Hypervigilance/Paranoia

Hypervigilance

: extreme or excessive vigilance : the state of being highly or abnormally alert to potential danger or threat

Hypervigilance ©2019. Acrylic on canvasboard, 12"x 16"

Paranoia

1: a psychosis characterized by systematized delusions of persecution or grandeur usually without hallucinations

2: a tendency on the part of an individual or group toward excessive or irrational suspiciousness and distrustfulness of others

Hypervigilance is kind of a mixed-bag of a term - medically it's treated as distinct from paranoia, but for me hypervigilance is more a symptom or even the outcome of paranoia. It's prominent in schizophrenia and schizoaffective disorder (I've been diagnosed with both at different times) - probably the most prominent symptom in general public knowledge. But for the most part, when not in a psychotic state but sometimes even within one, I've suffered it and been aware of it. I'm lucky the people closest to me - my husband and parents - are good at alerting me when I sound paranoid to them. If my mom says "Can you hear yourself?" after I've said something really odd, or my husband says "That sounds kind of paranoid, Jen" in a non-confrontational tone (as always) I trust them and it's usually a huge relief. Then I know there's no true threat and I can relax. 

It also quells the hypervigilance. For me, it's something I can't always turn off. It makes me overly watchful, it's one of the most unpleasant experiences. While I'm in remission from psychosis (which is most of the time, it's been almost 10 years since my last episode) it really only hits me hard during the second half of my menstrual cycle, during the time I suffer from PMDD (Pre-Menstrual Dysphoric Disorder, or "PMS on steroids") I get really uptight, anxious, paranoid, and extremely hypervigilant. I'm always watching myself (hoping not to anger or upset anyone) or I'm watching others ("Are they mad at me? Do they hate me? Did I fuck up again? Am I being ignored on purpose? What did I do wrong? I know I did something wrong!"). It doesn't stop. It doesn't rest. It feels no pity. It's the goddamn Terminator. The only difference is it dies off after about two weeks, a few days into the actual period. Before that I'm a mess to be around. 

I'm actually writing this in a state of PMDD-instigated hypervigilance. It's been a rough day or two. My apologies for any talk that's too dark in this post.

Like the painting above, finished last week, the voices (internal criticism from my own mind) are hissing at me about how horrible a person I am. So many reasons, so many different thoughts. An onslaught of disgust. It's hard to understand in this frame of mind why people like me. Or why they tolerate me. Then the depressive voices chime in - "You're cruel! You've hurt everyone around you. They'll all leave you!" Hence the mouths screaming at the subject in the painting. She is unprotected by hair, clothes, any covering whatsoever. Presented in humiliation, perpetually on the verge of tears, trying not to listen while the voices only crowd around closer, louder.

The crown of eyes is the hypervigilance itself. Eyes watching in all directions to spot the smallest clues to validate a reason to be so overly observant. What did I tweet that was so offensive/cringy/embarrassing/wrong? What did I "like" on Facebook or Instagram that makes me look so horrible to everyone? What did I say to anger my family? Have I been too mean to anyone? Should I apologize again? What have I said or done that makes me a burden to everyone I know? I don't know. Keep looking!

or

Did they just say that because they know I'm horrible? Is that comment actually a passive-aggressive dig at me? 

It keeps on going like that. It's worse at night. Sometimes it becomes rumination that speeds up and keeps me from being able to sleep. Too many thoughts, or only one thought circling in my head until I get so exhausted by it that I fantasize about trepanation. At least momentarily. Instead though, I usually just get up and start drawing. Just for an hour, then I go back to bed. My eyes are always scanning, for my own mistakes or external threats. A crown of unblinking eyes, ever watchful. Yet I never find anything conclusive, only speculation. Not knowing is the worst.

If you've made it down to this point in the post - well, even to those who haven't - thanks for listening. Thanks for not rejecting me. I'm not the only one that's like this. I made this painting to try and tell in an image (that's probably hard to understand) what it feels like. It's very weird, I know. It feels as bizarre as it looks. The thing is that there are other people with schizophrenia out there (1% of the general population - you know, one in 100 people) or schizoaffective disorder. There are others (3% to 8% of those who menstruate) who suffer from PMDD. There's another subset of people with both. I know quite a few of these people. I'm one of them. Please treat us kindly, please forgive us if we get uncharacteristically angry.  It really isn't your fault. It's an illness, or more than one illness. As of yet there's no cure - only management for the symptoms. All you need to know is in the face of the woman looking out at you from the center of the painting. It hurts.

As always, thank you for your patience with me and the things I say or do. I hope you can appreciate the painting for what it is. I hope those like me who suffer similarly (or those who identify with the painting) will be comforted that they are not alone.

Two Weeks In Hell

"From The Wreckage of my Twisted Dreams" ©2001

Everyone (or at least most women) know what PMS is. Stereotypes abound, not all of them are wrong. Hormone fluctuations - primarily between the switch from estrogen to progesterone in the latter 2 weeks of the monthly cycle tend to render us vulnerable to issues we're familiar with: moodiness, pain, weepiness. Some physical symptoms like bloating. But out of all of those who understand it, does anyone know its even more intense and furious sister, PMDD?

As PMS stand for Premenstrual Syndrome, PMDD stands for Premenstrual Dysphoric Disorder. I've heard it described as PMS on steroids, and I agree. I have this condition, I think it developed within the past 5 to 10 years. I go through it every month. Two weeks I'm myself, I'm fine. The other two weeks I get increasingly irritable, angry, overwhelmed with guilt... maybe I should define it here.

Premenstrual Dysphoric Disorder is a more severe version of PMS, although some of the mood issues of the disorder are so overwhelming and uncontrollable that they tend to disrupt relationships between family, partners, spouses, co-workers. The mechanism of action (how it works) is not known, although it is a relatively new field of study. Many doctors in person though - psychiatrists and gynecologists specifically - don't know how to help. It was entered in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, or the"Psychiatric Bible") when it was revised in 2013. That's not very long ago. It's suspected that it affects 3% to 8% of menstruating women, a subset of all women. It may be infrequently found, but as it is a profound problem (for those of us who have it and our loved ones too), I don't know why there isn't more information out there? It is a women's issue, which makes it a human issue. However, it is a taboo topic because of what I'd suspect is the disgust most people have (even among women) of menstrual-related issues. As a psychological/psychiatric issue, it has that stigma as well. It can easily cause a lack of empathy in the people who love the affected woman, as the outbursts at times can be interpersonally traumatic. The rage of the patient and the guilt afterward, shouting and then so much crying, for up to two weeks. Every month. Anyone on the receiving end (or merely in the same room) would be understandably upset, and honestly, I feel a lot of pain for my loved ones because of mine (which is part of the guilt over it all).

"Fuck You All!" ©2009, acrylic on canvasboard.

"Nobody Hears" ©1999-2000, acrylic on canvasboard.
Two extremes of the same illness.

Symptoms

They begin around the same time, two to three weeks after the past cycle. You never see it coming, but you know it's on its way. These are similar to PMS symptoms, but they're even more exaggerated. 

           screenshot credit: www.medicinenet.com

Fatigue, mood changes, abdominal bloating, breast tenderness, which sounds pretty familiar to many women. The difference is the magnitude. From then on it goes into irritability that could start an outburst of rage (or if at all controllable, a highly pressured "peace" that could be revoked if the irritations continue - whether from another person or even an inanimate object, or even the self). If not rage, then a general argumentative mood where nothing is good and anything nice you could say to the woman suffering might get turned against you. For me I tend toward both, but then afterward is the guilt. Extremely intense guilt. It doesn't matter how good you are at hiding your emotion, or if you're out in public, the tears just start seemingly out of nowhere. No one can console you. Either you feel extreme guilt for something (or nothing), or the depression hits with the intensity of a 2' by 4'. You just start crying, because what else can you do? Afterwards, it's a matter of time until you start crying again, usually for reasons you don't know. 

"Uninvited Wallflower", ©2007, detail.

For me it's guilt. I don't know why. Perceived guilt, usually, not for anything I may have actually done. This past January I was visiting my parents in America with my husband. For several days straight I sat at the kitchen table and cried over a perceived (or not?) offense I thought I'd committed against my parents. They told me no, I hadn't done anything. They were fine. I get the feeling they wanted to help but had no idea how. But they couldn't. Several days straight my eyelids were so puffy from it that I looked strange to myself. Like I'd been hit a couple times in the face. Only to myself, as far as I know.

As for the rage, I've been able to crank it down to something manageable but I'm wondering if it's hurting me internally, and that scares me. I do hold it in. I try to work it out through my art, sometimes though I just get mad at the paint or the canvas or myself (or all three). I don't talk about it but it's there. I speak softly, but it's there. Always under the surface. Even at night in bed, if I haven't fallen asleep after an hour, I get mad at any tiny sounds I hear (even just a clock ticking or a fly buzzing), and I become so infuriated that I have to get out of the fucking room as fast as I can without waking my husband. I end up going to the living room of the apartment and drawing something like the sketch below. With headphones on...although it does sometimes happen that my own choice of music angers me too. The vocalist is too nasal, the drums are annoying, the guitarist thinks he's just SO great at soloing, at some point I can remember thinking all of these to the point it's unbearable to continue listening. NEVER at any other time in my life, only when I'm getting sicker. I'm using dark humor in a sense right now, but I tend to be nowhere as minutely musically critical as even these things unless I'm already compromised emotionally at the worst possible time.

Untitled sketch, 2019.

It's even worse if anyone in the building has guests over, because no walls are ever thick enough. I want to throw things around, shout obscenities at the offenders, stamp on the floors or the walls of the offending neighbor. It stops just short of me actually doing it. And only right before my period starts.
No one is safe from me.

The crying, it just comes out of nowhere and it's not just tears, it's full on "ugly" crying. Especially if I have time alone. Horribly broken sobbing. It's absolute hell. When neither the rage or the sadness is happening, it feels like a depressive episode. My body feels heavy, I care about nothing. Terminally bored, unable to move, unable to sleep, unable to feel. Because I have schizophrenia/schizoaffective disorder, it aggravates the symptoms. Especially the depression.

Then there are some lesser-known symptoms. Light is too bright, sound is too noisy (and you get angry at whatever is causing it), and for some reason touch is absolutely unbearable. I feel sorry for my husband because how do you say (nicely) "Could you please not do that?" when inside you're thinking "If you fucking touch me again you lose both hands"? I tend to be passive-aggressive at best, but I can only be so calm for so long. It's a weird thing, the touch is worse the softer it is. Like electricity. In trying to be civil and stuffing the rage down, it stokes the fires for the next outburst. It's somehow unbearable.
What is more irritating (to me and my loved ones as well) is the brain fog. The forgetfulness. I can't remember what someone has said to me 5 minutes ago, and if I have plans set for the day I usually have forgotten all of it. (Disclaimer: I've had memory issues for a while, since around 2010, mostly due to bad psychiatric and Parkinson's medication, I haven't been the same since and neither has my memory. It's still much worse during the last two weeks of my cycle, however.)

I had a therapist describe all of this to me by explaining that the MRI scans of normal female brains vs. the same women's brains during the span of PMDD show a "ring of fire" around the cortex. Even when compared to women having PMS. In other words, the brain is working overtime in areas that should not be busy, are not usually busy. Sensory information, perception (you have no idea while you're in the midst of an episode that you're in the midst of an episode. A lot like any psychosis, although this isn't a psychosis, per se.) If you already have another underlying mental illness, that will be exacerbated by the hormone switch beginning two weeks before your next period.
This same therapist also had me write on a card for myself when I knew a period was coming up that my parents are not trying to hurt me, they love me. Also that my husband is not trying to hurt me in any way, he loves me. Whether it seems like it or not, they love me and are trying to help. Believe it or not, you do forget this going into an episode of PMDD. You really do think even our loved ones are picking on you just to get a rise out of you, or maybe they even secretly hate you. My therapist's answer to this was to get me to put the card somewhere I could see it prominently every month during the end of my cycle so I would remember.

I wrote this tweet almost two weeks ago. I'd had (if I remember correctly) something of an argument with my husband before he left for work, I was crying heavily writing it, and the following thread. I was desperate. I somehow realized it was a PMDD issue (I think my husband reminded me) and because I've never had help to calm it and there's no treatment for it really. My psychiatrist told me I may just have to "live with it". I can't, I can't do that! So what's the easiest thing I can do to alleviate some pain? Tweet about it, I guess. At the very least you know someone may see it, that you're not lone in all of this (because it sure as hell feels like it). That you're trapped in a body that is betraying you and with a brain that wants to orchestrate a total mutiny. 

One of the worst parts of all of this is you're one person for two weeks out of a month, then like a werewolf  during a full moon you are someone else entirely, someone murderous and paranoid, and suffering. Not being able to be your normal self like nearly every other woman during the latter  two weeks, or seeing those two weeks coming up on a calendar... your heart drops.

Please don't just take it from me, listen to other women and what they have experienced as well.

Screenshots courtesy of medicinenet.com.

I wish I had some optimistic ideas to end this with, but unfortunately, I don't. I can ask a psychiatrist for help, but they will probably send me to a gynecologist. When I see my gynecologist, they'll tell me I need a psychiatrist. I've had this happen to me in the US (the country I grew up in) and also here in Canada (where I live now). Truly, no one knows what to do. ("Live with it" - as the one Dr told me - is not an answer.)

Sometimes SSRI antidepressants are reccommended first, and then a birth control to stop ovulation next. If nothing else works, get a hysterectomy. So truly, sometimes the cure is as bad as or worse than the disease. We need something other than just this. And the ignorance of doctors who should know better (or at least keep up with the research) is astounding to me.

On a brighter note, a word to my sisters who are dealing with PMDD - it's not your fault. It's an illness with biological beginnings. It's not the real you. The real you is who you are the first two weeks. You aren't evil, you aren't histrionic, you aren't hysterical, you are merely ill. This isn't a flaw of yours. And we deserve a better treatment than the ones that are currently out there. 

Medicated Into Compliance

"Medicated Into Compliance" ©2019. 11"x 14"

I've been a psychiatric patient for so long that it's hard to remember a time when I wasn't. Some of the things I used to have a photographic memory for have faded, mainly because of the medication.

In the interest of full disclosure, I've had a diagnosis of either paranoid schizophrenia or schizoaffective disorder since 1994, when I was first treated for what I thought was a panic disorder at age 19. I've been medicated ever since.

I have a love-hate relationship with the medication, because it has kept me sane - and if not sane, it has kept me from suicide and institutionalization (although part of that credit goes to the therapist I had at the time). I still have quite a bit of paranoia, but I'm not psychotic (to my knowledge), and when I was my therapist reminded me of it because in schizophrenia you lose insight of it and will remain in a state of believing in your delusions and hallucinations. Having had both, I would much rather be aware of it coming from inside my mind than in believing they are actually real. That is at least 1000 times more frightening than having an awareness of them as constructs of my broken mind. Medication helps me to keep track of these thoughts and experiences.

However, I have to take a TON of medicine to maintain this awareness.

                                                  Morning                                                    Night

My psychiatric medication.

Supplements to keep the side effects of the medications in check.

All my medications/supplements, together.

Medicated Into Compliance

Many times I've been taken off of and restarted on so many different medications that I cannot possibly remember the names of all of them. Some I do remember are:

Antidepressants - Prozac, Paxil, Wellbutrin, Effexor XR, Lamictal, Trazodone, etc.

Antipsychotics - Trilafon, Risperidone, Zyprexa, Abilify, Seroquel, Lamictal?, etc...

Antianxiety/Anxiolytics - Ativan, Xanax, Clonazepam - these are all benzodiazepines and addictive.

Many of these medications work, others don't. Some stop working after a long enough time. I have to sometimes take different new non-psychiatric drugs to maintain my body's health due to the various side effects of these meds, including (as warned in the Rx literature) but not limited to:

Constipation, urinary retention, weight gain, suicidal thoughts or behaviors, closed eye visuals, blurred vision, dry mouth, inability to metabolize the medication, and the worst: acute dystonic reaction.

After time has passed some unexpected side effects were: hair loss, enlarged bladder, urinary blockage, Irritable Bowel Syndrome, substantial memory loss, pre-diabetic condition, akathesia, restless leg syndrome.

The one primary side affect unique to all of them: Sedation.

These are just things that have happened to me, I can't speak for everyone. Because of these I need to take L-methylfolate (a supplement) to metabolize medications. I've also become extremely physically sensitive to new medication, psychiatric or not, and the methylfolate is to (hopefully) keep me from yet another dystonic reaction where I end up in the ER, inevitably. It's happened so often I've developed Psychogenic Non-Epileptic Seizures, or PNES. This just means I have acute dystonic-like convulsions not related to medical imbalance, but as a reaction to physical anxiety or a hidden mental anxiety that comes out through the convulsions/seizure-like activity. 

At least I'm compliant with my medications, though. I'm sane. Somewhat.

My second psychiatrist, whom I saw for a long time - the longest time out of all psychiatrists I've had, we used to call Dr Feelgood because he doubled the medication for each symptom (since schizophrenia has no cure, you can only manage the symptoms) so that I'd have two antianxiety meds, two antipsychotics, two antidepressants, and so on. I don't know wy he did this. It may have been the pharmaceutical companies he worked with encouraged a quota, maybe he wasn't as reliable as I thought, maybe he was inexperienced (he was fairly young), maybe he was trying to stop a disaster I couldn't see coming. I don't know why. But this led me into a zombie-like state that I've grown accustomed to over the years. It's not fun. It sucks to be so tired even after a night of nine hours' sleep that you need two naps during the daytime, and then back to bed at night. It meant I couldn't drive (I kept falling asleep at the wheel and in one instance totaled my mom's car), I had to sleep, I had to be indoors most of the time. It caused more depression because I had no life to speak of except for painting.

In the end, this particular psychiatrist quit his practice without notice to me or his other patients, and we were all shocked. He'd taken up a job as a prison/penitentiary psychiatrist. (I'm sure that went over well with the security guards and other authorities. Drug them into silence, to sleep.)

This is what this painting means for me. "Medicated into compliance". I am (obviously) still somewhat bitter about some of the psychiatrists I've had and what they've done to me. Two of them in particular, the rest were just trying to help. But throughout all this, my medicinal cocktail has always made me sleepy, slow to respond, exhausted, zombielike. Sometimes (with certain psychiatrists I've had) I've felt like they just wanted me to stop calling, stop asking for help, stop my parents from calling on my behalf because I was too tired to explain properly - "just load her up on more meds and she'll stop." Yeah, thanks. 

So I'm bitter. How should I feel? 

Currently, however, I'm going down on Seroquel (the one antipsychotic that has helped more than it hurt) because I'm tired so much of the time and have to cancel a lot of plans (for more than just sleepiness, but usually because of something one of the side effects is causing). It was only as high as it was temporarily, so that I could move up from the U.S. to marry my husband and live up here with him in Canada. The immigration process beforehand (and even now, sometimes) was causing more stress than I could handle and I actually had to ask for more medication, primarily Seroquel. For legal reasons and because Clonazepam (antianxiety med) is a controlled substance, I couldn't raise that. I'd be in a stupor, anyway, it would defeat the purpose. Still, I was afraid I was going to have a relapse and from the inside view (the only one I have) I thought it was likely I would. Happily, I didn't. My psychiatrist at the time (the best I've ever had, arguably!) told me it was only for a short time, and to lower it when I was settled in and calmer. Well, I'm settled in and (I hope!) calmer, so we are now lowering Seroquel as expected with my new Canadian psychiatrist.

Psychiatric medication is never a sure bet, but most often it alleviates more issues than it causes, and for that reason, I participate in my compliance. It doesn't mean I'm not tired though! I do have coffee and it works wonders to keep me awake enough to do my art, my only work. I think if the pros outweigh the cons, and to prevent suicide, medication is good for me. I can't speak for others because every patient is different. But the pressure schizophrenia and/or schizoaffective disorder put on me, the medication saved my life. I'd have been dead since 1994 if not. And I'm glad I'm still here, even if I am overly tired most of the time. It's worth it for me. But I still wish I didn't have to take anything. 

Medicated Into Compliance time-lapse.

What's Going On and Where the Hell Have I Been?

Spiral Madness, ©2007. Acrylic on Canvasboard. Sums up how I've felt for a long time.

Anyone who knows me somewhat online might have noticed I haven't been painting much, and to some degree I've been exceedingly quiet (except maybe for Twitter). Some of you who follow me might remember the website I've been talking about making for at least the last 2 years, without anything to show for it yet. 

(Heh, there is a website - it's just not live yet or usable as a store - need to fix some bugs and that costs $$$. Here's a link if you feel inclined to give it a look:

http://provokingdrama.com/ )

Maybe you've noticed I'm doing more sketches than paintings the past 2 months, or that my Facebook page has only been sporadically active since early 2017.

Well, let me tell you what's happened. Hopefully it won't sound like a bunch of "woe is me" wallowing, but really, it's been a really up and down time.

recent mood swings

By now I think the cat is far out of the bag that I have mental/emotional issues (schizophrenia / schizoaffective disorder), and that has been the worst part of it. I haven't been psychotic - but my medications have been fiddled with and not very carefully handled by two of the last psychiatrists I've had in just as many years. I had some physical medical emergencies in May 2016 that required me to lower my medication immediately. The medical problems (severe urinary retention/possible kidney infection) were created by compounded side effects of the massive amounts of psych meds I was on then. The thing about psychiatric medications is that they do cause some minor urinary retention (it depends on the person and the dose) and constipation, so because of the emergency the doctors told me this is why I had the problems. Also, that I would have to work with my psychiatrist to correct the issues. Doctor's orders.

So within a week of this, my then-psychiatrist decided to lower all my meds at the same time. 

That was a horrible idea. 

I was taking high doses of several meds at the time (not counting the non-psych meds):

1. Neurontin/Gabapentin - mood stabilizer

2. Seroquel/Quietiapine - antipsychotic 

3.Effexor XR - antidepressant

4.Trazodone - sleep aid and very old (1st generation) antidepressant

5. Klonopin/Clonazepam - a benzodiazepine that is addictive in nature, anti-anxiety.

After the 1st round of med reduction, I had too much trouble sleeping, nightmares, horrible paranoia, angry outbursts at the 3 people I love the most, etc... It was weird and I tried as hard to hold onto sanity as I could. Not even a week later I had told the psychiatrist it was problem-ridden, and mercifully he slowed the reduction down. It was still awful, just not as much as the first 3 days. I had the shakes and a lot of sweating (thanks to the benzo addiction with the Klonopin), hot flashes, cold flashes, it was like being very ill with an endless migraine. Sensitivity to all stimuli. Light, sound, touch, smell, taste. Everything. And so much outrageous irritability. 

There were some auditory hallucinations peppered in. Just a few, but disturbing enough. Just sounds of people talking late into the night while I was awake in bed. I couldn't make out what they were saying, fortunately. Over the summer of 2016, I was constantly sick and on antibiotics for recurrent UTI problems due to a foley catheter I'd been wearing for two months. The antibiotics did nothing to help my brain issues, they exacerbated them. Until January 2017 I stayed as far away from social media as I could due to my recently acquired paranoia. By that time though, I had gone down far enough on all my meds - especially Seroquel (the antipsychotic, probably the most important med I take) - that my psychiatrist wanted to start me on a new antipsychotic called Abilify. So we did.

It worked wonderfully for about a month on the first dosage. Aside from the side effects (restless legs, pressure of speech (very unusual for me because I'm not much of a talker), and more insomnia, the good things were that I felt much more sociable as well as feeling full of ideas for my art, especially the paintings. It was awesome and I do wish I still felt as disinhibited and imaginative. However, after that short time we went up on the dose again. That was bad.

Within a few hours or days (I honestly can't remember), I started having movement issues in my arms, legs and jaw that I knew - from experience, unfortunately - meant I needed to get to the ER as fast as I could because I was on the verge of an acute dystonic reaction.

And, that's what it was. I don't remember much, it impedes your ability to understand time in a normal way even though you are somewhat conscious the entire time, if not in and out of it. I remember having to go a second time the very next day as well. I also noticed upon arriving home that everything was just weird... I can't explain it adequately with words but I'll try.

There were lots of voices, I know some of them were internal monologues (the kind that everyone has) but they were mixed up with all the external voices in an odd cacophony, I couldn't separate any of them. When I spoke, I realized my words didn't make sense. The sentences were weird, I'd fly off topic and get embarrassed and start giggling, which I'm sure didn't make me appear sane as I thought I was. And all the visuals one sees in their head, the mind's eye - they were mixed up with actual visuals from what my eyes could see as well. I was also terrified I wouldn't be able to sleep that night, but the weird thing was that the moment my head hit my pillow I was out. On the way there though, were visions and sounds of constant talking mixed together. It was confusing and scary. It has happened before though, and I realized it was drug-induced delirium. Fortunately, that kind of thing tends to fix itself in a few days or less. If not, it's back to the ER for you.

My psychiatrist heard about this through my mom (who had been my caretaker for a long time along with my dad). I had to quit the Abilify cold turkey. Again, doctor's orders. Nothing was said about adding back any seroquel or any other antipsychotic. Then there were the withdrawal symptoms. 

I have few memories of this time except my body would not stop moving or squirming, and I felt as though I literally needed to claw myself out of my skin. There was no comfort in sitting quietly, because I couldn't. My memory was impaired heavily for most of March/April 2017. I think my mom was able to convince my Dr to assign me more medications back so I could return to baseline functioning. He did - to a point. By summer 2017 he refused to go any further due to ethical reasons (his own). I was having routine anxiety attacks and because of the nature of Clonazepam (a controlled substance and a benzo) because it would worsen my memory issues. He would do no more and said I was welcome to a second opinion.  While he was right about the memory loss, the anxiety made life unlivable and our second opinion was not from a doctor but a psychiatric nurse. If I wanted another psychiatrist I'd need new insurance or I'd have to pay out of pocket. 

Psychiatrists are not cheap.

I have nothing against psychiatric nurses - I have nothing against the psychiatric nurse I went to because he really tried his best. But he only knew so much, most of it about depression and anxiety - but not about psychotic illnesses. Fortunately, as by July that year I was having disabling anxiety and couldn't leave my bedroom, he allowed me some clonazepam additions, and it kept the anxiety at bay. I'm very thankful for that. But there was nothing that could be done about the new, increasing and overwhelming depression. I wasn't having any other issues aside from that the way I was after the removal of Abilify. I was sane, but still paranoid and incredibly afraid I was letting the world and myself down. Most things I did or said online (those that were humorous) were not representative of my actual feelings, and as for art, the well of ideas was dry. Humor was a defense mechanism for me so no one would think I was worthless to be acquainted with. Or crazy. Whether it worked or not, I don't know. Thanks to those of you who stayed.