Seven months after I was knocked off my bicycle by a container truck my physical recovery rate had reached a plateau. The same could not be said for my mental state – it had plunged to new depths.
The decision was made for me to be admitted to G22, the Psychiatric Ward at Groote Schuur Hospital first thing on Monday morning.
I spent the rest of the day wondering if I was willing to be ‘locked away’ in a Psychiatric Ward for 8 full weeks.
G22 represented make or break for me; failure here would surely lead to rapid downward spiraling.
Already struggling to fall asleep, sleep was now totally out of the question. I lay wide awake for 5 full nights worried stiff that I had reached the point of no return.
G22 may well be the final nail in my coffin.
Even though I was exhausted beyond belief I was completely unable to find any respite from my wakeful woes. By the time dad wheeled me into G22 on the Monday morning I was almost delirious from lack of sleep.
One of the first things the psychiatrist addressed was my anti-depressant medication. For the past 6 months I had diligently popped my prescribed 25mg of prothiaden in the vain hope that it would help lift my mood.
The psychiatrist gave me strict instructions not to stop taking my anti-depressant drugs. Discontinuing the drug may just tip me over the edge, he warned.
In my mind it was inconceivable to imagine that I could possibly feel any worse. Given my tenuous mental state, though, experimentation was out of the question.
There was thus absolutely no way for me to tell whether the anti-depressant made any iota of a difference to my mood.
Talk about a catch 22.
I had experimented with my medication before. This happened about 2 months after my accident when I was in the Spinal Unit of Libertas Hospital. Struck down with such terrible nausea that my exhaustive rehab program had stopped dead in its tracks, I ended up bedridden for a full week.
Numerous tests had all came back negative. Mom did not take kindly to the insinuations that I was malingering and let the physician know in no uncertain terms.
A friend suggested that I stop taking the pain and sleeping pills to see if it was the side effects of these drugs that were taking a toll on me.
The next day I declined these medications and felt much better for it. Psychosomatic or not it worked for me and my rehab at the Spinal Unit was soon back in full swing.
Things were a lot different at G22.
My physical recovery had reached a plateau, my head was pounding non-stop and three quarters of a year had now passed with my life still in complete disarray and no ray of hope in sight.
My self-confidence had been completely shattered and chronic pain wracked my entire body. I simply did not have the mental resources to do any more experimentation. Simply following the process was all my devastated system could cope with.
I suspect the psychiatrist’s reasoning went something like this. ‘Patient is still depressed on current medication, hence needs a stronger dose of preferably a more powerful drug’.
And so I landed up being given 60mg of fluoxetine, which the psychiatrist hoped would have a more potent tranquilising effect to help me to sleep at night.
A most noble aim, but it neither helped me sleep nor improved my mood. It did however make me even more dizzy than I already was.
The increased dizziness may well also have been psychosomatic; my self-belief in what I could and could not manage had been stretched to the absolute limit.
The guy in front of me had an eating disorder, I had suffered a very severe traumatic brain injury, yet we received the exact same anti-depressant drug. In fact, if memory served me correctly, most of the other patients in the queu were also on the same drug.
Why is that? I inquired. "Doctor completed his studies in the US and he knows best", came the pat answer. Little did I know that fluoxetine was the biggest selling central nervous system drug in the world at the time.
The next time the psychiatrist completed his ward rounds I asked if I could perhaps stop taking the anti-depressant drugs altogether as it was making me too dizzy to walk.
All I got is this textbook answer: "Any new anti-depressant drug will take a few weeks to reach the correct levels in your brain."
Who can argue with that.
I see it as poetic justice then, that in the last few years, despite ever growing markets, major drug companies have substantially cut back or discontinued funding new drug discoveries for psychiatric disorders.
The reason is simple - there are few, if any, validated molecular targets for their mass produced drugs.
Personal experience combined with scientific research gives me a deep understanding of the importance of balancing the feel good chemicals in the brain.
A great way to achieve this is via posturally correct movement from the spine to teach one to meet life’s challenges on the front foot while remaining deeply relaxed.
The reason I emphasise deep relaxation in some way also stems from my experiences in the Psychiatric Ward. The drugs I received weren’t all useless; there was one to celebrate.
When I was first admitted Valium had mercifully completely shut my whole teetering neuronal system down. Pain, anxiety, depression, delirium, confusion and all; I managed to fall asleep for the first time in 108 hours.
Though only managing to sleep for 4 hours it was pure bliss.
Somewhat worried about the addictive qualities of Valium I was reassured that addiction is only a problem if one take Valium without a physiological reason for doing so.
Two more nights of Valium - somewhat disheartening that even with the Valium I couldn't sleep more than 4 hours a night – gave me additional respite.
Probably the most important chemical to balance is serotonin. Serotonin is released from the R-brain into the thinking brain and also into the lower brainstem and right down into the spinal cord. The anti-depressant drug I was given attempted to achieve this for me, however all that these SRI type drugs are able to achieve is to increase the availability of brain serotonin levels in shotgun fashion.
The human brain is so intricately put together that if one tweaks one part of a brain process you can be sure that this will impact another brain process or more. The only way to ensure the correct balance of serotonin levels in the whole of the brain is to leave it entirely up to the R-brain - that was designed to do this very thing - to regulate.
Serotonin modulates the homeostatic processes in the brainstem and it is critical for energy and weight regulation processes in the hypothalamus. The serotonin production in our R-brains follows the light dark cycle and it requires a full 7 to 8 hours of complete darkness for the brain to completely recharge the serotonin levels. Without enough serotonin, pretty much everything we attempt will give rise to frustration and irritability.
Another crucial chemical for our R-brain to balance is the release of dopamine (DA). DA is released both into our thinking brains and into the brain areas (caudate and putamen) that co-ordinate our skeleto-motor system to thereby increase our mental focus and our motor vigour in the pursuit of our goals.
There are around half a million DA neurons in our R-brains that are mostly inhibited.
Switching on a large enough percentage of these midbrain DA neurons will have a massive effect on our motor drive and on our productivity.
Most importantly though, the first step is for us to strive to be as deeply relaxed as possible so that we are always aware of any danger signals that may be going off in our bodies. Equally as important is that it is heart and brain healthy and it also facilitates falling asleep at night.
Without those 3 Valiums I'm not so sure I would have learnt half as much as I did in the 8 weeks I spent at G22, or even if I would have lasted the full 8 weeks!