This is a first of what may be a set of posts around the same theme- recovery in mental health or recovery from mental health issues, regaining one’s sense of wellbeing after an emotional/psychological setback.

The past year has gone in a lot of work in this area (also among the reasons I could not write on this blog). So now is the time to talk about the work which has been done away from the public eye.

Let me begin with the book, which comes out later this year, I put to bed a few months ago. Currently the last phase of that is underway- on the production front.

As an aside, a somewhat disconcerting thought which has always been there at the back of my head is that when we say the word ‘recovery’ in the context of mental health it conjures a particular kind of image. Recovery is often mistaken to be the recognition of someone’s suffering as a diagnostic reality. (Oh, but this was not the disconcerting thought I had in mind- it was about my book and how academic it is!)

“Oh, now I know why I was feeling so bad. I have anxiety after all“.

“I got a diagnosis of PTSD and chronic depression. I was also wondering what is going wrong.”

This description of suffering and its reframing into a diagnostic “truth” is what happens all the time in the field of mental health, something that troubles me immensely. But I will not go into that trouble right now. I better share with you what is the problem for me to solve here- the problem of talking about recovery.

I recovered from bipolar disorder. It may sound like something un-relatable, for one is not supposed to. In other words I am an outlier by all standards. This sudden disclosure is not part of my identity politics and I do not use mental health as a means for attention-seeking for I am troubled by it. For me my positioning is an ethical stance which comes with an agenda, largely research driven.

My agenda

My agenda post my own recovery was twosome. First it became to map my own recovery- for how did I recover?

I had no clear cut ways to share with another. I am talking about the year 2011. That was the time I started on recovery research, and a number of articles followed in diverse journals across the globe- Psychological Studies, Canadian Journal of Music Therapy, World Cultural Psychiatry Research Review and others (you are welcome to check them from my linkedin profile, ResearchGate or Academia networks. Oh yes, there is one article which is just a click away in which you can both read my (less academic) writing and hear my (self composed) songs (ghazals to be more precise). A longer piece of writing about the ghazal and its role in my healing is there in the World Cultural Psychiatry Research Review (2015).

My second agenda is/was to see if one person can recover, why are others not able to. Or rather, what is it that does not allow more people to recover- which became my PhD research (2016-2020)

Three decades in the field and five decades of life behind me, I know there was none other than this which was my goal, at least for now- recovery research. So while the research was done as a PhD and barriers to recovery found the next and more befuddling (may I say unenviable) option is how to tell others they can recover as well?

This is what I am doing nowadays- creating those other resources to disseminate the findings from my work, advocacy about recovery from mental health issues and suchlike things.

I am not going to say further in this post except having introduced the context- of who I am, where I come from and why I talk about recovery so much. And yes the resources I am busy creating- resources for recovery, advocacy and helping others recover just as well as me.

The first put to bed was the book of course. I will talk about it closer to the time it publishes (later this year)

The second is DIALOGUES FOR RECOVERY with the support and handholding by Vidya Sagar, Chennai. Here is a sample of that work, though we are not yet adept with this sort of work. Whatever else is unfolding is still firming up and I will share about them in subsequent posts. But I invite you to read the writing I have shared, which are scores of articles about my recovery and where I stand today, or what ideas I propagate via diverse means. The video that follows is a sample. There are at least five others of its siblings you can check from the same link and you get to hear my other ideas too (not mine solely, of course for we all stand on the shoulders of giants after all) …

This post is a response to a query someone sent. Since it requires some study I thought I would share my findings, which are as follows. Everything that I am citing from others is in purple and my writing remains in black.

Akathisia (Greek “not to sit”) is an extrapyramidal movement disorder consisting of difficulty in staying still and a subjective sense of restlessness. It is a recognised side effect of antipsychotic and antiemetic drugs but may also be caused by other widely prescribed drugs such as antidepressants (Akagi and Kumar, 2002). Citing further research Sharma, Guski et al (2016) note that ‘Akathisia is an extreme form of restlessness, which some patients describe as wanting to “jump out of their skin,” that may increase the risk of suicide and violence’ In plain language Akathisia is a kind of trembling which individuals on antidepressants may experience, which makes them very agitated, restless, and even suicidal (Healy, 2003, p.72), and homicidal.

Antidepressants and their uses

Antidepressants are used to treat several conditions. They include, but are not limited to: depression, generalized anxiety disorder, agitation, obsessive compulsive disorders (OCD), manic-depressive disorders, childhood enuresis (bedwetting), major depressive disorder, diabetic peripheral neuropathic pain, neuropathic pain, social anxiety disorder, posttraumatic stress disorder (PTSD) etc says Ogbru. This of course is a diagnostic view of the matter and does not necessarily talk about whether antidepressants really help someone deal with their depression. So how do we figure this out? For those who have great faith in the efficacy of psychiatric medication some of the following points are noteworthy. It may be pointed out that these is coming from an implausible source- a psychiatrist! People seek out psychiatric treatments as ways out of their suffering hoping medication is going to rid them off their socially produced suffering. How does this come about- how can something which occurs as a response to their social living be dealt with by chemicals? Of course there is a complicated pathway via which people come to believe in the efficacy of drug treatments and is not the subject of this post. Instead I maintain my focus on antidepressants and their side-effects, in particular akathisia.

Another aside, about clinical trials. The average intelligent person is far removed from the world of drugs and pharmaceutical operations. Instead their focus is on accepting their situations as truthful medical diagnoses and attempts at maintaining drug compliance in the faith and hope that science is working in their favour and best interests. Clinical trials or randomized clinical trials (RCTs) are therefore taken as the gold standard for new drug and their development and few have the ability to read beyond the rhetoric of pharma companies. In this context psychiatrist Joanna Moncrieff writes this piece about drugs trials of antidepressants. Here is a brief excerpt- “Whatever the reason, STAR-D suggests that in real life situations (which the STAR-D mimicked better than other trials) people taking antidepressants do not do very well. In fact, given that for the vast majority of people depression is a naturally remitting condition, it is difficult to believe that people treated with antidepressants do any better than people who are offered no treatment at all.” To simplify this language: Moncrieff is saying that depression is not a permanent state and people get well even on their own, by other means. So it becomes difficult to believe that people who are not given any treatment are worse off than those who are treated. In other words taking medication for depression is not necessarily useful. You can also hear this podcast in her voice. which sheds further light on her work, ideas and findings.

Side effects of antidepressants (or SSRIs)

As the title of this post suggests antidepressants, of which SSRIs are one major variant, often have side effects of diverse sorts, and akathisia is only one among them. Antidepressants may cause withdrawal symptoms if abruptly discontinued. Withdrawal symptoms include nausea, vomiting,  dizziness, headache, irritability, sleep disturbance, nightmares, psychosis, and seizures, according to this site. Here I would also like to share another piece I wrote on my own blog sometime ago, which talks about SSRIs and brain damage, which includes a video interview with some doctor that I forget for now. And here again is another article that is not only a bit more technical but also talks about increased suicide risk due to SSRIs.

So the long and short of it is that taking antidepressants may be approached with caution for it is likely to increase the risk of other forms of debility, sexual dysfunction and other side-effects or outcomes which can be difficult to deal with in the long term. I am leaving you with further resources to read : by Robert Whitaker, and the absolutely brilliant blog by psychiatrist David Healy, which has scores of articles about suicide, side effects of different SSRIs, about sexual dysfunction disorder and so forth.