Sunday, January 04, 2015

Ten Years : Six : Cracking The Vicious Circle

I’ve suffered from recurring anxiety and depression for much of my life. From my early twenties to my mid-forties, I’d been bouncing between psychiatric therapy and prescription antidepressants. The therapy had become ever more specific, and the drugs had become stronger and the regimes longer, most notably a sustained five years on Fluoxetine (Prozac). I was a high-maintenance kind of bloke.
Antidepressants aren’t very pleasant for me. They make me fat, sleepless and impotent. But that’s better than opening my wrists or jumping off a viaduct.
They’re also an after-the-fact medication, for treating symptoms. Within a few weeks, one can become functional again. That’s great – life-saving in many cases – and it can be all some people need to bump out of a rut and achieve lasting mental health.
Not so in my case. Every time I came off the drugs I’d feel clear-headed and efficient for a few months and then, always, one day, without fail, I’d notice that my reactions to events were wrong, out of proportion, unhealthy. I became very attuned to this – it was sometimes almost as literal as finding myself crying over split milk.
There was an underlying cause to my depression. Therapy and reading indicated that it was anxiety, but I didn’t understand why I was so prone to it.
I think that stopping drinking in 2005 brought a clarity which helped me towards the answers. We recovering alcoholics talk of clarity a lot, and it’s easy to interpret the word as simply being the opposite of blurring and slurring. For me, this clarity means consciously noticing things and being honest about them.
As a result of this clarity, two really vital things happened. The next time I detected the return of depression, I asked my GP not for another prescription but for a referral for counseling. I mentioned that I’d already undergone CBT (Cognitive Based Therapy) and found it helpful and applicable, but wanted to try something else. He referred me to a voluntary counseling organization, which assigned a mindfulness-based therapist to me. So began a productive partnership.
We began tuning in to what my thoughts and feelings actually were, stripping away the layers of interpretation the higher mind places on them. The mindfulness part of the discipline involves, amongst other things, stepping back from your thoughts in order to consciously become aware of them happening. It’s like using the Task Manager on your computer to see all the processes running, with the perspective of a supervisor, instead of letting each one fill the whole screen as though it were the only show in town.
What a family, an orchestra, a circus I found going on in there. All these thoughts clamouring for attention. All these aspects of my personality needing to take the stage for enough of the time. All the arguments between them. I needed to treat it less as a war zone and more as an ecosystem.
After a year of regular sessions, I’d discovered, returning to the computer metaphor, how to bring up Task Manager or Control Panel and see what was going on. 
This new internal insight led to the second really important development. Spouse and I moved house. I had always been a bit obsessive, sometimes a bit emotionally disconnected, always pedantic. I’d thought I might have OCPD or similar. But in our new house, I found that the sounds of the building really bothered me. The acoustics of the dining room made it hard for me to follow what anyone else was saying, and my anxiety levels were rocketing just from the sounds of traffic outside. It didn’t bother her at all, and she didn’t seem to even notice any of it.
I did some reading, and it dawned on me over a couple of days that this hypersensitivity (and I get it with light, smells and touch as well as sound) together with the aforementioned personality traits and of course my sustained anxiety levels indicated that I had Asperger’s Syndrome.
I’m autistic. This was swiftly confirmed by an expert consulting psychiatrist, following another GP referral.
I had somehow reached the age of forty-six with this significant developmental disorder completely undiagnosed. You can read my initial reaction here.
How could this have lain undiscovered all my life? Predictably, the answer is alcohol. Take a hypersensitive, socially introverted pedant and put him in a social situation. It’s terrifying for him, until he has a few drinks, when not only does the terror recede, but he loosens up enough to pass for normal, not only with others, but to himself. And the following morning, when the sun burns like an atomic bomb, and every newspaper page turned on the bus sounds like a mainsail in a hurricane? The sensations of Asperger’s hypersensitivity and a well-fuelled hangover are astonishingly similar.
I believe that my Asperger’s is the root cause of all of this. It sustained an anxiety level that pushed me to abuse alcohol as soon as I was old enough. And that alcohol abuse meant that when I was with other people I passed as neurotypical. The cruel cycle is that my Asperger’s used alcohol to hide itself behind, helping it stay undiagnosed, and therefore continue to promote my drinking.
Only when I stopped drinking and broke the circle did the Asperger’s become exposed and unmistakable.
My diagnosis in 2012 was a turning point. I came off antidepressants for the last time shortly afterwards, and I’ve only had one significant depressive episode since. I have semi-regular therapy sessions, which I regard as preventative mental keep-fit.
Not only is there still a stigma about mental illness, but there’s a kind of stiff-upper-lip British attitude that talking, even thinking, about oneself on such terms is not proper, not for a chap. We leave that sort of thing to the Viennese and the New Yorkers.
Bollocks, I say. Look under your bonnet. Find out how your head-engine runs. Talk to a mechanic. Learn how to service it yourself, or at least identify the squeaks it makes when it needs looking at. 
You’d be mental not to.

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