The Darkest Night had it’s Dawn

TW / CW // Suicide

The Darkest Night

Roughly this time last year I was falling into extreme Autistic Burnout. It’s a period of my life that to be honest – I am still dealing with the consequences, relationship damage, mental health destruction, and personal implosion that occurred. It was unlike any time in my life.

I didn’t know how I would be this year coming into Winter. Seasonal Depression is extremely prevalent for me. I am trying to work out what it is exactly about the winter season that keeps me so depressed. At best I feel like it gives my often lingering but not clinical depression about the world an excuse to express itself more fully. I’ve had it as long as I can remember. I’ve never had standard major depressive disorder as it goes away during the summer months every year.

There are still ramifications I can’t talk about from this time that are making me revisit it mentally on a daily basis. In the months in the peak of my burnout I did something that made my life far more complicated than it needs to be, and the resultant consequences almost made me end my life.

Seasonal depression was different. It never involved my senses or overloaded me like this did. The Void is my affectionate name for the cognitive space that exists when inside the worst of burnout. Every sense overloaded – every sound like a hammer against the side of my head, tastes too strong, skin on fire from touch, with no means to filter. The biggest challenge for me was controlling the plethora of rapidly negative emotions – pure rage, complete melancholia, and abject hatred – all directed inwards.

I was trapped in this state for months – unknown to me that I was Autistic. This was Autistic Burnout. At the same time my family had to watch me implode – the toll on my wife was extreme. While I never directed my anger toward her – she got to see me with enough rage to scream at myself, cut my arms, punch myself repeatedly, ruminate while staring at walls, break a bone in my hand hitting a wall – every morning waking up with an existential dread that only not existing could prevent.

I spent six months on medications that I believe exacerbated the situation. The seasonal depression part was still here in November and I had no clue why – this hadn’t happened before. I then started tapering off the anti-psychotics they had me on. It was those. They extended it – and they seemed to make me far more unstable as a person as soon as they lapsed.

I eventually was seen by a psychologist in our public system. However, I had incredibly awful outcomes generally. The beam of light I needed out of the darkness was the knowledge that I was Autistic – but what that means outside of the scientific community and text books that fail to understand the Autistic mind – I needed to find the Autistic community.

The Choice to End It

There’s a word that I’ve heard a lot in my life. It’s one that can trigger me pretty easily – “burden”. I am innately familiar with it. I grew up in a critical environment, and I was abused at a young age. Unfortunately the same things that make you an “old soul” are the same things that seem to indicate that you’ve not been allowed to be a child. I was constantly reminded of my worth – told that I was a problem. It was personal – a fault or flaw within me that made others hate me.

Seeing myself starting to destroy my marriage, and hurting my family – I realised I had become a burden to those I had loved most. In Autistic Burnout with no capacity for reason or logical thought and a tornado of thoughts and actions from my past reminding me what I burden I was – as medication lapsed – I rebound and decided it was time to go.

I attempted suicide – I thought that was it. I woke in hospital with no recollection and was discharged that day. I don’t know what I said or how I managed to negotiate a release.

That night I tried again – I’m ready to laugh about this now. Sometimes you fail at something so spectacularly and maybe I need to take this as a sign it wasn’t meant to be. I wanted to drown in the ocean – to be with my Dad as that is where his ashes were scattered. I left my house at 1am at night, with no glasses. I live roughly 8km from the coast where I intended to go.

I couldn’t find my way in the dark – my ability to navigate relies pretty heavily on my ability to see and the entrance to a road I needed seemed to have moved – I was also pretty compromised mentally from the overdose earlier in the day. I gave up trying to find my way to the beach about an hour after only making it less than 2km from my house.

I made it home – and told my wife I would be trying again in the morning – I laugh now, but I was so angry at myself for failing at this so hilariously.

I thought I was resigned to being a “crazy” person for the rest of my days – at that time I agreed with my family to be sectioned voluntarily in a mental ward to protect my family from the harm of them seeing me hurting myself.

I was lucky – the ward was full. The first inkling of recovery came during suicide watch during the three days I was waiting to get seen. A worker who was assigned to make sure I was under watch at all times just treated me normally. Everyone else had been treating me like I needed their worry, or concern. The problem is that with hyperempathy I just internalise that as being a burden more – and it justifies me feeling like crap.

I am comfortable in my discomfort, but I do not like that my suffering causes others to suffer too.

I was discharged. I was still undiagnosed.

The Slippery Staircase Into the Light

I used Twitter for a lot of the therapy that doesn’t exist in New Zealand. Our mental health crisis is going to be major news for many years – unfortunately no one in power is dealing with this crisis as though it is one – the issue also being that it’s been neglected for so long as an area of health that needs treating – we have no means to scale up.

My previous advocacy for ADHD probably ended up saving my life. It was though it that I connected with other neurodiversity movement advocates. It was here I learned I might possibly Autistic. You can read the diagnostic process for having this confirmed – it wasn’t easy.

None of my diagnoses at this point could explain Autistic Burnout. I had Seasonal Affective Disorder, Attention-Deficit Hyperactivity Disorder, and Generalised Anxiety Disorder/Social Anxiety Disorder.

Between November and the end of January, I delved heavily into whether I was Autistic. I had it confirmed twice. In February I discovered Autistic Burnout – as a phenomenon that happens to Autistic people through the extreme pressures of masking every day in society, and constantly coming up short and not knowing why.

That moment was kinda watershed for me – having some understanding of why I seemingly just seemed to break down when I had been able to withstand a lifetime of previous extreme trauma (I score an 8/10 of the Adverse Childhood Experiences, not including the stuff that’s happened as an adult). I didn’t know why this caused me to fall apart.

Breaking Good?

After discovering I was Autistic I had a resolve to live that I haven’t had in the past. I actually believe I should exist – I know I have a lot to contribute to the world. On my darkest days now I entertain the possibility of leaving the world behind – but there’s an underlying control that won’t happen.

Burnout was the worst and the best thing to ever happen to me – a fitting paradox for me existing as an Autistic person. It was the worst for the reasons above, but it was the best for what is going to follow now.

There is a quote I found around this time that helped me – it’s from When Things Fall Apart by Pema Chodron.

“Only to the extent that we expose ourselves over and over to annihilation can that which is indestructible be found in us”

Pema Chodron – mentions this poster in the book – unknown who first said it

Skirting the Void

A black hole

This winter was always going to be the challenge. The real test to see if I was deluding myself and I was still the broken, miserable, burden that I saw myself as a year ago – would the effect of the winter season make me regress?

Almost.

I like to envision my mind as a galaxy, the concepts of space seem to fit in here. My analogy is that trauma that I have had in my life creates black holes in my mind, neuronal pathways are redirected through the black hole – allowing no good memories or light to come though. I got good at compartmentalising these black holes. Limited my capacity on certain things – avoided topics.

Autistic Burnout caused all the black holes to coalesce into a supermassive black hole. The pull of this into a place from which there can be no escape is strong. The ‘flight paths’ for neurons have to take this into account.

I know the Void is there with me always – but I’ve learned getting close will be the point at which I cease to perceive any light in this universe, and so now my days are spent skirting the void from a safe distance.

Where to now?

Making sure that other people can avoid creating their own blackholes – helping others find their way out of the ones they are being pulled towards. Training to be a coach. Making sure in whatever way I can that I improve things for people who are like me – because I know what it’s like to feel like no one gets you or is on your team.

I get to be actual me too – not the many masks I had constructed.

Book Review – ADHD: an A to Z by Leanne Maskell

[Disclaimer: I received this book for free to read – no review was part of the deal but I really enjoyed it and I think it’s a good resource.]

This is an excellent book for an overview of ADHD – it’s not extremely scientific although touching on the science of ADHD. The book is written from a personal perspective and with a focus on practical ADHD management and giving a breakdown of the many ways in which ADHD will affect every facet of your life.

Each section covers a different aspect with chapters titled from A to Z (surprisingly based on the title!). The book gives an overview of how the current topic affects you as well as each section providing a number of self help activities or recommendations for overcoming and dealing with obstacles.

It might not have extremely detailed descriptions of ADHD but it deals very effectively with the day to day challenges of having ADHD. Common pitfalls and barriers are recognised, as well as providing a number of recommendations for support to get help with managing your ADHD, as well as systems you can develop yourself and suggestions from Maskell’s own successes in management.

The book can be read in any order with non-sequential chaptering – whatever you are currently struggling with or want to know about can be jumped to without any fear of missing out on content and where there might be applicable cross-referencing Maskell does an excellent job of highlighting the specific chapters.

The book has a UK focus with a few sections or pages dedicated to dealing with the minutiae of the NHS and the current appalling state of ADHD care in the UK (Something New Zealand is no stranger to).

The source material used for research is good, most is peer reviewed research with a few anecdotal or article based publications without peer review but the content is understudied rather than incorrect, and is not based on pure conjecture – there’s a large amount of anecdotal evidence that has no formal investigation based on my experiences as an ADHD person.

Please note – there are a few caveats. Some of the resources recommended will only be available to those who have the means (financially) to access services. The UK advice isn’t very useful for other people (but was interesting to learn about). Light on some of the more intersectional concerns about ADHD.

Overall: This is a great starting point for those looking to manage their ADHD. It contained a few tips for me (who is no stranger to looking for ADHD help advice or trying to implement it). It’s an excellent book to keep coming back to with a number of suggestions to try when you get caught up in a certain area of your life. Lots of helpful advice from someone who has struggled with ADHD and is now passing that information on so that others might find these solutions a little easier themselves!

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.