Handling a Diagnosis of Tardive Dyskinesia

 

Tardive Dyskinesia (TD) is a condition of involuntary, repetitive movements of the jaw, tongue or other body movements. It frequently is a side effect of the long-term use of antipsychotic drugs used to treat schizophrenia or bipolar disorder. It is almost always permanent. I’ve been told Vitamin E might help a bit.  Benzodiazepines have also been used with mixed results on a short-term basis.

Some examples of these types of involuntary movements include:[3]

  • Grimacing
  • Tongue movements
  • Lip smacking
  • Lip puckering
  • Pursing of the lips
  • Excessive eye blinking

(Wikipedia)

I recently was diagnosed as having TD after the use of Zyprexa. My version is my lower jaw moves from side-to-side, unless I concentrate on not doing it. I quickly revert to this involuntary movement when I’m not aware of it. I recently saw a video of myself (with my family) and sure enough there I was, doing the ‘jaw thing.’ It was very obvious. It was also very embarrassing. (I have the ‘lithium jitters’— where my hands always shake, but TD is different.)

There are a couple of things I might mention:generics7

1) I’ve discovered that there is a real social isolation with this TD stuff. To be doing this in public is “not acceptable.” I have had people come up to me wanting to know what’s my problem. Since I can’t control the movement I just say, “It’s my meds— they affect me this way.” In a way it’s like wearing a neon sign saying, “I’m a fruit cake.” Having a mental illness is stigma enough, but the TD just puts a new edge on it.

2) As a natural introvert the isolation has only deepened. (I avoid crowds and most social engagements.) I guess if the truth be told, I’m uncomfortable when others look at me strangely or whisper to each other. My standard ‘paranoia level’ has taken a new twist. I feel like I’m always compelled to explain. I guess I’m embarrassed when others are embarrassed.

3) I settle myself down in my faith to cope. I know I’m not alone in this– the Lord Jesus is always with me. He holds me tight through all these twists and turns. Since I isolate myself so much, I savor the connection I have with a few friends who have become inured to my condition. Social media helps out— Facebook is a gift.

4) One of the things I try to remember are the issues of selfishness and pride. I keep reminding myself it’s not about me all the time. One of the significant areas mentally ill people deal with is self-absorbed thinking. It seems it comes with the illness.

5) I try to keep a sense of humor everyday. It breaks down the mental pain to tolerable levels. We can take ourselves too seriously sometimes. Be more patient with yourself.

I certainly ask that you remember me in prayer. I’m in ‘uncharted waters’ (it seems) and I sometimes feel all alone with my mental illness and all its tangents. I want good to come out of this. (An instantaneous healing would be o.k. too.)

 

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When Despair Empties You

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“It is through much tribulation that we enter the kingdom of Heaven.”  

Acts 14:22

As a broken believer this happens. I breakdown, my faith is questioned, and I feel all alone. Issues like a simple hot shower and eating something seem impossible. I’m embarrassed to say I once went 34 days with a shower. I laid in bed unable to function. That is the insidious truth about chronic depression, I know it well. God seems far, far away from me. Life doesn’t matter anymore.

There is much I can do before  it gets to this point. And although life seems insurmountable. Clinical depression kills people. It slowly devours “a sound mind.” It cripples before it takes away your life. There is nothing quite like it; people tell you it will pass, and that you’ll see the sun again. But at the time that seems to be the worst advice ever given.

For God has not given us a spirit of fear, but of power and of love and of a sound mind.”

2 Timothy 1:7

Meds help a lot. I take Zoloft and that is a godsend. I never miss a dose. I know I’m not bulletproof. I’ve taken it for several years now. (It’s like insulin for a diabetic).

Afflicted souls are special to God. And that truly comforts me. Sometimes it seems like there is an invisible tether that holds from completely dropping off the edge. When I do pray, it is desperate and brief. More like a quiet scream for help. There are no frills and no eloquence, but I know I’m being heard by Him who guards my soul.

People for the most part, are of little help. I admit that my attitude can be less than stellar. “Unless you have been lost in this section of hell yourself, it’s best if you just shut up.” (I don’t really say this, but I’m tempted to.)

But there are a few that can speak. Almost always these are the ones who have been through some affliction themselves. They have been hurt and they ‘walk with a limp.’ I’m convinced that they can speak in direct proportion to the pain they themselves have suffered. I once woke up to another pastor praying prostrate on my bedroom floor. He didn’t have to do or say anything else. He left without saying some ‘pious’ word to me, what he did was wonderfully done.

“I will trust Him. Whatever, wherever I am, I can never be thrown away. If I am in sickness, my sickness may serve Him; in perplexity, my perplexity may serve Him; if I am in sorrow, my sorrow may serve Him. My sickness, or perplexity, or sorrow may be necessary causes of some great end, which is quite beyond us. He does nothing in vain.”   

John Henry Newman

Take care of yourself. If this isn’t your first major depression, prepare in advance spiritually for the next. Identify those ‘dear-hearts’ who can help you in advance. Keep taking your meds, even if you think your o.k. And speak often with the Lord, and learn to listen to His voice. That “sound mind” is a promise for those who truly need it.

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Mental Illness in Children & Teens

Does your child go through intense mood changes?

Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice he or she is very sad at other times? Do these changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. Read on to understand more.

What is bipolar disorder?

Bipolar disorder is a serious brain illness. It is also called manic-depressive illness. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or “up,” and are much more active than usual. This is called mania. And sometimes children with bipolar disorder feel very sad and “down,” and are much less active than usual. This is called depression.

Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The illness can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide.

Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.

Who develops bipolar disorder?

Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.

How is bipolar disorder different in children and teens than it is in adults?

When children develop the illness, it is called early-onset bipolar disorder. This type can be more severe than bipolar disorder in older teens and adults. Also, young people with bipolar disorder may have symptoms more often and switch moods more frequently than adults with the illness.

What causes bipolar disorder?

Several factors may contribute to bipolar disorder, including:

  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.

The causes of bipolar disorder aren’t always clear. Scientists are studying it to find out more about possible causes and risk factors. This research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.

What are the symptoms of bipolar disorder?

Bipolar mood changes are called “mood episodes.” Your child may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. Children and teens with bipolar disorder may have more mixed episodes than adults with the illness.

Mood episodes last a week or two—sometimes longer. During an episode, the symptoms last every day for most of the day.

Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels.

Children and teens having a manic episode may:

  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.

Children and teens having a depressive episode may:

  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.

Do children and teens with bipolar disorder have other problems?

Bipolar disorder in young people can co-exist with several problems.

  • Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.
  • Attention deficit/hyperactivity disorder, or ADHD. Children with bipolar disorder and ADHD may have trouble staying focused.
  • Anxiety disorders, like separation anxiety. Children with both types of disorders may need to go to the hospital more often than other people with bipolar disorder.
  • Other mental illnesses, like depression. Some mental illnesses cause symptoms that look like bipolar disorder. Tell a doctor about any manic or depressive symptoms your child has had.

Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, like drive too fast or spend too much money. Some young people with bipolar disorder think about suicide. Watch out for any sign of suicidal thinking. Take these signs seriously and call your child’s doctor.

How is bipolar disorder diagnosed?

An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child’s mood and sleeping patterns. The doctor will also ask about your child’s energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other than bipolar disorder is causing your child’s symptoms.

How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in a similar way they treat adults. Treatment can help control symptoms. Treatment works best when it is ongoing, instead of on and off.

1. Medication. Different types of medication can help. Children respond to medications in different ways, so the type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.

Children should take the fewest number and smallest amounts of medications as possible to help their symptoms. A good way to remember this is “start low, go slow”. Always tell your child’s doctor about any problems with side effects. Do not stop giving your child medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

2. Therapy. Different kinds of psychotherapy, or “talk” therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together.

Sometimes a child’s bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms.

You can help treatment be more effective. Try keeping a chart of your child’s moods, behaviors, and sleep patterns. This is called a “daily life chart” or “mood chart.” It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.

How can I help my child or teen?

Help your child or teen get the right diagnosis and treatment. If you think he or she may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

  • Be patient
  • Encourage your child to talk, and listen to him or her carefully
  • Be understanding about mood episodes
  • Help your child have fun
  • Help your child understand that treatment can help him or her get better.

How does bipolar disorder affect parents and family?

Taking care of a child or teenager with bipolar disorder can be stressful for you too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.

If you are taking care of a child with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job. It might help your child get better too.

Where do I go for help?

If you’re not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency.

I know a child or teen who is in crisis. What do I do?

If you’re thinking about hurting yourself, or if you know someone who might, get help quickly.

  • Do not leave the person alone
  • Call your doctor
  • Call 911 or go to the emergency room
  • Call a toll-free suicide hotline: 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline.

Contact NIMH to find out more about bipolar disorder.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663

Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Web site: www.nimh.nih.gov

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Delusions of the First Person Variety

When I first watched the “Matrix,” I completely flipped out. It explained too much. It took me a month to recover.

I need to briefly share what delusions are like.  I’m going to flip the switch and flood the room with light, and watch the “critters” scuttle to find a hiding place.  I’m doing this to help heal myself, and for you to understand this awful state of mind.

First of all– definitions

Delusion n.
A false belief held despite strong evidence against it; self-deception. Delusions are common in some forms of psychosis. Example.  Because of his delusions, the literary character Don Quixote attacks a windmill, thinking it is a giant (that’s the dictionary workin’ it for you.)

Delusion de·lu·sion n.
A false belief strongly held in spite of invalidating evidence, especially as a symptom of mental illness.

Typically, my delusions have a common core of pride or self-centered thinking. For instance, I have experienced all of these:

  1. A woman loves me and she is secretly trying to be with me. This is very flattering and egocentric.  This  one can really mess with your thought-life. (Ego.)
  2. I’m the center of the universe, people really do not exist, except when they come into my life or influence.  [This one is a bit metaphysical.] See #7.
  3. I have special powers that ‘know” a person’s motives, plans and heart.  I am hyper-discerning.  The opposite can be true at times, where I become exposed to people, which necessitates me never leaving my room. I feel “naked” and of course, very uncomfortable.
  4. I get paranoid, thinking people are plotting with each other behind my back, working to destroy me.  Chat rooms, and Facebook are focal points for me with this one, but not always.  With this one I get really verbal, and I start zapping people.  I guess because it’s the internet I can do this with impunity.
  5. Clocks are always at the top of the hour, like- 7:00 am.  Or they are at the bottom of the hour, like 11:30 pm.  I call this “chronosynchronism.” I believe this is evidence that my life is orchestrated, purposeful, and this is evidence I am very significant.  This is my latest.  And it really isn’t super disruptive.
  6. I can read secret messages in books meant for me.  I also line up spaces in what I’m reading to form an unbroken line.  I compulsively do this.
  7. The big one is this, I am in my form of “The Truman Show”.  The universe is just a set and I am the only living thing out there.  Everything is focused on me (of course).
  8. I hear voices sometimes, but mostly a radio or sometimes the “dot-dash-dot” of a telegraph.  I think its trying to warn me in some code.  It can be persistent. And it can be disruptive. Paranoid that my giftedness is cause for the NSA to control me.
  9. My wife intends to poison me.
  10. Personal hygiene issues. Afraid of being murdered in the shower creates a super-phobia. I once went 6 weeks without showering. (I made my own eyes ‘water’, lol).

I guess all of these have things in common.  They are self-centered.  They are unreasonable and illogical.  They are compulsive. And yes, meds do work.  And the above list?  The delusions are only mild-to-moderate issues of delusional paranoia.  There are so many Christians and non-Christians who have worse. I once met a man who seriously believed he was Jesus. (And no, I didn’t worship him).

As a believer working out his discipleship, I’ve discovered that humility and openness is always the way of keeping one tethered to reality.  However, I have a fear that I will break loose and never come out again.  I MUST live in “brokenness”.  (So in a strange way, following Jesus Christ is easier.)

Also, I must be open to things that will invalidate my delusion.  Even if I’m 99% convinced, that 1% will cause me to consider thinking through a scenario.  Truth is your best friend when you are challenging a delusional paranoid.  But it has to be gently applied. Life doesn’t have be lived this way. Also, delusions will often ‘morph’ and change and take on modified characteristics. This seems to be part of the mental illness, but can also indicate demonic oppression (or both even).

A psychiatrist should be informed in most cases. Very often meds will be necessary to get your loved one through this time, but not always.

Praying for delusional behavior

People have prayed for me, more then I have prayed for myself.  Your intercession bridges a gap over this illness.  When you pray, you power up the energy cells and get instructions.  It may mean wait, or proceed.  Every person and situation is different. Prayer is always the best approach.

(So many delusions and so little time.) They will vary from person-to-person. An active prayer may help, “Lord, may it be the real me who touches the real You.” Remember, Jesus stands at the right hand of his Father praying for you [which can’t be all bad].

“Who is to condemn? Christ Jesus is the one who died—more than that, who was raised—who is at the right hand of God, who indeed is interceding for us.”

Romans 8:34

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An Inconvenient Madness, [A Broken Believer]

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Very simply, bipolar disorder is characterized by mood swings that are defined by major shifts between incredible mania and clinical depression. It’s usually intense and quite disabling.

Depression: There are days when I wake up and I don’t like what I see in the mirror. At times a deep and profound sadness seems to grip me like a vise. It’s like a huge heavy grey cloak covers me, and I can’t shake it off. Typically I hide and crawl into bed for weeks at a time. All is hopeless and I despair of life. I am irrevocably lost. This is bipolar depression and I’m slowly learning that I can shake it free.

Mania: When I’m manic it’s as though I have wings! I’m blasted with a special grace which makes me creative and intelligent and superior to mere mortals.  I become energetically impulsive and irritably crass. It’s all about ME! Thankfully these times don’t happen too often. These moods don’t last long but they’re intense. A measure of freedom can also be found.

Medication prescribed by my psychiatrist helps smooth things out. It was hard to adjust to taking them, but now I know I did the right thing. It’s been over 10 years since my diagnosis and I suppose I have the dubious honor of just surviving. I have several scars on my wrists that remind me of a long journey. Those afflicted will understand.

It’s been suggested that bipolar people can become more empathetic and sensitive to the suffering of others. I’d like to believe that this is true. This seems like a biblical idea.

“He comforts us in all our troubles so that we can comfort others. When they are troubled, we will be able to give them the same comfort God has given us.”

2 Corinthians 1:4, NLT

 “The Sovereign Lord has given me a well-instructed tongue, to know the word that sustains the weary.”

Isaiah 50:4

For the broken believer, I’m confident that the Lord can turn my mental illness into something positive and good. The Holy Spirit empowers the Christian to do the extraordinary. It’s in our weaknesses we can become strong. We are fully enough in Christ. (2 Corinthians 12:9).

I stepped down from my positions as a pastor and a Bible instructor when the bipolar symptoms became clear. This wasn’t easy but I knew it was what God wanted. Today I still speak on occasion at a local Church.

I also minister here at brokenbelievers.com and http://www.lambfollowers.com.. I try to post everyday and I get constant feedback from those who are in need. Just a single post, a list of 24 hour crisis hotlines, averages 175 hits a day by itself! (https://brokenbelievers.com/247-crisis-lines/)

I do covet your prayers for both ministry sites.

This work would never have happened unless I was “detoured” by my bipolar.

“And we know that God causes everything to work together for the good of those who love God and are called according to his purpose for them.”

Romans 8:28

I want to urge you to look at the big picture of mental illness. Sure it can be remarkably disruptive, but the Lord can transform you. Meds and therapy are vital for me. Prayer and Bible reading even more so. You can find a way through this. It’s not easy. Don’t fight the illness. The Father works close to His “special” children. There is a real and abiding hope for you. I’m convinced you can find it.

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From a Mental Hospital Ward, [Crushed]

3 For the enemy has pursued my soul; he has crushed my life to the ground; he has made me sit in darkness like those long dead.”

Psalm 143:3

Some time ago,  I was hospitalized for my mental illness. (Actually seven times.) And though each time was bitter, but the Lord carried me.  They would take from me my shoelaces, and belts, and fingernail clippers.  Basically, I was stripped of everything, anything that I might use to harm myself. But I was creative, I took a clock off the wall and rolled it in a blanket,  I smashed it and used the shards of glass to cut my wrists.The nurses were exceptionally observant, and within moments they intervened.

I had already been stripped, searched, and then brought into a ward full of very sick people.  Much of all of this is a terrible glazed blur.  There was a real awareness of unreality.  I was quite confused, and it would take several weeks before I could reconnect.  Things were no longer ‘reasonable’ and I could discern nothing.  But I didn’t know I was so confused (but I did suspect it). The staff were quite aware and accommodating.  They let me be, so time could take care of the rest. I needed to unravel things  

Besides, Jesus knew exactly where I was if I didn’t.

Days rolled by, quite slowly.  The tedium of a mental hospital is the worst— much more difficult than jail or prison.  You walk in a very limited corridor, back and forth.  You wait for your shrink, and wait, and wait.  You pace, and pace. You pray, stupidly.  The other patients were equally disturbed.  There was a great variety among them.  One guy would urinate in any corner. Once he jumped up on the nurses station, and took a “whizz.” It was hysterical.  He almost shorted out their computer.

In all of this, there was a very bleak and strange awareness, of being incredibly ‘detached,’ and only remotely aware that something was not right with me.  I tried to get well, but I was mentally lost.  I paced, and I remained confused.  I was most definitely in an ugly place.  Desperate and increasingly bewildered, I knew I had no place to go.  A fine place for someone who used to pastor, and teach at a Bible college.

If you have been in this place, you will recognize the ‘lostness’ of being on a ward of a mental hospital. It is confusion mixed with despair,  and without a part of very strong drugs, and there is nothing you can do to be released.  And really until you come to this fact, they will never let you go.  They wait for you to snap out of your confusion, unfortunately that takes time. Sometimes many weeks and whole months. Sometimes never.

It’s worse when you have a family.  In my case it was my wife, and two small children.  This at times, would twist my heart.  I would get a very short phone call, once a week.  But this was quite difficult.  I gained very little from those calls, and I found myself quite disturbed after each call.  Being on this ward tinged me completely. It was like being dipped into darkness.  I was very much affected.  Now on the outside, I admit I was quite disturbed, but at the time I honestly did not understand a way out.

Dear friend, having a mental illness is cruel and disturbing.  And being committed to a mental hospital is a desperate thing.  Having passed through its locked doors is something you will never forget.  The way I figure these seven hospitalizations have stolen over six months of my life. Its work is irrevocable, its fingerprints will be on your life, for as long as you live.  But God will bring good out of this. This I know.

“Do not gloat over me, my enemy!
    Though I have fallen, I will rise.
Though I sit in darkness,
    the Lord will be my light.”

Micah 7:8

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Hope for the Hopeless [Joy]

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12 Rejoice in hope, be patient in tribulation, be constant in prayer.”

Romans 12:12

Three things are critical for the New Testament believer:

  1. To rejoice out of a real hope,
  2. a deliberate endurance,
  3. and a prayer life that is unceasing.

These three are vital for us if we want to be authentic saints. These three aspects must become foremost in our discipleship.

Of the three, the first is to rejoice out of a real hope is the most important. It seems like I take the most “hits” over this one. There is a constant erosion  over my joy and my hope. I encounter the false belief that I will be one of the damned. A variation is that I’m ‘cursed’ by God and my life from this point is always going to be hellish and miserable. Frozen like a mosquito in ancient amber.

For me, my mental illness is a sin– the sin of despair. I don’t insist on the right terminology or of definitions. Some believe these issues are demonic. Some wonder about the use of meds, or the value of seeing a psychiatrist or going into therapy. These are all valid, but it seems like polishing the brass rails as the Titanic is seeking.

I won’t try to give answers, because there isn’t a single one to be found. There’s a complexity about the human heart, and God’s sovereign plan that I can’t venture anything. I will only suggest we give room for our own misunderstandings. Perhaps it’s the presence of Jesus we can agree on.

Rejoice in hope,” goes a long ways to combat the enemy, our own fallenness and our own sin of despair. A ‘song to the Lord’ breaks our souls free and is the brokenbelievers true hope is the best antidepressant. But I vote we keep singing out of our cells (Acts 16:25).

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