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When things are going well, the last thing we want is a sudden change.

When I saw my psychiatrist last week my feet were both swollen particularly around the ankles. My psychiatrist recently checked my kidney and liver function so I wasn’t worried about that, but I was worried (I am a big worrier) about congestive heart failure. Because of other symptoms that were present, he felt pretty confident that hormones (changing hormones) were the cause.

We talked about menopause. I’m at that age. The idea of swollen ankles, hot flashes and moodiness do not seem too bad. What seems terrifying is the possibility that my medication will stop working which my doctor said is a possibility. We talked about the fact that many women with a mental illness have a very difficult time with this change in their lives.

The thought of losing the stability I fight for every day is so frightening to me. There are times when I can put the thought of psychosis out of my mind for days, or even weeks. Now, I think about what it would look like if my medication stopped working and I needed a psychiatric intervention.

I hope that sleep would go first, because that is a clear sign that my husband and I could deal with. I hope if something does happen it is the very slow unraveling of my thoughts like the way  it happened the last time I became psychotic. Last time my thoughts became increasingly paranoid and delusional, and in some ways grandiose, over a year before I was actually suffering from the symptoms of a full blown psychotic episode.

I am terrified of it happening quickly like flipping a switch, the switch being the line between reality and psychosis. I struggle to be rational every single day, but if that switch gets flipped, I no longer have a choice. Fighting to stay rational is not an option once that happens. Psychosis is powerful and takes over every corner and level of the mind. I wouldn’t even know what a rational thought was or how to work my way toward one.  Paranoia, delusions and grandiose thinking would be my reality while I was unable to reach the world of reality that most other people live in.

To be relatively rational, and have the fear of becoming completely irrational is like a bad dream, but one I know is possible, one I know I may have to live.

As I sit here, writing this, I think of the nightmare like existence of being psychotic. I do not want to go down that road. I do not want to be suicidal. I do not want to be lost inside my own mind. I do not want to run away from my life with my husband, because I no longer feel the love, the care, the trust of our marriage.

I do not want to think of the worst case scenario, but I have paranoid schizophrenia and not thinking of the worst possible outcome is not in my nature.

I am under a lot of stress. It has rarely, if ever, crossed my mind that my medications wouldn’t work. I must find a way to make each day during this transition as productive as possible considering my limitations. I want to squeeze the joy I get from writing out of each day. It is possible I will lose that ability to read and write again, and be left voiceless in the sea of other voiceless people. To be left without the ability to write, like I was for nearly twenty years, will be a loss I don’t think my soul could recover from.

I used to think that this illness had thrown some pretty dangerous things my way. I hoped the worst was over, but I guess vigilance is required at all times in this life, a life of broken mental health.