tales from urban dilettantia

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The Amazing Writing Lab Rat

This week has been the week of Interesting Times on Setraline. Given how sick fluoxetine made me, we decided to start with a very tiny dose of setraline to see how my body reacted, ramped up to 50mg – still a low dose – over a two week period.

For me at least, this has been a really interesting medication even at low doses. For about a quarter of the time, my anxiety levels are normal (well, my normal, which is manifestly sub-optimal) and for the other three quarters, it’s like an anxiety switch has just flicked off in my brain.

However, some clinical trials have also indicated a statistically significant increase in suicidality for patients on setraline, especially during the first few months, and from my own observations I can see how this might work – I’ve had a couple of twelve hour windows where my brain has crash landed into a deep depression.

While it’s frustrating as hell and horrible while it’s happening, it’s not an uncommon thing to encounter during the first few weeks, so for now I’m hanging in there to see what’s next.  The short term plan is to see what happens as the dose increases, as my hormone levels fluctuate, and as we combine it with a mood-stabiliser / anti-seizure medication. I feel a bit like a lab rat. A lab rat that’s medicating itself and writing down the results.

The other thing that’s happening (and this is something I personally consider to be the single most useful function of brain-altering substances) is that the medication is giving me the brain space to start processing things again, rather than storing them up in a big bucket of Survive Now, Deal Later. The upside of this is thinking, discovering, untangling, doing CBT stuff again. The downside is that over the past couple of years, the bucket of unprocessed stuff has become…big. It’s more like a large skip of unprocessed stuff, with all kinds of startling surprises in it. I have been reading about abandonment and object constancy, and it’s given me a whole lot more to think about, which is a another post in itself.

So, in short, life, brain, universe…a little overwhelming right now. Interesting science. Trying to spend quiet time under the covers, letting it all work itself out.

All This Stuff’s Just Ordinary

I’ve been trying to write this post in bits and pieces over the past six months, in part because quite a number of people have asked me to write more about my brain, and in part because it is my story and it is in want of the telling.

I’ve tried to begin it by writing down words like ‘depression’ and ‘anxiety disorder’, and each time get caught in a mire of doubts about the value and validity of pathologising my ordinary. Caught by my dawning understanding that these are not exactly diseases in the way that influenza is a disease, and that they might be more accurately understood as the language and expression of suffering that is prevalent in my culture.  (And yet, the irony – we’ve fought so hard for them to be spoken of in the manner of physical ill-health. Out of Bedlam and into the medicine cabinet and all that.)

I’m caught by my awareness that, in any case, the vast majority of research in this field has been performed on populations at the far end of the bell curve.  Attempting to write about mental health, to untangle the known, the unknown, the physical, the psychological and the interface between is difficult. Attempting to do the same and apply it to myself, seems barely possible at all.

And so, instead of talking about this in terms of disease and disability, this is my ordinary.

Five mornings out of seven, I get up and go to work. Except I set the alarm early, very early because I never know which of those mornings will be one where my brain feels scattered and it will take me two hours to work out what I need to do to be ready and leave the house. Now that I have a list on my fridge, this works a little better. Get dressed. Brush hair. Brush teeth. Feed pets.  Take meds. And so forth.

Seven nights out of seven I go to bed to sleep. Except sometimes I wake up at night in the middle of a raging panic and can’t remember what I need to be well again, and a hour later I’ll make it to the list on my fridge and realise that some water and medication will break the loop of panic.

Sometimes I shop for groceries. There are a number of ways to do this. Going to a supermarket after work is the most flexible and affordable, but is almost guaranteed to trigger a brain failure and knock me out for the rest of the night. Going to a little boutique-ish food market is expensive, but somewhat less likely to be a problem. Ordering groceries online is my favourite, but has a knock-on anxiety effect in terms of time-management since I have to be home. I am often very, very unreasonably anxious about time.

Each weekday, I work. And the foggy depression and the tightly-wound anxiety come and go, and some days it feels almost overwhelming to keep working, to speak to people or in front of people, to eat, to read, to breathe. And other days, I walk in and sit down and work, and everything is fine and I’m mystified as to why it is often so difficult. And yet on other days I experience massive concentration failure, and come home exhausted because even completing a small amount of work feels like it has used up all of my resources. And then again on other days I am sparkly and productive and everything flows.

Today, I had my first consultation with a psychiatrist in twelve years.

He says the medication I am on may be causing my attention problems. And that I’ve worked hard with the self-awareness and the CBT and the Happiness Project stuff, and that I’m not doing anything wrong. (Oh, the validation.  I am needy for validation.)  That the medication I’d first been prescribed (it was Aurorix) was not really appropriate. That the medication I’m now on may be hurting as much as it is helping. That Premenstrual Dysphoric Disorder might be something I actually have, and not just something pharmaceutical companies invented to sell more Prozac. (This contradicts everything I think I know about PMDD.) And that that, if I am willing, it might be wise to take a fresh look at my big, co-morbid bundle of depression, anxiety and OCD symptoms, and try something new. I am willing. And so, this month the brain and I get off the Venlafaxine and the Clonazepam and see what happens.

Maybe this will not always be my ordinary, but if it is, then so it goes. Maybe ordinary will become a different, stable medication, or no medication at all. We will live on regardless, brain and I.  We do well with what we have.

Welcome To Leftovers-Night

This post is like a Leftovers-Night dinner.  You’ll see.

Right now I’m doing some work that involves re-running a model through twenty or so different scenarios, and each run takes around a minute, so I have Notepad up and am using the runtime to write. It feels like a luxury to have some time to start thinking about having a page to fill with words.

I’ve been trying to manage the number of hours I’ve been spending in the office, but even when I’ve been able do that, the intensity of the last month has been something to behold. There’s not much I’m able to say about it in a public forum, but it involves a lot more responsibility and a whole bunch of time-critical work. I’m hopeful October will see a promotion, as I feel there’s a significant mismatch between the level I’m on and the work I’m doing.

Over the past month, the last module of my professional qualification has started up, so I’m studying and involved in a bunch of other things too. I know it’s something I come back to time after time here, but the struggle to manage commitments seems to be something of an ongoing theme in my life. I made a mind-map while I was having lunch yesterday, and even though many things spawned sub-commitments and began to ooze from the edges of the A4 page, it feels better to have the majority of it laid out.

Out of everything I’m doing at the moment, passing the last module of my Grad Dip is far and away the most significant one when it comes to my long term well-being. In part, this is because repeating will be a very expensive exercise, but more because the timing of finishing the course directly relates to when I’ll be free to leave my current employer without having to repay my sizable study debt. ‘Freedom, horrible freedom!’ as they say. (‘I’m the Queen!’ ‘No you’re not!’)

What else? Oh yes, the week just gone has been a shocker when it’s come to mental health – by far the worst in recent times. While horrible, the upside of this has been that I’ve managed to get through it without messing up anything significant, which is quite exciting – my ability to manage depressive episodes has really lifted in the past couple of years, and this is a topic I’d like to write more on at a later date.

Other than that…well. I’ve seen The Mountain Goats, Jeff Martin and Henry Rollins recently. Rollins was doing his Frequent Flyer spoken word tour, and I don’t think I have anything near the articulacy to express how moving and inspiring I found it. The man is a spectacularly interesting human being, and I find much of his discussion around depression, adventure, happiness and human experience to be almost painfully resonant. (I’m selfishly frustrated that he’s famous, because if he weren’t it would be easier to say ‘hey mate, come have a drink with me and we’ll talk about life the universe and everthing’.)

Musicwise, I’ve been obsessing over a few things, mostly relating to recent gigs. Jeff Martin’s Live in Dublin album is excellent, and I would strongly suggest getting it from iTunes if you haven’t already. portabledave has also put me onto The Tallest Man On Earth aka Kristian Mattson, a profoundly Dylan-esque folk muso from Denmark whose new album, The Wild Hunt, I’ve had on repeat. And then there’s the latest Mountain Goats album, The Life of the World to Come, which has this song about the thylacine, the dodo and the golden toad which just about moves me to tears every time, because (like most Australians?) I’m well aware of the heartbreaking footage they’re referring to in the first verse:

The sun above me and a concrete floor below
Scratch at the chain links maybe bare my teeth for show
Fed twice a day I don’t go hungry anymore
Feel in my bones just what the future has in store
I pace in circles so the camera will see
Look hard at my stripes, there’ll be no more after me
Laze by the shoreline while the sailors disembark
Scratch out a place to sit and rest down in the dark
Smell something burning downwind just a little ways
They set up camp and sing and sweat and work for days
I have no fear of anyone I’m dumb and wild and free
I am a flightless bird and there’ll be no more after me

In Costa Rica in a burrow underground
Climb to the surface, blink my eyes and look around
I’m all alone here as I try my tiny song
Claim my place beneath the sky but i won’t be here for long
I sang all night the moon shone on me through the trees
No brothers left and there’ll be no more after me
(- Deuteronomy 2:10)

 

And finally, a few links that I’ve stumbled across and appreciated in recent weeks:

Flickr


Tern, Coffs Harbour Coffs Harbour Coffs Harbour Nudibranch, Arrawarra, NSW Sea Cucumber? Arrawarra, NSW Urchin, Arrawarra, NSW Starfish, Arrawarra, NSW Polychaete Worm, Arrawarra, NSW Shrimp, Arrawarra, NSW Shrimp, Arrawarra, NSW Mollusc, Arrawarra, NSW Gastropod, Arrawarra, NSW 

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About

@dilettantiquity is interested in an unreasonable number of things, including the wide and wonderful universe, happiness, well-being, wine, optimal human experience, non-violent communication, complex systems, existential nihilism, rationality, technology, grassroots organising, cacophony, music, creativity, learning and love.