flyingblogspot.com (tales from urban dilettantia)

The Brain

I’m still in the middle of the great brain experiment.   I’m going to persist with 150mg of Sertraline a day for the next month and reassess at the end of it. Right now, it’s making me dopey as all hell, and isn’t doing much for the pre-menstrual merry-go-round of general anxiety, social anxiety and depression. However, aside from the PMDD phase, it seems to be a step in the right direction. (I actually typed ‘depression’ instead of ‘direction’ there and fixed it on an edit – what are you trying to tell me, brain?)

Right now, I’m feeling exhausted and negative about the whole thing and am at the point where in the past I’ve tended to say ‘I can’t do this anymore’ and give up, but I intend to push through this time and see if it’s possible to find an optimal treatment.

The Christmas

Christmas…there’s something I’ve been wanting to do for years, but have been worried about coming across as terribly self-righteous or critical of other people’s choices, which isn’t my intention at all. It’s this: I am happy to announce that I am not sending physical cards out again this year. And I am not going on the Annual Shopping Ordeal (I hate shopping) to find Arbitrary Stuff to give to people as Meaningful Presents.

I have ordered my parents some prints of my art which I will frame for them. Portable Dave, you can have a voucher to spend on whatever you will most use and enjoy – let me know what that might be. Everyone else: I will bake, give away my art and craft, take cuttings from my garden, maybe put them in little terrarium jars to give away, and distribute the abundance of eggs from my chickens. I will cook for you, draw for you, love you and hug you. (Some of these things may be delivered a little late, as I know quite a lot of people.) I may donate a goat or some ducks to charity in your honour. If you have any special requests, let me know, as I do like to give things that are wanted. But I will not angst about buying you plastic things and wrapping them in shiny paper for you to throw away.

The Tame Chicken

The chicken called Boomer is super-tame now and allows me to pick her up.  All of my chicken-related dreams have come true.

The Seeing of You

There will be another Open House Day at my place in the near future, so long as I don’t go completely crazy or something. Oh wait.

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.

I want to backtrack a little to the All This Stuff’s Just Ordinary post I wrote last month, because the response awed and humbled me more than a little.

Ju submitted it to the most recent Down Under Feminists Carnival in the Health & Disability section, and wrote openly about Her Ordinary. And you brilliant people over at the LiveJournal mirror of my blog commented and commented and commented with your support and your stories. And there were emails, and private conversations, and…well, I will attempt to stop gushing, but you all helped me remember that telling my story creates windows for other people to talk too.

And so, I think it’s a good story to keep telling. To talk about how venlafaxine withdrawal made me vomit and shake uncontrollably for over a week and to curl up in an awful, horrible ball of quivering pain, and that it was every bit as nasty as people had assured me it would be.

To talk about how I was somewhat silly, and somewhat frightened, and felt I had taken so much time off work sick this year that I didn’t want to get a medical certificate. That I went into the office day after day, and sat there shaking and goodness knows what everyone thought. That being a woman in a blokey corporate finance team feels so damn hard sometimes that I ducked out on talking to my boss about being a crazy woman in a blokey corporate finance team. That I spent a great deal of time hiding in the toilets instead. That I walked out of the office randomly to shake and walk and cry in the sunshine. That this was not a wise choice, nor a brave one.

To talk about how Nathalie and Cary saw me on the bad, bad days when I didn’t want anyone to see me, and held me tight until I could breathe again. Because that is the ordinary of venlafaxine withdrawal, and it is not a good ordinary.

And now, mostly past that withdrawal, I’m working with my new psychiatrist (who I am starting to like a great deal) and trying something new. It’s giving me a somewhat brutal anxiety spike right now and we’re not sure if that’s going to stop, but it’s also kicking the depression and it feels like it has opened up my brain and flicked on the lights again. I can think and reason again, communicate about life and love and fear again, focus again, and it’s been so sudden and bright that it’s almost painfully overwhelming.

And in the aftermath (and indeed continuation) of all this, I’m quite preoccupied by terror of the possibility of Moscow and of more than likely making this jump alone into the unknown.

But, as ever – audentis fortuna iuvat – fortune favours the brave.

For the first time in quite a while, I wandered down to Quaker meeting this morning, which was a wise choice as it turned out that the hour of quiet thinking was particularly useful and enlightening.  This post is the outcome of that hour of quiet thinking.

Two of the ideas that have been trending for me recently have been Fear and Shame.  (Why yes, I did have an excellent Catholic education – how did you guess?)  And over the past week, I’ve had a couple of really, really useful conversations about Life, The Universe and Everything which have helped me piece together a pattern I hadn’t noticed.

This is what happens when I do something that scares me:

1. I am scared.
2. I am dismissive of being scared and do the thing anyway.
3. I feel icky, shamey, guilty afterwards, even if the thing was good.

After thirty-one fine years of obliviousness, I noticed this and realised it was rather strange.   I wasn’t getting anywhere figuring it out intellectually, so I tried something else while I was sitting in meeting today and decided to run it past my inner monsters and see what they thought.  (I’d like to note here that my inner monsters care a whole crapload about my well-being; they just tend to have tunnel vision and can be really inept at implementation.)

So, this is what turns out is actually going on in my head:

1. I am scared.  Often I am scared beyond reason because I have had both a personal and a cultural upbringing where women who do scary things are punished and hurt, and regarded as foolish.  And I am scared beyond reason because my brain – for reasons of upbringing, mental health or other – tends to return a lot of false positives.

2. I am dismissive of being scared and do the thing anyway, at which point my inner monsters start shouting ‘hey woman, you have all these shiny fear signals that are supposed to be saving you from being hurt or punished – what the hell are you doing ignoring them? This is horrible, self-harming behaviour – how can we trust you to look after yourself when you dismiss everything we flag as scary!’

3. And then, I feel icky, shamey, guilty afterwards, because I have a vague and hard-to-pin-down sense of having chosen to be self-harming, foolish, unwilling or unable to look after myself.

This is such a strange little pattern, and one I haven’t come across before in anyone else’s writing or discussion.  And I can see there are actually two things here to work on, which is what has been making it a bit more difficult – I need to do something about the false positives and the learned fear at (1), and I also need to work out how to negotiate with the inner monsters at (2) and have them know that I really, truly will listen to them and that they can trust me not to engage in acts of self-destruction.

Now what I really want to know is, is this strange little pattern specific to my brain, or do you recognise it too?