TEOTWAWKI Mental Health Issues, by Dr. Bob

There are many things about our “on-the-grid lives” that really are not all that fun.  We get depressed about stuff and certainly have anxiety over lots of things that will simply disappear WTSHTF.  My personal philosophy, along with many of our readers and patients, is that without a grid, life will be a little more simple.  With preparation, things don’t have to be that gloomy.  It will sure be a bummer for lots of other people, but for us and ours, it means a return to the basics.  The reality is:  none of us knows how we will cope with such big changes surrounding a major collapse.  As stated before and I will state it again, don’t come to me for counseling advice and I won’t give it here.  There are lots of good articles about how to help cope and what resources are available.  My focus will be to prepare you to think about how and what will happen to our citizens WTSHTF.

Any health care facility will be an absolute nightmare, post-collapse.  Read the nursing home chapter in the novel One Second After if you need a reminder of how things will look.  It will be horrible.  Nursing home patients with Alzheimer’s Disease, Schizophrenia, Bipolar Disorder, and a host of others will quickly suffer when there is no power and no support system.  The filth and chaos depicted in the book mentioned above is probably extremely accurate–but in an actual psychiatric facility it will be worse and degrade faster.  Picture any horrible scene from an old 19th century sanitarium and that will get you close; but it will be louder and more violent.  Throw in the raiding drug-seekers that think or know that there are drugs available in these places with poor security at best, and you have yourself an “avoid at all costs” area.  The one caveat to think about:  if you have a loved one in one of these facilities make plans to remove them IMMEDIATELY post-collapse.  My own Granny doesn’t always seem to have all her chips on the table sometimes, and it is up to me to get her and bring her home.  If you don’t get them out sooner rather than later, you may be putting your own life at risk to attempt to do so.

With that pleasant intro picture, let’s move on to those that walk among us, in order of severity, more or less.  Schizophrenics in society have had great advances in medication over the last 20 years, and many people take powerful anti-psychotic drugs to control their thoughts and behaviors.  These folks are usually harmless except to themselves, huddled under bridges when they are without medication; but some can be very dangerous when their voices direct them to act out.  Schizophrenics are unlikely to survive long post-collapse.  Most medication-dependent schizophrenic patients would have a return of their symptoms within a week of being off their meds.  Those with milder schizo-type personality disorders will last much longer, but may progress without medications to more frank schizophrenic symptoms.  Some of these folks are pretty well managed, normal-appearing individuals in our current existence.  They will quickly become very different once the pharmacies are all empty and closed down.  These folks generally do much better with a very routine, non-stressful environment around them.  There is not much positive news to forecast for these severely affected individuals.

Bipolar patients:  These folks used to be called manic-depressive back in the olden days (pre-2000), but that term was somehow not politically correct enough so they are now all suffering from Bipolar Disorder (BPD).  There are millions of these folks out there, but this term has morphed into a much broader and harder-to-define group of patients.  They take medications like:  Abilify, Saphris, Zyprexa, Symbyax, Seroquel, Risperdal, Geodon, Lamictal, Topamax (Topiramate), Depakote (Valproic Acid), Lithium, and Carbamazepine.  There are new meds added and some people also take other combinations, so this is not an inclusive list of medications.  It does give you an idea of how many people are out there with BPD as you may have seen some of the medications listed advertised on television.  These folks are largely intelligent, capable, and when manic can be destructive to themselves and certainly to others.  We believe that those with BPD should make CBT (Cognitive Behavioral Therapy) a part of their prepping plan, we have seen it work for some of our patients.  Now, there will be people commenting like crazy (no pun intended!) about how they have BPD or their brother or mother or Auntie does and that this article is ridiculous.  Are we not all entitled to our own opinions?  These groups of patients need to be generalized for the sake of information, and there are obviously exceptions to the rule.  My argument about you or brother or mother or Auntie is:  fine, they are normal and don’t fall into this group of dangerous folks, so you take care of them WTSHTF.  Just like my Granny in the above example, it’s a lot easier to think about how normal they are when someone else is taking care of them, but the responsibility falls to family first.

The next group of folks are the anxiety sufferers.  These people have been on anti-anxiety medicines for a long time and without them will withdraw.  Whether it is their SSRI (Paxil, Prozac, Zoloft, Wellbutrin, Effexor, etc.) or benzo (Xanax, Ativan, Valium, etc.) they will not only have anxiety that will bubble up, but they will also be more anxious with the knowledge that they will not have pills.  Some of these folks are truly dependent and will get a little squirrely looking for more to help their withdrawal.  Most will simply withdraw and deal with it.  A special category of these folks need to be mentioned:  The abusers.  They are taking these medications for the “high” of it and will truly be among the most dangerous immediately after they run out of medications.  These are the addicts out there, and if you have some of these pills in your house, make sure nobody knows it.  Or just get rid of them.  Having pain pills and anxiety pills seems like a good idea to most preppers out there; but, having these medications will also make you a target if anyone even sniffs the chance that you have them.  In my opinion, it is just not worth it.  We have none on our shelves, we just feel better being able to have deniability.  Each group or family will have to make their own decision on this one–but be advised.  If you are on these medications, try to wean off now.  Suddenly discontinuing these medications is not a good idea, as the symptoms of the withdrawal can be severe, even for SSRIs.  At least try to get to the point that you don’t have to take one every day, it will make it much easier in the future when you have none.

Lastly, but not least, the depression.  Depression can be debilitating.  While never actually having been on meds myself, we all know how bad depression can get either with first-hand knowledge or having watched someone we love go through it.  The medications for depression are a long list indeed and many are now generics:  Paxil (Paroxetine), Prozac (Fluoxetine), Celexa (Citolapram), Lexapro (Escitalopram), Luvox (Fluvoxamine), Zoloft (Sertraline), Pristiq, Cymbalta, Effexor (Venlafaxine), Wellbutrin (Bupropion), Remeron (Mirtazapine), Trazodone, Amitriptyline, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline, Vivactil, and the MAOIs that are now only rarely used.  This list is pretty inclusive, although some doctors use some “off label” dosing of antipsychotic meds to treat depression.  The real question about those clinically depressed is a depressing one:  just how many of these people will commit suicide when they are out of meds and facing the stress of TEOTWAWKI?  That question applies not only to the clinically depressed, but to us all.  Surely there will be suicides in a post-grid world as many people have the attitude:  “If it is that bad I don’t want to live”.  While most of us preppers cannot understand that line of thinking when there is still time, many people truly say that now…but how many will feel that way when they are hungry?  Surely, all of us wish that these scenarios never happen and that the happy gridded society continues for all time.  If not, be prepared for this reality.

While working on this together, we thought we needed to have a disclaimer on this article and state very plainly:  DO NOT STOP YOUR MEDICATIONS ON YOUR OWN WITHOUT CONSULTING YOUR DOCTOR.  Talk to your doctor, therapist, church, support group, etc. about how you can better prepare yourself for bad times if you have any of the above conditions.  While we stated it in a couple areas in this article, we will soon be posting a much more dire and detailed article about drug seekers and the problems they will pose for us all.  We will list withdrawal symptoms specifically so that you can spot them and be better prepared.  You really don’t have any idea how bad this problem is, we surely didn’t until opening up the clinic.  As always, stay strong and stay sane, – Dr. Bob and Docswife

JWR Adds: Dr. Bob is is one of the few consulting physicians in the U.S. who dispenses antibiotics for disaster preparedness as part of his normal scope of practice. His web site is: SurvivingHealthy.com.