Despite sleep medicine doctors and psychiatrists telling me that the amount of Klonopin I took each day for 9 years was “nothing at all”, the intense withdrawal symptoms I had whenever I went a day without it lead me to believe I was physically dependent. I decided I wanted to find a way to safely taper off, but the lack of information and support I received was unexpected. This was particularly disturbing since I worked and received care at OHSU, which is a research institution. I had no idea there was a peer recovery movement where I could have received support, but it seemed reasonable that someone at OHSU would be able to help me. I did a literature search at OHSU’s library to see if I could find any information or research. The only academic resource I was able to find was the Ashton Manual, which was developed by Dr. Heather Ashton of Newcastle University’s Institute of Neuroscience from a 14-year longitudinal study of people withdrawing from benzodiazepines. I talked with my primary care doctor who I liked and trusted and she agreed to support me in my taper. She suggested I also start counseling sessions with the social worker in the family medicine department. My doctor was glad I found Ashton’s tapering schedule and said she intended to share it with other doctors. We followed the guide to a “T” and started the taper by switching from longer-acting Klonopin to shorter-acting Valium in the autumn of 2007.
I took my last dose of valium on the evening of December 30, 2009. My first day off benzodiazepines was New Year’s Eve; the end of a year and—I had hoped—the end of two rough years of tapering. I was aware of the long list of withdrawal symptoms listed in the Ashton manual, but I was convinced that I had been through the worst of it and would be feeling better soon. I was working out and doing yoga every day at that point, and was in really good physical condition. But I didn’t sleep at all on New Year’s Eve and for many nights to come. I participated in an online forum called BenzoIsland where people who had previously tapered off benzos using the Ashton manual offered support to folks in withdrawal. Everyone assured me the insomnia and rapid thoughts I was experiencing were “just the benzos talking”, but my paranoia grew. I didn’t want to go into the hospital, but I became completely detached from reality and knew I needed to sleep.
I was extremely unpleasantly surprised to experience psychosis in acute withdrawal because the Ashton Manual doesn’t discuss it and I had tapered off the valium so slowly and with so many supports. But I had quit counseling a year before my taper ended and was depending solely on the support of the BenzoIsland forum. I had also gone through some very traumatic family emergencies in the two years of my taper. In retrospect, I realize that I really needed counseling, but I couldn’t deal with the end of life closure the social worker wanted me to work on with my parents… it was too much with the stress of the taper. I imagine this is a difficult balance for many people to bear and I have forgiven myself. I was able to take up the emotional healing with my parents once I was stable again with the support of my holistic care team, partner and friends.
I had experienced and recovered from psychosis once before in 1991 when I was 24 years old. At that time, I was struggling with sexual trauma I experienced in my teens and early 20’s, and needed support to start my coming out process. I knew it would take a while to recover and there would be a period of deep depression, but I had never experienced the cognitive problems I had in early 2010. I couldn’t focus enough to speak coherently and I was so disconnected from my body that none of the activities I did for self-care felt good or made any impact on my mood. I slept 16 hours a day and was in a state of near-catatonia for the rest of the day. My hands shook, so I wasn’t able to do draw very well or do other kinds of crafts like beading. More complex skills like creative writing or video editing were beyond comprehension because I could barely keep my thoughts organized enough to make myself breakfast and get dressed in the morning. I was completely compromised in every facet of my life and felt like this was the way the rest of my life would be: an over-medicated haze where I was unable to feel, speak, create or engage with the world. I deeply longed for the creative life full of love and connection that I once knew.
Despite trying everything that usually made me feel better, this deep depression went on for nine months. My unresponsiveness to my usual self-care strategies led me to decide to go back to work to see if daily activity of that sort would help. In November 2010, I started a new medical research support position at OHSU. Despite being very nervous and feeling like I was about 50% “there”, I gradually met new people and started talking again. I had huge anxiety attacks, but I found a restorative yoga class a block from my house that was taught by a woman who used to work with people who were coming off of psych meds. Going to this class twice a week helped me feel more grounded and helped with the body pains caused by my sympathetic nervous system. I also found an acupuncturist in my neighborhood who used to work in a drug rehabilitation center. The treatments and Chinese herbs helped with my fatigue and insomnia. I had a great care team with classes and natural treatments that helped me build skills to fight the anxiety and insomnia I’ve had since childhood. I would take short breaks at work to go to the library to do breathing exercises—especially if I was going to have lunch with a new work friend, because interaction was still hard. As the winter started, I was triggered by the anniversary of my months of acute withdrawal. I knew that creative pursuits helped me feel better in the past, but I wasn’t inspired to do visual art or videography, and writing poetry sometimes took me to dark places that I wanted some relief from. I had briefly experimented with crochet in 2005 and 2006, and had developed a series of three easy stitches. I remembered enjoying the sculptural nature of crocheting without rules or patterns, the colors and textures of the yarn, and the soft, cozy hats and scarves I had made.
I followed that impulse to tap into my creativity and bought a really pretty dip-dyed, wool blend yarn in every color of green you can imagine. Green has always been one of my favorite colors, and just looking at the yarn and feeling the softness as it went through my fingers lifted my mood. I made a cozy cowl in three sittings while I unwound from work in the evenings. When I wore the finished product to work the next day, so many people commented on it that it made me overjoyed to finally regain some of my creativity. I proceeded to buy every color of that dip-dyed yarn and cranked out cowls every night. Having a new cowl to wear in the morning also motivated me to get dressed and go to work, and even though I was still depressed, the anniversary of my hospitalization passed without any problems.
From 2012 to early 2013, I managed to taper off the antipsychotic medication and mood stabilizer I was prescribed in acute withdrawal with the help of my empathetic counselor who specializes in existential psychology and an open-minded psychiatrist who was willing to do some research on alternatives like fish oil and vitamin D. These natural supplements and visits to my acupuncturist for a treatment and some herbs if I have trouble sleeping have kept me off the meds. My self-care routine of daily walks, hikes in nature on the weekends and my home yoga routine once or twice a week when I’m feeling good and daily if I’m feeling ungrounded have also kept me stable. Stability is great, but I am 100% positive that crochet and my other creative endeavors have been the source of recovering my sense of self-efficacy, which has kept me going steady in attaining my goals over the past 7 years. I’ve found evidence to support my beliefs in current literature in neuroscience and occupational research.
Positive psychology describes flow as harnessing the emotions in the service of performing and learning. In flow, the emotions are not just contained and channeled, but positive, energized, and aligned with the task at hand. Many activities can promote flow experiences where one is completely absorbed in the task at hand and able to focus on the present moment and release stress. In the late 80’s, Mihaly Csikszentmihaly studied flow in chess players, mountain climbers, dancers and surgeons and found a set of characteristics common to flow experiences: 1) complete absorption in the activity, 2) reduced awareness of the external environment, 3) sense of “oneness” with the activity, 4) immersion in the present moment, 5) reduced fear or anxiety with engagement in the activity, 6) feelings of personal satisfaction (Gutman & Schindler, 2007). Anyone can experience a sense of flow in activities they find rewarding such as cooking, gardening, playing a musical instrument, sports or daily walks. The basis of flow experiences is neurological… the brain’s reward system distinguishes pleasurable activities that should be repeated from harmful ones that should be avoided by releasing the neurotransmitter dopamine (Gutman & Schindler, 2007). With each cowl I made, a neural network in my brain was strengthened as I built a routine around a rewarding creative activity that released stress and improved my mood and cognitive skills. With an improved state of mind and a new hobby to talk about with friends and strangers, I started feeling more confident about myself and my abilities.
The cognitive and emotional benefits of flow experiences are similar to those found in meditation practices. Activities that promote flow experiences reduce internal conflict and environmental stimulation that can contribute to sensory overload. Activities that enhance flow can be used to prevent or reduce symptoms of depression by training the mind to regulate emotional responses to negative stimuli. This results in increased levels of concentration, and the release of anxiety about the future and regrets about the past, which all contribute to complete immersion in the present moment (Gutman & Schindler, 2007; Riley, Corkhill and Morris, 2013). When I crochet for even a few minutes, I can literally feel tension leaving tender points in my body—especially in my abdomen and chest. When I crochet for 15 minutes or more, no matter how stressed or agitated I am, my perception of things that usually irritate me changes. I can accept chaos more easily and am able to clear my mind of circular negative thought patterns. Crocheting on the bus also reduces the anxiety and sensory overload I often experience in any form of transportation. I really wish I could crochet and drive at the same time!
These changes in perception that I experience are the result of activating the relaxation response, which is the physiological counterpart to the body’s stress response or fight/flight syndrome (Gutman & Schindler, 2007). Some common characteristics of activities that promote the relaxation response are: 1) performed in a quiet place, 2) enhances the ability to focus inwardly, 3) increases concentration on task-specific skills, 3) promotes the release of everyday worries, 4) involves focused attention on a repetitive mental stimulus or activity (Gutman & Schindler, 2007; ; Riley, Corkhill & Morris, 2013). With each loop I make around my crochet hook, I become more focused on the task at hand and any other idea or worry in my mind fades. This is particularly true if I am at home or another comfortable environment in silence or listening to calming music. I sometimes crochet while I watch a movie, but this reduces the attention to the repetitive motion and focus on the task at hand, so it isn’t as physically relaxing, but it can elevate my mood if I am depressed, worried or agitated.
Crafts like crochet, have been found to promote: 1) motivation and self-esteem, 2) sense of self and positive identity, 3) sense of competence and achievement, 4) perceived sense of control and choice, 5) sense of purpose, 6) means of coming to terms with illness (Riley, Corkhill & Morris, 2013). Crafting also involves learning practical skills that build self-confidence and pride in one’s work. Making household items, clothing and accessories for oneself and gifts for others is also associated with being more content in life, less materialistic and feelings of self-sufficiency (Riley, Corkhill & Morris, 2013). I started my crochet practice in earnest when I was cognitively impaired. In 2011, I taught my partner the three simple stitches I developed, but she got bored after completing three projects. She encouraged me to learn standard crochet stitches, but the instructions were hard for me to follow and I got frustrated and anxious. Without reading any research, I instinctively knew what I needed. I explained that it was really important for me to have a sense of mastery over something I could do every day because my sense of self and what I could do had been so diminished. Plus, my usual self-care routines didn’t feel so good in my body. The form of crochet I do is relaxing to me because the stitches I use are not standard and I make projects without following any patterns. People have told me my stitches resemble a slip stitch, which I gather is more of an attaching stitch than a building stitch in crochet. I’ve also been told that my stitches look like old net-making stitches and that the end result looks more like knitting than crochet. All I know is that I watched a beginning crochet instructional video on YouTube back in 2005 and riffed on it experimentally until I found a way of sculpting shapes I liked. I did it as a way to relax and made hats and scarves as gifts when I first started. The first project I felt proud of was a cloche hat I crocheted for myself. A friend bought a vintage woven braid cloche that I coveted. Since I couldn’t steal if from her, I used her hat as a pattern for the overall shape and tailored one out of a wool and mohair blend yarn for myself. As the old saying goes, necessity is the mother of invention. This is very true for me regarding crochet. I definitely feel like it was a necessary part of my recovery and I’m proud to share my practice through the instructional videos I’ve produced. I know I will continue to crochet for the rest of my life and hope my presentation and videos help others develop a relaxing form of creative activity.
Gutman & Schindler, (2007). The Neurological Basis of Occupation. Occupational Therapy International, 14(2), 71-85.
Riley, Corkhill & Morris, (2013). The benefits of knitting for personal and social wellbeing in adulthood: Findings from an International Survey. British Journal of Occupational Therapy, 76(2), 50-57.