Losing Your Mind On Cannabis

Margarita glass with cannabis leaf decor

Cannabis Edibles

While cannabis smoking is controllable, edibles can take you on an entire different plane. Smoking cannabis is convenient because you get to decide when to stop, based on how high you are. Cannabis edibles are very difficult to titrate and that is one main reason why many people show up to the ER in states that have legalized it. Losing your mind on cannabis is real and it can happen to you!

The biggest mistake that people make with cannabis edibles is impatience: they believe that it must not be working because they are still sober an hour later. So what they do is indulge in more edibles hoping to increase the effect. But what happens is that by the second or third hour after the first ingestion, the cannabis finally starts to kick in.

At this point, you might wrongfully believe that it’s the second edible that kicked in, when in fact, the second edible is still in the process of being absorbed by your digestive tract. So now you have a ticking time bomb cruising through your digestive track. At this point, your mind is slowly being altered by the THC from the first edible.

The difference between smoking and eating an edible is that the effect of the edible takes longer to kick in, and the high is more spread out, as opposed to smoking which is a “quick on, quick off.” But going back to the mistake mentioned above, two hours later, the second edible starts to kick on top of your ongoing high.

This is what is meant by a “recipe for disaster.” Not only do you have too much marijuana in your system, you are now juggling two superimposed highs. You are praying for the first one to end, and as soon as you sense a coming down from the high, the second edible takes you back up, like a never-ending rollercoaster ride.

One of the worst experiences under a high dose of marijuana is the feeling of losing your mind. It’s like you don’t know anymore which mindset is in touch with reality: your perception of reality has been divided into two. One mindset is your normal one that is buried under the intense high, and the other is the intense high which is sitting on top of your normal state of mind, preventing it from reaching the surface.

At this point, you either don’t fight the feeling and accept the notion that you may very well have lost your mind, or you keep wrestling the feeling, hoping that you step back into reality. Both scenarios are extremely uncomfortable: accepting the possibility that you have lost your mind puts you in a state of panic.

You start to feel your heart racing as if you’re about to have a terrible panic attack. So now you try to fight this uncomfortable panicky feeling, on top of the dooming mindset that has swarmed your consciousness. On the other hand, you can continue fighting the high by refusing to believe that you have lost your mind.

The second option is miserable as well because you cannot do anything but keep fighting the high, hoping that it will soon come to an end. Except that it doesn’t, because the marijuana high from two edibles may last up to 4-10 hours. At a certain point, it’s just better to close your eyes and try to fall asleep. Keep in mind that you may wake up from sleep and still be cruising in space; the high doesn’t end just because you went to sleep.

Overall, the lesson that should be learned here is that if you want to indulge in marijuana, do so by consuming a small dose of an edible and allowing 2-3 hours to see if the effects will kick in. Do not eat a large dose or rush into eating a second dose prematurely. Losing your mind on cannabis is a real phenomena that you want to absolutely avoid at all times.

Safety, sanity and happiness always come first.

Are you Ready? (This is Defeating Stigma Mindfully)

Schizophrenia and the Evolution of the Human Brain β€” Dr. Elliott Gruen β€” HeartyPsych

An experienced psychiatrist, Dr. Elliot Gruen currently practices in Maine. Dr. Elliot Gruen draws on experience with a range of psychiatric conditions, including an in-depth familiarity with schizophrenia and its development. Schizophrenia is a complex mental illness that affects approximately 1 percent of the population. It causes abnormal activity in many different areas of […] viaΒ […]

Schizophrenia and the Evolution of the Human Brain β€” Dr. Elliott Gruen β€” HeartyPsych

Experiencing Command Hallucinations

Man with disturbed facial expression experiencing command hallucinations

Voices Inside Your Head

Imagine not only hearing voices inside your head, but scary ones that degrade you and your family and instruct you to harm others. Command hallucinations are the most dangerous types of auditory hallucinations experienced by people with psychotic episodes. They are not easy to control because they may be so demeaning, that patients eventually succumb to their instructions.

Command hallucinations may be experienced in schizophrenia, schizoaffective disorder, bipolar I disorder with psychotic features, major depressive disorder with psychotic features, substance-induced psychotic disorder and more. Patients usually complain of the voices being unpleasant and disturbing.

It’s important to keep in mind the differences between men and women with schizophrenia:

  • Men tend to develop it at an earlier age (early to middle 20s)
  • Men tend to have more negative symptoms (apathy, social withdrawal, blunting of affect, poverty of speech and thought, loss of motivation and anhedonia)
  • Men tend to have a poorer course
  • Women tend to develop it at a later age (late 20s and on)
  • Women tend to have more affective symptoms (depression, mood instability) and auditory hallucinations
  • Women tend to have a better course

Because women tend to have more auditory hallucinations, they should logically also experience more command hallucinations; however, it’s not clear if this is true. But what is true is the distressing nature of command hallucinations. For instance, when a patient hits a staff member, it’s not always due to the patient disliking the staff or being angry with them.

Sometimes patients hit staff or others in their surroundings because “the voices told me to do it.” A patient may complain that they were hearing voices inside their head degrading their family members and making them very upset. When this occurs, a patient may become very restless, attempting to neutralize the voices with violence.

During a psychotic episode, the voices tend to get worse. This may then be followed by the voices confusing the patient, by telling them that a certain person is out to get them. The patient refuses to believe but at the same time, can no longer take these menacing messages within their mind.

The voices then command the patient, “Hit him now! Kill him already! What the hell are you waiting for?” And that’s when the patient unfortunately reacts. Whenever a loved one or a friend tells you that they’ve been feeling different lately, take a compassionate stance and actively listen to what they are trying to tell you.

Can you imagine how hard it is to come out to your friends and family and tell them that you are hearing voices within your head? It’s almost as if you don’t want anyone to know. But if you are experiencing voices within your head, you have to let someone who you trust know about them.

Never keep these experiences to yourself, because you never know when they might become too overwhelming, causing you to commit a tragedy. Coming out and sharing your experiences is always the best step that you can take. Forget the existing stigma; allow the The DSM Ready Movement to take care of it by working hard every day to extinguish it.

You just do your part and share your experiences with the world. In return, we’ll give you the help, comfort and support that you deserve!

Are you Ready? (This is Defeating Stigma Mindfully)

The Road To Psychosis

Aerial photography of colorful roads and highways merging during nighttime

Losing Touch With Reality

There is no single road to psychosis. Rather, imagine many small streets and alleyways merging into one big highway, leading to a final endpoint called psychosis. The question is not what psychosis is; that can be observed in any psychiatric patient diagnosed with it. The question rather becomes, how does one end up on a wrong street leading to psychosis?

The medications used in the treatment of ADHD is an example of a route potentially leading to psychosis. In children and adolescents diagnosed with ADHD, these medications called stimulants do not cause psychosis; they work to improve the inattentive and hyperactive symptoms.

However, it could be possible that an adolescent with ADHD is genetically predisposed to developing schizophrenia. In that case, theoretically, stimulants have the potential of inducing psychosis. But the worry lies with stimulant diversion, when the medications hit the streets and are abused by thousands of high school and college kids for academic purposes.

When stimulants are abused by adolescents and young adults without a diagnosis of ADHD, it does become possible for transient psychosis to develop. Another street leading to psychosis is the genetic predisposition one may have to developing schizophrenia. Schizophrenia is a mental illness which involves hallucinations, delusions and disorganized speech or behavior.

The genetics behind developing schizophrenia is in its infancy. It is tied to the two-hit hypothesis, where one is prone to developing schizophrenia based on genetics and environmental stimuli; the first hit being their genetic makeup, followed by something environmentally toxic, such as marijuana!

We have only described two roads that likely lead to psychosis: the abuse of stimulants such as amphetamines and methylphenidate, and the genetics and environmental stimuli that can cause schizophrenia in a susceptible individual. In reality, there are many more roads that can lead to psychosis:

  • The abuse of marijuana by susceptible individuals
  • The abuse of cocaine, methamphetamine, alcohol, PCP and others
  • A severely traumatic experience resulting in Brief Psychotic Disorder
  • A traumatic-brain injury
  • Dementia-induced psychosis
  • Many medical conditions such as SLE, Huntington Disease, Parkinson Disease, brain tumors, AIDS and other viral etiologies

. . . and the list goes on. Regardless of the road one falls upon, the ultimate destination often involves one common experience: the loss of touch with reality.

Are you Ready? (This is Defeating Stigma Mindfully)

Stuck Within A Psychiatric Institution

Psychiatric patient standing on gray mesh surface

Imprisoned By Your Mind

To be institutionalized means that a patient has been in a psychiatric institution for such a long period of time that they have become used to it. They no longer have any interest in leaving the hospital because they have become too comfortable; their family has become the staff working on the unit.

Even if a psychiatric patient is qualified for discharge, they still may not want to leave; it just doesn’t matter anymore. Too much time has passed; they have lost the sense of what it feels like to live in society. The thought of leaving their comfort zone sounds terrifying; they prefer to remain locked up.

Imagine the government banging on your door and saying, “we are knocking down this house, you need to pack your bags and go. You have one week!” This is how some psychiatric patients feel when discharge becomes an option. Even though they may be asymptomatic and functional, they view the idea of discharge as “packing up my bags and starting from scratch.”

Most if not all psychiatric patients enter an institution with displeasure and discomfort. Their daily goal is to get one step closer to discharge; every day brings new hope. But there is a threshold upon which a patient has either lost hope or has become too comfortable with their new environment; this is the point of no return.

Once a patient crosses this invisible line, it becomes very difficult to get them to accept the idea of discharge. Some patients will actually regress and become symptomatic again in order to avoid being released. Some even start to improve and then will say things such as, “I don’t want this treatment anymore because I want to remain psychotic.”

Some patients have been mentally ill for so long, that if they start seeing their symptoms go away, they become uncomfortable. Their mind has become so used to their illness that they view sanity as a threat; an unfamiliar territory. So they start to become noncompliant with medications, forcing psychiatrists to obtain court orders.

The reality is that for many chronic psychiatric patients, they want to remain psychotic and institutionalized. This is their reality; their way of viewing the world. They have established their routines and their way of living. And if you step inside their world and start making plans for them, they start to see you as an intruder who is interfering with their life.

The dim reality as viewed by one person is paradise as viewed by another.

Are you Ready? (This is Defeating Stigma Mindfully)

Brief Psychotic Disorder

Grayscale photography of man experiencing brief psychotic disorder

Brief And Limited Psychosis

Brief psychotic disorder is a mental illness that lasts anywhere from one to thirty days. It is more common in women and usually occurs after someone has experienced a very stressful situation or trauma, such as a natural disaster, assault or the death of a loved one. It is also common postpartum and in geriatric patients due to their fluctuating hormones and mental status, respectively.

The symptoms may include: hallucinations, delusions, confusion, mood changes, disorganized speech and behavior and catatonia. These symptoms may promote violence or suicide, depending on the severity. As previously stated, it can occur in the elderly, but the majority of cases present in the second and third decades of life.

Brief psychotic disorder is not triggered by drugs or alcohol abuse. If drugs or alcohol are involved, the correct diagnosis is substance-induced psychotic disorder. The prognosis of brief psychotic disorder is generally good but there is always the chance of it progressing over one month; the disorder is then changed to schizophreniform. If schizophreniform progresses over six months, the disorder is then changed to schizophrenia.

Treatment may include antipsychotics, antidepressants and psychotherapy. Psychotherapy helps the patient understand the nature of the illness, what may have caused it and how to adjust to it psychologically. Regardless of the symptoms, psychosis is very unpleasant. Imagine being detached from reality, not being able to properly answer questions, hearing voices in your head telling you to harm yourself and no longer taking care of your appearance.

Psychosis presents itself differently in many individuals depending on their personality, past history, current situation and resilience. It is not a uniform presentation in which every person is painted with the same color of symptoms; some presentations are more vibrant than others. But regardless of the symptoms, each individual must be treated with love and given the proper attention and respect; behind each psychotic mask lies a human being who was once a normal child!

Are you Ready? (This is Defeating Stigma Mindfully)

Into The Mind Of A Schizophrenic Patient

Schizophrenic patient with inappropriate laughter

Psychosis Meaning

Psychosis is a mental disorder in which thoughts and emotions are so impaired that contact with external reality is lost. Patients with schizophrenia either have hallucinations, delusions or disorganized thinking; usually multiple symptoms are present.

Taking the time to listen to a schizophrenic patient will give you a glimpse into their world; their eyes are the windows to their psychotic reality. When you listen to a schizophrenic patient describe their reality, you will come to realize how different they view the world.

They may hear voices in their head that are “half animal and half human;” can you imagine how frightening this must be for any person? Their entire psychological well-being is disturbed; it feels like a living nightmare. They may also experience bugs crawling on their skin; this is known as tactile hallucinations.

A schizophrenic patient may be very disorganized in their thoughts, often interpreting reality in a distorted way that does not make sense to others. They may believe that their family has turned against them, that people are after them and stealing their clothes or that their mind is being controlled by the government.

It is very sad to obtain a glimpse into the world of a schizophrenic patient; your heart just melts when you come to the realization of how distorted their reality has become over the years. You want to help them as much as you can and you hope that when you come in to work the next day, the patient will be in a better place psychologically; sometimes they are, but other times the rabbit hole became deeper overnight.

We need to come together and be supportive of schizophrenic patients; the mental health stigma must end! They are often very loving and creative individuals; just because they have “lost their mind” does not mean that they should lose our support! We have a responsibility to help our fellow human beings come back on a level playing field and join us in a healthy state of mind!

Are you Ready? (This is Defeating Stigma Mindfully)

Alcohol-Induced Psychosis

Blue alcoholic drink in martini glass

Alcoholic Rabbit Holes

Alcohol-induced psychotic disorder (AIPD) is not a primary organic psychotic disorder like schizophreniform or schizophrenia; it is due to the substance itself, in this case, alcohol. Psychosis is a disorder that involves hallucinations, delusions or disorganized thinking; it classically is known as having a “break with reality.” AIPD can occur during an acute intoxication, withdrawal or chronic long-term use.

AIPD is more common in individuals struggling with alcohol dependence or addiction. Once a person develops AIPD, the psychosis may last anywhere from 1-6 months. If it is secondary to alcohol withdrawal, it usually clears up within one week.

AIPD Secondary to Acute Intoxication

When a person consumes a very large amount of alcohol in one sitting, they may develop AIPD. Some of the symptoms include: aggression, hallucinations, delusions, amnesia and impaired consciousness. The condition usually ends during hospitalization when the alcohol is cleared from the body, but the person is still at risk for alcohol poisoning, which must be monitored for to prevent death.

AIPD Secondary to Withdrawal

Also known as alcohol withdrawal delirium, this occurs when a person drinks a large quantity for a long period of time and abruptly stops drinking all together. Because the body becomes physically dependent on the substance, it starts to experience side effects when alcohol is no longer present in it.

Some of the symptoms include: agitation, anxiety, chest pain, irregular heart rate, headaches, mood changes, nightmares, hallucinations, delusions, delirium, fever, seizures and involuntary muscle contractions. The symptoms progress in severity from time to last drink, starting as early as 6 hours since the last drink and even continuing 48 hours later; hallucinations and seizures are the last symptoms to appear.

AIPD Secondary to Chronic Use

After long-term heavy alcohol use, a person may develop alcohol hallucinosis, paranoia or Wernicke-Korsakoff syndrome. Alcohol hallucinosis manifests as: auditory or tactile hallucinations, delusions and rapid mood swings. It can appear in a person who has a clear thought process but has been drinking heavily for many years. Alcoholic paranoia manifests as: extreme anxiety and the fear that others are after you.

Wernicke-Korsakoff syndrome is caused by a lack of vitamin B1 in the body secondary to poor nutrition in heavy alcoholics. It manifests as: the inability to form new memories, confabulation, confusion and hallucinations. There is no recovery from Wernicke-Korsakoff syndrome, as the mammillary bodies of the hippocampus have been severely damaged.

It is important to moderate your alcohol intake and never cross the invisible line leading into addiction territory. Alcohol was responsible for over 85,000 deaths per year from 2006-2010 in the United States; why lose your life over a substance? Always drink responsibly and remember that there is no substance that can ever replace natural happiness obtained from healthy relationships!

Are you Ready? (This is Defeating Stigma Mindfully)