I’m off my antidepressants We’re now long distance pals

** Disclaimer: Not a medical professional. My views based on my experiences only. Please visit your GP, mental health professional, or Mind for more expert advice! **

I’ve not been taking my medication for a month now. GP approved, for immediate clarification. I would never endorse taking yourself off your medication without talking it through with your GP first. Sorry to be ya mum, but… do as you’re told. 

It’s been… ok? I think. It’s hard to self-reflect, especially when you live with different forms of anxiety. I try to differentiate between ‘me’, ‘me with anxiety’, ‘me on medication for anxiety’ and ‘me having just come off medication for anxiety’ which is a whole new territory.

I came off them for a few reasons, some of them good and some of them bad. I felt ready to try and come off them, primarily. That should always be the main reason. Do it when you’re ready. But I also came off them because some of side effects had started to make my anxiety worse: I put on three stone in a year and I had absolutely no sex drive. Zilch. Nada. Nothing. IT WAS SO SAD.

I know that those reasons are trivial compared to the fact that I could now function, but them being relentlessly thrown in my face when I couldn't fit in my clothes anymore, or when I saw a flash of my boyfriend's bum and didn't start growling, was getting tiresome. So when I felt confident and comfortable to try and come off the medication, those particular side effects made my decision much easier. 

I started to cut down at first. I skipped taking them on weekends, then I only took them every other day, then I only took them every three days… then I didn’t take them at all. This was definitely the best way of doing it. The withdrawal effects weren’t strong but they were definitely there even at the start of the slow process, so I’d never recommend going cold turkey. 

The withdrawal effects I’ve had so far have been:

• Mad dreams. Like... really weird. Baffling. Could-consider-for-a-Tim-Burton-movie dreams.
• Slight trouble sleeping. Courtesy of the above, mostly. But I've been super nervous of going to sleep and haven't slept through a lot.
• Weird appetite. One week I wasn't hungry at all and the next I was reaching for the pregnancy test because surely I was eating for two?
• Irritableness. Sorry friends.

Aside from the simmering anxiety of being off them, I think that’s it. For now, anyway. No, the weight hasn’t just dropped off but I’m hoping that I can have a better relationship with my body now that I feel more in control of it. And yes, my sex drive back. Bangin’. Literally. 

I feel good. The anxiety is definitely there but my eye's on it. I’m happy I made this decision and, to be brutally honest, I’d be absolutely gutted if I needed to go back on my medication. But I know that that’s a possibility and I shouldn’t feel guilty or ashamed at all if it came to it. But one step at a time… 

Antidepressants are wonderful things. I’m definitely pro-medication, and I’m also pro-doing what’s best for you. If you don’t get on with medication, that’s fine. If you need medication for the rest of your life, that’s fine too. There are many different treatments for mental health struggles for a reason; one type won’t work for everyone. I, personally, hated counselling. But medication turned my life around, and once that was working in my system, I then learnt how to self-care properly and the combination of the two worked marvellously.

For me, medication gave me a boost in confidence and a gap between something triggering my anxieties and my anxieties acting upon them. It gave me time, and it gave me hope. It let me sleep, it let me believe in myself, it let me go out, it let me learn and adapt, and it let me improve my relationships. 

It also gave me weird appetites, made me put on a lot of weight, beat up my sex drive, made me twitchy, and sometimes made me clumsy, forgetful, and ‘not with it’, but those last effects only happened when I had to up my dose earlier this year. That dose didn’t last, needless to say. 

I still keep my trusty Sertraline on my bedside table. Just having it there in my sight makes me comfortable. I know it’s there if I need it, though I desperately wish I won’t. I don’t feel scared of ‘going at it alone’. I did, at the start of this year. The thought of not taking medication terrified me and made me so vulnerable. But I depended on it then. I relied on it to get me through the day. But I can get through days myself now. Weeks. Months! Look at me go. I’m far from over with my mental health struggles but, for now, I’m keeping up with them. We’re friends.

MY SELF AND MY MIND

My Self is present only when I am awake. When I was asleep I missed the happenings around me; I was not aware of my surroundings. I was unconscious. When I woke up I regained consciousness.

Consciousness is not merely wakefulness.  When I wake up from sleep I do not look around vacantly, taking in the sights and the sounds around me as if my wake mind belonged to no one. I am the proprietor of my mind. I am aware of each and every happenings and things around me. The myriad of contents displayed in my mind are connected with me through invisible strings  and I feel or experience these connections with me.  In other words my consciousness is endowed with subjectivity. ‘I’ move forward and look back with this innumerable things displayed and connected with me. This forward-moving merriment in me is my Self.

Search for Self

Search for self had been going on from time immemorial. Brihadaranyaka Upanishad is a treatise on Self and the great saint who composed it found that Self is the infinite universe. (Aham Brahmāsmi)

Aristotle 

Buddhist tradition holds that the root cause of suffering is the Ordinary Man’s erroneous view of Self as an unchanging essence. Furthermore, the tradition holds that this error is inevitable in the natural course of life because it is based on inborn patterns, pre-theoretic and unreasoned. 

Aristotle, following Plato, defined the soul as the core essence of a living being, but argued against its having a separate existence. Aristotle also believed that there were four sections of the soul: the calculative and scientific parts on the rational side used for making decisions, and the desiderative and vegetative parts on the irrational side responsible for identifying our needs.

 Avicenna  said that the idea of the self is not logically dependent on any physical thing, and that the soul should not be seen in relative terms, but as a primary substance. This

Avicenna

argument was later refined and simplified by René Descartes in epistemic terms when he stated: "I can abstract from the supposition of all external things, but not from the supposition of my own consciousness."

An eighteenth century philosopher David Hume thought that Self is a bundle of perceptions. “For my part, when I enter most intimately into what I call myself, I always stumble on some particular perception or other

of heat or cold, light or she, love or hatred, pain or pleasure. I never can catch myself as any time without a perception, and never can perceive anything but the perception.  When my perceptions are removed for any time, as by sound sleep, so long am I insensible to myself,  and may truly be said not to exist. And were all my perceptions removed by death, and could I neither think, nor feel, nor see, nor love, nor hate after the dissolution of my body.” David Hume: A Treaties on Human Nature.

All these were brilliant imaginative speculations by the fertile brains of the past. The first psychological enquiry of Self came from William James, an American psychologist who initiated scientific psychological enquiries. He admired Hume’s dazzling speculation on Self, but criticised. “But Hume, after doing this good piece of introspective work, proceeds to pour out the child in the bath, and fly to as great an extreme as the substantialist philosophers. As they say Self is nothing but Unity, unity abstract and absolute, so Hume says it is nothing but Diversity, diversity abstract and absolute; whereas in truth it is that mixture of unity and diversity which we ourselves have already found so easy to pick apart… he denies this thread of resemblance, this core of sameness running through the ingredients of the Self, to exist even as a phenomenal thing.”

Let us leave the brilliant speculations on Self and consciousness in the past. The conscious mind and its proprietor the Self are constructs of the brain. In a series of pioneering studies conducted in North America and Italy during the middle of the twentieth century established with certainty that the brain stem is the

Brain stem

critical contributor to consciousness. More recent studies conducted in neurological patients whose consciousness was compromised by focal brain damage.

Relationship between consciousness and self

Portuguese-American neuroscientist, Antonio Damasio in his marvelous book Self Comes to Mind says: “When selves do not occur within minds, those minds are not conscious in the proper sense. This is a

Antonio Damasio

predicament faced by humans whose self process is suspended by dreamless sleep, anaesthesia, or brain disease.”

Two notions of Self

The Self is a process and not a thing, and this process is present all times when we are conscious. We can consider the Self from two vantage points. One is the vantage point of an observer appreciating a dynamic object.  This dynamic object is constituted by certain working of minds, certain traits of behaviour, and a certain history of life.

The other vantage point is that of the self as knower. This is a process that gives a focus to our experiences and eventually lets us reflect on those experiences. Combining the two vantage points produces a dual concept to Self. In everyday life each concept corresponds to a level of operation of conscious mind, the Self-as-object being simpler in scope than the Self-as-knower. There is no dichotomy between the two. The simpler Self-as-object evolved earlier in the course of evolution and the later evolved Self-as-knower is piled up on the top of the Self-as-object.

The Self as the witness of the mind

Countless creatures for millions of years have had active minds happening in their brains. But only after those brains developed a self as the protagonist capable of bearing witness did consciousness begin, in the strict sense, and only after those brains developed language did it become widely known that minds did exist. The Self, as the witness, is the protagonist is something extra that reveals the presence of implicit brain events that we call mental. Understanding how the brain produces that something extra, the protagonist we carry around  and call self, or me, or I, is an important goal of the neurobiology of consciousness. 

Parents and Adult Children React to My Descriptions of Borderline Family Dynamics

Parents and Adult Children React to My Descriptions of Borderline Family Dynamics

In my post about the family dynamics of Borderline Personality Disorder (BPD), I describe the role of the spoiler. A child or adult child of a family that exhibits the family patterns described in my posts on this subject begins to behave in ways which turns things around. The child invalidates the parents' efforts to "help" or "take care of them" in nasty ways. He or she essentially responds to invalidation by making comments that invalidate the parent right back. 

The reason the children do this is because they believe the parents need a child to be a target for their anger, and volunteer for the gig. They give the parents just cause by behaving in unreasonable and infuriating ways.

When it comes to the people who make comments on my posts on this and similar subjects, it always fascinates me how parents usually think I am putting all the blame on them for the family problems, while the adult children with the disorder react to the exact same post by thinking I am putting all the blame on them! 

Family systems therapists used the term punctuation to describe these types of reactions. People take something that is an ongoing problem created by continual reactions to feedback from two people with each other, and look at just one isolated segment of it - thereby breaking up a process artificially into misleading cause and effect relationships. They then react accordingly.

Of course, there are readers who do see the whole of the patterns in their lives but still do not know how to put a stop to them. In many cases the problems continue in spite of honest declarations of personal responsibility and even apologies -because there continue to be underlying issues that remain unaddressed.

I have reproduced two comments and my replies which illustrate these phenomena quite well. The first comment doubles as a description of spoiling behavior which illustrates it far better than I ever have.

The Blame Game

Submitted by A Mother of a Possibly BPD Child on November 6, 2016 - 11:39am

Regarding blaming the parents for "invalidating" feelings: I think it's a dangerous idea that all feelings are valid. Does anyone truly believe this?

When you are dealing with someone whose thinking is so distorted that they misperceive all your motives and react to your natural withdrawal as abandonment after they have been screaming abuse at you for an hour, you will just distort your own thoughts if you try to get into their head. If I say to my daughter "When you told me X it hurt my feelings," she often perceives that as an attack and starts to mock me: "Oh did that hurt your feelings? POOR YOU!" This can often escalate, and soon she is telling me what a horrible parent I am. That she is in so much pain that she'd lash out at me like this (again) does *not* mean I was abusive to her. She did not learn how to talk that way from us. We would never say something like that, even though she tells other people that's how we talk to her, and she probably believes we do. We did not cause that pain. Her mind did.

And this is the crux of the matter: just because someone perceives something as hurtful does not necessarily mean it's time to blame someone for hurting them. If someone trips and falls on you, and you scream, and they get mad at you for hurting their ears and making them feel ashamed with your tears of pain, should you feel sorry for them, since they honestly feel hurt by what you did? Should you feel mortified at yourself for inflicting such a nasty guilt trip on them with your tears? Some feelings *are* invalid! We invalidate our own feelings all the time. We *have to* if we don't want to be complete narcissists. A non-BPD person might feel a flash of anger at the ear-pain, but they would quell it, and then feel sorry they fell on you, sorry they hurt you accidentally. And if the screamer is non-BPD, they will probably be furious for a second at being fallen on, but then accept the apology and understand that it was an accident, perhaps even apologize for the loud sound they made - and everything will be fine afterward.

But if it isn't like this, the non-BPD screamer might reflect that they shouldn't have screamed and they certainly shouldn't have cried, since that just escalated things with the BPD person. But they were just behaving the way they would to anyone who fell on them. The reason they might think they shouldn't have screamed though, was because it made things into a conflict they didn't want, and they knew they could have avoided it.

This is CRAZY-MAKING.

And here's something else that's important: if (in the scenario with the falling person being BPD) the screamer pretends nothing bad happened afterward and tries to be loving again as if the falling person had been apologetic and understanding, are they *enabling* this bad behavior? Spoiling a tantrum-thrower? And if the falling person is the screamer's child, is the screamer not providing a terrible role model for the child? Should the *child* learn to tolerate this kind of behavior in other people? Should they not stand up for themselves and have high standards for their own behavior and that of other people?

Parents want to teach natural consequences, encourage empathy, and model the way one should behave in certain situations. BPD totally warps this. You start to think it's impossible to teach anything useful. You start to think that *ANY* response you have is doing irreparable harm to the BPD person. Walking on eggs to reduce conflict, or refusing to tolerate bad behavior - it's all bad. So what would be *good* for a BPD person? How would we recognize it?

As parents, we are not mind-readers. However we respond to behavior, it should teach something (how to respond, how not to respond, natural consequences, etc.) If the behavior is terrible and entirely lacking in empathy and remorse (just self-loathing, which doesn't do a darned thing to enact change), and if normal parenting only makes it worse, that cannot be - and is not - our fault for not knowing what would set the kid off this time. Of course we guess, of course we suspect - but we don't *know*. If we knew, we would necessarily be mentally ill too!

If we as parents caused this escalation by "invalidating" some feelings that originated in a distorted version of reality, or if we offended the child by refusing to be her punching-bag, that means LIFE itself would have provoked the same outburst. We just happen to be here trying to get her to have some self-knowledge and resilience. We are trying to help her learn how to deal with the real world. The real world will never be as careful as we are trying to be. The real world will never ask itself "Should I try not to take this personally, since she's clearly in so much pain she doesn't know what she's saying, or should I just react the way I normally react, since those are the natural consequences??"

The real world will react to BEHAVIOR. Often wrongly, often nonsensically, often (sad to say) maliciously. We are supposed to prepare kids for this! And as parents, we are supposed to train our kids to control their behavior and take responsibility for their actions. But what if, despite our best efforts, they don't learn this?

Many of the families that seem to shun someone who stops behaving so abusively were probably put through hell and just can't take any more. It's like they were holding up the car out of sheer adrenaline, and now the car is gone, they are burned out and need a break. Castigating them for shunning the person is asking way too much of them. Those were the natural consequences. Natural consequences usually teach non-BPD people how to control themselves and take responsibility for their actions. But what works with BPD people?

Parents of BPD kids need support and skills, not blame. They need tools to cope with a situation that is literally crazy - and quite possibly crazy-making.

·report

blame game - my response

Submitted by David M. Allen M.D. on November 6, 2016 - 4:21pm

Hi A Mother of a Possibly BPD Child,

"Blaming" and finger pointing are counterproductive, but all adults - both parents and adult children alike - have to take responsibility for their part in the family dynamics if these dysfunctional patterns are ever going to stop.

What you have written is a beautiful description of spoiling behavior by a child (or an adult child) with borderline personality disorder. It is designed on purpose to invalidate YOU. The child thinks for various reasons that you need them to do that, believe it or not.

For an explanation of how this seemingly crazy situation may arise in families even if there is no obvious abuse, see the posts

http://www.psychologytoday.com/blog/matter-personality/201109/the-family-dynamics-patients...

http://www.psychologytoday.com/blog/matter-personality/201205/borderline-personality-disor...,

and

http://www.psychologytoday.com/blog/matter-personality/201205/borderline-personality-disor...

Communication to Estranged Children

Submitted by Ria on November 12, 2016 - 2:10pm

I am so grateful for the comments of adult children on this page. It gave me insight in the feelings and minds of adult children who cut off parents. My daughter has cut me off a year ago - it happened a few times before she had children, I always reached out and tried to mend the relationship, but now the grandchildren are used as pawns. Although I am broken with the loss of my daughter as well as grand children, I have decided it is final this time. I was not the perfect mother, not even a good one. At 64, after many years of therapy, after two marriages, I understand that. 

I know my daughter is angry and anxious and use this cut-off defense after irrational anger outbursts - this time in front of the kids, which was the final straw for me. But you cannot cut off love and wipe out precious memories. I wonder all the time if she is happier without me in her life. Perhaps she has a better chance of growth, sorting out her own anger and pain without me. I want her to be happy and content within herself. It saddens me even more when I read of the bitterness and pain adult children express here and I cannot help to think: is there anything more I can do for her? Can I help her? Or is letting go the better option? I know no one can really answer, but let's talk about this. I know there are really evil people, but many parents were simply damaged as children. When they have children, usually when they are very young, they have no skills or boundaries or knowledge of parenting to care emotionally for their young, especially 38 years ago when information and education was not a given. The result is emotional abuse, neglect, and / or physical abuse. The horrible old cycle - how do we break it?

Communication - my response

Submitted by David M. Allen M.D. on November 12, 2016 - 2:42pm

Hi Ria,

Of course I can't say anything about your situation in particular, but in general, of course it is best for parents to acknowledge their problematic behavior in the past, explain what they had experienced with their own parents, and apologize.

However, if the parent then goes on to continue to feel too guilty and beat themselves up for their past flaws, that may backfire. The adult child may then start to think that the parent is better off without them - just as you say you wonder about your kids being better off without you - because the child sees that his or her presence makes the parent feel really bad. In response, they may continue to avoid the parent so as not to add to the parent's burden. 

Additional point not in my original reply: Alternatively, they may act nasty to feed the parent's guilt because they think the parent wants to be punished for various sins - or they may go back and forth between the two depending on whether the parent seems to need to be punished or then starts to feel too guilty.