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:

  • 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:
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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 I’m 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 big help, as well as my two blogs.

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 know I have to.

I ask that you remember me in prayer from time-to-time. 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. But, I’m not too finicky.) Sorry for so much.

If you can’t pray, don’t feel at all impinged upon.

Battle Scars

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It is a bad habit to try to teach without personal knowledge. We can preach, and yet we do not possess. This is one of the occupational hazards of those of us in our profession. It also seems to carry a horrible curse of spiritual sterility, that the wise believer can discern.

It’s been 13 years since a diagnosis of Bipolar 1 was made. I believe I was BP in my teens. Life is a roller-coaster for me, up and down, with a twist or two along the way. I am now fairly aware at 58 that much of my earthly existence has already been lived. Life can become such a grind. I’m tired and broken and ready for eternity.

“One should go to sleep as homesick passengers do, saying, “Perhaps in the morning we shall see the shore.”

–Henry Ward Beecher

Billy Bray (a bearer of an unfortunate name) was an illiterate Cornish evangelist in the 1850s. He was heard to pray this: “Lord, if any have to die this day, let it be me, for I am ready.” By faith, I think I do understand these sentiments. I am ready to go as well.

I love collecting good quotes. But here’s two more good ones:

“God buries His workmen but carries on His work.”   -Charles Wesley
“If we really think that home is elsewhere and that this life is a “wandering to find a home,” why should we not look forward to the arrival?”  – C.S. Lewis

Sorry if I’m being too maudlin. But the battle is so long, and it doesn’t ever let up, does it? We all can become weary after a while. What we need is to be ‘shut in’ with the Lord. The Word reminds us:

Strengthening the souls of the disciples, encouraging them to continue in the faith, and saying that through many tribulations we must enter the kingdom of God”

Acts 14:22

“Tribulations” are common, and each must battle through them. And without being melodramatic, we each must walk through the blazing furnace. But I can also boldly attest that there is more than enough grace for each of us. We just need to become desperate enough. (Which shouldn’t be too hard).

Armor is given. Wearing it means you’ll survive (and thrive) to see another day. Those who may suggest that the Christian life is a “bed of roses,” I would say that they haven’t read Ephesians 6. If there is no war, why would the Holy Spirit tell us to put it on?

“Finally, be strong in the Lord and in the strength of his might. 11 Put on the whole armor of God, that you may be able to stand against the schemes of the devil.” 

Eph. 6:10-11

We are just starting to learn we must fall in love with Jesus. He receives us with a massive kind of love. And His mercy meets us at every doubtful corner. You have His Word on it. Simply ask Him to come to you. 

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Antidepressants for Believers?

What do you think of Christians taking antidepressants?

By Pastor John Piper, given on March 30, 2010

The following is an edited transcript of the audio.

What do you think of Christians taking antidepressants? I have been on them and have been accused of not relying on God.

That relates to an earlier question about how any physical or personal means that you use can signify that you’re not relying on God. So eating might be a failure to rely on God, because he might just fill your stomach by miracle, and you don’t have to eat. Or not sleeping would be a way of relying more on God, since you don’t have to have your psyche made stable by sleep at night. And so on.

God has ordained physical means. Aside from the ones that seem more natural, like food, there’s medicine: aspirin, Nyquil, etc. This water is helping my throat right now. [Sips it.] Was that sip a failure to rely on God?

Could be. “Just throw this away and rely on God! He will keep your throat moist. You don’t need to be drinking. You’re an idolater, Piper. You’re idolizing this because you’re depending on it.”

Well, the reason that’s not the case is because God has ordained for me to thank him for that. He created it and he made this body to need a lot of fluid. And it’s not a dishonor to him if I honor him through his gift.

Now the question is, “What medicines are like that or not like that?” Taking an aspirin?

My ophthalmologist told me about 4 years ago, “Take one baby aspirin a day and you will postpone cataracts or glaucoma or something.” He said, “I can see just the slightest little discoloration, and the way it works is that circulation helps.” So he told me to pop one of these little pills in my little vitamin thing. And I take it every day. And I just said, “Lord, whether I have eyes or not is totally dependent on you. But if you would like me to use this means, I would.”

My answer is that when you start working with peoples’ minds, you are in a very very tricky and difficult situation. But I think I want to say that, while nobody should hasten towards medication to alter their mental states—even as I say it I think of caffeine, right?—nevertheless, I know from reading history, like on William Cooper, and by dealing with many people over the years, that there are profoundly physical dimensions to our mental conditions.

Since that’s the case, physical means can be appropriate. For me it’s jogging. I produce stuff in my brain by jogging. But that might not work for somebody else, and they might be constantly unable to get on top of it emotionally. I just don’t want to rule out the possibility that there is a physical medication that just might, hopefully temporarily, enable them to get their equilibrium, process the truth, live out of the strength of the truth, honor God, and go off it.

When I preached on this one Easter Sunday a woman wrote me, thanking me that I took this approach. She said, “You just need to know that I live on these things, and I know what it was like 20 years ago and the horrors and the blackness of my life. And now I love Christ, I trust Christ, I love my husband, our marriage is preserved, and I’ll probably be on these till I’m dead.”

So I’m not in principle opposed. I just want to be very cautious in the way we use antidepressants.


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English Pigeons

“I will instruct you and teach you in the way you should go; I will counsel you with my eye upon you.”

Psalm 32:8

In April 2002, I was sitting in this cavernous waiting room at King’s Cross in London, England.  I was waiting for a bus to Cambridge, UK.  I sat all alone, and stared at the tiled floor at my feet.  The doctors had warned me not to travel alone, but I had disregarded their restrictions.  I was taking several psych meds and felt somewhat stronger than I had in months.

As I sat there staring at the floor, within my field of vision, came several pigeons.  They were fat little guys, apparently thriving on bread thrown out to them.  Several very large windows were open, and these pigeons seem to have no fear as they took advantage of a meal from bored travelers.  I remember their audacity and resourcefulness as they came up just a couple of feet  from my chair.

Depression had followed me like an old friend all the way from Alaska to England. I had pushed my limits and was completely drained and quite confused.  I was crying out to the Lord, very desperately.  All of a sudden, a pigeon came across the floor and “presented” himself, right square in front of me.  I was amazed that he was crippled, one of his feet was a twisted claw.  He had been profoundly injured in such a way, that he would never be the same.  He was damaged, and yet somehow he survived.

It was like receiving a lightning bolt.  I understood for the first time in a long time, the Father’s love and care over me.  I saw the pigeon, and I saw myself.  It was a moment of a reassuring grace.  In the ‘mega-hustle’ of 13,614,409 people in London, and in the midst of my profound mental crisis, I knew God’s caring touch.  A grace much greater than all my sin and confusion. He was just letting me know that He was close.

Later that day, I found myself walking the streets of a busy Cambridge with its great universities.  I was all by myself, and I had gotten hopelessly lost.  I was terribly manic, and my meds just couldn’t keep the lid on.  I felt people staring at me, I was talking out loud to myself, disheveled and thoroughly confused.  I just kept wandering and talking, for hours.  I desperately needed psychiatric shelter.  But I was all alone. I knew no one at all.

I kept walking past the many universities, and churches.  They were very beautiful, but I was lost.  I then remembered the damaged pigeon, completely oblivious to self pity. I started to call out to the Father out of my confusion.  Within a few minutes I found myself sitting on the top level of a double-decker bus, with the driver aware of my problems who specifically guided me to the place I was staying.  I was being cared for. I think he was an angel sent to my aid.

I have come to realize that this trip to England was not for me to see Big Ben, Parliament or wander the academic centers of Cambridge University.  Rather I was brought there to meet a certain pigeon, who was waiting to meet me, and pass on vital instructions.  He shared things that I need to know.  The history and landmarks were nice, but I’ve forgotten much.  But all I really needed was somehow given.

P.S.  Two things:

  1.  If you can avoid it, don’t travel alone.

  2. Never call pigeons, “rats, with wings.”

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