The Well of Depression

I have a hard time relating to how things are discussed in medical text books or even online resources. Depression for me is all encompassing – a creeping void of dark energy that seems to drain me completely.

I envision my seasonal depression like a giant well.

Every year I build defences as I climb out of the hole, sometimes I create a new cognitive foot grip. I spend time building the fences around the hole, I create a small staircase that goes from just inside in case I fall in a little.

At the bottom of this well are all the “versions” of me that will never get out. They tell me of all the other times I have fallen in – they remind me that months and a year at one stage were spent in this place.

Even worse though are the parts of me I label the diggers – these parts of me are not content with me simply being kept here a few months every year – they have been digging the hole deeper – they have found mementos from my childhood of when I have done things I am ashamed of – or painful memories and they use them as spades to dig deeper under ground.

At the moment I am in the depression hole trying to find my way out – I have a few foot grips, and I can at least see the light at the top of the hole. I am clambering my way out again and building new stairs that go further down.

I always know it’s coming – but sometimes things happen externally that make it worse – One such thing is doing that for me at the moment that I cannot discuss.

In the middle of the worst period of my life each year I am being made to retread an extremely awful time in my life – it’s laden with tons of trauma not just from the period then but for a part of my life in which I have had struggles previously – one that contains more than a fair few shovel memories for a team of diggers.

No medication has worked for me unfortunately – I have to just rough ride through the experience. It’s been especially brutal some days – one recently was the first in a while where I have genuinely wanted not to exist anymore. The problem with these dark moments is that counterintuitively they are where I need to not be questioned by those who love me.

In this state I am a tornado of self-sabotage. I can limit the damage now because I am aware of it. The people I love closest to me now know to listen if I tell them to not try and talk to me that day – because at the bottom of the pit all I see is the near impossibility of getting out.

There is a ladder – it used to be filled with rungs like:

  • Your pets
  • Your friends
  • Your family
  • Your interests
  • Your goals
  • Your future

Now the ladder has life experience which has weakened each rung with etchings that I can’t avoid when I try to climb out again.

  • Your pets will die they always do. Enjoy them briefly before they leave you to.
  • Your friends barely know you exist. Most of them wouldn’t realise if you had actually passed on because you’re awful at keeping in touch.
  • Your family tried to commit you last year during Autistic Burnout. They love you still but thought that throwing you into a cell was the best thing for everyone at one stage.
  • Your interests are meaningless. You cannot organise yourself well enough to be talented at any one thing.
  • Your goals are a graveyard of failures. There are few things in life that you have truly succeeded at, and you have a litany of failures behind you.
  • Your future won’t come to fruition. The world is dying through climate change and there is little hope of a good future where you can thrive and limit your eco footprint.

Each time I fall in here I have to fight my demons, climbing back up a ladder that is being eroded by external forces, and I do wonder if one day I will truly get stuck here – taking up a spade to get out.

That day isn’t today – so I will try and avoid the traps and triggers and climb for the surface again. Maybe leaving a few good foot holds for me in the future.

A list of things that are associated with Autism or ADHD – Pt 1 – Co-ordination and Vision

Disclaimer

I do not know which of these is responsible for each trait I am going to mention here, it could also be other factors such as unrealised or realised trauma. The overlap of ADHD, Autism and OCD is quite large. There are similar brain structures – so much so that these are considered by some to be the same condition based on neurology.

It is estimated that between 53-78% of those with an Autism diagnosis also have co-occurring ADHD, and around 21% of those with an ADHD diagnosis also have Autism. Source here.

Here I will give you a list of things I have discovered in science that appear to be associated with either ADHD or Autism – The categories might not be 100% with how science currently defines them – the classification and inclusion of overlapping criteria of these things is somewhat open to interpretation.

It’s almost certain no one will have all of these but these occur in higher rates in Autistic or ADHD individuals.

Co-ordination Traits

Apraxia and Dyspraxia

Apraxia – is the total loss of ability to co-ordinate and make purposeful movements and gestures with neurotypical accuracy.

Dyspraxia – is the partial loss of these abilities.

Dyspraxia Traits (Sometimes called Developmental Co-ordination Disorder)

  • May not be able to run, hop, jump, or catch or kick a ball when their peers can do so.
  • Many have trouble managing walking up and down stairs.
  • Always falling over.
  • May not like solid food that needs to be chewed.
  • Poor at getting dressed.
  • ‘Clumsiness’ – not good at picking small things up; tends to break small toys.
  • Slow and hesitant in most actions; tends to trip up.
  • Muscle tone may be high (the muscles seem hard or tense).
  • Muscle tone may be low (a baby may seem floppy when being held).
  • Having trouble copying things from the board in school.
  • Avoiding PE and games.
  • Delayed language development or problems with speech. For example, speech is odd and inconsistent, so that it is difficult to understand.
  • Drawings seem very immature compared to those of other children.

Source: Dyspraxia

Sub-classes or specific learning disabilities

A lot of these seem to overlap as is the case with many neurological differences.

Dyslexia – a reading and writing disability

Those with dyslexia generally have difficulty with a variety of things. Spelling, reading, writing, identifying direction (e.g. left and right mix ups), telling the time, following multiple instructions, and reading comprehension problems may all be present.

Since a large part of dyslexia is about processing difficulties (that is – mentally ordering specific inputs from the world around or the classroom), a child/adult can be very good in some areas but may struggle in others.

Dylexia

Dysgraphia – an issue with fine motor control

Writing requires a complex set of fine motor and language processing skills. For people with dysgraphia, the writing process is much harder and slower. Just holding a pencil and organising letters on a line is difficult. Their handwriting tends to be messy. Many struggle with spelling and putting thoughts on paper. These and other writing tasks, such as putting ideas into language that is organised, may add to struggles with written expression.

It’s important to recognise that dysgraphia is a language-based weakness that may affect information and/or motor processing (including handwriting).

DYSGRAPHIA

Dysgraphia is the most undiagnosed of all specific learning disabilities with estimates of around ~60% of ADHD or Autistic children and teenagers being affected by dysgraphia. It is also one of the least understood disabilities.

For specific information on how dysgraphia presents as an adult there is information here that is the best I have seen.

Dyscalculia – Mental Math Ability

It’s been described as the number one cause of maths weakness that you’ve never heard of. Dyscalculia is a specific learning disability we know very little about yet it affects around 6 percent of the population.

People with dyscalculia may have these traits:

They can lack an “intuitive feel” for numbers and struggle to learn basic number facts and procedures

Even if they produce a correct answer or use a correct method, they may do so mechanically and without confidence

There may be issues with long-term, short-term or working memory or with sequencing

These difficulties can have an adverse effect on day-to-day activities such as following directions, keeping track of time and dealing with finances

DYSCALCULIA

For me the easiest way to think of this is a quite extreme difficulty of doing mental math. I cannot do things in my head.

Again the best source for the presentation of dyscalculia in adults can be found here.

Dyspraxia – General Co-ordination issues

Developmental dyspraxia primarily affects motor function, particularly the gaining of new skills and carrying out of those already learned.

It affects children in different ways at different stages of development, and is inconsistent – as if sometimes information is `put away’ in the wrong drawer.

Dyspraxia is not a behaviour problem, not an overt physical disability, and may not even be visible – until the child tries to learn a new skill, or to repeat a learned one out of context.

Dyspraxia

This is considered it’s own thing – basically general clumsiness is something that they consider to be dyspraxia – the uniform definition of these terms does not exist in science – different websites will tell you different things.

Visual Traits

Vision difficulties

Aside from the common eye problems – namely nearsightedness (myopia) and farsightedness (hyperopia). There are some unique considerations related to visual co-ordination.

These problems can usually be corrected by an optometrist with glasses. These can occur with hyperopia or myopia also.

Irlen Syndrome

Irlen Syndrome (also referred to at times as Meares-Irlen Syndrome, Scotopic Sensitivity Syndrome, and Visual Stress) is a perceptual processing disorder. It is not an optical problem. It is a problem with the brain’s ability to process visual information. This problem tends to run in families and is not currently identified by other standardized educational or medical tests. 

IRLEN Syndrome

This encompasses quite a few things – but light sensitivity is covered by that (I will cover this later on – in the sensitivities section). Reading problems are also included here, as are writing problems.

Astigmatism

Astigmatism is a condition in which your eye isn’t completely round.

Ideally, an eyeball is shaped like a perfectly round ball. Light comes into it and bends evenly, which gives you a clear view. But if your eye is shaped more like a football, light gets bent more in one direction than another. That means only part of an object is in focus. Things at a distance may look blurry and wavy.

Astigmatism

Strabismus (Crossed Eyes)

Crossed eyes, or strabismus, is a condition in which both eyes do not look at the same place at the same time. It usually occurs in people who have poor eye muscle control or are very farsighted. 

Strabismus is classified by the direction the eye turns: 

Esotropia: inward turning.

Exotropia: outward turning.

Hypertropia: upward turning.

Hypotropia: downward turning.

STRABismus

Vertical Heterophoria

An eye condition that is caused by the misalignment of the eyes. Vertical heterophoria is what’s known as a binocular vision dysfunction. That means there is a slight imperceptible difference in your eyesight that could be causing you an array of unpleasant symptoms. Your eyes are designed to work together to create one clear image to present to your brain. When there is dysfunction there, your eye muscles work overtime to help correct the misalignment with the images. People who have vertical heterophoria can experience increasingly debilitating symptoms as their eye muscles work overtime to compensate for the visual disturbances that vertical heterophoria can cause. Some of those symptoms can include motion sickness, anxiety, vertigo, neck pain, and more.

Vertical heterophoria

More to come

I intended this to be a far shorter blog – but nearly every sense ADHD or Autistic people have has a ton of co-occurring sensory issues or things that may need to be dealt with at the same time.

On a personal note I am currently in my Seasonal Affective Disorder period as it is winter in New Zealand. This leaves me with a lot fewer spoons to actually do stuff and I am prioritising my ADHD coaching course and trying to maintain my mental health. I will be posting updates less frequently during this time.

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The inescapable dread of winter

I’m pretty subdued at the moment – it’s Winter in New Zealand. Seasonal depression happens every year and it seems no amount of preparation and “wellness” activities will actually do anything to curb this difficult mental health period of my life each year.

It starts in May/June and lasts for 3-4 months. Just doing anything during this period is hard enough, but I have been proactive this year (and every year before it).

I am currently:

  • Meditating
  • Acupuncture
  • Spending time in the sun/outdoors when possible
  • Staying productive on tasks:
    • Reading books (still have to write a review for some)
    • Writing chapters
    • Coaching course
    • Cleaning house
    • Planning research
  • Taking every vitamin
  • Exercising

Pretty much everything I can.

It’s like an uncontrollable force keeps guiding me to the darkest possible thoughts and perceived future existence.

I know it’s partially tied to the weather as whenever the air pressure drops so too does my mood, summer or winter. I also know that this time has always been the worst in my life – mid year exams were the worst. My mood was bad, I got sick frequently during winter. I am not so sure if it’s chemical in nature or just an ever repeating cycle of being reminded of the hard times in my life.

The problem with this depression isn’t so much that it’s survivable or that I know it’s short term – it’s the experience of having it that makes it seem inescapable. There are times still where I do wonder if there will be a point at which I give up – I’m not suicidal – just exhausted.

It’s easy to know “this too will pass”, but living through thing you want to be over faster than is possible every year doesn’t bring me any more ease.

“It’s this awful time where all you are ever reminded of in your life is the bad things that have happened or are going to potentially happen is here for 3-4 months – try to think of other stuff but don’t worry I’ll always find a way to link it back to something hurtful” – my Brain.

I do wonder what my life might have been like if I didn’t have to work through so much of my past like unpicking a Gordian knot.

I get intermittent calm – but it’s always robbed of me as soon as I start to get to a point where I feel ok. All I want to do is sleep to be through this time. Taking any medication just makes it worse and often extends the depressive period out over a longer stretch.

I’ll be ok. I’ll make it through. I just have to ride out the darkness.

This song sums up how absurd and futile existence feels at times. Maybe I’ll get my mental health sorted in time to watch the world end.

How did I even survive and learn?

I am not sure how I learn. This is probably a weird thing to say. I failed school a lot – especially traditional school. I didn’t do well at University either. When I was made to apply what I knew in some way with clear instructions I was able to do it and to help others to do it – I was a social learner stuck in a system where I was expected never to help. One thing I am certain of now is that I learn by teaching. I am also someone who needs novelty constantly. I need to be doing new things, or figuring out a way to make things new because nothing tunes me out more than repeating myself.

There is no doubt in my mind now that if I had been tested as my mother was told to do when I was young and at school – I would have been ‘intellectually disabled’. I have dysgraphia, dyscalculia and I am fairly certain that I have dyslexia as well. I am uncoordinated – I have dyspraxia.

I had myopia (near-sightedness) and astigmatism (I got this through blunt force trauma to the eye by my bullies – it was always the right eye they punched – I am nearly unable to wear contacts). These issues were not diagnosed until I was fourteen.

I have aphantasia (no mind’s eye) but I am not sure if this has always been the case. Do you know what it’s like having to remember people who you can’t visualise – and yet I don’t have prosopagnosia. I have figured out a way to identify people – I can’t see them in my mind – but I implicitly know their faces… somehow – and usually with better accuracy than other people I know.

I have cobbled together so many coping mechanisms for all these drawbacks. I had a speech impediment that meant I couldn’t say my own name properly. Honestly my name is a phonetic nightmare for a little kid.

There’s no doubt in my mind that I am not traditionally “smart”. I have spikey as hell skillsets. One thing is true about me – I am voracious in the pursuit of what is interesting to me.

A monotropic mind is one that focuses its attention on a small number of interests at any time, tending to miss things outside of this attention tunnel.

I live in the now – more than I realised. My attention span is limited by ADHD making me want to do everything all the time. Sensory sensitivity flooding some neural channels. Over time I’ve trained my brain out of doing certain things. But they were still doing them – I just ignored my perception.

I had the wrong instruction manual for life. I have TOO MUCH attention – bottlenecked by my capacity to process this amount of input. I can train my brain in ways that seem incredible to me. If I talked about my capacity to alter my reality to most people they would lock me up, but I can just experience things differently.

The one thing I thought I lacked in my life appears to be one of my greatest strengths – persistence. Tenacity. A never ending drive to make up for all the things that were not made for me. I have overcome every challenge that life has thrown at me.

Do you know what it’s like finding out that your life is completely different to everyone else around you? While I share traits with people – I doubt there are many people on this planet who have the same experience as me.

Here’s a list of my challenges.

Cognitive (Thinking / Processing):

  • Dyspraxia – motor coordination issues (issues of coordination of movement), speech issues
  • Dysgraphia – issues with fine motor control and writing, grammar
  • Dyslexia – issues with reading and writing – specifically spelling, word order. I learn by spatial formation rather than distinct lettering.
  • Dyscalculia – issues with math acquisition, mental math is near impossible.
  • Aphantasia – no visual memory, no mental imagery
  • Time Agnosia – inability to perceive time

Visual:

  • Myopia/Astigmatism (Undiagnosed till 13 or 14) – near sightedness and lens distortion
  • Photophobia – light sensitivity
  • Eye contact issues – looking at peoples eyes is like staring into the sun

Touch/Pain:

  • Hypersensitivity to touch – clothing tags frustrate me, light touch causes my skin to crawl.
  • Hyposensitivity to pain – I don’t feel things that really hurt at all.
  • Crohn’s disease – a gut condition that causes inflammation
  • Food textures are extremely sensitive.

Hearing:

  • Hyperacusis – extreme sensitivity to sound
  • Misophonia – emotional reaction to certain sounds
  • Tinnitus – ringing in the ears
  • Audio delay – intermittent amount of time, can often perceive it instantly – often it can be delayed hours.

Smell:

  • Hyperosmia – sensitive smelling

Taste:

  • Supertaster – extremely strong sense of taste

Interoception:

  • Cold insensitivity
  • Heat extreme sensitivity
  • Bad at detecting need to urinate

Emotions:

  • Hyperempathy – feel other people’s emotions at a physical level even if not interacting with them.
  • Anhedonia – inability to feel joy (I can feel it from other people due to hyper empathy but I cannot do it on my own)
  • Intermittent Alexithymia – sometimes when I am in extremely stressful situations I just shut down my ability to process emotion so I can do stuff. I go from feeling everything to feeling nothing – the best description I’ve seen of this is the ‘humanity switch’ from Vampire Diaries. When my emotions reboot – I have to feel all the emotions that were delayed intensely and at the same time – it’s exhausting.

So… how did I learn? Mimicry and just brute force, teaching others, training myself to learn new ways to do things.

At some stage I will pick these all apart, but for now I am just taking a moment to celebrate me. I did so much. I fought against so much.

I could die now “happy” because I at least know why life was so hard for me. I finally have peace… some peace in a mind of endless thoughts.

Unified System of Mental Health – Part 2 – Nervous Systems

The Nervous System

Technically there is one nervous system and it appears to be broken up to different ways depending on your interpretation. This is a crude overview of the nervous system.

The Main Division

The two main divisions are:

  • Central Nervous System (CNS) The main set of nerves that encompass the spine, and your brain – the central (duh!) part of the nervous system. It acts as a messaging and response system (according to Western science).
  • Peripheral Nervous System (PNS) – Then all of the nerves that link off the Central Nervous System.

The Peripheral Nervous System in detail

The CNS is made up of cranial and spinal nerves – these main nerves are the communication lines between the central nervous system and the rest of the body. The PNS both sends and receives impulses to the CNS.

The sub divisions of this system are still debated a lot – and there are multiple systems that seem to work together – these are the divisions I have found most useful for understanding it:

  • Motor Division (efferent – meaning carrying impulses away from the CNS and PNS) – This is made up of motor nerve fibers – it takes impulses from the CNS to effectors (muscles and glands). This is made up of two separate divisions also:
    • Autonomic Nervous System (visceral motor) – This is the involuntary part, no “conscious” action is usually involved here. Here impulses are conducted to cardiac muscles (heart), smooth muscles (myocytes – found in the stomach, intestines, urinary bladder, uterus, walls of passageways such as arteries, veins, and the tracts of the respiratory, urinary, and reproductive systems. Also the eyes and skin have smooth muscle cells). This is made up of two separate divisions also:
      • Sympathetic division – Mobilizes “fight or flight” systems during activity
      • Parasympathetic division – Conserves energy and does housekeeping functions (heartbeat, breath etc when not conscious of it)
    • Somatic Nervous System (somatic motor) – impulses conducted to the skeletal muscles
  • Sensory (afferent – meaning carrying impulses to the PNS and CNS) shapes reality and allows for the experience of the world

Why is this important?

For so long we’ve been led to believe that there is a mind-body duality. That the mind is something that can be fixed with medication alone, separate from our body. It turns out our body and our mind are inseparable.

Examples of this in action:

  • Touch (sensory) generates Oxytocin (CNS)
  • Anxiety (CNS) affects heart, muscles, urge to urinate, lungs (CNS->PNS->ANS->Sympathetic)
  • Depression (CNS) affects intestines, heart, sensory (PNS->ANS, lower Somatic input->ANS->PNS->CNS)
  • Stress (CNS) affects Motor Division, both Autonomic and Somatic, heightens awareness of Somatic system.

The mediating factor here is the brain. The brain contains a lot of different neuropeptide generation pathways. I will dive deeper into this when I talk about neuropeptides/neurotransmitters in another post.

The issue is that our minds and bodies are not disconnected. There’s emerging proof of the existence of psychosomatic illnesses. Trauma not only seems to affect the structure of the brain, but this change in structure seems to affect the body. While there is a genetic component for a lot of autoimmune disorders – they present at higher rates in people with anxiety issues or early childhood trauma.

Atomization of science and medicine has been causing some massive issues – a lot of Western medicine is based on evidence that has lots of issues with the methodology. The serotonin theory of depression appears to have little substantial evidence – while serotonin is important for wellbeing – the mechanism by which SSRIs work is still under investigation.

The more interesting developments about the nervous system in recent years have been around alternative treatments for some significant illnesses – of most interest is the developments in Vagus Nerve Stimulation.

The Vagus Nerve

I have written about the Vagus Nerve specifically in regards to the neuropeptide vasopressin here. I do however think after further reading that isolation of the single neuropeptide vasopressin is again falling into the same trap of SSRI medication. Until we have a testable hypothesis that is replicated beyond a population of 20% efficacy vs placebo – I would be careful talking about the efficacy of any mental health medicine – given some of the severe side effects.

Vagus Nerve Stimulation

Vagus nerve stimulation is an emerging therapy (in modern* Western cultures) that seems to help a lot with a number of mental health conditions, and autoimmune diseases.

In this review, we provide an overview of the US Food and Drug Administration (FDA)-approved clinical uses of vagus nerve stimulation (VNS) as well as information about the ongoing studies and preclinical research to expand the use of VNS to additional applications. VNS is currently FDA approved for therapeutic use in patients aged >12 years with drug-resistant epilepsy and depression. Recent studies of VNS in in vivo systems have shown that it has anti-inflammatory properties which has led to more preclinical research aimed at expanding VNS treatment across a wider range of inflammatory disorders. Although the signaling pathway and mechanism by which VNS affects inflammation remain unknown, VNS has shown promising results in treating chronic inflammatory disorders such as sepsis, lung injury, rheumatoid arthritis (RA), and diabetes. It is also being used to control pain in fibromyalgia and migraines. This new preclinical research shows that VNS bears the promise of being applied to a wider range of therapeutic applications.

A review of vagus nerve stimulation as a therapeutic intervention

Stimulation of the nerve with low intensity electricity seems to work – there are now also ways to do this without surgery simply by stimulating the outer ear.

So I want to talk a bit about other ways that the vagus nerve can be stimulated – it seems to be responsible for mediating the Oxytocin/Vasopressin pathway among other things.

Here are some ways you can stimulate the vagus nerve:

You might be noticing some common themes here in all except the first one – cold temperatures. They are generally social activities.

This is my main hypothesis – we are a social species – we are wired for being social. I will cover the importance of social interaction in another post. But so much evidence is pointing to the fact that the way we live is actually making us sicker.

What is important to know is that the lack of judgement is a mediating factor in the success of each therapy – the more a person feels judged either internally or externally the less successful the therapy.

What if what we seek is harmony, but we’ve been made to compete…

People do all these things all the time – religious services, Indigenous celebrations, dance parties, concerts, comedy venues. Most of the time these activities cause vibrations that stimulate the nervous system.

People stop doing these things when they feel judged – we are isolating people from their human experience through stigmatisation.

In conclusion (with some common phrases):

There is definitely evidence for needing “good vibes”.

There is definite evidence for having a “gut feel”.

Laughter can be a medicine (not necessarily the best).

Our body and our mind is the same thing – we cannot separate one from the other and disconnecting them for so long in science through atomization has put us miles behind.

Maybe, just maybe, we could start listening to Indigenous people and Eastern cultures – they’ve been doing this for years, and been saying this also. Everything is connected.

The Vagus Nerve and Vasopressin

So the vagus nerve works really well at reducing the severity of so many things… but we don’t know why that is exactly. I am going to propose a hypothesis – welcome to my brain.

Here’s a study on vagus nerve stimulation

Vagus Nerve Stimulation (VNS) has been proven to be a useful treatment across a number of domains and has been used effectively to treat epilepsy and depression in adults. There is accumulating evidence to suggest that it can be used to help quell inflammation in a number of other autonomic or inflammatory disorders, which would make it useful for a wider range of pediatric patients as well. Preliminary studies have shown promise for VNS being used for stroke, autoimmune diseases, heart and lung failure, obesity, and pain management, but further studies are needed to fully elucidate the mechanistic actions that explain VNS’s potential role in treating these disorders. Many of these studies are not mechanistic in nature, and further pathway analysis and studies focused on the mechanisms by which VNS alters autonomic tone are key to further our understanding of vagus nerve modification. VNS interacts with the body’s immune system to modify inflammatory tone by altering the release of pro- and anti-inflammatory cytokines. We have summarized some of these key inflammatory markers in Figure 3. There is an overwhelming evidence to suggest that vagus nerve is an important component of the immune response and manipulating vagal tone is a way to modulate the immune system. Using VNS to manipulate vagal tone provides an exciting new opportunity for minimally invasive therapeutic intervention in adult and pediatric patients.

A review of vagus nerve stimulation as a therapeutic intervention

The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. In this review article, we discuss various functions of the vagus nerve which make it an attractive target in treating psychiatric and gastrointestinal disorders. There is preliminary evidence that vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease. Treatments that target the vagus nerve increase the vagal tone and inhibit cytokine production. Both are important mechanism of resiliency. The stimulation of vagal afferent fibers in the gut influences monoaminergic brain systems in the brain stem that play crucial roles in major psychiatric conditions, such as mood and anxiety disorders. In line, there is preliminary evidence for gut bacteria to have beneficial effect on mood and anxiety, partly by affecting the activity of the vagus nerve. Since, the vagal tone is correlated with capacity to regulate stress responses and can be influenced by breathing, its increase through meditation and yoga likely contribute to resilience and the mitigation of mood and anxiety symptoms.

Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders

It seems that it’s tied to inflammation. I have been wondering about blood flow – I did a whole blog on blood.

But more importantly I wanted to know why it made you happy and what might be a reason for it seeming to make it so that you can socialise more easily – which is apparently another one of it’s effects – because it reduces anxiety.

Then I came to something no one really talks about that much.

Vassopressin

Vasopressin, also called antidiuretic hormone (ADH), arginine vasopressin (AVP) or argipressin.

Literally this is it’s current function according to science:

Vasopressin regulates the tonicity of body fluids. It is released from the posterior pituitary in response to hypertonicity and causes the kidneys to reabsorb solute-free water and return it to the circulation from the tubules of the nephron, thus returning the tonicity of the body fluids toward normal. An incidental consequence of this renal reabsorption of water is concentrated urine and reduced urine volume. AVP released in high concentrations may also raise blood pressure by inducing moderate vasoconstriction.

Basically according to theories now all this one thing does is control the amount of water.

It does stop you from urinating if you lose too much water. Ever noticed that when you don’t drink that you don’t need to pee despite maybe having a lot of water still – that is vasopressin doing it’s job. When you lose as little as 2% of your body water it can double the content of vasopressin in the blood.

Why do I care?

Vasopressin and Oxytocin appear to have complicated transmitter interactions – it’s been hypothesised that these are the behaviours:

Literally the interaction between Oxytocin and Vasopressin appear to modulate the love-fear reaction in humans. The above article covers it in more detail.

Hang on I thought stress was related to cortisol – and only cortisol…

Yeah it is – it definitely seems to play a role in a lot of things. But do you know the most common way of getting rid of cortisol? – Excreting it. This is done by drinking water – which will in turn allow your body to release cortisol through urination. You can also exercise – there are many ways of excreting water from the body.

Ok so what’s the connection with the vagus nerve then?

When Vagus Nerve Stimulation (VNS) was put into rats to test fluid consumption they found something interesting – they drank the same amount, but they didn’t drink as often. Not only that – the amount of arginine vasopressin (AVP) was lower in the blood.

These results suggest that VNS may activate vagal afferent components which related to inhibition of AVP secretion and then suppressed the augmentation of thirst. Frequent drinking small volume may benefit for homeostasis in CHF.

Chronic vagal nerve stimulation suppress thirst through decreasing vasopressin secretion in the rats with chronic heart failure

Wait a second – if VNS seems to work, and it also seems to supress vasopressin does that mean vasopressin might have a role in inflammation?

Vasopressin is a small neuropeptide initially identified as the physiologically essential antidiuretic hormone more than 50 years ago. Since then, it has increasingly become apparent that vasopressin is an important hormonal component of the response to stress. In fact, it appears that the antidiuretic effect is only one of several biologically significant actions of vasopressin exerted during the response to stress. This review highlights the main features of vasopressin as a stress hormone produced by relatively simple hypothalamic neurons that release their neurotransmitters into the blood stream and also send axonal projections to key parts of the brain that control the response to stressful environmental challenges. Special focus is on the role of vasopressin in (1) setting the efficacy of adrenal corticosteroid feedback inhibition; (2) the stress of pain; and (3) supporting the response to inflammation.

Vasopressin as a Stress Hormone

My point is this:

I think Vasopressin might be the single most important neurochemical for understanding anxiety, depression, inflammation – it seems to control blood flow. When it was injected into the guts of rats it inhibited gastric motility, it could be the thing that’s causing all the issues with inflammation throughout the body – and especially in the brain.

If VNS works by reducing the amount of vasopressin, and causes a decrease in inflammation then it stands to reason that we should DEFINITELY look into the function of vasopressin outside of it’s current small understanding.

DRINK WATER.

My Mental Health Self-Help

Ok so a few people have asked what has helped with my mental health. I haven’t had much success in therapy. I have tried so many things outside of therapy. I ended up just reading the books explaining the techniques that the therapists are going to use on me and using other resources. This doesn’t cover psychoeducation which was the other part that was important for me – but that will be a far longer post.

All of these have been important for my mental health – please note I have picked and chosen the parts that are good for me – and I don’t think they will work for everyone.

Philosophy/Social Justice

Ok so as a heads up Philosophy has been the most important thing for me to learn there are a number of ways to engage with this – the area of philosophy I was most interested in was virtue ethics – and particularly the concept of Eudaimonia (which means to lead a good life). I love all philosophy though. I also think that social justice was a huge part of learning about what I needed to achieve some peace in my life so I am going to include some other books also.

Books:

Podcasts

Philosophize This! – Steven West – An excellent overview of the development of the field of philosophy – you can then dig in more to certain philosopher’s who you find interesting.

Stoic Meditations – Massimo Pigliucci – A short meditation on Stoic writing – I listen to these each morning on random as inspiration.

TV Show – The Good Place

Ok if you don’t want to dive into philosophy – this TV show is incredibly good at breaking down some of the important moral implications about being a good or virtuous person. It’s actually one of the best shows ever made – it can take a while to get into but there are so many great lessons in this show.

Saying “Goodbye” to “The Good Place” | by Richard LeBeau | Rants and Raves  | Medium
The Good Place

Self Help Books that helped me

These books are written from a religious perspective – but I am a pantheist – the advice was helpful to me.

Books

Psychology

I’d recommend reading these in order – don’t do mindfulness without reading the risks involved if you are traumatised – I made this mistake before learning why it happens to be a bad idea. These books are for practitioners generally and do not go heavy into the application in some cases.

Books

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My Adult Autism Diagnosis Process (New Zealand)

TW / CW // Suicide, Self-Harm, Autistic Burnout, Depression, Honest Mental Health Talk

Please note: I have privilege – I have public healthcare even if it’s slow to respond, I am a white person so when I called the cops they treated me well. I am a masc presenting non-binary bisexual person in a heterosexual appearing relationship – so I most likely got the best care.

Alright I have had a few people enquire about my Adult diagnosis process. I will cover it in detail here – a bullet point summary. I am going to be honest. I hate a lot of what I did here, and it still absolutely breaks my heart it happened like it did – my family was put through hell because I was in hell myself.

  • At the start of 2020 – I am diagnosed with ADHD, Anxiety, Depression, Seasonal Affective Disorder – I am only on Dexamfetamine at this stage – no antidepressants as I have been having massive issues with SSRI/SNRI medication.
  • March I have to drop out of my Masters at University due to COVID-19 – lockdown is relatively peaceful except for the extreme anxiety.
  • April last year I start massively ‘breaking down’ and I have no idea what is causing it, nothing is directly attributable to this time period – we come out of lockdown
  • June I am falling apart in a big way and I am scaring people around me. I have been dissociating, self-harming frequently, I am having regular panic attacks.
  • 9th July I am in a pit of existential dread – I can’t take it – my suicide ideation is almost constant. I call the cops the first time on myself as I have screamed at my wife “I wish I didn’t love you so I could kill myself” – this is a permanent memory I have now. I am taken to the police station and given quetiapine (50mg) to start stopping my “psychosis”.
  • 10th July – I meet with a psychiatrist who advises me to meditate 3x a day and to keep taking quetiapine. They will get me in to see a psychologist ASAP.
  • 20th July – We call the police again because I am still absolutely falling apart – the medication is not helping, and in retrospect I think it was making me more unstable personally.
  • ~21st July – I see a new Psychiatrist who sees some of the trauma that has been giving me PTSD. They prescribe 3x Lorazepam (3mg total) a day, and 100mg Quetiapine to try and stabilise me. I am taking 2xZopiclone (15mg total) to sleep every night.
  • 8th August – I call the police again it’s still not helping things are getting infinitely worse overseas and my hyper-empathy is destroying the core of who I am seeing people suffer. I can’t take it. I have been trying to avoid media but it’s near impossible. I am bumped up to 200mg Quetiapine as well as the Lorazepam. I am seeing my psychiatrist frequently at this point to try and get medication right.
  • 11th September – I can’t take it – so many cumulative things are getting to me, my friends are hurt from the lack of protection in the games industry – many are left with significant mental health problems. I do something I cannot talk about to try and prevent harm – this has extreme consequences – I attempt suicide after missing a dose of Quetiapine. I am discharged the same day from hospital. That night I try again. I end up failing in a pretty darkly hilarious way that doesn’t need discussing. I return home and sleep.
  • 12th September – I wake up the next morning – I just want to not exist. I don’t really want to die I just can’t keep living. I tell my wife I need to be committed into a mental institution. I sign paperwork to voluntarily commit me – but the ward for mental health is full so I am placed in a normal ward.
  • 12 -> 14th September – I am on suicide watch in hospital – I am fully expecting to get committed – I have no access to my devices. I am watched at all times – still on the same medication. A few of the people who have been assigned to watch me make me feel ‘normal’ for the first time in a long time – they just talk to me like I am a person, they get me a book to read. I for the first time in a long time feel like I am not someone who is going ‘crazy’ or ‘insane’. They helped me far more than they probably realise. On the 14th my psychiatrist says that they don’t believe it will help me to be committed into the ward – they sign my discharge paper work. I am still awaiting seeing a Psychologist.
  • 30th September – I finally see a psychologist – I am able to see them for six sessions every two weeks working on DBT therapy. I do not do well in this therapy, I do get some value out of it but it mainly leaves me feeling that I am bad at therapy – a lot of therapy doesn’t seem to be suitable to ND people – there’s a communication issue.
  • 9th October – I have been interacting and following a few Autistic people on Twitter due to my ADHD advocacy. One of my mutuals posts an online Autism test – it says I have a high chance of being Autistic – I don’t know what to do with this information because I have really awful ableist views on what Autism is, and I don’t believe it can be me because when I learned about Autism in psychology it said Autistic people can’t think for themselves, are not social, and cannot have empathy.
    This is not me. I start researching a bit about what Autism is – the top search result is well… Autistic people know what it is – and it was awful information. I start looking into the dominant narrative around Autism in research.
  • Decemberish – I finally talk to an awesome person on Twitter about my concerns about being Autistic as well as ADHD – at this point after interacting a lot I realise that I knew absolutely nothing about what Autism actually is – this person states to me that they think I likely have it. I end up going on a research binge. I am pretty certain I have it which is why I talked to them.
  • January – I am improving (because I have been using Autistic advocates methods for dealing with the negative effects of being Autistic in this world). On my last session with my psychologist I point blank just ask “Do you think I have Autism Spectrum Disorder?” They tell me they think I am ‘Atypical’.
  • Februaryish – I talk to my doctor who is back again and ask them if they have it on file that I am Autistic. They tell me that is not there and has not been sent over – due to NZ privacy laws a single handwritten copy of my notes exists in a metal filing cabinet. I find out I cannot be “officially” diagnosed by my psychologist under NZ regulations. I discover the concept of Autistic Burnout – I cry, a lot. I finally had an explanation for what happened to me – because I still had no clue about that part of being Autistic.
  • Marchish – I only seek official diagnosis as I want to contribute to Autistic research and to do so with some organisations I need an official diagnosis. I ask my mental health nurse (who I will say here has been the best part of the entire mental health system – I am so so grateful for them, they are the best person, although we got off to a rocky start) to see if I can get an appointment – they organise this for me – it’s May 10th before I can get an appointment.
  • This whole time I have been advocating about being Autistic – there’s no doubt in my mind that I am Autistic and I have spent nearly every waking moment since late November researching. Trying to dig through fact and fiction that exists – picking apart the science. I compile a ton of evidence based on what I know
  • May 10th – I deliver a presentation to my psychiatrist – who is actually a really awesome person to me and treats me with a level of dignity I admired – they tell me they have read my articles on The Spinoff on being Autistic. They corroborate with the notes of my previous psychiatrist and psychologist – they talk to my Mum, and they ask what my wife thinks. I am ‘officially’ Autistic.

Here’s the presentation I gave – click to view it:

It should not be this hard. I nearly died trying to find out. There’s still not really any support for me that is suitable. So I am working to advocate for better care – I am doing everything I can to improve the lives of Autistic people and challenge the science around Autism.

It’s important to know you are Autistic – but this is not a good way to find out.

If medication works for you to manage other co-occurring stuff that’s awesome – please keep doing that. I just had extremely negative experiences and not all of it is anyone’s fault.

My life has been made awful by people’s good intentions, and they were working with the best data they had been given – it’s just a bankrupt system for so many.

A Unified Theory of Mental Health – Part 1. Blood

IMPORTANT DISCLAIMER: I am not a qualified person. I just spend my time reading everything I can to get a unified picture of mental health. Do not do anything suggested here without talking to a medical professional first.

I think that mental health is hard to deal with currently because we’ve disconnected so many fields from each other. I’m going to postulate a few ideas I have about what might need to be included to work toward a more unified complex system model of health. There’s evidence of things working in isolation – but the fields seem too disparate and disconnected to make sense to my brain after wide reading.

I think a lot of current autoimmune conditions are the result of psychosomatic occurrences – that absolutely does not mean that these do not occur but I think when it’s been repeatedly demonstrated that cortisol causes an exacerbation of many of these – the role of this hormone and it’s production in the adrenal gland cannot be ignored.

Blood

I got interested in blood because they said in the old days to just drain it all the time – that’s something they stopped doing – then I started to look into the treatment of conditions in non-Western countries. Blood letting is still used in a lot of places – it might actually have some therapeutic effect. I will talk about why soon – I don’t know if this is the best practice – just removing it, but I want to discuss why it might work.

I think two things are important in regards to blood – blood flow, and iron levels, not necessarily blood pressure.

Iron (Fe) – Specifically Iron Homeostasis (The right level)

A complex set of interactions occurs with iron – one of the most important trace elements in health.

Iron deficiency has been associated with obesity, congestive heart failure, gastrointestinal disorders, and neurological conditions such as restless legs syndrome and attention deficit disorder, whereas iron excess contributes to a number of diseases including neurodegenerative diseases 

Evidence for communication of peripheral iron status to cerebrospinal fluid: clinical implications for therapeutic strategy

There’s a number of studies that have come out recently that support the hypothesis that iron levels in blood may play a major role in neurochemistry. The mechanism is from my research still vaguely understood and there’s a reason why it might not be as simple as supplementing iron or reducing iron.

In this study one of the things they noted is that serum ferritin levels (blood iron concentration) was not as important as hemoglobin concentration. Hemoglobin protein’s primary function is to transport oxygen.

We need iron to make more red blood cells – and those who have anemia are likely to have low hemoglobin. One of the things the brain appears to do is to regulate where iron is directed if it is low, and when it does this – it will forgo using serum ferritin levels in place of making sure that hemoglobin production takes place as oxygen transportation is more essential for survival

Our data are also consistent with the report that Restless Leg Syndrome symptoms fail to respond to intravenous iron treatment in individuals with low hemoglobin levels (< 12.5) and suggest in that study, the brain may have participated in an active redirecting iron delivery rather than simply a failure of enough iron to reach the brain in the anemic patients.

Evidence for communication of peripheral iron status to cerebrospinal fluid: clinical implications for therapeutic strategy

These results are to be viewed with caution as this is a single study the further avenues for research here are presented as follows:

These findings provide a number of avenues for further basic science and clinical investigation: (1) hemoglobin levels signal the brain, presumably regarding oxygen availability, which releases some factor(s) into the CSF that alters iron transport across the BBB; (2) efforts to provide iron to the brain could be impacted by hemoglobin levels, even if these are in normal range, (3) the brain is seemingly tolerant of some degree of brain iron deficiency (i.e. in the case of RLS there is hypomyelination and impairments in synaptic dopamine signaling;) but intolerant of diminished oxygen availability (4) the therapeutic implications of the findings in this paper suggest that hemoglobin levels, not serum ferritin should be considered as the peripheral indicator for efforts to replenish brain iron levels.

Evidence for communication of peripheral iron status to cerebrospinal fluid: clinical implications for therapeutic strategy

Blood Flow to the Brain

This is different to blood pressure, but also tangentially related. Recently a couple of drugs have been approved for ADHD treatment of impulsivity and aggressive behaviour. Both of them are heart drugs – Clonidine and Guanfacine.

I was wondering why these drugs might work. They say it’s a neurochemical reaction – but I am skeptical of these claims, their suggested mechanism of action is that with Guanfacine in particular it binds to neurotransmitters and therefore repairs damage – this might be entirely true – but here’s what the drug is supposed to do for people with heart conditions:

Guanfacine treats high blood pressure by decreasing heart rate and relaxing the blood vessels so that blood can flow more easily through the body. Guanfacine extended-release tablets may treat ADHD by affecting the part of the brain that controls attention and impulsivity.

Guanfacine

What if it wasn’t neurochemistry but simply blood that was important actually regulating the level of amygdala function – when the amygdala is primarily used for interpreting signals this triggers anxiety responses – it’s the fight or flight centre of the brain. If we argue that blood flow is important it might better explain how blood is able to reach the prefrontal cortex that supposedly controls impulsive behaviour. If you look at how blood is transported up the brain stem and out into the other regions of the brain maybe the simplest answer here (Occam’s razor) is the right one.

Supporting Evidence – Massage

Blood flow has beneficial effects and this has been measured in a variety of contexts – investigating the sport benefits they have consistently found that blood flow increases with massage.

Massage is believed to benefit sportsmen through its biomechanical, physical, neurological, and psychological devices. Research has reported the effects of massage on physiological (investigated by simply blood flow and blood-borne substance)

Determining the Benefits of Massage Mechanisms: A
Review of Literature

Ok that’s sports people what about evidence for other conditions?

In summary, evidence indicates that acupuncture treatment may be of benefit in several neuropsychiatric disorders, including depression, anxiety, schizophrenia, and AD.

The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer’s Disease: A Review of the Literature

Supporting Evidence – Exercise

So everyone knows that exercise seems to work for mental health – but exercise improves blood flow…

Sensitivity analyses revealed large or moderate to large antidepressant effects for Aerobic Exercise (AE) among trials with lower risk of bias, trials with short‐term interventions (up to 4 weeks), and trials involving individual preferences for exercise. Subgroup analyses revealed comparable effects for AE across various settings and delivery formats, and in both outpatients and inpatients regardless symptom severity. Notwithstanding the small number of trials reviewed, AE emerged as an effective antidepressant intervention.

Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta‐analysis

Personal Observations

My ADHD symptoms are reduced with exercise, I feel better with massage – I am not going to deny there’s an underlying neurological difference in my brain. But couldn’t it be partially explained by blood flow or iron homeostasis?

Want to know how my ADHD/Depression/Anxiety and OCD get worse – especially when seasonal depression kicks in? This happens:

  • It’s winter / I have anxiety / I have no motivation to do exercise / I am stigmatised in life / I have no time to exercise as I am overloaded with sensory stuff or emotional stuff at work from bullying
  • I reduce my exercise by withdrawing from this activity
  • My blood flow decreases
  • I start getting asthma issues
  • My blood oxygen transportation and iron transportation levels probably decrease
  • My body gets fat – I feel society judging me for this
  • I end up with massive amounts of unknown muscle pain from sitting incorrectly most likely
  • There’s no release of this stress so it constricts blood flow
  • Winter finishes / I start exercising / I get therapy that’s useful / I start to exercise again with a partner / I am scared of looking awful for summer because body standards are ridiculous
  • My symptoms reduce as I increase exercise – I feel good about myself – positive neurochemicals start being absorbed
  • I feel way more anxious in Winter than Summer…

Why do we have to complicate it with neurochemistry? This seems like an atomization of science – an attempt to reduce things down to a level that is not needed – and Occam’s razor could provide one reason why these apparently different things work.

The reason I ask is that genes significantly impact the role of neurochemicals. I had serotonin shock syndrome for over 10 years due to the fact I think that I am Autistic and there’s a high level of hyperserotonemia (ie. I have a higher than normal level of serotonin in my blood). When I was put on different drugs for treatment of “depression” all of them gave me lasting side effects – but no improvement – some of these made me want to kill myself – blocking my norepinephrine in combination with my serotonin caused the worst of all of these – Venlafaxine almost killed me.

This is not guaranteed for all people but the risk of trying to treat Autistic people especially as though we have the same brains is utterly wrong.

This is just one of the theories I have for mental health – I will be going through them in a series – they need to be addressed at the same time – combination therapy.

Supporting Evidence:

IRON

MASSAGE/BLOOD FLOW

Classical Medicine & Mental Health

DISCLAIMER: NONE OF THIS IS MEDICAL ADVICE – IT’S TO BE TAKEN AS IS. DO NOT DO ANYTHING WITHOUT TALKING TO A MEDICAL PROFESSIONAL FIRST.

Just a few weeks ago I was trying to refute the idea that those who have mental health issues should be discouraged from Stoic philosophy – which I saw as an interpretation – turns out that this was largely due to this author’s biased interpretation of ideas – you can adapt philosophy. Arguing about one correct interpretation of philosophy is a terrible concept anyway – you can make it meaningful to you.

Sometimes the internet takes to you weird places…

I came across a name – Caelius Aurelianus (believed to be of African descent) – a 5th Century physician and writer on medical topics who wrote a book called ‘On Acute Diseases, On Chronic Diseases’. The book itself contains what is thought to be a translation of previous works by the Greek physician Soranus of Ephesus – who was alive during the 1st/2nd Century AD. It was translated in 1950 by someone called Israel Edward Drabkin.

Some things were discovered earlier…

The book contains a number of amazing things that are not acknowledged in most medical history. I want to first take a look at two conditions that are ascribed to being discovered by physicians far later in life – Asthma and Sleep Paralysis.

Asthma

Most people believe that Sir William Osler considered by many to be the the ‘father of modern medicine’ to have been the first to describe Asthma with clinical accuracy – I’d like to point out – this is wrong.

Men are more subject to attacks of asthma than are women; old men and boys more so than young men, and soft bodies more so than those of a hardy nature. The attacks come more often in the winter and at night than in the summer and during the day. In some cases asthma arises spontaneously, in others it supervenes upon a previous disease, often coming after a severe chill.

In asthma there is difficulty in breathing, frequently of short rather than long duration, and a choking sensation in the chest together with a feeling of heaviness and burning heat.

The disease is marked by alternate periods of attack and remission. The latter intervals are sometimes completely free and clear of symptoms of disease, but at other times are marred by the presence of traces of the ailment. That is, even in the intervals of remission the patient may still suffer from shortness of breath, a condition which becomes quite obvious when he does any climbing or hurrying or is distressed by indigestion, fatigued by venery, or troubled by cold, dust, or smoke.

Asthma is a disease involving a state of stricture.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

Compare this description to the one given by Sir William Osler.

Spasm of the bronchial muscles

Swelling of the bronchial mucous membrane

A special form of inflammation of the smaller bronchioles

Having many resemblances to hay fever

The affection running in families.

Often beginning in childhood and sometimes lasting into old age.

Bizarre and extraordinary variety of circumstances which at times induce a paroxysm:

Sputum is distinctive: rounded gelatinous masses (“perles“) and Curschmann spirals & octahedral crystals of Leyden

A Brief History of Asthma and Its Mechanisms to Modern Concepts of Disease Pathogenesis

The language used to identify the organs is more precise but the mechanism of action is exactly the same.

Incubus (Sleep Paralysis)

Again this is attributed to someone in the 16th Century for clinical presentation – but it’s described here in perfect clinical accuracy.

The condition cannot be called a disease unless it occurs continually and with bodily discomfort. But nightmare when it is a disease is a forerunner of epilepsy and Soranus in his work On Causes, which he calls Aetiologumena has shown abundantly that the incubus is not a god or a demigod or Cupid.

Those who suffer from the disease of nightmare show extreme sluggishness of bodily movement and stiffness. And particularly during the dream there is a feeling of heaviness and oppression and a sort of choking. They imagine that someone has suddenly attacked them and stunned their senses, exhausting them and preventing outcry.

From the feeling of heaviness we gather that the disease involves a state of stricture; from the length of time it lasts we consider it a chronic disease.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

I’ve had sleep paralysis – it’s terrifying. I do not have a visual mind’s eye (aphantasia) – so I wonder if this is the reason why I never see visions of a demon, but I can understand the concept of feeling like something is standing on your chest.

There’s nothing more terrifying than waking and you do not know how to tell your lungs to take in air – it’s absolutely indescribable. The brief amount of time it usually takes you are in pure terror – how do you turn on an automatic process? One you never think about.

On My Autism…

I think my Autism is described here across two separate conditions – Epilepsy and Mania. I’ll explain…

Sensory Sensitivity and Epilepsy

I have extremely high sensitive sensitivity – when I lived in cold housing I was affected by dust, asthma, tinnitus, sometimes I get visual hallucinations as described here when extremely sleep deprived – as do most people. Here it’s described someone who is on the verge of an epileptic attack – what’s interesting to me is that these have been the conditions that preceded my sleep paralysis in a few cases.

Those who are on the verge of an attack of epilepsy show symptoms in common with those of other diseases originating in the membrane of the brain, e.g., heaviness of the head and dizziness, head noises, sympathetic pain in the back of the head, eyes staring, ringing in the ears or impairment of hearing, and blurring of vision accompanied by dizziness. Certain objects may appear as if dangling before the eyes, like the sparkling points in marble (Greek amarygmata or marmarygae) or spiders’ webs or thin clouds or small winged animals, such as gnats. And patients see sparks flashing or rings of fire spinning before their eyes. The tongue feels rigid, the muscles quiver, and there is pain in the back between the shoulder blades. And patients see sparks flashing or rings of fire spinning before their eyes.

There are also the following symptoms: stiffness of the throat, constant precordial distention, yawning, sneezing, flow of saliva, distaste for food or else an uncontrolled desire for it, continued wakefulness or else excessive and unprofitable sleep, troubled dreams, difficulty in digesting food, … mind unsettled and troubled, a tendency to become angry for no good reason, forgetfulness of what has just recently taken place, and a susceptibility to anything that blurs the vision.

As the disease emerges and takes hold of the body, the patient is bereft of his senses. As the attack gains full sway, in some cases the patient remains completely immobile; his face is pale and lowered, respiration slow, and pulse large; he is overcome as if by a deep sleep.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

This is almost text book signs also that I am about to have an Autistic meltdown and this is what happens to me a lot of the time – I literally shut down.

Epilepsy is one of the highest co-occurring diagnoses for Autistic people, it’s very hard for me not to believe that epilepsy is the more advanced form of my sensory sensitivity – when the brain is overly connected between regions things can overload me. I actually do have mini-seizures for certain things – sometimes my mind wipes if a noise is too loud – I do not collapse or seize but my mind goes completely blank as if I have been briefly concussed.

What also points this out to me is this particular thing they mention for making sure you do not trigger a further attack:

Thereafter many of the previously mentioned symptoms which indicate the onset of the disease, e.g., dizziness and dimness of vision, may occur when the patient does something while bending forward, or watches a ship or a swiftly rotating potter’s wheel, gazes at flowing water, looks up a great height or a cliff, hears a loud noise or shout, suffers a severe chill, takes too hot a bath, or smells strong odors whether pleasant or unpleasant, such as that of burning storax, frankincense, bdellium, lignite, bitumen, or stag’s horn.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

Mania

Sometimes it arises from hidden causes, at other times from observable causes, such as exposure to intense heat, the taking of severe cold, indigestion, frequent and uncontrolled drunkenness (Greek craepalè), continual sleeplessness, excesses of venery, anger, grief, anxiety, or superstitious fear, a shock or blow, intense straining of the senses and the mind in study, business, or other ambitious pursuits, the drinking of drugs, especially those intended to excite love (Greek philtropota), the removal of long-standing hemorrhoids or varices, and, finally, the suppression of the menses in women.

Before the disease emerges, those who are not attacked suddenly by it have the same symptoms as persons on the verge of epilepsy or of apoplexy. These signs may be found, then, in what has already been said. But some seek to distinguish the antecedent signs of these diseases by listing specific signs for each of them in addition to the general signs common to all. Thus deep sleep, they say, is indicative of the coming of epilepsy; light and short sleep, on the other hand, of mania. So, too, they take it as an indication that mania is imminent when a person in a state of anger suffers congestion of the head and believes that he has gone mad or, again, when such a person is overcome by speechlessness resulting from groundless fear.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

I… These are the things that cause my Autistic meltdowns. These are the things I am constantly balancing. Here Caelius Aurelianus talks about how ‘Mania’ presents – I want you to think about modern descriptions of Autism, Schizophrenia, and Autistic Burnout.

Now when the disease of mania emerges into the open, there is impairment of reason unaccompanied by fever; this impairment of reason in some cases is severe, in others mild; it differs in the various cases its outward form and appearance, though its nature and character are the same. For, when mania lays hold to the mind, it manifests itself now in anger, now in merriment, now in sadness or futility, and now, as some relate, in an overpowering fear of things which are quite harmless. Thus the patient will be afraid of caves or will be obsessed by the fear of a falling into a ditch or will dread other things which may for some reason inspire fear.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

So these are things that are described to treat this condition…

As for the treatment, we hold that measures should be taken similar to those employed in epilepsy. Thus, to begin with, have the patient lie in a moderately light and warm room. The room should be perfectly quiet, unadorned by paintings, not lighted by low windows, and on the ground floor rather than on the upper stories, for victims of mania have often jumped out of windows. And the bed should be firmly fastened down. It should face away from the entrance to the room so that the patient will not see those who enter. In this way the danger of exciting and aggravating his madness by letting him see many different faces will be avoided. And the bedclothes should be soft.

Do not permit many people, especially strangers, to enter the room. And instruct the servants to correct the patient’s aberrations while giving them a sympathetic hearing. That is, have the servants, on the one hand, avoid the mistake of agreeing with everything the patient says, corroborating all his fantasies, and thus increasing his mania; and, on the other hand, have them avoid the mistake of objecting to everything he says and thus aggravating the severity of the attack. Let them rather at times lead the patient on by yielding to him and agreeing with him, and at other times indirectly correct his illusions by pointing out the truth. And if the patient begins to get out of bed and cannot easily be restrained, or is distressed especially because of loneliness, use a large number of servants and have them covertly restrain him by massaging his limbs; in this way they will avoid upsetting him.

If the patient is wakeful, prescribe passive exercise, first in a hammock and then in a sedan chair. The rapid dripping of water may be employed to induce sleep, for under the influence of its sound patients often fall asleep. And heat should then be applied to the eyes with warm sponges, and the stiffness of the lids relaxed; for the beneficial effects of this treatment will pass through the eyes to the membranes of the brain.

And then prescribe passive exercise, first in a sedan chair and then in a cart drawn by hand. When the patient’s body has gained strength, prescribe walking and also vocal exercise, as required by the case. Thus have the patient read aloud even from texts that are marred by false statements. In this way he will exercise his mind more thoroughly. And for the same reason he should also be kept busy answering questions. This will enable us both to detect malingering and to obtain the information we require.

Then let him relax, giving him reading that is easy to understand; injury due to overexertion will thus be avoided. For if these mental exercises overtax the patient’s strength, they are no less harmful than passive exercise carried to excess.

And so after the reading let him see a stage performance. A mime is suitable if the patient’s madness has manifested itself in dejection; on the other hand, a composition depicting sadness or tragic terror is suitable in cases of madness which involve playful childishness. For the particular characteristic of a case of mental disturbance must be corrected by emphasizing the opposite quality, so that the mental condition, too, may attain the balanced state of health.

And as the treatment proceeds, have the patient deliver discourses or speeches, as far as his ability and strength permit. And in this case the speeches should all be arranged in the same way, the introduction to be delivered with a gentle voice, the narrative portions and proof more loudly and intensely, and the conclusion, again, in a subdued and kindly manner. This is in accordance with the precepts of those who have written on vocal exercise (Greek anaphótièsis). An audience should be present, consisting of persons familiar to the patient; by according the speech favorable attention and praise, they will help relax the speaker’s mind. And, in fact, any pleasant bodily exercise promotes the general health.

Now if he is unacquainted with literature, give him problems appropriate to his particular craft, e.g., agricultural problems if he is a farmer, problems in navigation if he is a pilot. And if he is without any skill whatever, give him questions on commonplace matters, or let him play checkers. Such a game can exercise his mind, particularly if he plays with a more experienced opponent.

When the patient has had his walk and rest, he should be carefully anointed. At first, massage him only slightly and simply. But when his recovery has become more obvious, massage him behind the shoulders and the neck with a downward motion, using a stronger stroke than before; this is the moderate rubdown which the Greeks call cataspasmos. In the final stage also massage the head; and when the head is relieved, prescribe bathing.

Then, if the patient shows no new symptoms and has accustomed himself to the various parts of his regimen, change of climate should be prescribed. And if he is willing to hear discussions of philosophers, he should be afforded the opportunity. For by their words philosophers help to banish fear, sorrow , and wrath, and in so doing make no small contribution to the health of the body.

But if the disease persists and becomes chronic, being marked by attacks alternating with intervals of remission, relieve the attacks, using the same remedies as those prescribed above for the initial attack of mania. But in the intervals of remission, prescribe, first, the restorative series of treatments including various types of passive exercise, vocal exercise arranged under the supervision of a musician, walking, passive exercise, varied food, and the like.

Again, in restoring the patient’s health, the services of a trainer should be employed. Use should also be made of natural waters, such as alkaline springs, particularly those free from any pungent odor which might injure the membranes o f the brain. A trip abroad by land or sea and various mental diversions are helpful in affording relaxation of the mind.

‘On Acute Diseases, On Chronic Diseases’ – Caelius Aurelianus

I don’t know how to tell you that all of these things help me with my Autistic difficulties… but they do – every one of these things is beneficial.

One of the assertions is that ‘Mania’ is caused by stricture of the body – massage is recommended to help with this – it’s been shown in widespread scientific trials to be beneficial in reducing anxiety and depression.

Acupuncture is also recommended and has some reasonable evidence in science in meta-analyses to be beneficial for anxiety, depression, and a number of auto-immune diseases.

Maybe the answers I was looking for are not in pharmaceuticals for me. Maybe they’ve been here all along – but people want to be known as the ones who discover stuff and most of these things have been frowned upon by the modern medical establishment.