Life after psychosis

April 15, 2023 1:40 PM

I had a psychotic episode three and a half years ago. I was in and out of hospital for three months. I've been faithfully taking my medication since then but the side effects are getting to me. I have no motivation, no sex drive and have lost my creative side. Will these things come back?

My episode was the conflation of a lot of factors, one of which was putting myself under intense pressure to succeed. I had gone freelance to try to break into film-making. My episode happened on a film set. Since then. my relationship to art and creativity is fractured. This thing that I wanted to devote my life to ended up hurting me incredibly badly, disrupting my life and setting me back for years. I now desperately miss art but feel blocked and disengaged with it. My life feels very bleak and meaningless without it though. I don't know how to take the pressure off, and just enjoy it. I think I may be depressed but its hard to tell what is the medication and general circumstance.

Thoughts and wisdom welcome.

posted by eyeofthetiger to Grab Bag (9 answers total)

I'm going to write a bit about myself, because I don't know the details of your situation. We have a lot in common, including attitudes about creativity and drug reactions. For me, something that helped (and it took years) was to realize that this wasn't something that was going to be fixed-- this is how my brain is wired and I'm always going to be dealing with and managing my conditions. That sounds sad, but it was very very freeing for me and a major turning point. This is going to continue for the rest of my life. And I am OK with that. And I can learn how to manage and make it better. And the thing that makes me a bit "crazy" (oof) is also the thing that makes me creative. As far as unblocking your creativity, I have two bits of advice-- The first is to start small, both in terms of project, and in terms of expectation. The second is to go orthogonal to a medium you don't normally create in. You're a film-maker? OK then, start with small sketches, or tiny sculpture, maybe with sculpey. Or write fan fiction. These things are all close to what you used to do, but not so close that you will have anxiety about them. Sketches are like story-boards, but still isn't film making itself. Fan fiction is like screen writing, but it isn't. You'll get that same dopamine hit of creativity-- really the best drug in the world-- but you aren't doing the thing that you are invested in and that you remember causing a break down. Rediscover that creativity in a hundred tiny ways that isn't about film-making, and your brain will still love that you are expressing that side of yourself. Again, these are things that helped me, they might not help you. I'm PTSD, ASD, GAD, and you are probably not any of those things, but I hope there is something there that will help you. As far as the drug interactions killing sex drive, yes that happened to me too, and it didn't end until I went off that drug. For me, I was eventually able to do that with a combination of CBT and making enough changes to reduce my overall stress that I no longer got physical symptoms. But the drugs got me to a place where I could do that. No matter what, you aren't alone with these fears, and you aren't the first person with these challenges. You can do it, and it will be hard, but it is worth it. Memail me if you want to talk more. I don't know you, but after reading your Ask, I do know you, because you are a lot like me, and I am doing better now than I was five years ago.
posted by seasparrow at 2:00 PM on April 15, 2023 [13 favorites]

Maybe a useful/encouraging parallel. I am on 15 mg Zyprexa and 2 mg Rexulti for depression, along with some other Rx. My sex drive disappeared for a long time but has come back now that, um, it has a reason to. Just one datapoint!
posted by 8603 at 2:10 PM on April 15, 2023

Hallucinations used with guided meditation helped me. You can get those illegally if you’re lucky or go to a ketamine clinic.
posted by waving at 4:55 PM on April 15, 2023

Psychosis (and a psychotic episode) is a symptom, and can be caused or triggered by many different things, including (but not limited to):
- schizophrenia
- depression
- bipolar affective disorder
- stimulant use
- psychedelic use
- alcohol withdrawal
- benzodiazepine withdrawal
- extreme stress / trauma (physical, mental)
- metabolic issues (various diseases, vitamin deficiencies, etc.)
...and many others

Why this matters? Each diagnosis may have a different prognosis. Understanding your personal situation is critical and can really help answer your question.

After only a single episode, getting a good diagnosis may be difficult....

Are you working with good and trusted psychiatrists and psychologists? What do they say?
posted by soylent00FF00 at 7:14 PM on April 15, 2023 [1 favorite]

I have been on a variety of psychiatric drugs over the years and have at times found both sex drive and motivation level to be casualties of the side effect profiles. You may find it worthwhile to work with your psychiatrist to find a set of drugs that gets the job done without the side effects.
posted by Tell Me No Lies at 8:13 PM on April 15, 2023

You have choices beyond

a) staying on your current meds and having these side effects forever

b) going off your meds and having another psychotic episode.

Option c) is working with a trusted psychiatrist to adjust your medication dosage and/or try different medications to find the best possible combination of mental health + no intolerable side effects.
posted by chariot pulled by cassowaries at 10:18 PM on April 15, 2023 [1 favorite]

Response by poster: Thanks for all the answers - some further details:
- Am in the UK, where the mental health system is overstretched. I am under the care of my GP, with whom I am currently tapering down my medication (aripiprazole) steadily.
- I am seeing a therapist weekly but not seeing a psychiatrist.
- My diagnosis was psychosis with mania.
posted by eyeofthetiger at 2:41 AM on April 16, 2023

Is it possible that you have some effects of trauma related to your creative pursuits and this episode? Seeking out more resources on the effects of trauma could help if so.
posted by lookoutbelow at 11:42 AM on April 16, 2023

Your GP may not be the right person to explore this with, but there are lots of atypical antipsychotics (the category your current med is in). They all have non-trivial side effects -- it's not, like, a gentle, warm and fuzzy med category -- but their side effects are at least different, so you can pick the one that hits you the least harshly. Aripiprazole was really rough on me, and quetiapine was better. For others, it's the other way around, or both suck and they prefer some third option.
posted by nebulawindphone at 7:18 PM on April 16, 2023 [1 favorite]