Seasickness v. mental health

[pbmaise]

Originally Posted by Mr B

My Passenger was seasick for 6 days straight, I even pulled into a river and ordered her off my boat,
Yes, It was that bad, She was endangering both of us and the boat too,
Gave her 50 bucks for a taxi to get to the airport and fly home,
I was sitting there thinking about it when she came back,
After a lot of talking, I reluctantly let her back on board,
We set sail and she was seasick again,

But remarkedly enough, She was never seasick when we hit bad weather and I told her to talk on the VHF to the ERS as I was too busy driving the boat,
Very calm talking on the VHF, but very seasick before and after,
She wasnt seasick for five weeks sailing around Fiji,

It wasnt till a long while after, I found her problem to be a Narcistic Sycopath,
Her seasickness was purely put on to annoy and upset me, Which it did,
Thankfully, She is long gone,

Yikes found link on this condition. Sounds like a well know politician.

https://www.learning-mind.com/narcissistic-sociopath/

I don't think we are dealing with that here.

[achil]

Originally Posted by pbmaise

I have been researching https://en.m.wikipedia.org/wiki/Emetophobia

I think another piece of the puzzle fleshes out. This past trip we had a guest aboard who was extremely seasick. She vomited constantly and her husband also brought on board a lot of alcohol and drank like a fish.

So there were two possible triggers aboard that helped trigger an intense prolonged anxiety attack.

I'm sure your husband is very afraid of taking any kind of drug because of the potential of getting addicted to those as well. He needs time to work through this. Perhaps some AA meetings would help him work through whatever is going on with him. Those meetings are all over the world.

[Dooglas]

Read this great book - Psychology of Sailing: The Sea's Effects on Mind and Body by Michael Stadler. He is a German psychologist and a cruising sailor.

[captmikem]

let me share something that may or may not help.
Beating across the indian ocean a few years back i became anxious and paranoid to the point where i could not sleep and actually hallucinated.

We were beating into an average of 30 kts for about a week and when the staysail blew a seam it took me two days to repair it, and I was becoming a liability.

My wife ( just the two of us on an 80 ft cutter) was getting a bit worried about me so she used the sideband and spoke with a doctor about my condition. Turns out I was taking Larium (mefloquine) as a prophylaxis for malaria and it can induce depressed mood, feeling restless or anxious confusion, extreme fear, hallucinations, unusual thoughts or behavior as a side effect, especially if you become dehydrated.

I stopped taking it and drank tons of liquids and in a couple of days of being hove to I started to become normal again. ( I stll kept an eye out for the two nuns I had seen hunkered down in the cockpit trying to avoid the spray...)

Gave me a real pause for thought about taking drugs at sea.

M

[Cadence]

Originally Posted by pbmaise

This last passage my spouse exhibited far more than just a typical case of seasickness. Waves were the largest he ever saw before, and one other crew member was also seasick and bedridden.

However, his behavior became odd enough that I put him in a hotel and bought a ticket to fly back.

Specifically:

1. I learned he had past anxiety disorder serious enough he was medicated.

2. Despite being now on solid ground, he complained he still could get zero sleep.

3. Despite being shown the bus to get to airport and having flown before he now claimed fear of flying and going on the bus by himself

4. It was like the seasickness triggered something far more serious that we are having to cope with.

Currently he has been one week off the boat and still complains of intense fear, high heart rate, and sleepless nights.

I went to the only available mental health professional and he proscribed two drugs for paranoid behaviors. However, he refuses to take any pills, including seasickness pills, because of negative reactions to prior pills proscribed for past mental health issues.

In 8 weeks I scheduled to leave again on a 2 month trip. Seas are not expected to be as rough. But could be at points.

We are trying to do cognitive behavioral therapy without the help of a professional. The one local source we have is a psychiatrist and is only a pill pusher and has "no time" for therapy that can takes weeks of work.

I'm no shrink by any means but it sounds more like anxiety than sea sickness. It is a shame he will not take pills. It might be a simple solution.

Best of luck.

[tarian]

His anxiety may have been caused by his fright and flight response being triggered when hes was in the large sea , this would have sent his brain into a flight stage and will take time to come down , most of us come down from a frighting experience quickly , i.e our blood pressure and Adrenalin etc , come back to normal , but in some cases this does not happen and the body stays in a state of flight and over time this stays the norm which then allows other memories and behaviours we have suppressed to come out which just feeds the anxiety ,
Anxiety can come in many forms and is rather underestimated in the male population as we tend to show our anxiety through anger,
CBT will definitely help but not in the short term this is a long road ,so in terms of going sailing your partners response will be highly heightened and may show itself more rapidly than before even when there is no danger , there is always risk , it is up to you and your partner to discuss it and find out the levels your are comfortable with , do not get sucked in to GOOGLE doctor as many symptoms are mirrored in many diseases and mental health conditions , and we can get some stressed reading about the doom scenario we forget what the real problem is , by all means do your research but do it with an open mind , also short term CBT as in skpye or a telephone is not he best (my opinion) it takes a lot longer to get the trust of the professional and for that professional to de code the human mind ,
Purely from experience of 2 years therapy after a serious car crash , with serious health issues after , I found it took 2 years just to get to the bottom of all that anxiety
P.S I am what you would class as an alpha male big strong and bullheaded , we all get mental health problems in some form or another and to accept their is a problem and help your partner will give him strength
good luck

[Biomed]

As you described his behaviour, I would not lean towards a psychosis, but more a neurosis. The treatments differ greatly. What I find of some concern, is that he has not taken you into his confidence regarding his past. Perhaps helpful to take a full inventory of his past behavioural issues, warts and all. Anxiety attacks are known to raise blood pressure and heart rate. They also influence the ability to make sound decisions and to execute them. During these events, his cortisol level may rise significantly, this hormone is a "stress hormone", and causes its own complications. Add: an addictive personality (previous alcohol abuse) and a father with the same issue. Children of alcoholics, have a hard life: they routinely have to hide the true situation at home from their friends, and learn to lie and to conceal, mostly out of loyalty to the sick parent(s). Abuse has many shapes, and need not be sexual or physical. Parents with abusive behaviour issues, are sometimes known as "toxic parents". Their children may be "toxic children" and may carry a very heavy burden for as long as it takes to get EFFECTIVE help. Many toxic children are very skilled at concealing destructive personality issues and corresponding behaviour. They learned well and young. It is possible, that other forms of abuse came his way too. That whole toxic soup may have surfaced when he was overwhelmed by his frightening sailing experience, and released the control mechanisms he has developed to cope with his legacy. In essence, he seems to have reverted to a frightened, not very competent, childlike behaviour. I have seen many patients, who had carried issues for many years, sometimes a lifetime. And these manifested in many different ways, often triggered by a severe stressor, which affected their ability to function. Sedatives may buy him much needed rest and sleep, he may well be exhausted by now. These should not be taken for any length of time, as they don't fix his problems. But to use them to induce forced rest, may be helpful. Anti psychotic medication, hate to say it, does not always work. And from what you write, there has not been a psychotic episode in any event. With my patients, working through the issues, and particularly crediting the abusive treatment shown to them, when they needed protection as a child, squarely back in the court of those who harmed them, released them from their trauma. This mechanism has been well documented and was part of a PhD thesis. It works a treat, but is not clearly understood. I very rarely prescribed anything other than what forced a couple of sound nights sleep, to get their strength back to face the issues. As things seem to be, I would not have him on board in any capacity, until he is well again. If he were a pilot I would ground him for a period. The good news is, that should he be be able to itemize the issues that befell him, and return them in all their glory back to sender, it is job done and he'll be the person he can be. No further treatment required. He might still not like big waves, though! But they will in all likelihood not cause him to behave this way again!
The path that worked for my patients, was short, harsh, painful and took a lot of guts. Having you by his side, makes it all worth it.
Fair winds!

[alansmith]

Phil, u in a pickle mate. Sad thing... u may not be able to resolve this. Mental health issues are incredibly tricky. Plus you have the issue of cultural differences and what he might consider in in his society as not being talked about. The old saying of ..”you can lead s horse to water but you can’t make him drink.”

I am accepting that you tried a patch of scopolamine for seasickness? I have a fella here in S.B. Bay who got his Thai wife seasick on a boisterous day and she has never sailed with him again. People can get so entrenched in their fears that flame throwers and grenades can nudge them out of their Fox holes.

Keep your fingers crossed Phil. I wish you luck. But you are in a tough situation trying to get this turned around. Too much pressure and it will only make him dig in harder would be my belief. Maybe just take a couple of months off and distress the situation. .

[hellosailor]

pb-
I think that you need to accept the high probability that there can be no instant fix here, and that you may have to plan around your husband not being on any boat, or taking any flights, for a good six months or a year. That's just reality biting.
Obviously he has a problem with more than seasickness, that's almost coincidental. In practical terms, you might look for a psychologist (they're not allowed to prescribe drugs, but other than that, they're about the same as a psychiatrist) or perhaps for a hypnotherapist, because hypnotherapy CAN be an effective way to reduce "anxiety" problems for many people. Neither it nor psychiatry work for everyone--but it does help some people some times, so given your limited options, I'd suggest exploring it. Or both of them. If one or the other helps, follow through with that one. And again, no drugs are involved, so your husband may appreciate that.
When and IF your husband decide to try boating again, I would also suggest that you look into the electric Relief Band. It is highly effective against motion sickness, and worn like a wrist watch. It involves NO DRUGS and can be instantly taken off if the user doesn't like it. Basically, it puts a small electric jolt on the nerves by the tendons in your wrist, the same accupressure point that has been known to work when manipulated manually for the same reasons. Highly effective, no drugs.
But first, he needs to get some help with the bigger issues. That's going to take time.

[BMasters]

Sorry to hear of your husbands troubles. There are a number of things that work well in these types of cases but without being able to perform some tests, these are simply educated guesses. These are available in any good health food store in the states, I don't know about the Philippines.

5-HTP - take on an empty stomach with a bite of fruit or drink of juice. This helps the body make serotonin. Contraindicated if he is already on an SSRI medication. May want to take it in the evening as it can make him sleepy.


Omega 3 fish oil this will not work fast but can be a real life saver in the long run. This makes the nerve cell walls more receptive to neurotransmitters (chemicals that help nerves talk to each other) To get results fast I would have him take 7000 mg per day. When I say fast I mean weeks not days.


I attached to this post a technique that has worked very well in my office. It is called 5 Min. Phobia Cure. Follow the instructions on the sheet. I would plug in to the blank line in part 1, "I love myself even if I get seasick" "even if I am fearful" This technique is not a cure all and needs to be performed repeatedly but it basically uses acupuncture point stimulation to internalize an affirmation.


I hope these things help but there is no substitute for having a professional look at him.


Good luck

[scarlet]

(I'm not a doctor, but I have lots of personal experience with mental health issues)

I find it interesting that the doctor prescribed to him something for "paranoia". Fear (which he clearly had on the boat, which probably triggered an anxiety attack) is a normal emotion. In fact, it is a very important emotion which is there to save your life. He was definitely scared on the boat because everything you mentioned in your post suggests that, which sent him into an anxiety attack. Anti-anxiety meds would certainly help, but I'm deducing that he probably doesn't want to take them because people get addicted to them. If he had a drinking issue, he probably knows to stay away from anything that is addictive. If he would reconsider, there is a great med (if he can take it) that is called Buspurin.. (or Buspar). it's something you take everyday.. not just when you need it, and is non-addictive (which may alleviate his fear of meds if it is related to addiction)

There are other options... CBT is good, and he doesn't need a therapist for it. There is a WONDERFUL book called "Feeling Good" by Dr. David Burns... It is wonderful. It also has a companion workbook, and it takes you through the whole premise of CBT...

Also, there is another therapy called "DBT" (Dialectical Behavior Therapy) Which combines Eastern and western therapy methods to help you control anxiety, etc. They use it a lot with people with eating disorders and self harm, but it is good for anyone who needs to control anxiety in their life. I don't have a specific book or resource, but you should be able to find info on line. It basically teaches you coping techniques.. (mindfulness.. mediation, a little bit of CBT.. etc.. ) Non-medical.. but highly effective.

Personally, I would get him out on the water as soon as you can.. but, nearby sailing on easy water, and light winds... otherwise the fear would grow.

You are free to PM me if you have questions... good luck

[JPA Cate]

Originally Posted by Biomed

As you described his behaviour, I would not lean towards a psychosis, but more a neurosis. The treatments differ greatly. What I find of some concern, is that he has not taken you into his confidence regarding his past. Perhaps helpful to take a full inventory of his past behavioural issues, warts and all.

Anxiety attacks are known to raise blood pressure and heart rate. They also influence the ability to make sound decisions and to execute them. During these events, his cortisol level may rise significantly, this hormone is a "stress hormone", and causes its own complications.

Add: an addictive personality (previous alcohol abuse) and a father with the same issue. Children of alcoholics, have a hard life: they routinely have to hide the true situation at home from their friends, and learn to lie and to conceal, mostly out of loyalty to the sick parent(s). Abuse has many shapes, and need not be sexual or physical. Parents with abusive behaviour issues, are sometimes known as "toxic parents". Their children may be "toxic children" and may carry a very heavy burden for as long as it takes to get EFFECTIVE help.

Many toxic children are very skilled at concealing destructive personality issues and corresponding behaviour. They learned well and young. It is possible, that other forms of abuse came his way too. That whole toxic soup may have surfaced when he was overwhelmed by his frightening sailing experience, and released the control mechanisms he has developed to cope with his legacy. In essence, he seems to have reverted to a frightened, not very competent, childlike behaviour.

I have seen many patients, who had carried issues for many years, sometimes a lifetime. And these manifested in many different ways, often triggered by a severe stressor, which affected their ability to function. Sedatives may buy him much needed rest and sleep, he may well be exhausted by now. These should not be taken for any length of time, as they don't fix his problems. But to use them to induce forced rest, may be helpful. Anti psychotic medication, hate to say it, does not always work. And from what you write, there has not been a psychotic episode in any event. With my patients, working through the issues, and particularly crediting the abusive treatment shown to them, when they needed protection as a child, squarely back in the court of those who harmed them, released them from their trauma. This mechanism has been well documented and was part of a PhD thesis. It works a treat, but is not clearly understood.

I very rarely prescribed anything other than what forced a couple of sound nights sleep, to get their strength back to face the issues. As things seem to be, I would not have him on board in any capacity, until he is well again. If he were a pilot I would ground him for a period. The good news is, that should he be be able to itemize the issues that befell him, and return them in all their glory back to sender, it is job done and he'll be the person he can be. No further treatment required. He might still not like big waves, though! But they will in all likelihood not cause him to behave this way again!

The path that worked for my patients, was short, harsh, painful and took a lot of guts. Having you by his side, makes it all worth it.
Fair winds!

This response, from Biomed, pblaise, is one that -- if followed -- can lead to a lifelong recovery. I hope you both have the courage to heed it. It is a tremendous opportunity, if available in the Philippines. Otherwise, I would consider a temporary return to your husband's country of origin for appropriate care.

Ann

[Capt Gill]

Originally Posted by john61ct

What we criticize in others says more about ourselves.

Man, there is truth to that ! E.g., those politicians who spout the evils of and denounce homosexuals only to be exposed they ...

[atoll]

in the old days they used to tie them to the mast to deal with their demons,then they discovered that Rum ,sodomy and the lash desensitised the crew enough to make them perform in any weather....

jokes aside,some people are just not cut out to be sailors,perhaps a FIFO solution might be best for you and your partner in the short term.

maybe not the ideal solution but more conducive to domestic bliss for them to fly in and rejoin the yacht in more sheltered waters.

[pbmaise]

Thank you all for your replies. Also private messages.

Seems an underlying mental health issue which prevents a spouse from enjoying sailing is not very unique. Given the size of this community I knew others would have more experience with this than I had.

Here is the latest update:

My spouse is back with me on the vessel while I am on a mooring. I am a cruising sailor and the vessel is my home. So he is essentially forced to come back to the vessel if he wants to remain with me. Hence, as someone put it there is a forcing issue in play. My plans to leave in early October are set and I am expected to be away until September 2019 on a 7 nation tour of SE Asia and haul out in Thailand. If he is unable to sail with me, then we will be apart at least a year.

Yesterday, we were able to return to the psychiatrist. This time we were together.

Like one person wrote, people can be very good at hiding a past issue until something dramatic brings it out. The combination here obviously brought it out.

Somethings I learned in the past few days include:

#1 It was University student anxiety which led him to become completely sleepless about 10 years ago and seek treatment before. Treatment was administered in the form of two drugs proscribed by the same psychiatrist.

#2 He was drinking and smoking concurrently as a university student and the psychiatrist convinced him to stop both habits.

#3 The psychiatrist basically admonished me for not providing him an environment with low stress in which he could sleep a full night. He really, doesn't report being afraid of the waves or the sailing. Hence, it is possible that too many sleepless nights in a row may have been a trigger point. Specifically, he did come on shift and help run a late night shift lasting 2 hours.

#4 We were proscribed two medications.
Zytapram (escitalopram aka cipralex and lexapro) and
Clonazepam 0.5mg/day (It searched 6 different pharmacies to locate this drug)

The good thing that I can see is the relatively low does of Clonazepam. For anxiety the web page indicates a does can be increased to between 1-4 mg/day so he is only being asked to take 1/8th max recommended dose. BTW when this drug is used to control epilepsy, max dosage is 20mg/day so it is about 1/40th maximum approved for a person in general.

#5 Getting to a doctor was one thing, getting him the meds another, having him actually take the medication is a third issue. Last night I agreed to move off the vessel with him to his small Filipino country farm home which is on his mother's property. He said he didn't want to be alone while taking these drugs and didn't want to start taking them while on the vessel. I agreed.

#6 However, just a few hours later he was already back tracking on this agreement and decided that what he needed was to do exercise to tire himself out. I was able to find and read to him a study which basically said that exercise in combination with drug therapy was shown to be more effective, and exercise alone was not conclusive.

#7 I have an immense amount of work to do to get the vessel ready again for this big trip.I do have time to be with him off the vessel while he begins medication, however, I have decided I am not going to go with him off the boat while he does exercise alone.

#8 I no longer think he has any phobia to vomiting or something like that. He doesn't fear sinking (the vessel can't sink), and doesn't report the waves as being that concerning. It was lack of sleep that was his big concern.

#9 He has been pushing me hard for a trip to El Nido to see a faith healer. I have been lukewarm on it. I am not looking forward to a 10 hour bus ride and overnight at a resort town to see a faith healer.

#10 On the one hand I would be pleased if he was able to get back into control of his anxiety using exercise alone. On the other hand I would feel more confident to take him on my next trip if I knew I had a medication aboard which would treat the problem and that he would take it. I plan to discuss with him. Same logic for the faith healer. There is no faith healer in the middle of the South China Sea.

#11 Currently he reports his heart rate is down, however, say she was sleepless last night from fear of taking the drug. Fear of taking a drug is also preventing him from taking seasickness pills. Interesting to me he has never been car sick and was not sick on previous airplane trips. Hence motion sickness doesn't seem to be the real issue.

#12 Moving forward the good thing about my up coming trip to Thailand is I have found 6 people to come along to share the work load when we do an overnight sail. I will be able to maintain a sleep schedule for him and not require him to pull a late night shift.