Friday, November 2, 2018

Coming off Psychiatric Medications?

Recently, my friend's cousin who lives in China messaged me and told me about her mental health situation. It's very unique. She used to be a happy and positive person, with no mental health issues whatsoever. When she was 19, she was a rebellious teenager. It wasn't typical at the time and it was extremely unacceptable in China. She was always angry and disrespectful towards her parents. Thinking that she was schizophrenic, her mom found a doctor and put her on antispychotic medications. Fast forward, 11 years later, she is still stuck on these medications and she is experiencing severe health issues, such as high blood pressure, tremors, poor quality of sleep, inability to control her tempers and emotions, high risk of breast cancer, inability to have children, etc. She is on an antipsychotic drug called Olanzapine and an antidepressant called Luvox. The amount of information on these drugs are very limited in Chinese and her psychiatrist claims that these drugs are "import", therefore they are "awesome", even though he confirms that she doesn't have schizophrenia, he thinks it's not a good idea to come off these medications. Indeed, when she tried to quit cold turkey once, she wasn't able to sleep for 5 days.

After Googling these two drugs, I found a lot of valuable information in English, including other people's terrible experience trying to come off it. In a woman's story, she even had a minor stroke as a result of her withdrawal from Olanzapine. Here is her story:

I then remember that I was on Olanzapine for a while as well, it didn't do any good to my mental health, and I was then switched to what I am taking now, which is Seroquel. I am aware of the fact that I am fully dependent on this medication, if I accidentally skip a dose, I won't be able to sleep for that night. But my dosage is only 150mg, it's the minimal dosage and I cannot go any lower than that. With the help of another medication called Epival (500mg), my bipolar disorder has been well treated. I have been doing great for over 11 years, I have not had a mental health breakdown for 11 years! I don't plan to come off my medications, I don't experience any side-effects. Aside from the fact that I might not be able to carry my own child, I don't see my life being affected in anyway by my medications.

Anyway, after doing more research, I came up with a few tips that could help my friend alleviate her side-effects by lowering her dosage. In this post, I want to share my findings, as well as some personal experience in lowering my psychotropic medications to achieve optimal mental health.

First of all, I don't think a person who actually has a mental illness, who actually has psychosis should come off antipsychotic medications completely. It will most likely cause a relapse, therefore a major set back in their life. The goal is to lower the dosage to a point where side effects are most minimal, or replace it with another type of antipsychotic that works better. 

1. Slowly and gradually. It's like quit smoking with Nicorette patches. Take off 5% the dose every 4 weeks. I am speaking from my personal experience. After landing the right medication, it took about 2 years to finally figure out the right dosage. And my mom actually "adjusted" my dosage without my awareness, and she dared not telling my doctor about it. I was doing better and better mental health wise. I had normal emotions, and my creativity, memory, and other aspects of my mental abilities were all enhanced. When my doctor was about to move to another city, I finally told him the truth on our last meeting. He was like, "oh, I can understand that."

2. Keep a diary. My mom had a small journal, every day, she would write the amount of meds I was on, the quality of my sleep and my mood. If you are writing the diary yourself, you can rate your sleep, your mood, and your physical symptoms out of 10 or out of 100. Monitor the changes you experience after a dosage has just been reduced. If you experience insomnia for days, and withdrawal symptoms that you cannot tolerate, you should slow down your pace, and add a bit back to your dose.

3. Have a healthy and structured life style. Quit smoking and drinking. Do more exercise, and eat food that are considered clean and healthy. Mental healthy is part of our overall physical health. In my experience, I was overweight at the time, therefore, I went swimming every day, I ate oatmeal for dinner instead of white rice. I lost about 40 lbs in the process. I felt like my mental health was restored right about the point when I was in a much better shape physically.

4. Work with a Psychatrist on a long term basis. Again, the goal is to lower your medication to a point where your side effects are minimal and your mental functions can be enhanced. The goal is not completely coming off the medications because you have a mental illness to treat! Sometimes, we need to come off a medication when we are switching to a different type of medication. That's why it's important to have a psychiatrist on a long term basis. When someone is acute, the type of medication prescribed is usually very strong and "toxic", but during maintenance stage, if the meds have bad side effects, a milder type of meds should be used. In my experience, I have tried many different types of meds and combinations before landing on the right meds, and my doctor played a key role in it.

5. Lastly, and most importantly, do not lose faith in medications just because you have a terrible experience with one type of medication. If one doesn't work, keep on trying until you find the right one and figure out the right dosage. I have heard people say, I don't take meds, I just try to deal with it, I have good days and bad days, I have to shower myself with inspirational quotes during the bad days. But speaking from personal experience, if your mental illness is well treated by the right meds, being happy and positive is effortless. You will find that being human is a complete different experience than you have ever known.

Hope this helps, God Bless!

Tuesday, October 23, 2018

A Shorten Version of Leap

Recently, it brought to my attention that for someone who is acutely suicidal, they don't have the patience to read a book. Here is my story in under 2000 words. It's also a much easier way to share. Thank you!

Click here for the PDF

Wednesday, August 29, 2018

Psychologist or Psychatrist?

Recently, someone reached out to me about her mental health condition. She is experiencing symptoms of depression that definitely needs medical treatment. She mentioned that she has seen a psychologist/psychotherapist a few times but she didn't find them helpful. I suggested her to see a psychiatrist because her mental illness is definitely beyond the scope of what a psychologist can do. It made me realize that many people do not know the differences between the two and that can be problematic if a person is seeking help for an acute mental illness.

A Psychologist is someone who usually has a PhD in Clinical Psychology. They have knowledge in psychotherapies, counselling and other treatment methods that improves some one's psychological well being. They are helpful to someone who experiences distress because something traumatic has happened to them. For example, someone who has witnessed the tragic death of a loved one, someone who has been robbed at gun point, or someone who has been abducted for decades and has just been returned to the society, or veterans who returned home with PTSD. In other words, they have very understandable reasons to be depressed. During treatment, the therapist will aim to help them with counselling and behavioral therapy, and if necessary, they might suggest the use of anti-depressants and anti-anxiety medications on a short-term basis. People can completely recovered from their condition after a series of treatment. There are other people who are not sick, but they see their therapist on a long-term basis because their therapist is like a good friend with a lot of wisdom, they can talk about their problems in a safe and therapeutic way. Most psychologists have their own private practice, their fees are not covered by public health care.

On the other hand, a Psychiatrist is someone who is a medical doctor graduated from a medical school. They treat people with mild to severe psychiatric disorders with the use of medications. From experience, when seeing a psychiatrist, they do not attempt to talk you out of your problem. They do not deal with the reasons and trigger of some one's mania or depression. For most mental illnesses, these external reasons are usually very trivia. The focus of treatment is to correctly diagnose the person and find the right type of medication for their condition. Since most conditions cannot be cured, a person should see a psychiatrist on a regualr basis to renew their prescription, likely for the rest of their life. Sometimes, a referral to a psychiatrist takes months in Ontario. When a person is acutely suicidal, they cannot wait that long. Therefore, the best way is to admit them into an Emergency department. A Psychiatrist is covered by Health Care.

If you are already depressed to a point where you are suicidal, it's very likely that you have a medical condition and you need to see a psychiatrist right away. If you are still able to function on a daily basis, meaning that you can sleep and you still have the desire to eat, and most importantly, the reason of your depression is big and everyone agrees with it, then, you are probably in a bad mental state that is temporary. You might not need to be placed on medications. Having a good psychologist/psychotherapist will help facilitate your healing process.

Tuesday, March 27, 2018

How to Help Someone who is Acutely Suicidal

Recently, I have a family friend who is experiencing an acute mania/depression. Helping his family go through it has given me an update on how the system works  (in Ontario Canada) for psychiatric patients and how to effectively help someone who is acutely mentally ill (which applies to all). 
It started a month ago when his mom told us that he had been acting strange lately. He had trouble sleeping, he was delusional and he was talking to himself all the time. His social media posts were disturbing.  His mom thought that he would eventually snap out of it and get better on his own. It was hard to convince her that her son must receive medical intervention. Then, he started to wander on the street for most of the day, she did not know where he had been to or what he was doing. Finally, she asked us to take him to the hospital. That’s when I saw him for the first time since he became ill. Honestly he didn’t look sick, except I could tell he was no longer the soft-spoken and nice guy that he used to be. His mom said that he had become a different person, really angry and verbally aggressive, which definitely gave me that kind of vibe.
But he refused to go to the hospital. So we called 911 on him. When the paramedics showed up he was furious and started to argue with them, some of the stuff he said was nonsense and delusional. He created a scene for sure. The paramedic told me that they had no authority to forcefully take him against his will, only the police officers could, but they were caught up somewhere and we had to wait for them. Almost 45 minutes later, two cops finally showed up, my friend did not resist at all this time. One of the cops told me that normally they would put a handcuff on a patient to prevent any incidence, but my friend looked relatively calm, they didn't think it was necessary. One of the cops went into the ambulance with my friend, the other cop followed the ambulance in his car. 
After arriving at the emergency room, we were asked to wait for the doctor to see him. The paramedics departed from us, while the police officers were sitting with my friend. We waited for almost 1.5 hours before it was finally his turn to enter the Emergency unit. 

Cops came out and asked us:"what do you think his illness is?" They were not at the scene earlier, apparently they could not tell if there was anything wrong with him. I think my friend was masking his illness in order to “escape” from the hospital. We told the cops about his strange and ill behaviours. The cops warned us by saying that he might be sent home tonight, “We have seen people who look sicker than him, and they got sent home. There was a guy here couple months ago, his wife took him to the hospital, they did not keep him but sent him home, he jumped off the building on that night. The ones who get to stay usually look very ill, they don’t take care of their hygiene, they look like homeless people or people who have obvious cuts on their body. Unfortunately, that is how the system works, we cannot hold someone against their will, unless you go to a judge or a doctor to ask them to sign what’s called Form 1: Application for Psychiatric Assessment. With this form, it gives others the authority to hospitalize him by indicating that he is not mentally capable of making decisions on his own. That way, he will be kept in the hospital for up to 72 hours. After that, an assessment will be made to decide if he should be kept for a bit longer (up to two weeks, then reassess again)“. 
“Where can we get this form at this time of the day?” We asked, it was 10pm on a Saturday night. 
“Unfortunately, he might have to go home tonight and you will have to come back tomorrow with the signed form. He might go home, he might, I don’t know, it depends on the doctor’s decision tonight.” 
There is no way that we gonna let him go home on that night, especially after hearing what happened to that poor husband and wife. After more pleads, the cops winked and said: “ you gotta tell them how severe he is. And maybe more severe than he actually is. . . hope he gets better soon.” The cops left after that. We were lucky that the paramedics and the police officers were very patient, compassionate and helpful.
Another 45 minutes went by, a nurse came to speak to us after speaking to my friend. She asked his mom about what happened and what kinda behaviours and symptoms he had lately. Did we exaggerate the situation? Maybe, but honestly after my own struggle with mental illness, I know that a sick person’s outward behaviour only reflects a small part of what they actually have in mind, their minds are probably 10 times darker than their acts. Therefore, we were probably right on about the severity of his problems. We told the same story to the psychiatrist who came 20 minutes later. It helped when I told them how my suicide attempt put me in a wheelchair and how I wish I could be locked away at the time. The doctor agreed to hospitalize him and he will sign Form 1. Thank God he was kept in the emergency room that night and for the next few days. 
For the next three days, he was staying in the emergency department, having a bed but only separated from others by a curtain. He was not medicated yet, the doctor was trying to confirm what he had and finally came to the conclusion that he was having a manic episode. I learned from the doctor that he had his first episode three years ago when he was in another city. His medical record helped confirm the diagnosis, which is bipolar disorder. His first episode was effectively treated after almost two months in the hospital, but he did not keep on taking his medications, because of severe side effects, though he had been doing well for the last 1.5 years, being off medications was like a ticking bomb, another episode would inevitable occur.
When a bed was free up on the mental health ward, he was then transferred there. He stayed in the hospital for a total of 3 weeks. He was taking his anti-psychotic medication. After he came home from the hospital, there were still times that he would say things or do things that were problematic. But fortunately, as of today, he is no longer at risk of suicide. 
There are couple important things to keep in mind when attempting to help a loved one who is suicidal 
1.    Call 911! The chance of a person staying in the hospital is higher if they are brought in by the paramedics and the police. 
2.    When someone who is sent home right away after being seen by the doctor, it would actually facilitate their determination to commit suicide because they have now lost all hopes that anyone is able to help them, they have lost faith that their condition is treatable. 

3.  When describing their behaviours to the doctors, make it sound worse than you have witnessed, chances are there are many troublesome symptoms that you are not aware of. You might not know just exactly how bad they want to die. 
4.   Keep them in the hospital for as long as they are allowed. Ideally, if someone is on medications and takes them consistently, they don’t necessarily have to be hospitalized. But for any types of psychotropic medications, it takes at least 2 or 3 weeks to kick in. During that period, staying in a hospital is the only way to keep them safe. When a person is mentally ill, they usually don’t sleep at night, therefore it’s impossible for family members to watch them 24/7.
5.    Taking medications in most cases is a lifelong commitment. The medication that my friend took during his first episode was very effective during his acute state. However, when he were at the maintenance stage, he should switch to a milder medication and he should have a long-term psychiatrist to help him adjust the use of dose of medication. Not having anyone to follow up with him regularly was a mistake.
6.    Having a mentally ill person in the family is extremely tiresome, therefore patience and unconditional love is really needed. Most importantly, being educated about their condition and monitor them to make sure that they stay on medications. It’s definitely treatable. 
To learn more about my journey and insights, read a free PDF of my story at

Monday, October 24, 2016

The Way We Think

Some people have a positive outlook in life, always hopeful and free of worries. Some people are always negative, seeing the worse in every situation. We might think it's because they are who they are, it has to do with this person's personality, character, or the experience they have gone through. It's true, maybe. But the chemical makeups in our brain can also affect the way we think, the perspectives we take, and whether or not we see a glass as half-full or half-empty. In other words, we may or may not have control over how we think.

Have you met such person, or are you that person? When you fly somewhere, you always fear that the plane is gonna crash. Or when your loved one is ridiculously late, you think that they must be in some kind of accident. If the reason or the outcome is unknown, you always think about the negative, you can't help it, you just cannot help it. That is all that you think about in your head.

I used to be like that, for the first 22 years of my life. Even when I was a child, I was lacking the naiveness of people my age. I would be so worry-sick whenever my parents had to go on a business trip. As I got older, things just got much worse. I would even lose sleep at night thinking about all the scenarios that would go wrong. I had heard all kinds of inspirational quotes, but I was incapable of thinking that way.

After being on the right medication and eventually figured out the right amount (after 2 years), I have since become a really positive person. Being optimistic is a default, it's effortless. My personality has also changed. I cannot even relate to the person that I used to be. A friend from high school reunited with me recently and she could tell the changes by just looking at "my expressions". Another thing I find it interesting is the fact that I used to LOVE to watch horror films. But now, it would haunt me for days. It's the only type of movie that I would not watch.

On the other hand, my mom said that she used to be a fearless and sassy young lady. She would walk ahead of my dad when they were venturing into an unknown territory. But after menopause, and after her health has declined because of aging, she has become an introvert, not knowing what to say in a social gathering and mildly pessimistic in almost everything. Only the fact can change her previous feeling and perspective toward uncertainties.

How to Improve Mental Health

A lot of people have tried medications, but the side effects have discouraged them from continually taking them. For others, they have "bad days" and "good days", perhaps their condition is not that severe that they probably can still function without medications. In these two cases, the only alternative "treatment" to improve their mental health is to improve their overall physical health.

When a person is already aware of the fact that they have a mental health condition, it's important to avoid drinking, smoking and taking any substances that would alter the chemical makeups in their brain. For me, I can't and I don't even drink regular coffee. It would make the quality of my sleep poorer and shallower. Often times, when a person is depressed, they tend to abuse alcohol or other substances as a coping mechanism. Unfortunately, it would only worsen their condition.

It's so trite to say, "we should drink 8 glasses of water each day, eat a lot of veggies and fruits, stop eating junk food, exercise regularly, have at least 6 to 8 hours of sleep each day, have a healthy lifestyle, etc. etc. " The truth is, they really are the keys to maintain and improve a person's mental health in a way that most people are not consciously aware of. The positive changes are slow and gradual, but once our physical body is clear of all the toxic substances and is well nourished, we will feel much better mentally. On the other hand, it takes extra amount of effect and energy for a depressed person to start making positive changes. It's easy to get pulled down but hard to bounce back. The effects are not immediate and it can be discouraging, but you gotta persist and not give up. It's worth the strive.

Friday, March 25, 2016

Mental Illness and Substance Abuse

Mental illness can be triggered and worsened by taking recreational drugs, especially if you already have a genetic predisposition that you might not know of. I heard a story of a teenage boy who used to be a happy and popular high school student. He went to a party and took two pills he didn’t even know what it was. He became psychotic for the next few days. People told him to drink a lot of water in the hope that the drug would just pee out of his system. Unfortunately, after the psychosis had subsided, he fell into a depression and eventually committed suicide. Therefore, really be careful with the choices you make in life. Drugs and alcohol abuse can also worsen a mental illness. Think about it, they can mess up a healthy person’s brain; imagine the damage it could make on a mentally unhealthy person. In addition, they can also offset the effects of psychotropic medications. Therefore, if you want to recover from a mental illness, get sober first!

Tuesday, March 22, 2016

Questions from You

Do you have to be on medications for the rest of your life?

The short answer is Yes. I always make sure I pack my medications in two different suitcases when I travel. If I skip a dosage, I would probably know right away as the pace of my thoughts will pick up at night and I am unable to fall asleep. Without a night of sleep, my heart will beat faster and I am a little bit more emotional and neurotic the next day. But as soon as I take my medications, all will go back to normal and I am myself again.

I have developed a dependency on my medications, perhaps you can compare that to an addict who cannot live without their drugs. However, I would define mine as healthy and normal. Just like someone who is born with type I diabetes, they need to rely on Insulin for the rest of their life. Having a bipolar disorder is innate and I need to rely on something extra to keep me balanced and functional. But unlike someone who has diabetes, they have to watch what they eat and change their lifestyle accordingly, when I stay on my medications, my life is perfectly normal. Right now, I am on a minimal dosage, which doesn't give me any side effects. But as to the long term consequences, I am not worry about it at this time.

Friday, March 4, 2016

Medication --- the Right Type and the Right Dosage

A lot of mentally ill person refuses to take medication or stay on a medication, they think that they are either ineffective or they are doing even more damages. This is actually true. It is very difficult to find the right type of medication that suits a particular person. The first medication I took makes me gain 60 lbs by the time I was discharged from the hospital. It was an anti-depressant medication. Two years later, I was hospitalized again for a Manic episode. It was then that I was correctly diagnosed with Bipolar Disorder. The anti-Depressant medication was actually the trigger of my Mania.

I was prescribed with Lithium Carbonate, which is a primary treatment for Bipolar Disorder. However this medication gave me severe acne to a point that my face was disfigured. It did not do any good to my mental health.

In 2007, my psychiatrist decided to put me on Epival, it is primarily an anti-seizure medication. Amazingly, after a month, I woke up one day and felt like I was different. I couldn’t explain in what way, but I was just happier for no reason. I never felt that way in the first 22 years of my life. As I took that medication more and more, I realized I finally knew what it feels like to be a “normal” human. 

Now, my personality changed, I used to be an introvert, but I am now a very outgoing and positive person. I don’t have phobias anymore and I sleep like a baby every night. My musical and artistic ability have also enhanced. I have truly reached my potential as a person and a human being because of this medication.

Though finding the right type of medication is the key in treatment, it is still not enough. The right dosage is equally important. For instance, not every middle-age female, weighs around 160lbs should be prescribed with the same dosage of medication --- everyone has a different metabolic rate. It took me about 2 years of experiment to figure out the right amount of medication for me. There was one time, my pharmacy ran out of pills in 125mg, instead, they gave me pills in 250mg. Without knowing the difference, I mistakenly took twice the usual amount for over a month. During that month, I felt so odd. I became lazy and moody, I didn’t want to do exercise and I was hungry all the time. I gained 15lbs by the end of the month. Then, my mom discovered the mistake. Within a week being back on the right amount of meds, I was myself again. Therefore, it’s important to be on the exact amount of medication that’s custom to that particular person.

Thursday, March 3, 2016

Why Is Mental Illness so Hard to Treat?

In my perspective, I think that every mentally ill person is potentially treatable. However, it is the most difficult illness to treat, for the following reasons:

1)      It is a very subjective illness. It cannot be detected by blood test, x-ray, MRI or other methods to diagnose an illness. Even the psychiatrists have a lot of limitations in knowing how each patient feels and what type of illness they actually have. Like me, I was not correctly diagnosed until 3 years after my injury.  Therefore, patients are the only ones who can access their own inner state, but most of them are too sick to even think and too easy to give up. And most importantly, they lack the knowledge and insight to help themselves.

2)      It’s hard to find the right type of medication, the right combination of medications and the right dosage. The side effects of some medications can even worsen the symptoms and make a person even more suicidal. Other side effects, such as appetite change, weight gain, acne, aloofness, etc. are big deals to most people. They could become the very cause of depression. Therefore, if one medication doesn’t work, keep on looking and trying on other types of medication. Do not give up on meds. Do not stop taking meds even if you are feeling better. My condition is treatable but I don’t think it’s curable. I’ll take my meds unconditionally every day for the rest of my life. I might compromise my chances of having my biological child, but nothing is more important than the quality of my mental health.

3)      The lack of social support is also a big problem for the mentally ill. When you are crazy and lose your mind, you really need someone to take you to a psychiatric facility and act on your behalf. But unfortunately, in many cases, when someone is mentally ill, people walk away from their life when they need social support the most. When a person lost their job, their romantic partner and other meaningful possessions during their acute state, how would they be able to feel happy again even if they are bio-chemically restored?

Tuesday, March 1, 2016

Questions from You

1)     Did you think of hurting an innocent person?

I did attempt to kill my dad. At that time, I was incapable of feeling love and sympathy. The illness turned me into a sociopath, literally. My nature and the basic elements of my humanity were taken away by my illness. I’d do anything to kill myself and because my parents were protecting me, I was about to kill them as well. This explains why we hear stories of mother killing their own children when they were depressed.

2)     What do you think of the school shootings in the U.S. perpetrated by people who are mentally ill?

I can’t understand their action, but I can definitely relate to their mentality. When a person is at the end of their rope, they’d feel jealous of people who are better off than they are. That’s why those shootings always take place in a school, they seldom happen in a nursing home. Secondly, killing one’s self is a huge commitment. It takes a lot of guts to do it. By committing a horrible crime, they basically leave themselves with no choice but to kill themselves, better yet, the police could do the job for them. Again, a mental illness can strip a person off their humanity. I don’t think all of them are pure evil, they are sick and they don’t believe that they are treatable. If gun control is not possible, then extensive levels of education on mental illness might be the solution to prevent more tragedies from happening.

Questions from You

Did you seek for professional help during your acute stage? And are they helpful?

I was seen by one social worker, one family doctor and two psychiatrists before my injury. They were not very helpful. The social worker and the family doctor were not specially trained in severe psychiatric conditions. Again, like everyone else they were trying to talk me out of my depression. I mean, can you talk someone out of their diabetes? They failed to understand that my condition is a medical problem. As to the two psychiatrists, one of them wrote me a note saying I am not mentally capable of completing my high school exams. The other psychiatrist prescribed me with anti-depressant and discharged me back to the community after 3 days I overdosed myself with sleeping pills. I felt like they could have explained to me what was really going on and gave me more assurance that this was a treatable condition. When the anti-depressant didn’t start working right away, I quickly lost faith on the meds, and lost faith on doctors as a whole thinking if they could not even help me, who could? I thought I would remain crazy for the rest of my life and that was my last straw. After my injury, I saw my Psychiatrist Dr. Mccullagh for the first time. He was my doctor for the next ten years. Right away, he was different from others. He was compassionate. Had I met someone like him prior to my injury, I wonder if it would have made the difference. I think a good doctor should have the heart of a parent, when they treat their patients as if they were their child, not only are they a good doctor, but they are a great human being.

Questions from You

If my love one is depressed and suicidal, what should I do for them? 
Take them to a psychiatric facility to prevent this person from hurting themselves and other people. I have heard so many stories of family members trying so hard to prevent their child from committing suicide. They take turns to watch the person to a point where everyone is extremely exhausted. At the end, they still could not prevent tragedies from happening. Lock a person up in a psychiatric facility is the safest place. All of those psychotropic medications take at least 3 weeks to feel the different, I don’t even mean “effective”, but it takes at least 3 weeks to kick in. During this important period, a person has to be monitored to prevent self-inflicted harm.

This might only apply to people living in countries where a psychiatric facility is an ideal place for rehabilitation. But in other less developed countries, this might not be the solution. I will write about that in another post.