accounting
Oct. 11th, 2020 12:26 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
spatchOctober 10th has been designated an international day of mental health recognition and awareness. That is a pretty noble goal. Many people suffer from mental health issues. A lot of people struggle, some overcome, some learn how to maintain. Many fail. Others don't even know they're suffering. Those of us who are capable of and willing to identify and own our illnesses should do so, to show that one's illnesses do not have to own them.
Here, then, are my own, presented as a list of symptoms and treatments, and not as any kind of woeful ballad or pity party invitation. It's pretty long, this list of things, but I own them. They're mine and I gotta deal with them as best I can.
I have what's called major depressive disorder, also known as clinical depression. It is not bipolar depression, as my mood upswing is not characterized as manic. I just get a lot of energy and can get shit done and handle stuff and generally feel great as hell until I don't. The downswings are long and drawn out, deep and heavy, often leading to great inactivity and anhedonia and guilt and self-harm and a great deal of spirals. One of the frequent phases is "Feel bad, then feel bad about feeling bad, then feel bad about feeling bad about feeling bad" and you just repeat until something breaks. I've had a lot of things break. I've broken a lot of things in that state, but mostly myself. I am not suicidal, but geez the bleak existentialism can really get to a person sometimes.
I've been treating the depression in one physician-approved fashion or another since 1996 or so, though I lost access to treatment in 1997 and didn't get it back until 2006. I started treatment for the anxiety disorder and the frequent panic attacks I was having. This came about due to a traumatic event in July 2006 involving a late-night police break-in (they had the wrong house) which left me now also dealing with severe post-traumatic stress disorder. For years I had to sleep with a door tightly shut because the sound of a door opening, any kind of sound, woke me upright in panic. This has included a tree branch scraping across the outside wall of my room at just the right register to sound like the hinges.
The anxiety disorder on its own mostly involves panic attacks in crowds, leading to episodes in which I either just up and suddenly leave a situation or, if I can't get out (like if I'm on a crowded rush hour Red Line train that has stopped between Harvard and Central) I tend to shut down entirely and disassociate like hell. The T has historically been the biggest source of panic attacks. Though I tend to dislike the use of much code or metaphor, there was a time when I would pre-emptively sit out an incoming train, preferring to wait for a less crowded one, on the pretense that it was "too shiny". Gimme a dingy grubby-on-the-outside Red Line car any day. Fortunately 2020 has given me absolutely no reason to take any public transit, train or bus, much less find myself in crowds, and I consider that a very very very very very very very very very minimal blessing.
From 1996 to 1997 I was put on Paxil for the depression, but turns out SSRIs do not work well with me at all. I lost the low swings but I also lost the highs. There was just an emotional flatness. Also, it gives the effect of electrical zaps through the brain, some Crucial Functions were affected in terrible ways, and if I took it without eating beforehand it would cramp me up with screaming pain. When I lost my insurance in 1997 I had to quit Paxil tapering-style off a final 90-day supply with no new incoming meds to help pick up the slack. They say Paxil's withdrawal symptoms can be on par with heroin. I'll believe it. I could get nauseating bedspin effects simply by turning my head, like I was on the Rotor centrifuge ride. I couldn't drive on those days.
From 2006 on I've been on quite a few kinds of psychiatric medication and have been trying to do as best as I can with them, though from time to time I had to bounce from antidepressant to antidepressant when it became clear one wasn't working as well as it had in the past. I stayed off the SSRIs which affect the serotonin levels in your brain, in favor of the antidepressants which work with dopamine. In 2014 however I was severely misdiagnosed by the RN serving as my pill doctor, who put me two SSRIs at once (even though I kept saying I was pretty sure SSRIs, even newer ones than Paxil, weren't gonna work) and when those didn't work, followed it up by the absolutely incorrect decision to put me on Effexor. Result: A mental breakdown resulting in abandonment of work, a state which I likened to walking zombieness, and long periods which I just don't remember. I'd just gotten married. We'd just gotten cats. I augured into the ground. I haven't recovered. For a year we lived in separate places. Things were very tenuous. Things still are.
In the five years since that breakdown I have been struggling to get back up into something resembling a working state. I have not fully succeeded. In 2015 I started a new pill doctor who immediately got me off the harmful shit and transitioned me onto a non-SSRI which brought me back up out of the zombieness. I'd also landed a part-time job at the Somerville Theatre which turned out to be a real saving grace. The five years at the Somerville helped in many, many ways and I have met so many wonderful people and made good friends and proved to myself that I can get shit done, man, but it's going to be tougher than it was before I broke. And it is. I have not written anything major since 2013. I've tried and failed several times on projects which in other times would have been challenges but doable and even fun. That's a separate issue however which needs to be addressed on its own time though, but I am really sorry for letting so many people down.
In 2019 I started working with a new talking therapist after a lapse of three years. And I started getting somewhere. While not undertaking full-on cognitive behavior therapy, I started learning and using exercises to keep away from the thought spirals, to center and ground myself during disassociative and other periods of extreme ungroundedness, and started talking a lot of stuff out that I hadn't been able to talk out before.
It was through talking a lot of stuff out, expressing frustrations over frequent and constant mental problems and blocks and recurring situations, which led to discussions of executive dysfunction and then, with my pill doctor, a diagnosis late last year of attention deficit disorder and the beginning of treatment. I got put on Ritalin. The mental energy I craved during the moments of good upswing, something I hadn't felt in years, had returned. December and January and February were the best months I'd had at the theater. We had midnight sing-along screenings of the Cats film flop; I organized a pre-show, was one of the hosts, gave out prizes for cat trivia and put together trailer reels of cat and musical-related stuff. The pre-show stuff was a lot of fun and something I wouldn't have considered talking about even a year before, I don't think.
And I was learning that this ADD had been with me for years, undiagnosed and untreated, right alongside the depression for as long as I can remember. Being able to go back and think through old wounds and trauma with this knowledge is illuminating though damn painful. The good thing is that I am understanding a lot more now about how this brain works and doesn't work, and why I am incapable of handling or processing certain functions that seemingly everybody else can, or doing them in different fashions. I can't write to a deadline. And putting sentences together well has become something I do much more slowly than even usual.
The problem is that since this went undiagnosed and untreated for so long, all the devices and mechanisms which I have had to build to cope with missing functionality, processing, and work priority are solely my own, created from first-person experience and not much else. There may be things which work better and more beneficially for me. I'm pretty sure there are, because I'll admit some of these internal mechanisms and routines are really shitty. Now I have to learn the new ones.
And the problem with this problem is that my talking therapist abruptly retired in July. It was something they'd planned to do by the end of the year and there would have been plenty of time to notify and transition and all that, but we had to go to phone visits only after March and I ended up getting the official notification of retirement in the mail a week after my final appointment with them. As we spoke for the last time, I was told in no uncertain terms to not continue seeking mental health services from the company that Harvard Vanguard has become. They're falling apart. Shedding personnel left and right. The primary care physician whom Sonya and I share went on maternity leave in the spring, and then announced she wasn't coming back. We now share a new PCP.
My current pill doc, however, remains with that group, and I very much want to stay with him. He claims I may be able to get into the MGH behavioral health program, which has very good therapists and takes our horrible insurance, without switching PCPs over. I am not sure how this happens. I've been trying to call them. It is tough for me to do. I don't know who to speak with or how to ask or any of this--this is the kind of freezing loop I get when trying to plan work processes for things I don't know how to do. And it's only been worse since Covid lockdown. The closure of the theater and the loss of my job and any other public facing thing I could do has been devastating.
I've frozen up quite a bit, functionality-wise. Example: I was doing the dishes, focused on that task, and was offered a bite of something on a spoon, and I froze up because hands-doing-dishes-incapable-at-this-time-to-make-decision-eat-or-not-EAT-OR-NOT-EAT-OR-NOT. When in better mindsets I can take interruptions to the brain's workflow much more better, adapt to incoming additions and alterations, and maybe even hum a bit as I do. But right now? Not at all. Every time I think about the processes I'll have to undertake to try to get the information from MGH and the help I need, I freeze at any UNKNOWN step. Planning contingencies on unknown outcomes is just not possible right now. I can't think forward enough. I freeze at decisions again hard.
And that's where I stand at the moment. Very tough and there's very little right now that shows evidence like it'll help. But where else to look? We'll have to think about that only after MGH pans out, if it pans out. But for now,
well.
Hi.
Here, then, are my own, presented as a list of symptoms and treatments, and not as any kind of woeful ballad or pity party invitation. It's pretty long, this list of things, but I own them. They're mine and I gotta deal with them as best I can.
I have what's called major depressive disorder, also known as clinical depression. It is not bipolar depression, as my mood upswing is not characterized as manic. I just get a lot of energy and can get shit done and handle stuff and generally feel great as hell until I don't. The downswings are long and drawn out, deep and heavy, often leading to great inactivity and anhedonia and guilt and self-harm and a great deal of spirals. One of the frequent phases is "Feel bad, then feel bad about feeling bad, then feel bad about feeling bad about feeling bad" and you just repeat until something breaks. I've had a lot of things break. I've broken a lot of things in that state, but mostly myself. I am not suicidal, but geez the bleak existentialism can really get to a person sometimes.
I've been treating the depression in one physician-approved fashion or another since 1996 or so, though I lost access to treatment in 1997 and didn't get it back until 2006. I started treatment for the anxiety disorder and the frequent panic attacks I was having. This came about due to a traumatic event in July 2006 involving a late-night police break-in (they had the wrong house) which left me now also dealing with severe post-traumatic stress disorder. For years I had to sleep with a door tightly shut because the sound of a door opening, any kind of sound, woke me upright in panic. This has included a tree branch scraping across the outside wall of my room at just the right register to sound like the hinges.
The anxiety disorder on its own mostly involves panic attacks in crowds, leading to episodes in which I either just up and suddenly leave a situation or, if I can't get out (like if I'm on a crowded rush hour Red Line train that has stopped between Harvard and Central) I tend to shut down entirely and disassociate like hell. The T has historically been the biggest source of panic attacks. Though I tend to dislike the use of much code or metaphor, there was a time when I would pre-emptively sit out an incoming train, preferring to wait for a less crowded one, on the pretense that it was "too shiny". Gimme a dingy grubby-on-the-outside Red Line car any day. Fortunately 2020 has given me absolutely no reason to take any public transit, train or bus, much less find myself in crowds, and I consider that a very very very very very very very very very minimal blessing.
From 1996 to 1997 I was put on Paxil for the depression, but turns out SSRIs do not work well with me at all. I lost the low swings but I also lost the highs. There was just an emotional flatness. Also, it gives the effect of electrical zaps through the brain, some Crucial Functions were affected in terrible ways, and if I took it without eating beforehand it would cramp me up with screaming pain. When I lost my insurance in 1997 I had to quit Paxil tapering-style off a final 90-day supply with no new incoming meds to help pick up the slack. They say Paxil's withdrawal symptoms can be on par with heroin. I'll believe it. I could get nauseating bedspin effects simply by turning my head, like I was on the Rotor centrifuge ride. I couldn't drive on those days.
From 2006 on I've been on quite a few kinds of psychiatric medication and have been trying to do as best as I can with them, though from time to time I had to bounce from antidepressant to antidepressant when it became clear one wasn't working as well as it had in the past. I stayed off the SSRIs which affect the serotonin levels in your brain, in favor of the antidepressants which work with dopamine. In 2014 however I was severely misdiagnosed by the RN serving as my pill doctor, who put me two SSRIs at once (even though I kept saying I was pretty sure SSRIs, even newer ones than Paxil, weren't gonna work) and when those didn't work, followed it up by the absolutely incorrect decision to put me on Effexor. Result: A mental breakdown resulting in abandonment of work, a state which I likened to walking zombieness, and long periods which I just don't remember. I'd just gotten married. We'd just gotten cats. I augured into the ground. I haven't recovered. For a year we lived in separate places. Things were very tenuous. Things still are.
In the five years since that breakdown I have been struggling to get back up into something resembling a working state. I have not fully succeeded. In 2015 I started a new pill doctor who immediately got me off the harmful shit and transitioned me onto a non-SSRI which brought me back up out of the zombieness. I'd also landed a part-time job at the Somerville Theatre which turned out to be a real saving grace. The five years at the Somerville helped in many, many ways and I have met so many wonderful people and made good friends and proved to myself that I can get shit done, man, but it's going to be tougher than it was before I broke. And it is. I have not written anything major since 2013. I've tried and failed several times on projects which in other times would have been challenges but doable and even fun. That's a separate issue however which needs to be addressed on its own time though, but I am really sorry for letting so many people down.
In 2019 I started working with a new talking therapist after a lapse of three years. And I started getting somewhere. While not undertaking full-on cognitive behavior therapy, I started learning and using exercises to keep away from the thought spirals, to center and ground myself during disassociative and other periods of extreme ungroundedness, and started talking a lot of stuff out that I hadn't been able to talk out before.
It was through talking a lot of stuff out, expressing frustrations over frequent and constant mental problems and blocks and recurring situations, which led to discussions of executive dysfunction and then, with my pill doctor, a diagnosis late last year of attention deficit disorder and the beginning of treatment. I got put on Ritalin. The mental energy I craved during the moments of good upswing, something I hadn't felt in years, had returned. December and January and February were the best months I'd had at the theater. We had midnight sing-along screenings of the Cats film flop; I organized a pre-show, was one of the hosts, gave out prizes for cat trivia and put together trailer reels of cat and musical-related stuff. The pre-show stuff was a lot of fun and something I wouldn't have considered talking about even a year before, I don't think.
And I was learning that this ADD had been with me for years, undiagnosed and untreated, right alongside the depression for as long as I can remember. Being able to go back and think through old wounds and trauma with this knowledge is illuminating though damn painful. The good thing is that I am understanding a lot more now about how this brain works and doesn't work, and why I am incapable of handling or processing certain functions that seemingly everybody else can, or doing them in different fashions. I can't write to a deadline. And putting sentences together well has become something I do much more slowly than even usual.
The problem is that since this went undiagnosed and untreated for so long, all the devices and mechanisms which I have had to build to cope with missing functionality, processing, and work priority are solely my own, created from first-person experience and not much else. There may be things which work better and more beneficially for me. I'm pretty sure there are, because I'll admit some of these internal mechanisms and routines are really shitty. Now I have to learn the new ones.
And the problem with this problem is that my talking therapist abruptly retired in July. It was something they'd planned to do by the end of the year and there would have been plenty of time to notify and transition and all that, but we had to go to phone visits only after March and I ended up getting the official notification of retirement in the mail a week after my final appointment with them. As we spoke for the last time, I was told in no uncertain terms to not continue seeking mental health services from the company that Harvard Vanguard has become. They're falling apart. Shedding personnel left and right. The primary care physician whom Sonya and I share went on maternity leave in the spring, and then announced she wasn't coming back. We now share a new PCP.
My current pill doc, however, remains with that group, and I very much want to stay with him. He claims I may be able to get into the MGH behavioral health program, which has very good therapists and takes our horrible insurance, without switching PCPs over. I am not sure how this happens. I've been trying to call them. It is tough for me to do. I don't know who to speak with or how to ask or any of this--this is the kind of freezing loop I get when trying to plan work processes for things I don't know how to do. And it's only been worse since Covid lockdown. The closure of the theater and the loss of my job and any other public facing thing I could do has been devastating.
I've frozen up quite a bit, functionality-wise. Example: I was doing the dishes, focused on that task, and was offered a bite of something on a spoon, and I froze up because hands-doing-dishes-incapable-at-this-time-to-make-decision-eat-or-not-EAT-OR-NOT-EAT-OR-NOT. When in better mindsets I can take interruptions to the brain's workflow much more better, adapt to incoming additions and alterations, and maybe even hum a bit as I do. But right now? Not at all. Every time I think about the processes I'll have to undertake to try to get the information from MGH and the help I need, I freeze at any UNKNOWN step. Planning contingencies on unknown outcomes is just not possible right now. I can't think forward enough. I freeze at decisions again hard.
And that's where I stand at the moment. Very tough and there's very little right now that shows evidence like it'll help. But where else to look? We'll have to think about that only after MGH pans out, if it pans out. But for now,
well.
Hi.
(no subject)
Date: 2020-10-11 03:20 pm (UTC)I'm really glad you posted this. I'm in your corner, wherever you need me. You are brave, and I'm glad you're here.