Coming Off Psychiatric Medication

Spinning for psychosis

The individual who wrote this piece did not use medication at any point in their recovery.

The evidence demonstrating the benefits of following a regular aerobic exercise regime in raising the mood of people with mild to moderate depression has been well documented. But whether regular exercise can be beneficial in managing or reducing the symptoms of psychosis has been less well researched and documented.

I began hearing a voice about 6 months ago. It was a time of change and instability in my life due to my career being threatened and it being an uncertain future. I was also feeling a loss of purpose and victimised. I was distrustful and suspicious and very angry at the world and myself. The voice would berate me, tell me how useless and pathetic I was and tell me to kill myself, suggesting ways to end my life. The first couple of months were the worst, I was very fearful of the supposed hold the voice had over me, he seemed to know my deepest fears and exploit them. I began to develop unusual ideas and became quite paranoid of people. This later built into a full blown conspiracy against me, people following me in their cars, number plates having special significance, facial gestures people performed were ways of communicating to each other about me. My voice would warn me about these people saying 'watch-out for those two over there, one of them has got a knife and is going to stab you'.

When I first joined the gym I was still quite paranoid, I was suspicious of the staff and the gym members that seemed to be at the gym whenever I was there. It didn't occur to me that it was part of their routine to be at the gym at certain times as part of their routine, they were there to spy on me. I would wear a hat and the most basic and plain jumper and jogging trousers. I was aware constantly of exactly how many people were on machines in my line of sight, how many behind me how many in front, how long they'd spend on each machine, I even considered visits to the water fountain to be a way that they could transfer information about me. But, despite all of these potential threats and warnings about the conspiracy from the voice, no-one ever confronted me. I began to feel less threatened and gradually able to concentrate on exercising, the tiredness in my legs, my heavy breathing. A few weeks later, now feeling the gym was a relatively safe place to be I saw a group of people in a separate room sat on strangely shaped, aerodynamic looking bikes, they all looked thoroughly exhausted, they were spinning. I had never 'spun' before and so decided to give it a go. I'll explain briefly what happens in a spinning class. There are approximately 20 people in a class, sat on modified exercise bikes which face the front of the room and loud dance music playing throughout. At the front of the class is the instructor who determines what intervals you will do to each track (e.g sprints, hill climbs). You can change the intensity at which you work by adding tension onto the front wheel, which is a 20kg weight.

Before I started spinning my voice would predominately talk mostly in the evenings and it would make getting enough sleep difficult. The evenings were times when finding distraction was particularly difficult and facing the voice on my own during these times made me feel relatively isolated. When I started spinning my voice would still talk to me and tell me to give up, try to make out that some of the others in the class were out to harm me, but I carried on regardless, counting the beat of the music aloud, 1,2 3, 4 etc. The instructor would shout out commands telling you to up the tension or work harder. Having this other commanding presence competing for my attention was at first very distracting and difficult to get used to. But in a way it was like the instructors voice was helping me fight and not listen to the one in my head. My voice would eventually back down and has now taken the tactic of passively commenting about the others in the class, the pictures on the wall, occasionally telling the instructor to 'sod off' when he tells us to up the tension when quite clearly my legs have already generated far too much lactic acid! The voice was on my side! Woo Hoo! We have found a common enemy in the instructor! I joke. The other benefit I have found from spinning was that it made me physically tired which helped me to get some sleep. As well as this, the pattern of when my voice would talk to me changed, he began talking to me predominantly during the day, whereas previously he had talked to me mainly during the evening and at night. To deal with his new daytime presence I found other ways of distracting myself from his voice (listening to loud music on my MP3 player, playing sports, running, going for long walks). Of course the change in the voices routine meant that I had to be able to hide the fact he was talking to me better in social situations. But I eventually became more comfortable with this.

I had developed ways of excusing myself from not being able to listen in a conversation, for example tying my shoelaces, so I could give my full attention to the voice and try to reason with him to go away. Meanwhile the other person in the conversation thinks I'm just tying my shoelaces. When I need to answer back aloud to the voice, talking to the mobile phone is useful, going running with your headphones on, you can shout back at the voice as loud as you want with this one and people who see you just think you're singing along to your music. Also, when I felt he was overwhelming me and getting on top of me, I found going to the woods or fields and just throwing stones or rocks into rivers a useful way of getting rid of some of my frustration and anger towards him and probably myself.

Spinning also helped to naturally lift my mood as I had become quite low with my voice constantly berating me and at first feeling quite powerless to him. I've been spinning maybe 3-4 times a week for about a month now. Spinning along with being able to discuss my voice and some perhaps 'unusual' beliefs that developed over the last 6 months at a local Hearing Voices group and the support of a very good friend, have been the best interventions in helping me not feel so isolated by the experience. The natural production of endorphins that comes with high intensity aerobic exercise helped to lift my mood, friends have also told me I appear more self-confident and I definitely feel a buzz for hours after completing a class. In the group I was able to explore the patterns of my voice (e.g. how he exploits my vulnerabilities to make me feel paranoid) and along with my supportive friend start to understand and decipher the meanings behind what he says to me. I was also able to start to develop a better relationship with him, which meant ultimately not feeling like a powerless victim to him. I was able to cope with him when he spoke to me and he wasn't able to stop me from doing anything I wanted to, which spinning proved. Spinning also helped me in that it provided some stability 'of self' when I started to work through and explore why my voice came, who he represents, and had to touch upon and talk about difficult times and events from my past. The kind of emotional upheaval of past events left me feeling very vulnerable and quite drained, so spinning with the physical exertion in a way enabled me to 're-ground' myself so that I didn't become too overwhelmed by this work and risk taking steps backwards in my recovery. I should probably emphasize the importance of finding ways to 'wind down' after spinning, as it gives you quite a buzz, on occasions where I have not wound down I have found it difficult to sleep and the paranoid ideas began to develop and the voice benefited from or took advantage of my lack of sleep, especially when my sleep was limited over a period of a few days. To wind down I might draw or paint, listen to music, play the piano or read a book, just something to re-ground me from the rush of endorphins.

I wonder whether some thing like circuit training, where there is a positive commanding instructors voice driving you to work harder would have a similar effect. Perhaps I should try that and see.