gets wrong, and only a handful of bands get it right. Pagan Altar get it right. It is a genre that needs perfection in its songwriting and performance, and if it fails to miss the mark, it becomes awful. Hard-hitting riffs, the perfect sound, meticulously accentuated percussion, solos that send shivers down your spine, and finally a vocal performance that is out of this world - that's how Pagan Altar avoid the omnipresent trap of getting doom metal wrong, and instead tower above the genre like titans. Their sound is one crafted to perfection through passion, hard work and a cunning sense of what works and what doesn't. They are not the kind of band you would show someone new to the genre as an introduction - their sound is too unique and different from what you'd expect of a classic doom metal band, but they are a band anyone familiar with a genre should know and cherish.

What makes them so unique is that they take the classic doom metal backbone and expand it with elements you'd be more likely to find in old progressive rock bands. I've heard them compared to Jethro Tull (minus the flute, thankfully), and it isn't far off the mark. There's more of course, some elements remind you of other bands from around the early 70s. It gives Pagan Altar a very adventurous ride, like they're taking you on a ride through a mysterious land they create through their music, like they're telling you a story about the happenings of this enigmatic world that exists in the band's unique sound. A lot of times acoustic interludes would build up little arcs of tension and suspense, released in monolithic doom metal climaxes. They don't go a straight line, they are taking you through unexpected twists and turns, occasionally employing small releases to give the build-up a new dimension, taking you through a faceted storyline that keeps you interested at any given point.

And finally, the vocals. Holy fuck, what a voice. Anyone who has ever tried taking up singing knows that pouring all your emotions into your singing and communicating them to the audience is as hard as playing Yngwie Malmsteen solos on guitar. Terry Jones does it like it's the most natural thing in the world. I used the word "passion" a few times to describe the music - the vocals are brimming with it. It is a one-of-a-kind voice, one you'll never have heard in any other band, and one you'll never hear in any other band, and it's so perfect. I don't think I can properly describe the style, it's just not something you'd expect in a metal band - more of a style you'd think of in an obscure 70s progressive rock band that is too serene in temperament to ever make it big. He delivers it with such deep and honest emotion, however, so that you can't help but hang on every word, every syllable. It commands attention like few vocalists can, and it is one of the truly defining elements of Pagan Altar's sound. This man will forever be a legend.

Like I said earlier, I am not really into this type of music anymore, it rarely ever gets a spin. But I have nothing but respect for this band's unique and amazing creative output. The three albums recorded - with a fourth in the works, the vocals thankfully completed before Terry Jones' tragic passing - will forever stand as classics not only in the doom metal genre, but in metal as a whole. Essential listening for anyone interested in some of the unique works of art created by the passionate and dedicated dwellers of the underground. Give this band the recognition it deserves and Terry Jones a legacy that won't be forgotten.

Friday, May 15, 2015

Pills against the ageless ills - Part IV: Who are you?

There have been some really heartbreaking stories about people changing into an entirely different person before loved ones' eyes, one moment they are the person they've known and loved for years, and the next moment, the moment that person was prescribed antidepressants or antipsychotics, he or she completely transformed into someone they didn't recognise. I've heard many such stories and it must be agonising. It's like losing the person you love, and getting someone you don't know who he or she is. All because of an antidepressant or other psychoactive pharmaceutical they've started taking. You could think it's almost devilish to do this to people.

Well, the truth is, it just doesn't happen. I mean, it does happen, but it's so rare that you can basically consider it a non-happening. It's probably the biggest and most prevalent misconception about psychoactive medications. Personality changes are a rare side-effect of some medications. The odds of it happening are astronomical. Yet you find a lot of people who believe that's exactly what's going to happen when you start taking antidepressants or mood stabilisers or anxiolytics or antipsychotics or whatnot. It's basically the first thing most people will tell you if you say to them that you've been prescribed psychoactive meds. "Oh, don't take them, you'll turn into a whole different person. Your whole personality will change." Yeah, right.

The sad fact is that this is another one of those artificially manufactured hysterias that permeate our sensationalist-media dominated life. Basically the same as the story about razorblades in apples at Halloween. Some guy hears about it, someone picks up the story, suddenly everyone believes that's what happens everywhere. It's something so blown out of proportion it's not funny in any way. And there's a sad undercurrent. While the razorblades-in-apples hysteria did nothing but to prevent some candy being eaten by children, the personality-changes-from-medication hysteria actually prevented and still prevents people from getting the help they desperately need. Imagine going around with an excruciatingly painful abscess in your mouth because you were told that the local anesthetics dentists use cause cancer. It's the same going through life with depression, anxiety, psychosis, etc. just because you believe that when you take medication, it will alter your whole being. Don't make people suffer from debilitating illnesses based on ridiculously blown up horror stories.

What is true for almost all psychoactive medications, and this is something I have observed in myself and many other mentally ill people I have met in and outside clinics, is that their effect is actually very subtle. Especially in the case of something like an antidepressant it is something where you hardly actually notice any difference from taking it. Everything is the same as before, except that some things that used to bother you more now bother you a little less. That sometimes when you used to not feel like doing anything you now have a bit more of an impulse to do something. It's not something you really notice unless you actively observe it. And people around you are going to notice even less of it. To them you are just the same you used to be, just a little livelier. You could say the same about anxiolytics, except that instead of livelier you seem a little less timid. Mood stabilisers go the same way, people are not going to really notice a difference except that there seems to be less interpersonal conflict than there used to be.

Antipsychotics? Yeah, that's the big, scary thing. But I've taken them. I've taken a number of them. And I know a good amount of people who have taken a whole selection of them. Being familiar with them, they hardly are the big, scary personality changers they are in popular folklore. There's actually a song by a semi-famous punk/metal band that complained about their friend being turned into a vegetable by promazine. I'm sorry, but that's not what that medication usually does, something must have seriously gone wrong with their friend. But a lot of people pick up on such stories and believe them. In reality, antipsychotics are a tremendous help for people who suffer badly. They're a life-saver, there's no other way of putting it. They alleviate some of the most extreme symptoms you can have up there in your body's most essential organ. Yeah, they have side-effects, but those are nothing like the nonsense stories going around. Akathisia isn't going to turn you into a different person or a vegetable, neither is dyskinesia. They're annoying, but you're the same guy or gal as before, only without those horrible symptoms you suffered from before. It's one hell of a bargain. You'll agree with me if you ever experience symptoms that require antipsychotics.

So yeah, there have been a few cases of psychoactive pharmaceuticals seriously fucking with a person's mind. But compared to the hundreds of millions who take these medications and live far better lives for it, you can see how the hysteria is blown far out of proportion and counterproductive to helping people get better. So if you feel symptoms of depression or anxiety or anything mental illness-related, and your doctor prescribes you medications for it, don't get all worked up over the false image popular nonsense stories have made up around it, there's so little to fear. Very rare side-effects are indeed very rare. The chances of you being affected by one are tinier than tiny. It's far more likely you'll live a much better life with great relief from symptoms that have seriously messed up your life, like it happened for hundreds of millions of people. Don't you think that is the story people should be telling each other?

Life with an anxiety disorder - Part IV: Relax!! It's only paranoia!

I really don't know if that's common for all people who suffer from an anxiety disorder, but I have literally not felt relaxed in years. There's just no feeling of ever being "at ease." I am constantly wired, constantly on edge, my stress levels are constantly high, and there is no way for me to unwind. I cannot tell you how or when it started, but it may well be approaching a decade. I mean, it has been a problem all my life, that I just can't seem to calm down most of the time, but the situation that it absolutely never happens anymore is something that developed in the latter part of my life. For me, there are only periods of medium stress and high stress. Medium is when I am the closest to calm, and below medium is simply out of reach.

You can see how this goes hand in hand with anxiety, it's interlinked with stress in an anxiety disorder. Never being able to relax means anxiety never lets up. It simply varies between medium (undifferentiated fears) and high (panic attacks) like stress does. A state of mind in which stress and anxiety are absent is something I have not experienced since at the very least 2007, and it is impossible for me to recall what it even feels like. Interlinked as they may be, however, the constancy of stress and anxiety leads to opposite problems for either. Constant stress leads to explosion at the slightest trigger. Constant anxiety leads to implosion at the slightest trigger. It the very definition of "on edge", like walking a tightrope in fluctuating windspeeds, hard enough to keep balance by itself, but blown hither and wither to opposite abysses perpetually.

Stress-related explosion is just what it sounds like, and because I am constantly on the edge to it, there were multiple occasions on which I have been suggested by doctors, therapists and psychiatric nurses to suffer from a borderline personality disorder. I do not, but some of the reactions are the same, such as rapid mood swings, outbursts of anger or general "freaking out." I just tend to have a very thin skin, a very low protective shield to the slightest emotional triggers. In periods of high stress anything can set me off, and because I am in a period of high stress a good chunk of my time, and the only let-up is medium stress, this happens a lot. I'm not a violent person (though not saying it never happened), I yell, kick things, slam doors, say massively inappropriate shit, accuse people, insult people, throw things, I just get so really fucking mad. Typical fit of rage when high level stress overloads your brain and you explode.

Anxiety-related implosion is pretty much the opposite, a depth of misery filled with nothing but terror and despondency. It's when all your anxiety and panic comes together and focuses into one tight beam melting you from the inside. It's a dissociative state in which nothing feels real anymore and you literally feel your mind and body disintegrating. It reminds me of Harry Harlow's "pit of despair" (see Wikipedia), a place of utter desolation and terror. This is what happens when high level anxiety never lets up and eventually pushes you to a level at which you collapse. When you feel all of yourself and the world around you as unreal, that dissociative state of being helpless in a limbo of fear, that's the kind of implosion you end up with when you don't get one second of a break from constant high level anxiety.

The big question to me is why. Why can't I relax just once? Not for an hour, not for five minutes, not even for a second. Why am I constantly on edge, constantly wired? I've been trying to figure it out for a while now, but due to lacking memories of certain periods of my past I have a lot of difficulty even pinpointing when and how it started. My thoughts have constantly been racing since childhood, but I know as a kid I at least got periods of calm. I know the extreme bullying I've been through in high school constantly put me on alert because I could expect an attack any second without warning. But I'd like to not think of something as trivial as bullying as the cause of such a deep issue. I've had some messy break-ups, a really crappy job career, and i think my huge problem with alcoholism contributed a lot, but none of that really makes sense as a cause of this problem. Soon I will be entering long-term anxiety therapy at a high profile clinic specialising on that diagnosis, and I hope finding the causes will be one of the priorities of therapy. I just can't figure it out on my own.

This paragraph may just be mad hypochondriac rambling, but there's also a theory that there could be an issue with my adrenal gland. It would explain a lot. A few years ago a benign tumour was found on my brother's adrenal gland and it was found to be the cause of all his restlessness, fidgeting, nervousness, restless leg syndrome and other things. Removing it surgically has helped him a lot. The doctors then said it was probably genetic, so there is a chance I have the same issue. It's just a wild theory, but it's something I'll have myself tested for at the clinic. All it requires is for me to collect my pee for a day, then doctors can see if there's any issue with the adrenal gland (and my kidneys while they're at it.) It's worth a shot at least looking into it, the symptoms certainly fit perfectly. But if the issue is all psychological, that will be taken care of as well, I hope.

Now after the emotional strain of writing another one of these rather intimate posts, I'd really like to sit back and relax for a few minutes. I know that isn't possible. C'est la vie.

Thursday, May 14, 2015

Life with an anxiety disorder - Part III: Somatoform autonomic dysfunction

I've talked about somatoform autonomic dysfunction in the previous two installments of this series and I really want to go into more detail about it. It's a new diagnosis that my psychiatrist and I arrived at after a long talk about my symptoms and how to properly classify them. Before that, I did not even know such a disorder exists, and I was under the assumption that the symptoms I experienced were just regular things experienced with generalized anxiety disorder.

I'll start with the official ICD-10 definition of somatoform autonomic dysfunction (F45.3), the defintion system all psychiatrists - at least over here - use:
Symptoms are presented by the patient as if they were due to a physical disorder of a system or organ that is largely or completely under autonomic innervation and control, i.e. the cardiovascular, gastrointestinal, respiratory and urogenital systems. The symptoms are usually of two types, neither of which indicates a physical disorder of the organ or system concerned. First, there are complaints based upon objective signs of autonomic arousal, such as palpitations, sweating, flushing, tremor, and expression of fear and distress about the possibility of a physical disorder. Second, there are subjective complaints of a nonspecific or changing nature such as fleeting aches and pains, sensations of burning, heaviness, tightness, and feelings of being bloated or distended, which are referred by the patient to a specific organ or system. (Source)
Now that is really interesting to me. As I briefly described in part II of this series, this is the type of diagnosis that fits what I go through perfectly. It's just spot on.

What started the conversation was a letter for a high profile long-term therapy clinic I had applied to and went to a preliminary examination at. I described to them my panic attacks, and how they are often based on actual physical symptoms that my brain assumes to be something really bad and usually deadly. The letter from the clinic to my psychiatrist described that as "hypochondriasis-like symptoms". I disagreed, because it just doesn't seem right. With hypochondriasis, you have a specific illness in mind, and you obsess over it, think about it all the time. In my case, I don't think I have any bad illness, and I don't really think about having one. However, when I feel a stinging in the center of my chest, I always assume it's the heart. If it's more to the side, I assume it's the smoking having fucked up my lungs. Even worse when there's discomfort in my throat, I assume it's an asthma attack that will kill me. Discomfort in the back of my head is interpreted as a stroke. That kind of thinking. However, unlike hypochondriacs, once the discomfort is gone, I no longer think about it.

I write this post with the full awareness that anything related to hypochondriasis is the most ridiculed and least taken seriously area of mental illness. I don't blame anyone. In fact, when I was at a psych ward around a month ago for about a week, there was a hypochondriac at the ward, and I referred to him as "the whiny guy." It was accurate in a way, since whining was literally all he did. And being a minority does not make you exempt from ridicule. However, it's also a shame we see some mental illnesses that way. The sad fact of the matter is that any mental illness is a lot less funny when you are affected by it. And the symptoms and experiences I described may sound ridiculous, but the panic attacks it causes sure are devastating and crippling. A feeling of certain death is never the nicest experience you can think of. Yeah, it's all in your head, but try to tell your head that when it's in the middle of telling you you're about to kick the bucket. Like any anxiety disorder it can be debilitating, or at the very least affect the number of things you can do in your life in a very negative way.

It was my psychiatrist who then suggested somatoform autonomic dysfunction, something which, as I said, I had never heard of before, and read the above description to me from his book (in German, of course). It was like an eye-opener to me, because to that point I had always struggled to get what I felt across to doctors. They always gave me some wild mishmash of diagnoses, usually with psychosis thrown in. I'm not psychotic, and I keep having to tell everyone, but they throw around that nonsense anyway because they just don't know how my symptoms fit anywhere. It is incredibly frustrating to have to deal with doctors who can't give you a proper diagnosis, because you end up with the wrong medication and the wrong treatment and everything wrong, just because they have no idea what they're talking about, coming up with all sorts of guesses that all miss the mark. It wastes my time and theirs and usually does more harm than good. Everyone who has ever had symptoms that don't fit into the "popular" (as in most wide-spread) mental illnesses will be able to relate to that.

Now I have this convenient diagnosis that when a doctor asks me what is wrong with me I can just tell them, and they'll know what's going on. And a few of them might even know what to do. Of course this isn't my only issue, I still struggle with other anxieties, particularly a very, very bad case of social anxiety (more on that in a later post), but the reason I am so relieved to have the proper diagnosis for my body-related symptoms is that those are the main reason I often end up with the psychosis stamp - which brings with it a whole lot of problems, as it is as much a stigma as a diagnosis and often prevents you to get proper treatment for your actual issues. Now I know that what I experience is something related to an anxiety disorder, and it is something that is treated very similarly, and usually treated effectively. May take a while to get rid of it, but getting the proper diagnosis is always the first step, and now I know in which direction to go.

Saturday, May 9, 2015

Tales from the schizophrenia ward - Part VI: Reptilian Astrology

It's been a long time since my last post of this series, but I never considered it quite done, there was one thing I kept thinking I still need to talk about. So here it is, the last part of the schizophrenia ward series. After all previous parts dealt with all the crap I had to deal with in that place, this part will deal with the one positive aspect: The people I've met. If anything can be seen as a redeeming factor in a place that is so out of touch with reality, fellow patients I've spent my time with in that ward would definitely be it.

Hanging out with paranoid schizophrenics really is a blast sometimes. The thing is that very few of them are the type of crazies the layman would picture when imagining people with the illness. The people I've met were really normal people, and we had very normal conversations, sometimes serious, a lot of times a lot of fun. What really is the icing on the cake though is when they break into schizophrenic mode out of nowhere and say things that no person would seriously say, but that they themselves perceive as indisputable reality. At that point you don't laugh at them, because I never got the feeling that they're making asses of themselves, but instead it is very interesting to hear entirely different viewpoints on what is reality than you're used to from talking to your obviously non-schizophrenic friends and family.

Like the first day. There was a guy who immediately talked to me because he liked my long hair and death metal attire, because he listens to some metal himself. So that was a good conversation starter, and in clinics it's great to have people you get along with. So in the evening of my first day, we sit in the smokers room like we did a lot, and somehow the conversation shifted to some of the bizarre conspiracy theories I've ever heard. I mean, I knew of chemtrails, how they're supposedly used to make the population docile and controllable. What I didn't know was that there's no secret cabal behind them, but that it is Obama himself who is in charge of it all, because Obama is the incarnation of the antichrist. However, the guy went on to make all sorts of astrological connections to his conspiracy theories, that this stuff happened because of something in that constellation, and something about the black hole in the constellation of Sagittarius, and the Ophiuchus between Sagittarius and Scorpio. And it kind of all became a weird mishmash. Some will think it's ridiculous and laugh, but I thought it was really interesting how convinced he was that that's the nature of reality, and I respected it, because it was his genuine perception.

Another time he was in the room with the couches where we liked to hang out, and a young girl from another ward was with him, a deaf girl who was scared of everything. She told him she was feeling a strange chill, and he told her that's because she's sitting in the same armchair as his dead uncle that he's been talking to along with a few other deceased relatives. She really freaked out. Another girl, her friend, got really mad at the guy and cursed at him for disturbing the rest of the dead. Not for freaking out the girl, but for bothering the dead. They're fighting over ghosts. In fact they used to get along really well to that point, but fell out because of that fight. Of course I was troubled by the fight, because they were both friends of mine, and I also don't believe in any sort of life after death. But the conviction with which they argued after ghosts and how to treat them was impressive in its own, weird way. I just genuinely enjoy being confronted with entirely different perceptions of reality, and I honestly believe since my time at the ward that more people should talk to paranoid schizophrenics. It's a unique experience. And you're not taking advantage of their illness by listening to them. They're normal people like you and me, most of them social like the average person. They just perceive things differently.

One girl was kind of weird, but in an interesting way. She came to the ward late during my stay there, so I only got to talk to her for a short time. She was one of the typical textbook schizophrenics who hear voices. One of them was her first boyfriend from years ago who was constantly criticising her. And she was talking to him aloud. Obviously no one could hear what he said, since that only happened in her head, but she talked to him like he was there. It really led to everyone overhearing some strange "conversations". Again, it was interesting how real it was to her. And how, despite everyone calling schizophrenia a grave illness, she seemed to not be bothered by it at all. It was just how things were to her, how reality was, and she wasn't suffering at all. Almost none of the people I met were. They were supposed to be really ill, and the staff treated them accordingly, but to them the realities they perceived were perfectly normal, and they felt perfectly normal. Very interesting experience being around these people. You get a whole new view of how the world can be to someone. Oh yeah, the other main voice she heard was herself. It was not actually her conscious self, so it was not like a monologue, it was more like a clone of herself was talking to her. Sometimes giving advice, sometimes arguing. Now that's gotta be weird. But she didn't seem to be bothered by it at all. And aside from talking to people that weren't there, she was perfectly normal like any other person you'd meet on the streets.

What really took the cake was the neo-Nazi. A semi-notorious Nazi asshole from my home town, who left the scene and changed his political views when he realised how violent and fanatic his comrades were. He wanted nothing to do with killing people or carrying out terrorist attacks, which he said they planned, so he left that world behind and tried to start a new life. Problem was that he was a massive paranoid schizophrenic who was completely messed up. Very friendly guy, very personable, fun to hang around with and talk to, but sometimes he'd say and do things so bizarre your jaw just dropped an arm's length. Like the time he talked to a Hungarian Roma girl about how he was a neo-Nazi for years, then began to hit on her, and invited her to his birthday party, and promised only one or two friends of his dark past would be invited, too. Do you see anything wrong in that situation? What was going through his head? Or the time he talked about his past in the scene, and mentioned that at some point he had sex with a black girl and it was the best sex he ever had. Did you tell her that you are a...? Oh yeah and he always loved Sahra Wagenknecht, leader of the German socialist party "The Left". Hope you didn't mention that to your friends. One time deep in his Nazi phase he met a few punks and decided it would be great to have a few drinks with them, and he came with them to the place with the freight containers in which a few of them lived and where a lot of them met to drink and party. Eventually one of the punks recognised him and freaked out and threatened to kill him. Well, what did you think would happen? Man, what a weird guy. But it all made perfect sense to him. It all made perfect sense to him.

There are more stories, but I think the ones I mentioned are enough to describe the kind of experience it was to spend eight weeks with a group of paranoid schizophrenics. A lot of them were great people, and a lot of times we talked and joked about perfectly normal things and had a great time. And then out of nowhere they'd break into their other reality and all sorts of weird things happened, and we still had a great time. I loved it. It was the experience of a lifetime. For all the shit I've talked about in the first five installments of this series, this was, like I said, the one major redeeming factor. I've been to psych wards again since then, but they were all mixed with all sorts of weird people. Something like the schizophrenia ward never happened to me again. And for all the bad things I experienced there, I will cherish the memory of those great, funny and a little bizarre people.

My thoughts on Portal and their new album "Vexovoid"

You know, for the most part I have pretty much given up on what the metal genre has put out in the last decade or so and continues to put out. Bands are either trying too hard to emulate what has been done in previous decades in a "retro", "true" or "revival" fashion without ever properly getting the point of what they are trying to emulate, or trying too hard to be "different" and "unique". Sure, there is plenty of stuff I may enjoy as background music, both new bands and new stuff by old bands, certain new bands are just solid enough that I don't mind them. Sunn O))) for example is one of these bands I can listen to and enjoy on a basic level, even if they are just a more "artsy" version of early Earth. And as for old bands, you certainly won't ever see me running away screaming if someone puts on a new Master album, lest they expand on the metalcore elements on The Human Machine. But there really is next to nothing from the past decade I really consider outstanding in any way, or even approaching a state of being on par with what had been done at the peak of metal's development.

Portal is a band that among heaps of praise has drawn a fair share of criticism for being extremely one-dimensional, one style of riffing, drumming, vocals, and especially atmosphere throughout their works from start to end without variation. I agree with that criticism. They are one-dimensional. They only do one thing. But I gotta admit that when I first heard them, that one dimension, that one thing they do, hit me like a neutron bomb. They never stray from their thing, but you gotta admit that their thing is extremely powerful. It's a relentless attack on everything light, everything pretty, everything hopeful, everything on the good side of life. One critic described it as a perpetual feeling of being drawn into an abyss. That was supposed to be a bad thing. To me, it is shockingly infectious. This relentless attack of malevolent bleakness. What is malevolent bleakness? It is evil, but not out of anger, hate or any emotion, but out of the absence of emotion, the absence of conscience, the absence of goodness. The force with which Portal hit me when first listening to their early material really does make them one of the assorted few bands from this millenium that really stand out to me. In fact, if it wasn't for Norway's Hjarnidaudi, whom all of you should check out right now, Portal would probably be the cream of the crop. I still would never rate it as highly as the classics from the 80s and 90s, but it certainly towers over anything borne of this millenium.

That was the impact the early material had on me when I first heard it, and it still does when I put it on occasionally. But the band continued. Eventually, along came Swarth. And the band remained one-dimensional and never strayed from the one thing they do. And as they did, the impact waned. I didn't really feel anything from that record. It was just an exercise of "here's a bit more of the same", and I didn't need more of the same. It was exciting the first two times, but starting with the third album it no longer was. If you don't have new ideas, don't release a new album. Just because you're from Australia does not mean you're AC/DC. Bring us something new, hit us harder, up the ante. Don't give us an album that sounds like leftovers that didn't make it on the first two albums. Such a great band, but they just can't keep my interest if they just keep on doing the same thing over and over again. Four years passed, and the final nail was hammered in the coffin. Vexovoid.

Oh my. Did they get so caught up in the undeserved praise for Swarth that they never realised what a disaster it was? How can they release what is basically the same album again? There is absolutely no sense in this, no purpose, no thought, no plan, no idea, no inspiration, no creative spark, no fucking clue as to where to take their sound. They go through the motions every second of this album. There's not a single thing you haven't heard in better shape and form on the earlier albums. It basically sounds like they used a computer program that randomly assorts new arrangements of earlier material they fed it. Remember the Simpsons episode where Marge finds an expensive designer dress for a cheap price and keeps pretending to get new dresses to impress the rich people by altering and retailoring the same dress? That's basically what Portal are doing here. They've been doing it on Swarth already, but on Vexovoid they hit rock bottom, scrape the bottom of the barrel. The horse they're beating is deader than dead. Even a global zombie virus outbreak couldn't revive it to an undead state, that's how dead it is. A one-trick-pony beating a dead horse, that's macabre.

They are doing the exact same thing they have done the exact same way before, only without the creative spark or relentless purpose. I can't help but repeat that they are completely going through the motions here. It shouldn't be called Vexovoid, it should be called ReSwarth. Have they completely lost their will to deliver anything that will provoke any reaction other than ambivalence? It doesn't leave any impression whatsoever other than a feeling that not only was it completely unnecessary for me to hear it, it was completely unnecessary for them to record it as well. I can't fucking figure out what the purpose of this record is. Stop making carbon copies of your classic material. It's unnecessary and is nothing but a stain on your discography. Either develop some new ideas or refrain from releasing such pointless material. Can't you think of a way to go completely crazy and ramp up your music so it has the same impact the first two albums did? There must be a way. And I hope if Portal release another album, they will go down the road of upping the ante and completely fucking with our heads again rather than release the same album a fifth time, which would be a dismal portray of creative bankruptcy.

Bring back the previously malevolent bleakness. You can't do that by writing albums like an office clerk zombie processes the same standard forms every day in his cubicle. You have to unleash that force from deep within. Not from a superficial standpoint of releasing more of the same just to have a new album as an excuse to tour. Bring back the Portal I loved. Erase and forget the Portal that gave up on itself.

Pills against the ageless ills - Part III: Just one fix

After the previous installment of this series talked about some of the worst medications I've had for mental illness so far, worst by either being entirely useless or by causing bad side-effects, this part of the series will talk about another type of awful meds that I deliberately left out in the previous post in order to dedicate an entire post by itself to it. Some of you might already have guessed it, we're getting into the twisted world of benzodiazepines here.

We all know Valium (diazepam), we've all heard of Xanax (alprazolam), in Europe lorazepam is all the rage, known as Tavor here, better known as Ativan overseas. You simply can't avoid coming across these brand names, especially not if you have a history of mental illness. And I'm willing to bet many people who are reading this post have had one of those benzodiazepines in the past or are currently taking one. They are as omnipresent as alcohol and cigarettes, and they mess with your body and mind just as badly as those two, but the major difference is that while doctors tell you not to drink and not to smoke, they tell you to take those pills. Doctor's orders. It's good for you. We want you to feel good. We're your friends.

Benzodiazepines are definitely great for short term relief in times of severe emotional distress. Anxiety, panic attacks, stress-induced psychosomatic symptoms, that sort of stuff. Take the pill, wait about half an hour, you're fine. That is a really fucking awesome thing to exist, so don't make the mistake of thinking this post is anti-benzodiazepine. They definitely have that one thing they are absolutely great for. Short term relief in extreme situations is one of the best things you can have for many types of mental illness and/or stress.

Where it starts to go down a darker road is when it comes to taking them regularly. Encouraged by your friendly doctor, of course. You can say anything you want, you can come up with a thousand arguments about how it is helping and how your doctor is supporting it, the simple and unavoidable fact is that you've just been made a drug addict. You can tell me the Earth is flat, you can tell me Elvis is alive, you can tell me Obama did 9/11, but you can't tell me a regular benzodiazepine consumer is anything other than a drug addict. That's simply how it is. You might as well be shooting heroin. The advantage is that you don't get any dangerous cutting agents from your drug dealer/pharmacist, and that in most places in the Western World your insurance will even pay for it. And you're not a social pariah because it's perfectly accepted to be a benzodiazepine addict. Doctors support it, must be a good thing.

All the directly inherent elements of drug addiction however are there. The constant need for a new dose, almost a craving, waiting for when it's time again to take the next one. And after a time it stops being effective and you need a higher dose. Then higher yet. You're on 12mg of lorazepam a day before you know it. Then what do you do? You need your fix, and the withdrawal from missing a dose or having to wait for a dose for too long is just horrible. Your whole life starts to revolve around the drug, and you either start going batshit from the stress associated with drug addiction or you take the only way out and go to detox. And that sure is one hell of a ride.

I've done lorazepam detox myself, and I've known a fellow patient at a clinic I've been to who has done diazepam detox. All the stress and anxiety you had before taking the pills is back, only increased tenfold. And you can forget about sleep. Even relaxing for a bit is impossible. You're incredibly on edge, constantly. You can't imagine how wired you are during benzodiazepine detox unless you've experienced it. It's like someone just gave you an adrenaline enema. And you're in that state for at least a week. Sometimes, if you've taken a lot for a long period of time, it can last several weeks. I've known a guy who's been through that, he's the one I got the 12mg of lorazepam figure from in the previous paragraph. Been in the clinic with him for eight weeks, and when I was discharged he was still not done with his detox. Not sure he ever slept more than one or two hours during my entire stay.

And that's the stuff your doctor prescribed you, and your pharmacist gave it to you. No regard for the obvious consequences. Can that be right? Isn't something going terribly wrong there? It's just something that should not be done. Use it occasionally in times of severe emotional distress, yeah, like I said earlier. But prescribing regular use, prescribing higher doses when the lower ones no longer work, what the hell is your doctor trying to accomplish? He can't deliberately want to make you miserable, he swore that goddamn Hippocratic oath. So what is it? What is the sense behind it? I can't figure it out. The whole thing is messed up. Just stop prescribing regular use entirely. May seem like a good idea at first, but come on, we all know where it will lead, and that the consequences of the use of this drug will be worse than whatever they were prescribed for in the first place. Stop prescribing drug addiction. That's seriously messed up. Seriously.