Sunday, November 30, 2008

43 Things: Eating Disorder - the latest

I have been noticing the amount of food I eat during a binge has been getting smaller over the past, oh, 3 months. I feel full/sated/whatever with less. I don’t know why, really. Last week, I think on Wednesday, I decided I was going to binge, because I was feeling horribly miserable about my life, lower than I had for a very long time. I don’t beat myself up about my binges anymore, since there is a reason behind them, and I’m working on it, so there is no point. And, the harder I am on myself the more reason I have to binge. Anyway, on Wednesday I made myself eat a meal before I binged, so maybe I’d binge less, and that is exactly what happened. I ate a very small amount of binge-food before I felt sick to my stomach and full, and not like bingeing anymore. One side of my brain said, “Oh great, on top of everything, you can’t even binge properly anymore”, but mostly I was okay with it.

I have also, in the last day or two, been thinking that the more I force myself to eat foods I don’t want to for meals, the more I binge. Which is really expensive. Technically, if I’m going to eat the junk food anyway, I might as well not eat the ‘good’ food. On the other hand, if I make food that I like that is not exactly binge-food (like, say, grilled cheese sandwiches), I am less likely to binge because I don’t feel deprived of food I like. So, this month I am just going to eat food I like and see what happens, see if it saves me calories and money.

I have also been spending a bit more time on preparation, and I have been able to deal with eating soup and rice and beans without feeling too much like I’m just shovelling “hunger stoppers” into my mouth and not feeling satisfied. So that is good.

Anti-procrastination?

Today I notice I procrastinated about something that is not a chore, not "good for me", nothing I usually fight to get myself to do. It was just something I had planned on doing. So now I am rebelling against anything scheduled whatsoever, chores, errands, exercise, fun stuff, everything. The most ridiculous thing about this is some of what I did to put off the 'scheduled' activity - chores. Yup. I did the dishes, a load of laundry, re-organized some media, went through my stack of accumulated papers and tossed the non-keepers in the recycling bin, took out the garbage...Sure in between I played cards and downloaded music on my computer, but I have to take breaks between chores for my body's sake. WTF.

On Friday night I was sure this weekend would be full of crafts, very productive. I'd been inspired all week to make stuff, and forced myself to finish the dog sweater (which STILL doesn't work, I discovered). Come Saturday I didn't feel like making anything. All I managed to do was teach myself brick stitch and make a little diamond shaped thing with green seed beads. It is now 8:30 Sunday night, and that is all I have to show for the weekend. I am really frustrated with myself right now, really angry with me. And my incredible magnitude to shoot myself in the foot. My unbelievable gift to find creative ways to be less than I could be. I can find a way to outdo my lowest standard on any given day. I don't understand! I want to make crafts. I want to watch DVDs. Why don't I?

This reminds me of my habit of NOT reading the books that I buy, the ones that excite me the most. 90% of the books on my shelf are ones I anticipate to be extraordinary, but won't read. The only reason I can see that I might do this is because I don't want to be disappointed. Maybe they will turn out to suck. Could be I'm afraid that what crafts I make will suck too. That never used to stop me, but things change, I guess. I keep putting off doing the things I know will give me the most pleasure, including yoga and swimming. It used to be just these types of things, ones that fall into the category of "good for me", that I put off. Now it seems to be everything.

This is not to say I did not enjoy my day. I had a great time singing and dancing to the music I downloaded while I did the things I did. But still, I am disappointed with myself. In order to get myself in the right frame of mind - to get down to 'work' (maybe using that word has a lot to do with it) - I made myself shower after I finished my coffee this 'morning' (more like 3 in the afternoon), as a mental marker of readiness to do what I had been planning on doing. It worked the other day, and it works on days when I have to go out to do an errand or two, but not today. I seem to have this absurd phobia about anything that even remotely resembles 'work'. That is a very large, loaded issue for me, but it seems to be making itself cover even more of my life.

I want to discuss more, and I want to talk about the Evils of the Chair, but my back hurts like mad (an example of the evils of the chair). I am not sure if I should just give up on this day, or attempt to sit down at this late hour and craft. I also do not know if I am really hungry. Yesterday I felt constantly hungry, even a few minutes after eating, so I realized this is probably some weird PMS symptom. So I don't know whether to eat right now or not, whether to eat a meal or something small... I am having difficulty making certain types of decisions. What is this aimlessness about? All these near-misses of goal-directed behaviour. I don't want to say I hate myself, but I really hate this, whatever this is.

Friday, November 28, 2008

Synchronicity

A few days ago, I was ready to be depressed and hopeless for who knows how long. I was so overwhelmed from writing all those entries and really detailing all the things wrong in my life. Usually I live in the pressent, don't think about the big picture, and this allows me to get by day by day with a reasonably positive attitude, though I still procrastinate hugely and have some guilt about the things I do not therefore accomplish. I just pop another pill and keep going. I know the percocet has a lot to do with my feelings of ease, and I have to admit that occasionally I have taken one not because of pain, but because I'm in a crabby mood and don't want to stay there (usually because I am with someone else and want to have a good time). I don't do this very often, and I never take a percocet if I've had one within the previous 3 or 4 hours. And there have been occasions where I have felt a little pain and a little grumpy and take a percocet for both reasons. In any case, I cannot credit the percocet for the improvements I want to talk about today.

Yesterday I woke up thinking I may not stay really depressed. I wasn't sure at first, because I never know what the day will bring, but it turned out to be an average day for me, and so did today. This is starkly different from earlier in the week when I felt like I was going into a real crisis, going to give up for good. I was angry at the world for giving up on me, angry at anyone I know with money for not recognizing how horrible my life is on my meager income and for not helping me. I was angry at my doctors for ceasing to investigate my condition once I had a 'descriptive' diagnosis. Those things have not been resolved, but I don't feel the anger intensely anymore. I am back to living in the present, enjoying my small victories and third-world luxuries.

I was thinking about this today, because this is the first time I've ever gone so far into feeling really depressed and just walked right back out of it. All my life I had episodes similar to this and could never stop sinking even when I tried, and I tried everything to fight sliding into the dark hell. I had no control over my thoughts, no control over my mood. I would just keep sinking deeper, it was just like quicksand. I could feel it coming on and it scared me to death. This time I was so angry, I actually wanted to be depressed. I said to myself, that's it, I'm giving up. Why should I bother if no one else cares? I can't do this by myself, but no one will help me, so why keep fighting when it's a losing battle? and so on. But here I am, two days later, feeling back to my normal, feeling okay again. Nothing has changed since earlier in the week. So what stopped me from sinking into the quicksand?

Today I was thinking about it, and the difference is this: I am not beating myself up anymore. All this bad stuff is happening to me, but I'm no longer telling myself that it's my fault. Somewhere along the line, in the course of my therapy, I 'snapped out' of it. I snapped out of the blaming-myself mindset, and it has made all the difference in the world. It seems more than just a turning point for me. It's like I went from black and white to colour, or walked through a door and locked it behind me. All those years I was struggling to forgive myself for being imperfect, I was asking the wrong question. Now I can see that question made no sense, because there was nothing to forgive. Once my therapist and I had teased out the thread, identified and discussed the cause and effect of the situation, I let go of the hatred I had for myself - for myself as a little girl, and myself as an adult. Once I really saw that being unloved as a child created all these wounds and the wounds made me think wrong. It's like I had my legs broken and they were never put in a cast, and I just grew that way, and my walking was mangled and lurching and every step hurt. And all along thinking it was my fault for getting my legs broke, and trying to hide my lurching, because if people saw my real walk, they'd know I'd done something so bad. I was ashamed of my broken legs, and I thought I should be. But then, with my therapist's help, I realized that someone else was responsible - someone else broke my legs, and that same someone else failed to get them fixed. That person was responsible for this, because she was responsible for me - I was a child, and she was my parent. She neglected to do the right thing, day after day, as I hobbled on my warped legs. (Interestingly to this extended metaphor, I was actually born with bowed legs. They were put in casts when I was a newborn.)

How to explain how this changed everything? My mind, which had been spewing forth indictments and criticism my whole life, stopped doing those things. I no longer needed to punish myself, because I had done nothing wrong. For awhile I was very angry about all the years of unfair treatment, locked in a torture chamber for so many years when all along I was innocent. It was a huge loss. And I was angry that she let me go on believing I was to blame, even after I'd grown up and was trying to live my own life. I went through a period of greiving what might have been. Don't get me wrong, I'd been thinking about what might have been for a very long time, but because I'd done it to myself (so I thought), it had an element of determinism to it, an element of 'it couldn't have been otherwise'. When I learned I wasn't responsible, that determinism element changed. Philosophically, when I think about it now, it is still there, for could she really have done differently? But it is easier to believe someone else could have chosen a different course of action than to believe that about yourself, especially since I know what was going on in my head. I was told once by a psychic that all my suffering in this life was not my fault, that it was karma from a previous life. I think my mother may have been the embodiment of that karma, for she is who has set me on this unusual path. And most of the time I don't begrudge this path, and I can be very grateful for it at times, because I feel like I have a real chance in this life to spiritually evolve an enormous amount. Attain the stream maybe. But the days when I feel so overwhelmed by my obstacles I am angry that she took away my potential for a normal life. On those days I ask that some of my suffering be more unconscious, not so in my face, ignorable. Or however 'normal' people have it.

Back to the point. I want to say that I don't think it is possible for me to be depressed now that the demon of my inner critic has become so muted. I can almost see her becoming a friend, though I'm not there yet. I still need to have some check and balance going on in order to keep my place, but that can be a friendly voice, helping me to stay on the path. It doesn't have to be malicious, just a "yoohoo" now and then. No, in order to be depressed, I need to have those 'tapes', that endless string of self-recrimination, self-doubt, self-criticism going on. I have to be telling myself that I should have done better, that I'll never measure up, anything less than perfect should make you ashamed, unless you are the best you are worthless etc. And most of all, everything bad is your fault. That demon makes me paranoid - a friend's bad mood is my doing. And catastrophizes - your mistake ruined everything. If you screw up once they'll leave you. And mind-reads - everybody thinks you are annoying. And all those other cognitive distortions. They stopped at the same time, too. All that extra commentary that 'regular' people don't do, I stopped doing also. Now I can take things as they are and move on, without analyzing my part in it, unless it's appropriate. The contents of my mind have altered, like someone flipped a switch and 'depressive thinking' was gone. The switch may as well be called "It's not your fault." The scene in Good Will Hunting where the counsellor kept telling Will "It's not your fault, it's not your fault" made me laugh, though I thought I understood how it worked, in its simple, cinematic way. Now I really get it. Because realizing "it's not my fault" changed my life too.

There may still be some remnants, some stragglers of abusive self-criticism, maybe that's what creates the guilt I feel for procrastinating (but I think this guilt is mostly about some other issue I haven't worked on yet). Maybe I'm still "shoulding" myself too much. JK has told me that in her perspective I am doing a lot of activity, when I complain that I haven't done much. I don't know if I can believe her entirely, because I'm here, and she's in another city, and so she doesn't see the hours I spend playing cards on the computer and farting around on Facebook. But maybe I can give myself more of a break. In fact, my therapist has said something about this too, that maybe I'm not procrastinating, maybe I'm resting because I need to rest. Or something like that, it was quite a few months ago. I've been thinking about my rest/activity balance lately...but that is a topic for later.

So, unless I bring that demon critic back by somehow re-convincing myself that as a child I should've known what was wrong and what to do about it, should have known that I was being neglected and not getting enough love and attention and sought out a way to compensate so I wouldn't be damaged by it. If I could somehow take back the compassion I've come to have for her, and start hating her again (I see I hated her because that was what was modelled for me - mom hates me so I should hate myself, because she must be right), if I could re-convince myself that I am utterly worthless and should be ashamed of myself and my life, well then the demon critic could reassert itself and I could really get and stay depressed. I could re-create the quicksand, hypothetically. But of course that is absurd. I do not want to give up the measure of inner peace this revelation has given me. I do not want to be under the thumb and out of control again. I don't want to hear all that negative stuff in my head.

I was thinking about all this, and wondering how I could effect a similar insight in my depressed friends. How to make them see that none of what they are suffering is their fault? I wanted to suss out what it took for me to get there, to get to that point, what finally flipped the switch. In truth, I think it was not only understanding the thread of cause and effect and seeing that a) I was not the cause, so b) could not be blamed for the effects, but also the space that was created for me by my therapist. Her acceptance, understanding, and above all, validation, opened up a safe space, and also a safety net, for me to be able to explore my being, past and present, and to see what came up with enough clarity. There was no lightbulb, no *ding*, no overwhelming sense of insight at the time. As I've said, the first thing I felt when I grasped this fact was not relief but anger and then, grief. Nevertheless, I'm placing a monument in my personal history by that memory, as the day that it was made possible for me to love myself, the day that my demon inner critic started to disappear. Maybe it was also the beginning of healing.

I don't know how to recreate this situation for my depressed friends. I don't even know if this is what is driving their self-hatred, their negative self-talk, their depression, but I suspect it might be, at least for one. This one had a childhood full of abuse, and is still abusing herself in her parent's place, just like I was. She is very hard on herself, perfectionistic and does a lot of self-harming. She has very real inner critics. The other seems to be stuck in a place where she thinks she should have been better yesterday, preventing her from starting where she is. I don't really know who she blames for her illnesses, but she also has perfectionistic tendencies. I know we are all different, and what works for me may not apply to them. But recovery seems to be a process with steps (not necessarily the famous twelve), and I've already heard one friend echo the first step - true willingness to take responsibility for making recovery happen, because nobody else is going to do it for us. So is it really so far-fetched to think I might be able to help her gain this one? But it is one thing to know intellectually that "it's not your fault", and another to internalize it and really believe it. To let it replace the core belief that you are to blame. To get to a place where your mind shifts from self-hatred to self-compassion, from self-abusing to self-accepting, self-helping. To literally just stop beating yourself up, and instead think about what will do you good, what will make you feel good, and be better, happier, more peaceful. Because despite all my recent complaints and pain and ongoing suffering, I've never been so emotionally well, so accepting of who I am.

I decided tonight to treat myself to lemon chicken dinner from the Lotus Leaf. Guess what my fortune-cookie said? "Good thoughts make life better." I couldn't agree more.

The Neurobiology of Trauma and the Developing Brain in Childhood

By Louise Maxfield

During exposure to a stressor, the brain initiates a cascade of responses. Glucocorticoids are released to mobilize energy, increase cardiovascular activity, and slow down unnecessary physiological processes. Chronic exposure to extremely high levels of glucocorticoids can seriously damage neurons; this is most evident in the hippocampus which contains a high concentration of glucocorticoid receptors. Various animal studies have shown permanent loss of glucocorticoid receptors in the hippocampus as well as significant damage to the hippocampal neurons, with resulting hippocampal degeneration.

Studies using magnetic resonance imaging (MRI) found reduced hippocampal volume in adults with PTSD. In their combat veteran research, Bremner et al. (1995) compared 26 Vietnam veterans with PTSD to 22 normal veterans, similar in age, sex, race, years of education, socioeconomic status, body size, and years of alcohol abuse. Combat veterans with PTSD had a statistically significant 8% smaller right hippocampal volume and a statistically insignificant 4% smaller left hippocampal volume.

In a similar study with adult survivors of childhood abuse, Bremner et al. (1996) found that those survivors with PTSD had a 12% smaller left hippocampal volume and a statistically insignificant 5% smaller right hippocampal volume. It is not known why persons traumatized as adults had smaller right hippocampal volume and those traumatized as children had smaller left hippocampal volume. The researchers suggest that larger sample sizes, with increased power, might find smaller volumes for both right and left hippocampal volumes. Another possibility is that there is a true difference in patients with early trauma, and that early trauma may interfere with brain development.

Diminished hippocampal size may be either a consequence of trauma exposure or a risk factor for the development of psychiatric complications following trauma exposure. Dysfunction of the hippocampus may be related to the fragmentation of memory that occurs with PTSD and to dissociation.

Similar findings were found by Stein, Koverola, Hanna, Torchia, & McClarty (1997) who measured hippocampal volume using the MRI in 21 women who reported being severely sexually abused in childhood. They compared these subjects to a control group of 21 socio-demographically similar women without abuse histories. A statistically significantly 5% smaller left hippocampal volume was found in the women who reported sexual victimization in childhood, as well as a statistically insignificant smaller right hippocampal volume. Left-sided hippocampal volume correlated highly (r = -0.73) with dissociative symptom severity. Stein et al. suggest that the relationship between symptom severity and hippocampal volume indicates that mesial temporal lobe dysfunction may directly mediate certain aspects of PTSD and dissociative disorder symptomatology.

Possible hippocampal degeneration is only one aspect of the complex picture. Studies on the physiological effects of trauma have found profound and substantial effects within multiple interconnected neurobiologic systems. Exposure to extreme or chronic trauma related stressors can result in abnormal patterns of neurotransmitter and hormonal activity, and in permanent changes in neuronal differentiation and organization. Neurobiological effects are evident in brain stem dysregulation, alterations within the central nervous system, irregularities in cortical function, alterations within catecholamine systems, and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the hypothalamic-pituitary-thyroid axis.

Since these effects are pervasive, powerful, and occasionally permanent even for adults, it is apparent that childhood trauma can have a massive impact on the developing brain, with its high levels of plasticity. The child's brain is structured and neuronally organized by experience. There are substantial implications for all aspects of children's development, with potential deficits and impairment in emotional, behavioral, cognitive, and social functioning.

end of article

I have heard before that people suffering from depression, chronic abuse, or stress have a smaller hippocampus. In some cases, antidepressants can reverse at least part of the damage. I did not know that chronic or severe abuse could affect all those other systems, as highlighted in the article above. It mentions the brainstem, which I have been researching, and the HPA axis, which regulates the stress response. If the latter is malfunctioning, it could mean it is not getting the feedback necessary to 'turn off'. I studied this axis in university, so I know how it works. If it is always on, you are under constant stress, constant 'fight or flight'. You will have high levels of cortisol and other chemicals that are meant for short, emergency use. They are damaging if they are in the body for too long. All this could lead to adrenal exhaustion. Of course, I'm purely speculating, but somebody has to if I'm ever going to figure out what is going on with my body, and nobody else seems to be interested in doing it. Anyway, pain and fatigue - my body breaking down - could certainly be associated with a chronic stress response. So could an exaggerated startle response.

Obviously, I have never been to war, nor was I physically or sexually abused as a child. I don't have an official diagnosis of PTSD, but I do experience almost all the symptoms. Doesn't a nervous breakdown or suicidal episode qualify as a traumatic experience? What about living chronically with the fears of 'losing it', being 'discovered', and subconsciously threatened with losing food and shelter? How about twenty odd years of feeling worthless, unwanted, abnormal, and ashamed? Twenty odd years of a voice in your head saying you have to be perfect or else, saying you are so horrible you have to pretend to be someone else, saying you are a burden and in the way, and that it is your fault? Aren't those years full of chronic abuse? I have re-lived intrusively my own "humiliations" over and over again without being able to control or stop it. I jump out of my skin at least once a day. I never feel safe, even behind my locked door in my one-room apartment. Experience shapes your brain, this is a proven fact. What mangled and warped gray matter lays beneath my skull?

43 Things: Sleep better: More complaints

In my previous entry on sleeping, I didn’t discuss how my chronic pain affects my sleep. Nor did I mention the noise factor. So I should mention these things, just to have the full picture.

My apartment is situated on the second-floor, above an often used alleyway. My bed is situated so that my head is directly beside the window, which I have to keep open a crack for air circulation. From early morning on, and sometimes all times of the day and night, there are trucks bombing down the alley. In the relative silence of ‘sleep time’, these trucks sound like 747s taking off a run way. My neighbour has also described the sound like this. In addition, there seem to always be loud drunk people walking and hanging out below my window. This is especially bad on weekends. This makes it difficult to fall asleep and stay asleep, and I often get woken up in fright of these noises. Often the drunks are screaming and swearing at each other, whether in conflict or rowdiness. I can’t move my bed – my apartment is so tiny, the current arrangement is the only one that gives me enough space. I can’t sleep with my head at the other end of the bed – my floor slopes downwards at enough of an angle that beads roll to the far wall if I drop them. I don’t want to be sleeping with all my blood rushing to my head.

The pain. My whole life I slept on my side. Since I have had the back pain, I have no choice but to sleep on my back. It is always more difficult to fall asleep on my back, and difficult to remain on my back while asleep. I have support pillows that I use under my knees. Last night while I was trying to fall asleep, I could feel pain in my back despite lying in the proper position. I don’t know what else I can do, I can’t afford a new mattress. Last night my legs were killing me as well, and I had to take extra pain medication, 2 melatonin, and a zyprexa in order to get to sleep. I woke up today at 7 a.m., worrying.

Then there is my feet. On a good day, the pressure from my heels on the mattress creates a burning pain. On a bad day, my feet are ice cold and extremely painful. That alone can keep me awake all night. Sometimes putting my moccasins on doesn’t even make them warm, because there seems to be absolutely no circulation, and massaging my feet doesn’t create any. I have to put an electric heating pad directly over my feet. So going to bed requires all sorts of props, drugs and rituals. And still I don’t get quality sleep.

Taken together, these two entries detailing the problems that affect my sleep are overwhelming. Enough to go to my doctor with. It is ridiculous, when I think that most people just get into bed and sleep. Writing out these entries earlier in the week made me feel very hopeless and depressed. I wanted to give up, but how can I? I can’t even lie in bed all day like a depressed person, it becomes so uncomfortable. It’s getting to the point that no position can relieve my pain, and that is a frightening place to be.

Other People's Egos

This is a bit of a tangent, relative to what I usually write about in my blog, but I feel compelled to share what I heard on the radio this morning. Every Friday on Kool FM, they play a game of Family Feud. The poll is from people who fill out the Kool Advisory Council Survey, to rate the music they play. The contestant, in this case a woman, has to give 3 of the top 5 answers in order to win the prize. Today's question was "What is your worst habit?". The contestant has to give the answers one at a time, and in between the radio hosts comment and repeat the question. This contestant made a point of saying, before each of her three answers (swearing, smoking, biting nails), "This is not my habit", "not my habit either", and "this drives me absolutely nuts". It annoyed the hell out of me that she had to protest, in front of each habit, that it was not HER habit. It was so self-righteous. The hosts even made a point of saying, after the second answer, that they would all assume that none of these habits belonged to her (so she would stop saying that). Afterwards, they asked her what her habit was. She didn't say anything at first, so they suggested that it was "denial". Then she said she drank a lot of coffee. Personally I think her worst habit is protesting too much. That or excessive impression management. I don't know why this got under my skin so much, but obviously since I'm still thinking about it and compelled to write about it, her attitude pisses me off. Maybe subconsciously I feel defensive because I do all three of the 'habits' she mentioned, but I don't consider swearing a bad habit, it is a vocabulary choice. I wish I could give this lady a wake up call, so she could be more self-aware. What motivated her to so strongly disidentify with bad habits? Does she think she's better than the rest of us? The hosts were nice about it, but made some comments subtly implying that even they noticed her superiority complex. So is it arrogance or insecurity? Who is she trying to impress? If any of her friends recognized her on the radio, they would already know she didn't swear, smoke, or bite her nails. The rest of us couldn't care less. As a matter of fact, I think less of her now then if she'd admitted to being human and having a bad habit. Her efforts back-fired if she was trying to be likeable. She's offended everyone who does one of these things, which is probably most of us. If her goal was to convince herself of her righteousness, well maybe she did succeed. Trouble is, she has to keep acting like this to keep convincing herself. It is much more likeable and relaxing to just admit you are human.

I may be calling the pot black here as I sit here analyzing some stranger in a somewhat public place. My own ego is asserting its superiority in a 'backdoor' kind of way. Is ignorance any less of a pet peeve for me as nail-biting is for this woman? At least I am not claiming to be a saint. Whatever. I may be making an ass out of myself and being intolerant by writing this, but so be it.

After re-reading this post, I can see there is a bit of projection going on. This woman was being very judgemental, and I hate how judgemental I can be. Am I trying to disown it? I don't know. I have done a lot of work to loosen up the critical voice inside me. It doesn't attack me anymore, but I don't know if it continues to attack others. I have this intuition that I'm not really judging this woman, just writing about something that bugs me. Maybe I'm judging the behaviour I see, maybe I am judging ignorance. That's probably just as unenlightened. It is still difficult for me to switch to a compassionate mind-set when dealing with this kind of thing. There's always the question of what this woman is suffering that makes her act this way. Then again, pitying someone because of their ignorance probably isn't really compassion either. I readily admit I need a whole lot more work on compassion. When it comes to getting the "nothingness/suchness", I'm there, but compassion is very difficult for me. Which makes sense, considering the way I was treated without compassion when I was a child. I think that's one thing my mother still doesn't have either. However 'nice lady-ish' she is, I have never heard her say anything truly compassionate. She doesn't give one thought to anything outside her little monkeysphere, not the environment, not the starving and wretched around the world, nothing. Hell she doesn't even care about the suffering of her own daughter. When it comes to suffering, her head is fully in the sand. *sigh* Why does everything always come back to her. Well I know the answer to that. When am I ever going to be free of the effects of Mother?

Tuesday, November 25, 2008

43 Things: Social anxiety not such a worry.

Over the past six months, the frequency of me thinking about social anxiety has slowed down to a stop. Really, I don’t even consider myself to have that diagnosis anymore. I still have some problems, but I would say they are on the normal side of the spectrum. I went to a party last month, the guests were mostly people I knew – friends of a friend and her husband. I’d had intermittent contact with them for years, but never really got to know or like them. So, it wasn’t a room full of strangers, but somewhat a room full of people who were part of two groups of friends, and a few other guests who knew each other. So, I’m not good at mingling, I have nothing to say, don’t know what to ask. I had one real conversation, instigated by one of those people I’d known slightly for years. The rest of the time I tried to busy myself by taking pictures, going for cigarettes, fiddling with the video game system or the stereo. Finally, my meds petered out and I had to rest until the next dose kicked in. I found myself lying on the couch watching the goings-on, and though I felt like a weirdo, I was able to accept the fact that this was necessary. By the end of the night I had probably exchanged at least a few words with 75% of the guests, and hadn’t felt like crying or that I needed to go home. This I call a success. This is the only party I hadn’t been able to avoid for probably 10 years, but there have been a few other occasions, such as weddings, that required mingling or something, and I can’t say I had a blast at any of them. And that is fine for me, as long as I can avoid them in the future.

On the upside, I’m much better at making phone calls, asking strangers the time (or whatever), making small talk with random people. I don’t walk down the street feeling everybody’s distainful eyes on me. If I do feel some distain, I think, “what’s their problem?” I am much more able to just go about my business and i don’t think about social situations with apprehension (unless it is a social gathering of many people, not family).

This is only one aspect of my fears, but it was a huge obstacle, a problem that effected everything in my life, so it is a relief to be over it. Of course, I still think it is solely the Effexor, and I will never stop taking it.

43 Things: Sleep Better - Is it possible?

I have had sleeping difficulties my whole life, or as long as I can remember. I’ve always had trouble falling asleep, as well as being plagued by intense, emotionally-negative dreams. I would not characterize them as nightmares exactly, because they are not usually about being chased or physically hurt or frightened. The majority of my dreams centre around themes of anxiety, such as being lost, late, or falling behind. I have talked about the dreams with counsellors, therapists, psychologists…and while I recognize what they are about, I can’t seem to get any relief from them.

In 2003, my body started ‘breaking down’, eventually leading to a diagnosis of fibromyalgia. The majority of people with this diagnosis have a sleep abnormality called alpha-EEG-anomaly, which is characterized by brief, awake-like brain patterns during periods of sleep. What this means is that we don’t get enough quality deep sleep, the restorative stage in which your body repairs the minor damages it receives from normal day to day living. The implication is that the body starts to accumulate more and more damage over time, leading to the condition. The first thing people with fibromyalgia need is enough good quality sleep to start the repair process. We are told to exercise, but this is only if we are getting proper sleep first. Otherwise, we are just damaging our bodies further.

So you can see my problem. I can’t make any progress healing my body because I never get enough of the right kind of sleep.

Recently I have used medications to help me fall asleep and stay asleep. They work for these purposes, however they do nothing to make sure I get the right kind of sleep, i.e. deep sleep. In fact there is evidence that the medications I am on interfere with deep sleep. I am in a Catch-22, because without the meds, I toss and turn for hours at night, and don’t sleep as long as I need to even just to feel “not exhausted” the next day. I know the ‘sleep hygiene’ protocol, but find it difficult to comply. I eat close to bedtime – if I don’t, I have more difficulty falling asleep and/or wake up early, starving. I also smoke, and I have been trying to quit…but that is another story, another goal perhaps. They say you should go to bed and wake up at the same time every day, but again, this is difficult. If I am not tired enough to go to sleep, I toss and turn for hours, and if I have not had enough sleep, waking up to an alarm is literally excruciating. My sleeping patterns are completely erratic. I may sleep 16 ti 20 hours if I haven’t had enough the previous 3-7 days. This throws the day/night cycle out of whack. I have always been a night owl too, so going to bed early is difficult for me, since I often have just started to feel good in the evening and want to pursue activities.

Recently, I have been able to use 3mg of melatonin, sublingual, to knock me out when I know I’m going to be tossing. Originally I was using Sleep MD, which contains melatonin as well as other natural ingredients. It may be I need those other ingredients as well, but plain melatonin is much cheaper and does the knock out job I need most. Some nights I don’t need it to fall asleep quickly, and this is a relief. I think I have finally taught myself how to fall asleep by taking the Sleep MD every night for a few months. Previous to this, I can’t think of even once when I fell asleep in less than 30 minutes.

A new complication has arisen in the past few weeks. Almost everybody occasionally has slight twitches as they fall asleep, but mine have become increasingly large and disturbing, and seem to occur much more frequently than they used to. Last night as I was in the process of falling asleep, my leg jerked a number of times, waking me up, so I had to start over. Then my entire arm flung itself out. I have had jerks that caused my entire body to startle violently. I have also noticed an increase in the morning of me talking out loud or gesturing with my hands while dreaming. This causes me to wake up at least to the point where I consciously notice what I’ve been doing, but I may be doing it all night without waking up.

This may have sounded like a whining testimony, but since I’m using this site and goal for my own purposes, I felt I needed to clarify where I was at. Now that I’ve written down everything I’m dealing with in regards to sleep (except for pain issues), I’m overwhelmed. I’ve been to a sleep clinic before, but it was a decidedly terrible experience. Not only was being hooked up to the machines utterly humiliating, but I am positive they got my results mixed with someone else’s but wouldn’t admit it. They told me I’d had at least 6.5 hours of sleep, but I remembered seeing the digital clock read somewhere after 1 a.m. and I hadn’t slept yet, and they woke me up at 7 a.m. That is less than 6 hours. In the end all they did was prescribe me clonazepam, which I’d had experience with before, and new it was addictive and only prescribed on a temporary basis. Needless to say I do not want to go back to the sleep clinic, but it may have become necessary considering all my problems. What else can I do? I don’t want my whole life to revolve around sleeping, but if I make it my priority (and if I want to do anything about my fibromyalgia, it has to be), that is exactly what will happen. I already spend 12 hours a night in bed, how much more of my life is this going to take away from me? I am on disability, but yes I actually do have better things to do than sleep or perform activities that should help me sleep.

If anyone reads this and feels like commenting, please do not respond with anything negative. I don’t think I could deal with that right now. Thanks.

43 Things: Eating Disorder - Update

I’ve signed up for two group courses, both of which I failed to make it to. I’m just no good in the mornings. However, my contact at the clinic keeps calling to find out if I want to try again, so I’ve signed up for the next group in January, in the afternoon. In the meantime, I have been bingeing less often, and extremely rarely do I eat large quantities when I do. Some of this has to do with my financial problems and not being able to afford it, some of it has to do with the progress I’ve made emotionally since working with my therapist. We rarely talk about my eating, but working through my emotional issues helps indirectly, because I most often binge when I have strong unpleasant emotions such as frustration and anger. Lately I don’t feel these as often, or as strongly, and on some occasions when I have felt them I’ve responded by not wanting to eat instead. I believe that with more therapy my eating will continue to improve, however, it can’t hurt to go to additional groups focussed specifically on eating. I am hoping to do the Skills group, which will give me ways to deal with my emotions besides eating. It may not be in the afternoon, however, so in that case I am planning to do the Symptom Interruption group, in which you make specific goals about eating and try to achieve them. Either group may be helpful.

One of those days

I'm having one of those days (or weeks, since it started yesterday) when it seems everything I try to do turns out badly. Yesterday I actually fell down in my own apartment - I stepped on the side of a pile of blankets and cushions I'm trying to use for a foot rest, turned my ankle, and fell against a chair. I was carrying a pile of materials to return to the library, which fell out of my hands, but not fast enough for me to break my fall. Thankfully I landed mostly on the cushions, and moderately hit my back rib on the chair. I have very flexible ankles from swimming, so I didn't sprain anything. Still, it was quite a shock to fall down. There were a few other minor things that happened yesterday, but nothing huge. Today I was planning to sit down, watch a DVD and finish knitting my dog's sweater, but my DVD player finally stopped working. It has been on the fritz for awhile, so it was not unexpected, but frustrating. I don't have any money to replace it, and my cable was shut off recently, so I have almost no viewing choices. My VCR is getting worn out, and I have very few videotapes. I also have unusable speakers on my computer. Well, this felt like the last straw in terms of keeping my mood on the positive side, which I'd been able to do so far. I felt so angry because my plans had been ruined, that I didn't know what to do with myself. I returned to playing cards on my computer in frustration, and finally attempted to listen to an audiobook called "Me to We". Turns out this book is about dedicating your life to helping others as a means to happiness. It was written by the young men who started Free the Children. They grew up in a family that consistently took action on any topic that interested them, and when the youngest brother read a story about child labour, he became motivated to help. This led eventually to his activism. From the start, listening to his story and how wonderful everything is for him, I feel extremely defensive and angry. It makes sense that he's this type of person, growing up the way he did, but he makes it seem like it's a no-brainer for everyone. Obviously they had no huge obstacles in their way, no mental illness, no poverty, no health problems. I had to turn it off. How can I be expected to dedicate myself to serving others when I'm so sick? I had just gotten over my own inner pressure to be some buddha-like saint. Now I feel it again as some accusation of selfishness from these authors. I know I am not in a position to help others, but there is still doubt. There is still the feeling that I should be doing something, that the work I have been doing towards my own recovery is not enough. This makes me feel guilty. Add to this now the guilt I feel for being angry about the implications in this book. Guilt is not a healthy emotion for me, it does nothing to help me, it does not motivate me, it only makes me want to crawl back into bed or find another way to disappear. It triggers all the beliefs I have been working on changing - beliefs about worthiness and deservedness. The voice of this author is joining the critical voice in my head that will always be saying "it's not enough" no matter what I do. I don't have the stamina to take care of myself properly, and it is pressuring me to pour myself into the service of others. Why don't these "others" feel this pressure? Why am I not identifying with them, since I clearly belong on their side in this hypothetical dyad? I am myself needy, a statistic. Maybe part of the reason I don't identify as this is that nobody treats me that way. Okay, there are people advocating for the disabled, there are Chronic Pain, Fibromyalgia etc. 'societies', and I am not involved. Why am I not involved? Because I don't have the energy. If I can't even advocate for myself, how can I possibly do anything for anyone else? Perhaps I feel guilty for not helping others because of my personality. Despite the selfishness I might display (necessitated by my poverty), I am always wanting to give to others. My first impulse is to grab things I think my friends might like, and then reality sets in and I have to put these things back. How much more of my nature is being stymied like this?

This morning I did some research on the internet regarding the increasing incidence of muscle twitching I'm experiencing. During the day, it is infrequent and minimal, to the point where I don't know if an observer could even detect it, but at night as I'm falling asleep, I'm twitching like crazy, and in increasingly bigger movements. The technical term for this is myoclonus, or possibly ballism(us) for the larger jerks. My legs and arms are flinging themselves around, and waking me up so i have to start the falling asleep process all over again. I can remember once a leg jerk scared me so much I had a full-body startle response. Sometimes there is a sensation of falling. My internet searching led me to the brain stem, and one article said that the area of the brain associated with the spasms is next to the area responsible for the startle response. I have had an exaggerated startle response for at least the past 4 years. Is it unreasonable to suspect that there may be a growing problem in my brain stem that is responsible for these two symptoms, and possibly others? Functions of the brain stem include autonomic regulation and movement. It is responsible for incoming messages from the spinal cord. Is it possible that messed up messages is causing my chronic pain? I am debating asking my doctor to refer me to a neurologist and requesting an MRI. I am afraid of being brushed off, of my doctor seeing this as a ridiculous idea and not worth the cost of an MRI. But I've never had my brain looked at, and it seems to me this is an oversight considering my plethora of symptoms and lack of any physical explanations. Maybe I am a hypochondriac, maybe this is a hunch, maybe I'm grasping at straws. But I would like to know definitively if there is or isn't something going on in my brain. What is there to lose? Don't I deserve every chance, however small, of overcoming my suffering and being able to live the best life I can? Truth is, I am not satisfied by my diagnosis. "Localized fibromyalgia" and/or myofascial pain syndrome are just descriptions, not diagnoses. There has to be some reason my back hurts in those specific spots. An article I read today said that it is reasonable that the brain stem could become damaged by accident or trauma. This all started when I was sick with Norwalk and throwing up so violently I could feel my lungs squeezed completely out of air. I've never been completely convinced that there isn't some other explanation other than fibro. Now that doubt is grasping onto this brain stem idea, for better or worse. I have achieved a lot of acceptance over the last year or so, about my emotional condtion as well as my physical capacities, but I still can't accept that I will spend the rest of my life with this, nor that there is nothing to be done besides pain management. I need an advocate. I need help, and belief and strength. Why do I have to fight so hard and push doctors so hard to get anywhere? I'm so frustrated, I need someone to take the reins and do these things for me, because I don't have enough energy to cope with the daily stressors of my life in even the most non-eventful periods. I'm sick of being sick. I'm sick of working so hard to do things that normal people take for granted, and I'm sick of all the obstacles created by my illness. Illness creates poverty,creates mountains of barricades, creates isolation and helplessness, creates more blockages, creates a life without meaning, joy, hope.

I take things minute by minute in order to avoid seeing the bigger pictures in life, because they look like that, what I've described above. I've learned how to celebrate small victories and enjoy tiny pleasures as if they are luxurious. I don't think about the future, I don't plan for tomorrow. I only ask of myself the things that MUST get done in order to maintain ODSP and housing. I don't make concrete plans, I say, "call me that day and we'll see where we're at". I don't make promises. I don't commit. I don't expect much from life, only that things don't get worse. I call long-term goals "dreams" because they probably won't happen. I pretend my poor memory and brain lapses are funny. I don't ask for sympathy or special treatment, even when I need it. I tell myself I chose this, that I want this way of life. Truth is, I don't know what I want anymore, and I don't know if I ever did.

Tuesday, November 18, 2008

Deprivation - a no go

A lot of my remaining "problems" seem to revolve around the deprivation issue, and the voice in my head telling me I should be able to live happily while deprived. That I shouldn't want or ask for more of anything that I'm deprived of. Things I am or have been deprived of include love, health and money, and everything that money can buy - comfort, novelty, excitement, a social life. Not to mention treatment, a healthy diet. Having money would mean having much better health, or so I believe. But I am stuck in the Catch 22 - my illness keeps me poor, my poverty keeps me unhealthy. I rarely go out with friends, and a big reason for this is because I don't have money to spend shopping, eating out, going to movies, even for taking the bus. I am and always have been living in a state of deprivation, on the edge of financial panic. Even when I was a child I was consistently made aware of lack of money, having to fight for extra clothes, feeling guilty because my father was often out of work and still trying to pay child support. My mother worked so much I felt we were very poor. I've been told by my father that wasn't the case, but, even if he's right, it doesn't change the perception I had when I was a child. Despite this, money was the only thing my parents gave me at all. My dad has always given me cash for birthdays and Christmas, and my mother gave me food and shelter. It is a proven fact that a person needs more than this to thrive. I've written before about the lack of love I got in my childhood. This core deprivation adds to the anxiety I have about money and material things, including food. I was once asked why I couldn't just stop when I had had enough, and I reacted immediately with defensive anger. To someone with my eating disorder, this question is akin to asking the depressed why they don't just get up and do something, or why can't they just be happy? Thinking about this incident later, I realized the truth is, there IS no enough. I can't leave a plate with food on it, nor can I stop eating during a binge until I feel sick or run out of food. I don't know how to explain the link between feeling deprived and not being able to stop, but seems an intuitive link that anyone could grasp. Fear of not having enough makes you take everything you can get your hands on. I am somewhat of a pack-rat too. I keep clothes that are ruined or don't fit, planning to use them for crafts. I have an entire wardrobe of clothes that are 3 sizes too small, because I keep thinking I'm going to lose weight. Throwing those clothes away feels like giving up. People on TV say that you should never keep clothes that are too small, because it damages your self esteem, and if you do manage to lose weight, you deserve to buy new clothes that fit. I don't have that luxury. If I lost a bunch of weight and didn't have those clothes, I would be stuck wearing things that were too big, or trying to alter them. The world is not made for people like me, poor people, sick people, single people. And I originally got sick and stayed single because I felt I didn't belong anyway, and pushed myself too hard for too long to be someone I wasn't. But, the topic is supposed to be deprivation. I really want to work on how it is affecting me, but I don't even know where to start, as evidenced by the fact that I went off on a tangent. I can't seem to even begin to dig into this issue, can't find any words to...there is almost a physcial resistance to asking myself questions about deprivation. My mind gets fuzzy, and I start feeling anxious. But I know I have to deal with this, and I want to, so it is frustrating that I am not getting anything to work with. I thought if I started writing, it would come. It hasn't. I guess I will have to wait to have a real entry about it.

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Disclaimer

I sometimes write things that I don't really mean or believe. These are not to be taken literally, nor as definitive statements about me or my beliefs. Thoughts and emotions are transient, and I reserve the right to change my mind, generalize, exaggerate, give strong opinions, or write other possibly offensive statements. I don't lie, but I may say something that's not true to check whether I believe it or not, or to make a point. Call it creative license. This is my blog, and do have the right to say what I want. I'm using it in creatively therapeutic ways. Whatever the reader may think of me and my words, please believe that my core intentions are always good and I never willingly hurt anyone.