š§ Listen to Sarah read this installment of Cured.
I sit at the kitchen counter. Next to me is a cup of coffee in my favorite white mug. The coffee is milky-white. My leg is propped on the stool beside me. My healing-but-still-broken ankle is wrapped in a cold pack.
Caffeine consumption, which I do a lot of, should be an obvious no for anyone diagnosed with anxiety disorders, bipolar disorder, and ADHD. Caffeine-induced anxiety disorder is a subtype of a diagnosis found in the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatryās manual. Caffeine has been found to trigger manic episodes. The evidence that it helps with ADHD symptoms is contradictory, leading many to believe that it makes it worse.
Thereās no number of cups of coffee or cans of Red Bull that mark the amount that will trigger its negative effects. Hereās how it works: The brain buzzes from the very first sip, which seems like a good thing, but thatās the complex effects of dopamine levels rising in the brain and levels of feel-good neurotransmitter serotonin falling. (Alertness doesnāt bring happiness.) Then comes the jitteriness in the hands, the restlessness. The heart begins to beat quickly or pound. The sweating starts. Maybe thereās a ringing in the ears, a sense of dislocation. Maybe nausea, chest pain, dizziness.
I take the ice wrap off my ankle and hobble to the kitchen. Shouldnāt quitting caffeine have been the first line of treatment my psychiatrists recommended long before any benzodiazepines or anti-anxiety meds or mood stabilizers or antipsychotics were prescribed? Iād been drinking it for yearsānot a lot, one cup in the morning and one in the afternoon but a lot for me. (It always hit me hard.) Before any clinician leveled a psychiatric diagnosis and told me (incorrectly) that I had a lifelong, ābiologicalā psychiatric condition due to a āchemical imbalance,ā my lifestyle should have been taken into account. How many people diagnosed with anxiety disorders and major depressive disorder and mania and ADHD regularly drink caffeine? Cut that out first and then see where we are.
The milky brown liquid splashes over the rim of the cup as I set it on the counter. If Iām going to heal from mental illness, it has to go.
I pour the coffee down the sink. A twinge in my chestāan urge for moreāmakes me regret what Iāve done. But I throw away the bag of coffee grounds and then my coffee maker.
*
I already donāt smoke or drink alcohol or take illicit drugs, which puts me at a distinct advantage when it comes to recovery. I quit drinking almost twenty years ago. It was clear to me even then that if I struggled with depression and regularly drank a depressant (alcohol), it wasnāt going to go well.
I experimented with drugs a handful of times in college; they, too, seemed like a terrible idea for someone like me. Drug use has been found to cause depression, anxiety, and psychosis. Speed (amphetamine) has been linked to a five-fold risk of psychosis. Other drugs that produce drug-induced psychosis include marijuana, psychedelic drugs like LSD, ecstasy, and MDMA. Ketamine is also known as the street drug Special K. Cocaine produces symptoms of psychiatric disorders, even in those who donāt suffer from mental illness, including agitation, paranoia, hallucinations, delusions, violence, as well as suicidal and homicidal thinking.
Knowing how hard itās been to recover from mental illness, Iām not sure how anyone heals from co-occurring disorders (mental illness and substance use disorders). In a few years, Iāll complete a one-hundred-ten-hour training in substance abuse recovery counseling. Iāll listen to people who quit heroin and crack, a few while living on the streets. A young womanāmaybe twentyāwho was a meth addict will exude ferocity when she speaks of her recovery. Some will talk of hearing voices and trying to drown them out with alcohol. Their struggle and ability to recover will fill me with awe.
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