I found this interesting article about schizophrenics and smoking at Brain Blogger recently. Since I have a blog this is the perfect place to get on a soapbox and rant a little about the topic.

Before I cured myself of schizophrenia, bipolar and ptsd I was a smoker. I started when I was fifteen as soon as I got out of a horrible psych group home for teens. I needed to cope with how little control over my life I had and the things people would do to me. I asked my foster father why he smoked and he told me it was to relax and calm down. I promptly asked for a couple of his Winstons and I was a smoker thereafter.

Smoking served several purposes for me back then. I was not allowed to smoke in the house. Anytime I wanted to smoke I had to go outside. This turned out to be in my favor as anytime I wanted to chill out and be by myself unsupervised I just went outside to have my smoke.

I found a nice big pine tree with branches so dense that it offered some shelter from the New England rain and showers. It gave me some space and time to think. I could let down my guard for a few minutes and chill.

For years after I continued to smoke. Once I had a job at the local Dunkin Donuts at the age of sixteen I could afford my own habit and it was not long before I was smoking a half a pack or more.

I got into trouble pursuing and defending my ‘right to smoke’ as a minor. After the foster home I ended up in other groups homes and did another go around inpatient. By then I was a smoker and I would be damned if some resident staff or psych nurse or program rule was going to stop me from smoking.

It became my single act of rebellion in those places. I built up trust from weeks long compliance with structure and as soon as I had a structure level where I could be out of sight with on-grounds privileges I always hid a stash of smokes somewhere. Usually a pack of smokes, wrapped in a baggie with matches tucked inside the box. I hid them in ceilings and under rocks.

Sooner or later I got busted. A non smoker staff got too close to me when I came back on the unit and smelled the smoke on me. The balloon would go up. The staff would go in a frenzy and start tearing my stuff apart.

I would taunt them and laugh at them when they did it.

“What, do you think I am an idiot? You think I would permit you the pleasure of confiscating my ‘contraband’ by stashing it my room? You people are such tools. In less than 300 days I will be 18 and you can’t stop me from smoking as much as I want, where I want and when I want. Go ahead and search. You will never find them you f***ing hypocritical morons who go outside and smoke on your lunch breaks.”

They never did find my smokes. It was glorious to frustrate the staff like that. Then all it took was going into a different, less restrictive program and suddenly anyone who was a smoker could go outside and smoke on the porch.

All those room searches and level demotions and furious and frantic staff searching for my stash. It was all in vain. My anger would just burn in my veins like lava thinking about those room searches and now here I was sitting on a rickety old rocking chair on a porch smoking to my hearts content.

It was a small personal victory of me versus the system to have never been caught with cigarettes or in the act of smoking while I was in those programs.  To deliberately disobey structure and do what I wanted and get away with it. It was a way for me to take control of my life in some small way.

A few months later I was a legal adult and the entire issue became moot. In my first apartment I had an ashtray by my bed. Before I opened my eyes my hands would grope for my pack and lighter. With cigarette between lips I would get up and go make coffee.

I did not know at the time but I would only be a smoker for four more years.

Flash forward and now I am twenty-two. I live 3000 miles away from all my abusers and those institutions and most of my friends and family. I had made a vow to pursue a holistic lifestyle and to dedicate my life to the study of meditation, internal martial arts and yoga.

At some point that year I quit smoking. It was very painful emotionally and psychologically. Intellectually I knew I would be healthier and that this was a good change for the better. Getting over the nicotine addiction, while also painful, was not the main problem.

For the longest time I dallied before completely quitting. I switched to lights. I tried to make smoking a ritual act and not an automatic, mindless process of lighting up whenever I had the impulse. I tapered myself down to 1-2 smokes in the morning (usually with coffee) and 1-2 smokes in the evening (usually after meals).

After awhile I got fed up with my procrastination and inability to sever the habit completely. When I asked myself honestly what my problem was, the answer was, I didn’t want to quit. I liked smoking. It was a part of me and who I was. Therein lay the problem.

Smoking had become part of my core sense of who I was. I am not exaggerating when I say almost all my family members and almost all my friends were smokers. I was not just getting a fix. Smoking was a communal, social interaction for me.

My father and I would smoke together on New Years. My brother was heavy smoker. When I hung out with my friends we might pass a joint around and afterward one person would light up and almost unconsciously and simultaneously everyone else would light up too.

Smoking had become like a good friend to me. I knew that if I quit smoking that I would not be able to tolerate people smoking around me. Some smokers homes are rank and even nauseating. Since most of my friends smoked cigs that meant that after we all smoked the joint I went home. I couldn’t stick around and breathe the subsequent nicotine haze.

The hardest part for me in all this was seeing myself as a person who did not smoke. My mental image of myself was a smoker. It was part of who I was not just a habit.

What ended up sealing the deal was a chance newspaper article or something I read in a health magazine or something like that. This was in the late 90s and that was when Big Tobacco was fielding massive class action law suits. The documents came out and told the truth about cigarettes.

Cigarettes have been engineered to get you addicted. That was all there was to it. These tobacco scientists had taken all the data on addictions and neurotransmitters and brain receptors and deliberately engineered a substance that messed around with your dopamine.

When I read that I was infuriated. I had never had a choice in the matter really. I was born to a smoking mother who smoked when she carried me. I was raised  in a smoking home breathing in my mother’s morning cigarette smoke while eating Cheerios before school.

It was fait accompli. My brain had been primed for dopamine addiction from the womb.The first cigarette I ever smoked was like coming home. It was already too late for me from the get go.

I was so enraged that I hurled my pack of smokes across the room where they fell behind an easy chair and lay forgotten for a year before I found them and gave them to a friend. I shattered my own addiction through sheer will. No hypnosis or patch or gum. I quit cold turkey and that was the end of it.

Then one day I tried an experiment. I borrowed a smoke from a friend. Took it home. In the privacy of my apartment I lit it and took one puff and put it out. Then I listened very carefully to my internal world. When you are fully conscious and present and you pay attention to how your body feels you can learn how substances effect you.

I realized that nicotine was a poison. It made me sick. My mouth tasted like ashes. The smell was horrid. The nicotine racing through my veins actually agitated me causing my thoughts to churn and my stomach as well. I realized most folks don’t pay attention like that. I would guess that almost every smoker noticed that effect the first time they smoked a cigarette but it does not stop them and then after awhile of smoking you don’t notice it anymore.

Here, alone in my apartment, meditating after taking a single puff I knew this was highly toxic. I cared about myself these days. I didn’t want to hurt myself or make myself sick. Although I partially regretted taking the puff it was a good experiment because it showed me that smoking makes you toxic and without a doubt effects your mind, body and feelings and not for the better.

Because of the unique experiences in my life I will forever associate smoking with mental health problems. People that have self esteem issues and hate themselves, their body, their life are not going to think twice about smoking. To them, it’s another nail in their coffin. (my brother’s own words actually).

Not all smokers are mental cases. Some people can genuinely recreationally smoke now and then and it’s not a big deal. It’s like any other recreational substance. These are people who can have a few drinks or do a line of coke or have a few smokes and they are not addicted. They recreate, they don’t self medicate.

A lot of people with mental health issues are self medicating. These folks are not smoking one or two smokes a day or a week. They go through 1-2 packs a day or more. When I was in the mental health system almost everyone I encountered was a smoker. I smoked like that too when I use to suffer from bipolar and schizophrenia.

Then I take a look at the healthiest people I knew around the time I quit and none of them smoked. My aikido and yoga teachers did not smoke. My tai chi and meditation teachers did not smoke. These were people who not only possessed good physical health but good mental health too.

Then I looked back at my friends and family. At least two of my friends had explosive tempers and they were heavy smokers. My mother, a depressive her entire life has always been a smoker. My brother who suffers from occasional bouts of depression is a smoker too.

Smoking may seem to be medication or a ‘coping stick’ but it is not. The health of your body, brain and internal organs effects your mental health and emotional outlook on life. Major smoking is self abuse that takes a toll on your entire body. Basically if you chain smoke and you have mental illness you are making it worse for yourself.

There is a saying about a sound mind in a sound body. If you smoke like that you working against your own recovery. Perhaps one of the best things someone with mental illness could do would be to quit smoking. No more artificially induced ups and downs, no more ‘nic fits’, no more dependency. Your entire health will rebound. You will get more oxygen which will help you think better. In time your energy will bounce back which can combat lethargy or lack of motivation.

You become more physically attractive when you don’t smoke. You smell better. Your skin and hair looks better. You have more endurance and better blood pressure. You remove a toxin which was negatively impacting your entire body being and it improves your mental functioning.

Why don’t more smokers with mental health issues see the light and quit? Well part of being mentally ill is not giving a shit about yourself anymore. If you have major depression, low self esteem or you hate yourself what do you care if you are toxic? You don’t care if you live or die.

Everyone is out to get you. Life is all about suffering and being morbid. The world is going to hell in a hand basket and no one understands you so why not smoke since it’s one small pleasure in an otherwise meaningless existence.

That’s part of why it’s called a ‘mental’ illness. You have beliefs and make rationalizations and decisions that you would not make or have if you were healthy and you both respected and loved yourself. Your point of view is self centered and skewed.

You don’t see the Big Picture with regards to the mind-body connection or you just don’t care. You don’t see how you are actually hurting yourself and making your experience of being alive less pleasurable by making your body sick and poisoning your internal organs.

Let’s talk about the smoking in institutions for a moment.  Let’s pretend for a moment that for some reason out of the blue I was majorly depressed and forced into a hospitalization. Now I am on the ward with all the chain smokers.

I would greatly appreciate it if smoking were totally banned inside the hospital. I don’t care if you are a schizophrenic or a bipolar and smoking is your coping method. You do not have the constitutional or God given right to spread your addictive, cancerous poison cloud and force me to breath it.

I know now what I didn’t know in my youth and that’s that smoking makes your mental health worse and not better. If you don’t care about yourself, fine, that’s part of the illness. But I do care about myself and I won’t stand for it. I would slap that cigarette out of your mouth if you lit up next to me in a closed, indoor environment and I wouldn’t care who you were on the outside.

Not all people with mental health issues are smokers. My younger brother has depression and is not a smoker. One of my sisters has a bipolar Dx and is not a smoker. My abusive stepfather was never a smoker.

Nevertheless I will always associate heavy smoking with mental illness. Everytime I see someone light up in public around other people and I can see them taking deep drags I can’t get the image of the lab monkey flipping a switch for hours to get another dose of cocaine in a research on addictions out of my mind.

Now for all that I said about how awful and detrimental smoking is, there is one and only one possible, highly unlikely, totally hypothetical circumstance I can think of where I might smoke again.

You know how they chemically castrate serial sex offenders as a judicial punishment? They punish you for having mental illness too. They call it a chemical lobotomy.

If you are one of those poor souls who is under an assisted outpatient treatment order then you are being medicated against your will. Antipsychotics are dangerous brain, gland and nervous system damaging drugs that are standard treatments now for people with bipolar and schizophrenia

One thing I extracted from the Brain Blogger article is that smoking can severely diminish the effects of antipsychotics. That is really nifty information to know. If I was under an AOT order and there was a nurse coming to my home to inject me with antipsychotics I would start smoking again.

Not because I hate myself. I would hate the necessity of smoking. I would feel remorse for hurting myself by smoking. But the need to resist and fight the effects of the meds short term would be a more important consideration than the possible long term effects.

As a strategy or a tactic I would smoke all day in the hope I could feel my old self again and have my critical faculties, memory and artistic inspiration back while biding my time for the day when I could get back in court to revisit the order for assisted treatment or the day that I could afford to escape to another state or country. I would quit later once I was free of the med.

Take note, all you victims of Fuller Torrey and TAC that smoking will reduce the brain lock that antipsychotics have on you. So light em up. Just don’t blow smoke at others (or tell your Pdoc).

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