Author: Angela Ellen Grey

Angela Grey is an Indigenous novelist, poet, and painter whose work explores the intersections of memory, identity, and healing. She, formerly an architectural drafter, studied creative writing, as well as spirituality and healing, at the University of Minnesota, where she deepened her commitment to storytelling as both an art and a form of medicine. Alongside her writing, Angela finds balance in yoga and Mindfulness-Based Stress Reduction (MBSR), which shape the reflective quality of her work. She lives in Eden Prairie, Minnesota, with her husband, one spirited pup, and four cats. When she’s not writing, she enjoys camping, budget travel to places like Maine, Oregon, and the coastal Carolinas, and gathering with family around a BBQ grill.

Exercise and Schizophrenia

angela grey treadmill

My new treadmill arrived and my family thinks that I’ll be similar to a hamster on a wheel. I love it. It has one touch incline and speed controls and a really quiet motor It only took us an hour and a half to assemble. I’m so excited. Now I just have to figure out what to do with iFit. The above image is from the brochure website.

Regarding schizophrenia and exercise, patients can be more lethargic but that is typically the medication side effects. When I was on a higher dose of Seroquel, I just sat around and had the munchies for days. Abilify (aripiprazole) teamed with Wellbutrin (buproprion) changed that so now I’m constantly moving around from situation to distraction.My doctor worked with me on changing the medication amounts considering I’ve had an eating disorder and am opposed to any such weight gain.

Patients with schizophrenia do tend to gain some weight due to the meds as well as have metabolic problems and thereby also have an increased risk for heart disease and stroke.Diet, lowering cholesterol and blood pressure, as well as controlling diabetes, high blood sugar levels and lipids in the diet are the main treatments.  But exercise does double duty by reducing weight gain as well as stress. To make matters worse for the person with schizophrenia, negative symptoms can interfere with motivation to exercise. But with my new treadmill, I’m doubly motivated.

Cognitive Behavioral Therapy (CBT)

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This will be my last week of cognitive behavioral therapy. I only tried it because my family pleaded but due to time and expense it is no longer an option. Plus I don’t think that I’m in that category of those whom it helps the most. CBT is a common adjunct to meds when the person with schizophrenia is stabilized but continues to have a baseline of functional disturbances. It is commonly done with exercises out of a workbook given to the client by the psychotherapist. CBT has both behavioral and cognitive aspects.

cognitive behavior therapy

Regarding behavior, CBT is supposed to weaken the mental connection to troublesome situations and thereby altering the reactions (fear, depression or anger). The cognitive component of CBT targets thought patterns and seeks to alter the emotional state and corresponding behaviors. My psychotherapist worked with me to make me aware of my irrational beliefs and alter them through cognitive restructuring (behavior modification). I did cognitive rehearsal and practiced different responses to different situations that I encountered. Not only did I have workbook exercises but I also was required to journal which this blogging assisted with over the time I tried out CBT. Overall the positive reinforcement and systematic desensitization helped me learn new tactics to handle my illness.

Magnetic Resonance Imaging

hospitalmri

At my request, my doctor set me up for an MRI (magnetic resonance imaging). I wanted to know more about the course of my illness and the prognosis. So he set me up for the MRI to determine a baseline point and then monitor how it changes down the line.

schizophrenia

My doctor said the above image shows a schizophrenic brain on the right as compared to a normal brain on the left. The gray matter (neuronal cells) and the white matter (fibrous connections) are shown. Volume is a major difference. With schizophrenia there are enlarged ventricles and reduced gray matter. There is also reduced volume in the temporal lobes and hippocampus which affect auditory processing, language and memory. I’m glad we chose to do the MRI because I want to know the structural and functional findings so it helps them consider what the possible outcome might be.

Course of Illness (Schizophrenia)

chart symptoms

My psychiatrist can’t confirm any possible course of my illness; but he does think that due to my later onset and of my being female that it will be milder. At this point on my vigorous medication regimen, I’m having essentially no positive or negative symptoms. He doesn’t think that there will be any deterioration in behavior or cognition. However, potential short-term working memory problems may arise and he also thinks that I may continue to have subtle peculiarities in my language (negative symptom).

Although, I’d have been the first to say that I never got depressed just anxious, it has been determined that I have suffered from depression and may continue to do so. My depression is an anxious case not the sad states. Fertility and fecundity are a non-issue for me as I’ve already raised my four kids. And my doctor doesn’t think that life span will be decreased but I am at risk for diabetes and high blood pressure due to the medication side effects.

As for the meds, I have to be symptom free for a year before he will cut back on any one or better yet discontinue all. He worries about the statistic of 90% recurrence within five years of stopping meds. So, that was the extent of my discussion with my doctor today.

Pet Companions

Bailey

We’ve solved our pet companion issue that I blogged about earlier this month. Instead of a dog, we found two other additions to our home. Bailey is a gorgeous, six month old Manx and Avery is a beautiful four month old Maine Coon. We can’t get Avery to sit still long enough for a picture. This image of Bailey came from the breeder. Now that all the kids have left home for college and their grown-up lives, we needed some different energy in our house and we found it in these two young cats. The energy is so different that I’ve lost sleep all week. It is like bringing home a set of twin infants. We have to attend to them constantly; but it is definitely worth it.

Hanmi Meditation

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Despite being busy, stressed and tired, I’ve found a quick, complete self-healing and rejuvenating meditation practice. It (Hanmi meditation) encompasses mind, body, and speech by using mudra (hand positions or body gestures), mantra (empowered syllable sounds), and visual imagery; the three being the means to transcending ones everyday struggles. The synergy can calm oneself, purify karma, and can improve the quality of life. Repeating the mantra keeps one mindful; meanwhile the mudras balance the elements of the body by opening energy channels and releasing stress and negative energy. Instead of being impatient and frustrated by the stresses of a hectic family life, by visualizing, my instructor said, you can stay focused and on the path to health, vitality and happiness by developing more inner peace.

Age of Onset

AngelaGreyonsetThe above chart shows the typical age of onset for schizophrenia. The onset of my symptoms occurred when I was twenty-six. It was just after my foster dad died and I returned to college. Women often do experience a later onset than do men. In addition, women typically experience less functional impairment and are more responsive to anti-psychotics. Later onset usually has a better prognosis, too.

That being said, our family worries about the possibility of onset of schizophrenia for our four college students. This being a more common age of onset, we needed family education. We found out that the irregular sleeping patterns, eating habits, pressure to compete, stressful exams and tendency of college students to experiment with alcohol can trigger the first break in someone that is vulnerable due to family history. Schizophrenia affects all socioeconomic and cultural backgrounds. Age of onset is just one commonality..

Relapse

angiegrey

One surefire way to go into relapse is not taking medications. Why or how would that occur? Degree of insight into the illness, disorganized thinking (forgetfulness of a complex meds regimen), prescription costs, negative side effects, or stigma towards taking anti-psychotics. For the longest time I thought that I was in control of my problem and that nothing really was wrong: I wrote the symptoms off as other things (PTSD or anxiety). Then I took meds for another more acceptable problem (depression). I shouldn’t have hidden my symptoms for so long; but I was afraid.

What are other possible reasons for a possible relapse? Susceptibility to stressful interpersonal conflicts, adherence to the complex meds schedule, or discouragement are but a few. My family knows to watch for the signs of relapse: withdrawal from social situations, changes in sleep patterns or eating habits, staying focused, controlling behavior, being obsessive or compulsive, fear of common things or places, strange or risky behaviors, feeling targeted, or definitely seeing or hearing things that aren’t there.

It is difficult enough with all the possibilities of relapse; but the one we shouldn’t have to worry about is stigma. Myths and misperceptions are preventable.People with schizophrenia aren’t serial killers or don’t have split personalities. Shame, humiliation, and/or isolation need not be another things that people with schizophrenia need to cope with in addition to all the other reasons for relapse.