Category Archives: Appetite

Appetite, Disability, Hospital, Schizophrenia, schizophrenia.com, Zyprexa

“Twin Realities”: schizophrenia article from 2003

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Pam and Lynn Spiro, in England, 1962

 

 

 

 

 

Kathleen Megan’s story from 2003, while DIVIDED MINDS was being written.

http://schizophrenia.com/stories/twins.htm

 

 

Carolyn  and Pamela, after she put on 60lbs on Zyprexa (olanzapine)

“The thing about twins is they invite comparison. Even though they may look identical, one usually has the edge — a little more confidence, a quicker smile, perhaps a bit more talent.

As babies and little girls, Pam Wagner and Carolyn Spiro were like that. They danced and acted and held promise that delighted their parents. They loved it when people mixed them up. They were a tight club of two.

And then in adolescence, Pam, the one with the edge, lost touch with her own mind. Life became confusing and the twins’s lives took separate paths, diverging and then intersecting repeatedly, as they once again do now. Pam is a poet and Carolyn a psychiatrist. In midlife, they’ve come together to write a book, to try to capture their story for the benefit of others, and also for themselves.

Their story is a tale of the inseparable bond of sisters, of twins, and their struggle when their lives became anything but identical.

• • •

When you enter Pam’s apartment you can’t escape the photo test: two adorable baby girls, ribbons in downy hair, one gazing intently, the other head-tilted, tentative. Both bright-eyed, identical. Which is which? Which is Pammy and which is her twin, Lynnie?

You can’t tell. Is that thoughtful tilt a Lynnie trait? The more focused expression Pammy’s? Impossible to say, so you guess and you guess wrong.

And you wonder, was the die already cast at so young an age? Were they already – though indistinguishable on the outside – so very divergent on the inside? The seed of illness, perhaps, already planted; the roles of caretaker and cared-for so early ordained. You try to reconcile these photos – these identical babies and later, mirror-image school girls – with all you see a half-century later.

So very different are they now. How do they live with this, the undoing of their twinhood? And, how has their family, so accomplished and talented, coped with the slap of fate? That one became psychotic, the other a psychiatrist. Pam catches you staring at the beguiling babies. “You know,” she says, “I was well once.”’

click on link above to find rest of story, written after a years long series of interviews, both at home and in hospitals.

 

Appetite, Uncategorized

Do I have PTSD and some Low-calorie PTSD Comfort Food

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I think I will start with the recipes, since that might interest everyone. First, what is more the quintessential comfort food than mashed potatoes? So this comfort food main course starts with mashed potatoes, but it adds a cholesterol-lowering “superfood” curly kale, which is not only a deep cruciferous green, and therefore anti-all sorts of cancer and a first rate antioxidant, but it is extremely low-calorie, so you can eat virtually all you want. What we are going to make is a healthy version of the Irish dish, Colcannon, a dish that many cultures have some version of. It is not only easy enough to make from scratch, but we are going to cheat, as much as we can, to make it absolutely as easy as possible. I do however insist upon using fresh curly kale, since that is the only way you can obtain all the benefits of that vegetable. Here is the recipe, but don’t stop with that because following it is a recipe for a low-calorie, sugar-free, diabetic friendly cheesecake!

LOW-CALORIE COLCANNON (mashed potatoes and curly kale plus…)

2 bunches of curly kale, or about 6-8 leaves

1 box of prepared mashed potatoes, enough for 8 servings of 1/2 cup each, though for our purposes we will be allowing each person a whole cup!

7 walnuts per person (crushed into pebble-sized pieces)

Butter-flavored salt or butter buds, or sea salt or any herbs or seasoning you like (I like Badia brand All-purpose Seasoning, but the choice is yours.)

Procedure: Chop off the Kale stems and then chop the leaves into small bite-size pieces, approximately 1/2-1 inch square. You can also use a food processor and coarsely shred the leaves too, I imagine. STEAM these in a small amount of water until tender but still a deep bright green. Do not over-cook or you will lose all the “goodness.”

Prepare the mashed potatoes without the butter or milk, using ONLY water. (If you really insist, you can add a tablespoon or two of low fat dried milk to the water but remember that this will add calories…). Add your butter salt or seasonings to taste.

Now mix the kale and mashed potatoes together in microwave safe bowl or a saucepan and add crushed walnuts. If you need to reheat at this point, you can do so either in the microwave or in the same saucepan as you made the mashed potatoes on the stove.

Ta dah! The best part of this is that you can eat 2 whole cups and only consume 300 calories, which is PDG, in my humble opinion because most people are quite full after that.

Here’s the breakdown, in case you don’t believe me.

Plain mashed potatoes without milk or butter = 70 calories per half cup.

Kale= 30 calories approximately for 3.5 ounces…essentially negligible but we will call it 1/2 C.

Walnuts= 100 calories for 7 nuts

Seasonings= 0 calories

If you eat 2 cups of equal parts of kale and potatoes, you are only having 1 cup of potatoes, or 140 calories, plus maybe 1 cup of 60 calories of kale, plus 100 calories of walnuts. So that comes out to 300 calories total.

Now for the Low-Calorie Diabetic Friendly Cheesecake. This one is unbelievable delicious and simple to make. If you want to avoid ALL fat, simply make it without the crust, or experiment with making the crust without butter. I think it should work fine.

Ingredients:

1 large container of NO-fat Greek yogurt (120 calories/C.)

1 package low-calorie, no-sugar cheese-cake pudding mix

1/2 large bag shelled walnuts

2-3 Tbs butter or oil

Approximately 1-1 1/2C sucralose or Splenda-like sweetener

Procedure:

First if you are making the crust with butter, heat the butter in a small no-stick pan on moderate heat until it begins to sizzle. Add the walnuts. Toss them for about a minute but do not let them brown or burn. Add the Splenda and toss for about a minute or two. The Splenda will not melt so the mixture will remain crumbly. It will not get particularly hot. After a couple of minutes, remove mixture from heat and pour into a slightly greased shallow bowl or platter with a lip on it. (I use a large salad bowl.) Make sure the layer has no holes or tears and is relatively thick. It should resemble a largish pancake of crumbles. About 8-9″ circumference.

For the “cheesecake”: scoop Greek yogurt into a bowl and add the package of cheescake pudding mix. Stir vigorously until mixture is nice and thick and makes hearty peaks. With a rubber spatula, spoon over the crust, being careful not to tear apart and smooth it with care. Cover and refrigerate for around 8-12 hours. Enjoy!

Depending on size of slice, you can calculate calories from these:

1 C Greek yogurt= 120 calories (4 C. per large container, so likely 1/2-1/3 C per serving of cheesecake)

7 walnuts=100 calories

1Tb butter=100 calories (Since this recipe makes a whole cake, your slice shouldn’t have more than a pat or two or 30-60 calories)

Splenda=0 calories

1 serving of low-calorie cheesecake pudding mix=35-40 calories

(My estimate from this is: approximately 250-300 calories for 1/8 -1/6 slice of the cake…)

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I will write more soon about the post topic, i.e. the personal question, Do I have PTSD? But I have written for an hour and a half already, including what is copied below, so for now I am too tired to add much more. I will only say that my results of the test at the bottom, when I took it, definitely indicated that I have PTSD, despite the fact that I did not experience a trauma involving death or the possibility of death or serious injury (as the good doctors have now decided to redefine trauma.) Note that if you take the test at the site, they will evaluate it and give you a score, which you cannot get by taking it here, though you can get some idea of how you would do just by looking at it.

Finally, I don’t know if it is really okay to “lift these” directly from another website, but as I am providing a direct link as well as full attribution, I cannot imagine that the originators would object strenuously.

The first website is PsychCentral.com and here is the link to the PTSD symptoms and diagnosis article below: http://psychcentral.com/lib/2006/symptoms-and-diagnosis-of-ptsd/

Also as is noted below, the article was written by Harold Cohen, PhD

Cohen, H. (2006). Symptoms and Diagnosis of PTSD. Psych Central. Retrieved on January 29, 2012, from http://psychcentral.com/lib/2006/symptoms-and-diagnosis-of-ptsd/

Symptoms and Diagnosis of PTSD

By Harold Cohen, Ph.D.

There are three main kinds of symptoms that clinicians look for when diagnosing posttraumatic stress disorder (PTSD). These include re-experiencing symptoms, avoidant symptoms and symptoms of increased arousal.

Re-experiencing symptoms include ways in which the person persistently re-experiences the traumatic event. These symptoms may include the following:

  • Intrusive memories of the traumatic event
  • Recurrent, distressing dreams about the traumatic event
  • Acting or feeling as if the traumatic event is reoccurring
  • Mental and physical discomfort when reminded of the traumatic event (e.g., on the anniversary of the traumatic event)

Avoidant symptoms are ways in which the person tries to avoid anything associated with the traumatic event. These symptoms may also include a “numbing” effect, where the person’s general response to people and events is deadened. Avoidant symptoms include the following:

  • Avoiding thoughts or feelings, people or situations (anything that could stir up memories) associated with the traumatic event
  • Not being able to recall an important aspect of the traumatic event
  • Reduced interest or participation in significant activities
  • Feeling disconnected from others
  • Showing a limited range of emotion
  • Having a sense of a shortened future (e.g., not expecting to have a normal life span, marriage or career)

Symptoms of increased arousal may be similar to symptoms of anxiety or panic attacks. Increased arousal symptoms include the following:

  • Difficulty concentrating
  • Exaggerated watchfulness and wariness
  • Irritability or outbursts of anger
  • Difficulty falling or staying asleep
  • Being easily startled

Difficulty in Diagnosing PTSD

Identifying people with PTSD can be difficult and this disorder is often unrecognized. PTSD is unique among psychiatric disorders in that it is identified not only by symptoms, but also by the precursor of the illness (the traumatic event). Since talking about trauma may evoke painful emotions, people often refrain from discussing past traumatic events.

When a person is unable or unwilling to discuss a traumatic event, accurate diagnosis is difficult. For example, domestic violence and sexual abuse are subjects that many persons feel uncomfortable in raising, even with professionals. For others, feelings of shame and guilt related to the event and social pressures to “deal with” the symptoms that come afterward make talking about it difficult. Additionally, persons with PTSD often have other disorders, such as substance abuse or depression. These other disorders share some of the symptoms of PTSD and can also make diagnosis more difficult.

Doctors and health professionals may also ignore the signs and symptoms of PTSD. Indeed, it has been argued that at times society turns a blind eye to the existence of traumatized individuals, denying that posttraumatic responses constitute a disorder. Indeed, PTSD has only recently been recognized by the official psychiatric nomenclature. Persons who suspect that they are suffering from PTSD should seek out professionals who have experience with this disorder.

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Then the following is an online PTSD Test, which you can also find along with other psychological tests at the link below. Note that I have NO opinion regarding the online therapy offered except to say, beware of all such offers and check everything out first…

https://www.online-therapy.com/test1.php?mID=26&cPath=155_161&osCsid=04911a5dcc299094dfc7aad79ee57901

PTSD TEST

Question True False
Do you often experience flashbacks? (A flashback is a painful or intense memory; a vivid memory of a traumatic experience that returns repeatedly.)
Do you have nightmares or thoughts frequently in regard to frightening, horrible, or upsetting things?
Have you been exposed to a traumatic event involving a real or actual death threat, a threat to your physical integrity or that of others, or experienced a serious injury that resulted in responses involving intense fear, horror, or helplessness?
Do you often re-experience the traumatic event in one or more of the following patterns: intrusive/recurrent memories; acting/feeling as if the event is still occurring; nightmares; intense psychological or physical distress once exposed to cues (triggers) that associate with the traumatic event?
Are you constantly watchful, on guard, or easily startled (extremely vigilant)?
Do you feel detached from others, your surroundings or activities?
Do you frequently have sleepless nights, or insomnia?
Do you persistently avoid stimuli associated with a traumatic event, or experience general emotional numbness?
Do you experience extreme reactions to images or sounds that remind you of a traumatic event?
Do you have persistent symptoms that increase arousal responses that were not there before a traumatic event? Persistent symptoms may include sleep interruptions, irritability, outbursts of anger, excessive vigilance, exaggerated startle-response, or difficulty concentrating.
Have the symptoms lasted for more than one month and caused significant disruption in your life, including significant distress or impaired functioning?
Do you experience night sweats often? (Note: not everyone with PTSD experiences night-sweats.)
Do you often avoid the things that remind you of the past traumatic event?
Have you experienced memory loss, or amnesia because of seeing something that reminded you of the past event?
Do you often feel emotionally numb, emotionally responsiveness, or feel deadening emotions after being triggered back to the past event?
Are you easily startled by noise?
Do you feel depressed?
Do you show a lack of interest in activities you once enjoyed?
Appetite, Eating, Nutrition, Schizophrenia, Zyprex

Symptoms, Zyprexa and Recovery Again

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Zyprexa: "The miracle and the monster"

 

Yes, I am kinda sick of this rollercoaster, myself. But there you have it. If I will not or cannot take the medication, and I have no other choice, what is a person to do? I know it is a miracle drug, yet I fight taking Zyprexa at every possible turn. Why? Because, frankly, I cannot tolerate the enormous weight gain it caused the first time I took it – and for many years, off and on. I simply cannot stand being that visible, eating up so much of others’ air, intruding, in truth obtruding into their space as I do  even now…People will ask me questions about some “trade-off” as if it were so easy as that, as if THEY could easily decide, would have no trouble opting to take the drug, and die early from diabetes, which almost a foregone conclusion after becoming obese on Zyprexa. Hell, even without the obesity factor, people develop diabetes on the drug…And that’s only for starters, what about the cholesterol and triglyceride levels  that go up and up? Or is that part of the trade off too? That a person with schizophrenia should not care about elevated levels the way anyone else does…

I have mentioned here, I believe, the recent studies that have shown that people with SZ  become overweight and obese SOLELY on account of the medications. Without these medications, as a group we would tend to be thinner than the average adult. I have suspected this for many years. It would seem to me that every time I read a memoir by someone with sz, they would tell a tale of being a very slim person, until they were plied with some typical or atypical anti-psychotic, at which point they started gaining weight. Now, it was never clear to me whether or not the old drugs really helped much of anything, except to alleviate a few positive symptoms in some people.

Oh, those who disturbed the peace could be quieted, calmed yes,but no one was cured. I met very few people who wanted to take meds because the drugs actually made them feel better. Oh, perhaps they did, since if one got rid of the hallucinations and delusions of course one would feel better. But for myself the old neuroleptics  didn’t work particularly well on either positive or negative symptoms, and the side effects were awful, esp the deadening  lethargy the drugs produced. I would never choose to take any of those drugs and I agreed to take prolixin because it was the lesser evil because otherwise, they would threaten me with consequences far worse…But had I had the choice no way would I have chosen to take any of those drugs.

I’m terribly sorry, but I must stop here. I just wanted to get start on someting, but it is 4 am and I need to go to sleep, plus my eyes are so wonky all over again that I can barely see what I am doing, and at times I cannot at all. My eyes are going nuts again, crossing over or going outwards whatever! All I know is the text dances around and I cannot see through the jumble of letters frlying around. It is hard even to figure out which hand is doing what!

Well, enough for now. I hope to be back here tomorrow, but time has a way of getting away from me…

Certainly, the side effects of drugs like Thorazine were problematic enough to begin with. And count weight gain among them. How is it that any doc in state institutions could not see this correlation? But as you know, “there are
none so blind as those who will not see…”

Appetite, Blog, Eating, Medication, Nutrition, Schizophrenia, Uncategorized

My Pyramid Tracker, plus Another Medication Change

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Before I tell you about the most recent medication change, I want to let you know about  My Pyramid Tracker at  http://www.mypyramidtracker.gov, a website of the USDA’s Center for Nutrition Policy and Promotion. My Pyramid refers to the new and improved USDA food pyramid (http://www.mypyramid.gov) which, by the way, recommends only five and a half ounces of meat or beans a day, which is just a little over a quarter of a pound. The pyramid tracker website is one I highly recommend, however, especially  if you are interested in losing weight or in keeping track of what you eat and how much you exercise. In fact, it is a website worth looking at even if you are only curious about how many calories you expend in everyday activities. You can use it  every day or once a week or on any schedule you choose, and all you need to do is follow the easy instructions at the end of any given day to see how you did, though it helps if you jot down what you eat during the day, so you don’t forget entirely. Every time you log in, the site keeps track, so you can see stats later on about how you are trending.

My Pyramid and the Pyramid Tracker are great sites for general nutrition info, calorie calculation and the general calculation of energy expenditure in your daily life. You can compare what you expend to your daily calorie requirements. That is, by counting such activities of daily life as dish-washing and childcare and yard-work as forms of exercise the site will tell you how many calories you expended on them. It also calculates your BMI — body mass index — your ideal weight, and how to achieve it as well.

Click this

If you happen to be interested solely in finding out how many  calories are in a given food, however, the Nutrient Data Lab website is great. It has a large number of brand name foods as well as fresh and raw foods as well: http://www.nal.usda.gov/fnic/foodcomp/search/index.html

Should you be on medication that causes weight gain, or makes it difficult to lose what weight you formerly put on, check out those sites (above). They could make a big difference, or at least be a helpful tool in your efforts to keep your weight under control. But two things nonetheless are very important:

Please, do not beat yourself up if you cannot lose weight.

Remember that will power is a matter of chemistry, not bad character.

In fact, in FACT, it is your meds and the chemical changes that they produce in your brain that has caused you to gain weight. It is NOT your schizophrenia and it is NOT your fault. Do not believe whatever they say about research “proving” a close link between your diabetes and your having schizophrenia. That is utter B.S. Diabetes is on the rise everywhere in the country and its increase is directly related to obesity: one gets obese because one eats more calories than one expends. Being more than a little overweight is known to be a huge factor in Diabetes, type II (insulin insensitivity).

Now it is true that you might have been or become overweight without the meds, but I assure you that certain meds all but guarantee it. When researchers have the gall to say that somehow obesity is directly or in some sense causally related to schizophrenia, or that diabetes is genetically connected to schizophrenia, that is a load of hogwash, and I suspect those researchers are on the take from certain well-known drug manufacturers. I’ll bet that for many of you who were once thin before you took medication, whether it was the older drugs or the newer atypicals, it was only when you started taking antipsychotics (and some antidepressants as well) that you began to gain weight, sometimes massive amounts. But “they” want to tell you that it has “nothing to do with the meds” no, it is YOU, it is your illness, not the Zyprexa or the Seroquel or the Risperdal that caused the weight gain, or for that matter, not the Thorazine or the Mellaril or the Prolixin. We know better. They also want to tell us that if we die 25 years earlier than our peers, that is our mental illness speaking or our own fault (somehow) and not their iatrogenic — that is to say, medically-caused, doctor-caused —  drug-related obesity, diabetes and heart disease. I won’t even mention the generally dismissive attitude of many doctors towards the physical complaints of anyone with a major psychiatric diagnosis, it is no minor problem.

So, what to do? Well, there is not much you can do at this time, if you have found a med that works well for you and are able and willing to tolerate the weight gain and potential side effects from it. In some ways I admire those who will make this trade-off, though I worry that they will lose their new found lives early because of it, in which  case is it really worth it? But I know that for some people it indeed is, and I would never question their choices. For me, I am lucky enough to have responded to at least one less-weight problematic drug besides the miracle drug/drug from hell Zyprexa, which is the combo: Abilify/Geodon. The Geodon by itself seemed to me virtually worthless, at least it seemed to do almost nothing for me in terms of improving my cognition or creativity. The Abilify vastly increased my cognition and such, but at the expense of extreme irritability and rage. However, the serendipitous co-administration of the two solved the problems of each so that now I can feel creative and cognitively less impaired (I still cannot read, alas) and yet I am not at all irritable or enraged. Added to that is the fact that my appetite is under control again. While I have not yet started to lose weight, which is already at a decent level, according to most people (just not me) I no longer find myself raiding the fridge constantly or exhibiting uncontrollable food-seeking behavior all day, hungry or no. It feels much better not to feel yanked around by the nose by a med that never let me feel in control of myself…

But what happened to the Saphris? Well, two things: one, I simply could not sleep, and that is a weird thing for someone with narcolepsy to complain of! It was great to be awake all day, but I was awake all night as well. I would but up except for an hour or two for days on end, and it was exhausting. But worse, according to my psyche, was the fact that I ate less than 700 calories a day, walked 8 miles a week, — keeping track via mypyramidtracker.gov and the nutrient data lab — and yet after 2.5 weeks, I didn’t lose a single pound. This was so terribly depressing that I had to change it, had to go back to the Geodon and Abilify on which I got to the weight I was truly comfortable at a couple of years ago…Now, though, I have to try hard, and i will, because I am determined to get there. My father is always saying, Appetite comes in eating. Well, he is absolutely correct. But the opposite is also true, because the less I eat, the less I want, and the more I forget to eat, the more I, well, forget to eat…As far as I am concerned that is fine with me.

I think that is all that I have energy for today, because I want to continue to read Karen Sorensen’s site and blog, which I haven’t seen for a long while. Her art is so creative. It might be called, as my professionally trained artist friend said, Outsider Art, but nevertheless she has such an imagination that I feel stunned. I simply cannot let myself go and “let it all hang out” as we used to say in the “old days.” I don’t know how to do it, not graphically. Not pictorially. I am so hung up on getting my pictures and portraits perfect that I cannot relax and let my mind run free. I can do so in poetry, let things happen, and to hell with what my inner self is “really” saying, Let the shrinks figure it out! But in a painting or collage, I have to be in control, I don’t know why. Perhaps because I am so new at it…?

Thanks Karen. I love your gallery, where I can “flip through” your art works and see them en masse.

I also have to visit Kate Kiernan’s  Ying and Yang blog as her writing is as good as her art, which is saying a great deal. I am not sure which I like better, though I don’t really need to choose, as her writing is very different from her paintings. Kate is also a terrific songwriter/singer as well. On her blog you can sample all three. She is truly one of the most talented people I know.

You can find both Karen’s and Kate’s websites on my sidebar.

Appetite, Eating, Medication, Mental Health, OCD, Uncategorized

The OCD Project on VH1

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I have to tell you that I do not usually watch VH1. In fact, thinking that it was always and only a music channel, and moreover that it featured music of the sort I do not generally enjoy, I have never watched it. But I was up all night last night because I couldn’t fall asleep and I was channel surfing, trying to “bore myself to sleep,” only to come across their amazing program, The OCD Project. Yes, it is comes under the rubric of a “reality show” and the OCD sufferers featured might in fact be “on stage” in the same way that I suspect those  “Housewives of New Jersey” on Bravo Channel are (the dames in that show must be acting, they are so ridiculous!). But it is hard to believe this is the case. Even if I am wrong, it doesn’t matter, because if they are performing in any sense of the word, the enactment of the disorder of OCD is so compelling and the treatment so gritty and potentially life-changing that I am going to recommend it to everyone who happens across this post.

Please, whether or not you have schizophrenia, bipolar or Lyme and you have come to this site because of those: if you have any interest in or symptoms of OCD, check out THE OCD PROJECT at the following link. Once there, scroll down to the links to the full episodes. Click on Episode 101 first, then the clips to 102, then the full episode 103 and you will be all set for Episode 104 when it appears either on TV or on the website.

Good viewing! I think you will be impressed and may learn a lot. I know I did. Let me know what you think.

Perhaps more important, let the producers of the show and of VH1 know your feelings, because such programming about mental illness is so very important and their efforts in that direction ought to be encouraged.

http://www.vh1.com/shows/the_ocd_project/series.jhtml

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Brief update:

The Saphris and Abilify continue to do me good without causing any particular harm or objectionable side effects. Except for the pills’ bad taste and brief oral anesthesia after taking Saphris –surely a tiny price to pay for what seem to be big benefits — I can’t think of anything I would improve about it. Perhaps it would be good to feel inspired to get back to “doing artwork” again, which has not happened. Not yet.  But I think this may be due to the fact that I have been focusing on writing poetry to the exclusion of almost everything else. On the other hand, I can read, a little, which is good, though it takes some effort to sit with a book and concentrate. When I decide to make the time and do it, I can. I am also, I think, losing the weight I gained on Zyprexa, slowly but surely, which is only to be expected, since the Abilify has all but caused my appetite to vanish completely. I am back to forgetting to eat, rather than emptying the fridge at all hours of the day and night.

That brings me to the subject of another post I will write soon: how drugs affect the appetite and how my experiences with Zyprexa and Abilify make me certain that while appetite may be all in the brain, it is “brain-chemistry” for everyone, even for those who do not take medications. It has virtually nothing to do with so-called willpower.