Unexpected and way out of proportion

I haven't written much during the fall. Summer and early fall I felt like I wasn't doing all that bad. And as it's been picking up, I haven't gotten around to writing about it.

I had to turn down a conference session chairmanship last minute because I was being too depressed, asocial and anxiety-prone to handle it.

And this entire winter trip back home to Stockholm has been littered with anxiety attacks, mood breaks and blue swings.

Today, I've been feeling somewhat off most of the day, but kept it mostly together and had a great time when we were hosting people for christmas day lunch. Evening I still felt slightly off but had a good time watching The Hobbit with my wife.

I went to brush my teeth before going to bed, looked at myself in the mirror.

And was overwhelmed by a feeling that I was ugly. It came so suddenly and so strongly I didn't get around to reminding myself that Depression Lies To You. By the time I got to bed I was spiraling out of control, mood wise, and by the time I got in bed, I was crying in huge, sniffling, shaking, hulking sobs.

Because I thought I was ugly.
In spite of the observational evidence against it gathered from friends and family.

I never can understand just what will set me off. It never seems proportionate after I recover. Never seems sane.

I am so borderline!: On symptoms, diagnoses and feeling all sorts of crazy

Not this week. But the two weeks before, I was struggling with excess sleep and lethargy to the point it was becoming problematic. I wasn't accomplishing anything because I was pretty much glued to my bed. When I did wake up, it was to eat or use the bathroom. On particularly hard days, I would cry. My neediness doubled last week and made a friend frustrated with me again. At the time, I didn't understand why he was frustrated because I was in "so much pain". So it didn't make sense that he was upset over me constantly calling and texting.

I usually focus on symptoms when talking about myself, but I am pretty sure the thought in my head last week was constantly: "I am so borderline!" Though borderline personality disorder has only been applied to me by my long-time therapist (psych docs usually stick with bipolar), I couldn't help imagine a picture of my face slapped right next to the description in the DSM. I could probably have ticked off each and every symptom listed for the disorder, however, I'll just briefly recap the most troubling for me.

• First, I was having very abrupt mood swings. Though my general mood was down, I was also cycling rather quickly. I would have very intense bursts of depression and anger for the most part. Only once did I feel an elevated mood: great clarity, concentration and focus. My anger got me into verbal fights at least twice with my family (who I live with now).
• I felt an extreme sense of loneliness. At night, I would almost work myself into a panic attack at the thought of being alone. When my friend I mentioned earlier became frustrated with me and sought to end the telephone conversation with me, I would employ tactics for him to remain on the line. I alternated between idealizing and devaluing him. 
• Thoughts of self-injury and suicidal ideation present. Enough said. (No actual acting on these thoughts, however)

I feel like I expended my friends and family's patience for me. I was (and truthfully still am) disgusted by myself. I kind of/sort of hate myself. And mind you, I am feeling a lot better this week! 

Isn't there some expression about sunshine after rain? Well, I feel like it rained all sorts of emotions in my head the last two weeks. And my body took a beating too. Now, the sunshine is only a ray really. But I guess what I am saying is that I have some hope. And I am seeing things in a new light, to keep playing on expressions. 

So yes, I loathe myself but I also commend myself for still being here and trying. I look at all the possible scenarios that could have happened last week. I could have checked in the hospital. I could have hurt myself. Returning to idioms yet again, I could have hit rock bottom. Because it was a bad week. But what's interesting about all this is that this was by no means my worst state or "episode". It does seem like my resilience is in full force. 

I think it took those two rough weeks for me to relearn some things about myself. First, I am a stronger than I thought. Despite the funkiness of my moods, I was able to go out on my first substitute teaching assignment yesterday. It was chaotic and overwhelming, but I lasted the day. Second, neither my symptoms nor my diagnoses define me. I still have my values, my education being one of the forerunners. When depressed, I sometimes just don't care. About anything, including my values. In times like these, I have to remind myself to be patient. Feelings are temporary after all; values are consistent (for the most part).

So it's another time of transitions. The last time I wrote it was about my physical and lifestyle transitions. Now, it's more of an emotional realignment.

Patience. Patience. Patience.

I've been slow lately

I had an interesting experience last night.

The last few weeks I have found it very hard to be effective at work.  I have for example a bit of marking that might take an hour.  I think I should do it at the start of the day.  At about 11pm I do it for an hour until midnight.  Which is ok, except that I have done nothing else all day, or just maybe meetings, because the next thing to do is the marking and instead I facebook or find any other displacement activity.  So I've not relaxed all day, and worried, and not done anything.

The last couple of days I've taken a workaround, of not worrying and not trying to do the small thing until late. Not ideal in many ways but better than before.

But the really interesting thing was last night.  I went to order some things online for Christmas presents.  It just seemed ridiculously hard.  There was something which I could no longer get, so there was a minor difficulty.  But it just all seemed so hard.

So it seems like I have been having a tougher time all round than I expected.

At least it's a good time for a holiday to be rolling round.

Vignette: No Joy

I would not say I have been doing too well the last few weeks.  Had a bad week a couple of weeks ago.

A lot of the time I tell myself "I want to kill myself" and "I am the worst person in the world."  It's a mental tic, not reality. I don't want to kill myself and I don't think I am the worst person in the world.

Yesterday I realised towards the end of the day that I'd had no joy in the day.  Which was odd.  I realised that very often even when I'm miserable - unless I am really bad - I have moments of joy even if it's just sharing a good joke.  Yesterday I seemed to be just at a level where I wasn't deeply miserable all day, but nothing was good.

In the end I did think of some joy I'd had, so that was nice.

Making changes & feeling optimistic

Some lifestyle changes:

• Since November 14, I cut out gluten, excess caffeine and sugar from my diet. I have had only a couple slips. 
• I joined a gym and have been exercising on average three to four times a week.
• I started taking supplements (fish oil, a B complex, probiotics, etc).

Some observations on my moods:

• I have a lot of physical energy even if I feel emotionally low.
• I have been relatively stable despite a feeling of apathy or dullness. 
• I have been able to concentrate on tasks such as reading.

Overall, I have been doing pretty alright. The new doctor I am seeing has lowered my Abilify by 10 mg since I started seeing her a little over two weeks ago. I haven't experienced any dramatic withdrawal effects. The doctor seems receptive to working with me to lower my medications, however, she did say if I experience symptoms, I will go back on a higher dose. 

So I guess my spirits are somewhat higher than usual. I plan to keep up my lifestyle modifications. I'll keep you updated. 

Hashtag My Depression Pointer

One of the first posts on Depressed Academics was "What is it like to be depressed?"

In that post I talked about my pointer. I often feel I can assess a day at a rough number from about -10 to +10.

In a possibly rash experiment I've decided to start announcing my pointer to the world via twitter.
One change though: in the post about my pointer I had negative be good.  But that's never felt right, so from now on, minus is bad, plus is good, and zero is neutral.  So zero is actually pretty good for me.  While minus is more common.   About -5 to -6 is where my functioning really starts to reduce.

If you want to see how I'm doing, go here:

#MyDepressionPointer on twitter

The medication dilemma (again)

It's been a couple weeks since I took a medical withdrawal from my university. I decided to move back where I am from and to stay with my family for the time being. After all, I won't have to pay rent and can focus on my health. 

I do have to admit I feel more stable now that I am home. But sometimes I am just so overwhelmed by anger I can hardly breathe. Mostly about the medications I am on and the side effects I am experiencing from them. The thought to go off my medications crosses my mind several times a day. But I know that going off my medications abruptly would only bring more problems. 

I know if I were to attempt to taper my medications again (with the help of a medical professional, of course), I would have to make major modifications to my lifestyle. And what about sustainability? Is it even possible for a person with a mood disorder to live medication free (or at the very least at low dosages)? 

I hate my stable but blunted moods. I hate how hungry I am and how it seems like I can't stop eating. I even crave different and unhealthier foods. I sometimes can't even look at pictures of myself without grimacing because of how much weight I have gained. I dislike people asking about why my left hand moves so much (from the tardive dyskinesia). 

The thing that bothers me most about medications is the fact that my symptoms are still there, sometimes in full throttle. And then the additional coping I have to do with the side effects.

Instead of feeling empowered by medications, instead of feeling like I have a greater grasp on my emotions, I feel dependent, discouraged, disappointed. 

Vignette: My head is screaming

And my feet are slowing down.

Tonight ended with an anxiety attack. I had been fighting internally to stay sane and not go to pieces for a few hours, sometimes successfully, sometimes losing the battle. For whatever reason I ended up wanting to get myself sane rather than actually talk to someone (say my wife, right next to me) about what I was feeling.

Towards the end of the evening, it felt like the inside of my head was screaming with the pressure of an anxiety attack that wanted to take over everything, to the point where it was getting hard to hear anything outside. Hard to hear my wife's conversation.

And then I started slowing down. I kept putting one foot in front of the other. I was even able to guide our path. But it was getting harder and harder, and my steps kept getting shorter and shorter. After outpacing me three-four times and not noticing for a while, my wife decided to walk behind me instead, to make sure she wouldn't leave me behind.

Now we're home. I've grabbed one of my anti-anxiety pills, for when I can't quite handle things on my own even if I try. One of the last-resort shouldn't-really-be-taking pills. Getting hold of water to swallow with was a struggle. Calming down my grimacing facial rictus to the point where I could put things in my mouth was a struggle.

And then things got better. I swallowed. I took care of our laundry. My wife unpacked our shopping. So of course, now that I can move again, the feelings of guilt are creeping back in. Guilt for making such a fuss. Guilt for not being able to control my feelings better. Guilt for all the sadness and upset this brings my wife when she has to see me suffering.

Guilt that doesn't help anyone with anything in any way whatsoever.

Ineffective at work

I talked to a student today - though telling you this is probably (quite rightly) an invasion of my obligation of privacy to students.

So I'm not going to tell you what was said in any shape or form. 

But what struck me just now was ... well let me tell you the background... 

I've been very ineffective for a few weeks.  For example today there were a few things I wanted to do when I went to work in the morning.  One was simple, rather urgent as I should have done it days or weeks ago, and would take a few minutes when I got into work at about 10am.  It's after 8pm and I haven't done it yet. 

When I got into work an even more urgent thing came up so that distracted me.  But that was another relatively simple task, which I finished about 1pm or just after. 

Very often the last few weeks I've been doing this kind of thing. Simple tasks getting done late at night or not at all.   I've just about been holding it together, but I just have not been effective at my job. 

So that's the background.

What struck me today was that this may be a symptom of having been depressed.  It's not been terrible but it's not been great either.   And when I'm on form I can zip through some of these simple tasks.  Because they are simple.  It's often a case of being able to start them.  Because I can do them if I start them. 

Also the last few days I've been having a mild cold or other mild illness.  Not a big deal but it's slowed me down a lot, maybe making me more aware of my uselessness.  Which I say (the word useless) not as an honest assessment, but as my internal feeling. 

An Honour and a Privilege

I am a person of enthusiasms.  It's a good thing and a bad thing.

A good thing is that I can move fast with something I care deeply about.  Such as Depressed Academics.

A bad thing is that I don't always sustain the energy to keep going - even at a slower pace - over a long period.

So my posting rate to Depressed Academics has been slow recently, while over at my regular blog I've been posting a lot about sexism and general inclusiveness in tech and CS because I think it's so important. Of course some of those posts could easily belong here, like this one, where I talk about one of the unhappiest times of my life when I MUST have been depressed in a clinical sense, but just felt like I was miserable.  It literally never occurred to me to visit a doctor.  (Please don't make this mistake: if life is awful for you, even if there is a good reason, please look for medical help.)

Here's a random story. I once applied for a job at a place that will remain nameless (I'm lying, it was HP Labs, Bristol). I didn't get it and one reason was because they hired a psychologist to do evaluations of applicants and he said that I was a "butterfly", i.e. got enthusiastic for one thing, then moved on to another, and another.  As I just said, he was right in one sense. But it made me extremely miserable to have been analysed by a psychologist whose professional interest was in stopping me getting a job I wanted, rather than helping me, and who had labelled me in what I felt was an unfair way.  It was one of those times I thought what I should have said when it was too late.  I really wish I'd said this: "Yeah, you're right, obviously as a student who is just about to finish a high quality Maths degree at Cambridge University, obviously I can't stick to anything really really difficult over a period of years."  

That story didn't mean anything.  I just remembered it, and I wanted to tell you.

So I've been feeling a bit guilty about D.A. recently.  But not very, because a butterfly can still do good things even if I don't post here regularly.

But it's nice to be inspired to come here and post again for a change.

And there's a good reason.  Not because I'm miserable but because I am honoured and privileged.

I am NOT going to go into details. But somebody praised me for starting this blog and told me things they never would have done as a relatively remote acquaintance. To be trusted like that is an honour and a privilege.

Whoever you are, and you know who you are, thank you.

The face of my depression or facing my depression?

There are many faces that a bipolar person has: the face of depression, mania and even of a mixed state. Sometimes we can conceal a depressed or manic face so that even our loved ones can't tell. Other times the face of despair and hopelessness is realized by others through dark circles under the eyes, a constant frown, tears. The lighted face of mania--wild eyed and flushed--can draw attention from even strangers. The most difficult part about this, however, is not what other people notice. But what we see when we are standing alone in front of a mirror, honestly looking at ourselves. Honestly looking into ourselves.

And because looking at ourselves at our most vulnerable is a very personal thing, I'll switch to the first person now....

What I saw today when I looked at myself was so subtle that I doubt anyone would know anything was wrong. It only took one glance into the side mirror of a car for me to tell that something was terribly wrong. Of course I knew my mood hadn't been great. But for the first time in a long while I saw hopelessness, disappointment, fear. I was seeing the face of my depression (again!).

Excuse me though as I try to catch you up briefly. My last post was end of June so there's obviously going to be pieces missing, but these are the big events since my last post:

• End of July: Moved across country to find a place to live for the upcoming semester.
• Mid-Late August: Began first semester of PhD.
• Early September: Made some poor choices.
• Risky sex.
• Drug use --> Mania-like symptoms.
• Irregular sleeping.
• Missing class --> Fell behind in school.
• Mid October: Was kicked out of house by druggie landlord in the middle of the night.
• October 22: Turned in paperwork for medical withdrawal from my university.

So the ugly face of depression has reappeared. As of today, I have withdrawn from my university, and I am wondering what the hell is next. I sort of have a plan in place and that means facing my depression instead of just staring at it helplessly.

The plan:

• Return to the basics.
• Sleep regulation
• Exercise & healthy eating
• Medication and supplement management
• Attend therapy.
• Mindfulness practice in between
• Mood-tracking and sending charts to both my doctor and therapist

Yeah so that's that. Oh, and also, I can still return to school (when I'm ready). I have to show documentation of improvement before I can be readmitted. But I'll think of that when it comes...

Vignette: Bang! Slump

I was doing great today.

My blog post on "The Petrie Multiplier" has been receiving thousands of hits and been tweeted and retweeted like crazy.   This is great because it's important, and people like it.

I was very happy.

I forgot to take my daughter to her piano lesson.  The piano teacher was not very gracious when I rang up to apologise.

Bang!

Since then I've been in a slump and miserable.

That's all.

Vignette: I must be doing ok

Today I surfed over to Google Scholar and discovered my h-index had increased by one.

If you don't know what h-index is, all that matters is that it's a measure of citations of an academic, and like logarithms, it increases slowly.  So a single increment in your h-index is fairly rare.  But if you know me, you know I can obsess over citations - both mine and other people's.

I was really happy it clicked up by one.  Which is normal.  But the last couple of times it has I felt nothing, just as I did when I had a major paper accepted.

So the fact that I was happy about my h-index going up suggests I must be doing ok.

These ring true to me [link]

http://www.buzzfeed.com/hnigatu/comics-that-capture-the-frustrations-of-depression

A collection of comics that capture the sense of depression from the inside. For me, they ring very true — I am worried of how many of these I recognize in myself.

Hello Again

I've been a long time gone from Depressed Academics.

First I went on holiday.  Then when I came back I was starting to work full time again, and for a couple of weeks that was not too busymaking, but with term about to start again I am starting to get busier.

Also we've been having a lot of work done on remodelling our house - which is of course a good thing (and yes, we are very lucky to have a nice house and be able to remodel it.)   But it is surprisingly stressful even though so far everything has gone more smoothly than we could reasonably have expected.

So those are some of the reasons I've been away.

So hello again.

The last few days I've been feeling low.

It feels like a combination of a few things.

I travelled the last couple of days to give a talk, which in itself was a good thing, but as I get older I enjoy travelling less.  I used to hate flying and be really scared of it.  Now I am not so much, but I miss the family dreadfully and don't want to be away from them.   I'm going away again on Sunday for a week, so the two together has made me feel bad - or at least it has let me feel miserable, since I guess it's myself making me feel bad.

I also have been feeling that I have not been doing as good a job as I should on my big project (recomputation.org).  In fact I think this is objectively true, but that does not mean it should make me feel miserable.

And being so busy - partly because I now work full time - makes it harder to catch up and/or focus on one thing I need to focus on.

All of this means the last few days, maybe a week, I've been feeling miserable and my default state is negative.  If I get in the flow - meaning maybe being in the middle of giving a talk, or concentrating on something - then I am fine.  When I stop I go back to feeling bad.

I've been telling myself I want to kill myself over and over again, and I've forgotten how to do my SMBC trick.  I'm too lazy even to put the links in to my earlier posts on those topics.  (But summary: no, I don't want to kill myself.)

Hello again.

Academia with anxiety disorder

The amazing «The Professor Is In» just linked this:
http://www.slate.com/articles/health_and_science/medical_examiner/2013/07/living_with_anxiety_and_panic_attacks_academia_needs_to_accommodate_mental.html
A Slate article on living and working with anxiety disorder in academia.

Vignette: frozen grin anxiety

Last weekend I had an anxiety attack. It came out of the blue and struck like a hammer blow.

We'd already gone to bed, when suddenly I start imagining that S doesn't want to as much as touch me. This happens a lot when I crash out. So I nudge away, and then my emotions just go into free fall. Horrified with myself and the audacity of daring to stay in the same bed as S, I sneak out. I sit down on the floor, trying to collect myself. I eat a banana because I realize, intellectually, that this might all just be blood sugar. And I take care of putting more clothes in our hampers, so it's all ready for the laundry early next morning.

Through all of this, I feel a fuzzy, ill-defined utter terror. I feel a deep and consuming despair. It gets strong enough that I can feel my face contracting into a grinning rictus of horror. It'd be hilarious if it wasn't so bad.

I sit there for quite some time. 10 minutes maybe. Maybe 15. Then suddenly, as if a light switch was flipped, my face relaxes, my whole body relaxes, and I am able to move again. I go back to bed, sit on the edge. S stirs, asks me how I am.

And I explode into hulking sobs. It takes me several minutes to even get any words out.

This one was scary.

On my facebook today

Nothing is appealing.
Nothing is appetizing.
Nothing is attractive.
Nothing I do works.
Nothing I do is a good idea.
Interacting with colleagues is terrifying.
Interacting with cashiers is terrifying.
Other people are terrifying.

Unmotivated --> guilty --> useless --> sad

I don't feel particularly motivated to do anything at the moment. Be it housework, preparing PowerPoint presentations on my research, lesson planning or private study. I feel guilty about not doing those things. Yes they are all work-related activities and one might argue that the sunny warm weather we are currently having in the UK is a great aid to procrastination. However, I don't feel particularly motivated to do anything fun either. I don't actually know what I would find fun.

In fact I just feel like staring out of the window and mulling over my uselessness to the world.

I should apply for jobs. But I can't. I don't know what is stopping me other than a mental block. But I can't.

I don't think I have anything to offer anyone. I have some skills, but don't have confidence using them. They are skills that the world doesn't seem to want. I don't have skills that are wanted: drive and motivation, ability to market oneself.

Am I of any use to anyone? Is there a point in me existing? I know there are people in my life who value me. But it's the same way I know broccoli is green. I can't get excited or happy about it. Nor do I feel particularly loved or cherished.

That again makes me feel guilty for not being able to appreciate the love that family and friends can and do give me. Makes me feel I shouldn't exist again, that someone else could live my life better than I could.

These thoughts keep cycling around in my head. I don't think I'm depressed, because I can still function. Routine helps. I can still take pleasure in things (I think). But ultimately I feel like a failure. And that isn't going to change.

...

Now I'm going to have a cup of tea and a chocolate biscuit (despite the diet I'm supposed to be on), and find something to organise. Sometimes the act of putting things in order helps distract me from my low mood. I'll do it when I can get the energy.

P.S. Can anyone else relate to this? How do you cope?

"I need to..."

Again I posted this after the event. Hope it's of interest.

I'm not sure why I'm writing today. Hoping it will be a cathartic experience, and that I'll feel better as a result.
My trigger for this low period, has cme about to a lack of sleep, hormones and not much 'do nothing' time.

I just cut short a driving lesson wasting something like £22. Felt too shaky and not able to concentrate for the full lesson. It would end in more mistakes, and I would just feel even more useless.

I'm contemplating cancelling my tutorial this afternoon. The thing that is stopping me doing that is my student needs to organise future tutorials with me in person, with her diary in front of her. Otherwise she forgets, and doesn't turn up, and I'm left waiting around. Maybe I'll just cut it short too... one hour instead of two.

I feel like it's a lack of progress that's making me feel bad. But it could also be too many demands, by too many people. My graduation day is coming up. The parents are coming down, but I don't know when exactly, or how long for. I need to book a hotel room for them. I also need to get organised for me: what to wear, hair, make-up etc... I'm also going abroad in August, and need to sort out visa and immunisations etc. Need to plan lessons. Need to study bookkeeping techniques some more. Need to book driving theory test, and study for it.Need to do some research for my volunteer organisation. I think I need to sort out an educational activity too for them.

Too many 'I need to's.

I need to sleep, and do nothing for a day. Then I need to do some organising around the house (my way of relaxing, is putting order to things). Then I need to do nothing for a day. Then I'll be ready to face the world again.

But that's more 'I need to's.

Today is a day I want to spend in my hole. Don't want to deal with people any more. End of.

Not the 100th post on Depressed Academics

I was looking at the blog page today and noticed that it was at 99 posts.   That made me wonder if we should do something for our 100th post.  Maybe some reflections by the various people who have posted.  Maybe a request for input from blog readers.  Except I couldn't ask the blog readers because ...well that would be our 100th post.

Then I realised that there are three posts in process of being written (or possibly forgotten about), so actually there are only 96 posts.  There will still be a couple more before the 100th - this is now the 97th.

So ... should we do anything special for our 100th post?  If you have any ideas please do comment - or if more private contact us by email.

If the answer is no that is fine by me.  Depression is not a topic to celebrate, so maybe having a 100 different things to say about it is not a thing to celebrate either.

Links: Stephen Fry, and Ambigrams

As with some other links, it's quite unlikely you won't have seen it.  But it's so good, here is Stephen Fry's wonderful piece "Only The Lonely."  Sample:

"I am luckier than many of you because I am lonely in a crowd of people who are mostly very nice to me and appear to be pleased to meet me. But I want you to know that you are not alone in your being alone."

In other news, a wonderful series of ads from Samaritans of Singapore.   They are ambigrams, reading differently the right way up and upside down.  I think I came across these from Doug Hofstadter many years ago, but they are by far the best use I've ever seen of them.  It perfectly illustrates the difference between what we say and we feel.

Depression Awareness Ad from Samaritans in Singapore

Hashtag Full Professor Problems

I had a paper accepted to a top journal and I felt nothing. #FullProfessorProblems

You've heard of first world problems? You know, problems which most people around the world would be thrilled to have.  The twitter feed for the hashtag #FirstWorldProblems is always lively.

I'm coining #FullProfessorProblems.

Yesterday I had a paper accepted for a top journal (JAIR, the Journal of Artificial Intelligence Research, since you ask.)  This is a fairly big deal. It will probably go into my "REF" submission as one of my four best papers for the last few years. JAIR is probably the second best AI journal, after the journal just called "Artificial Intelligence" (or AIJ).  This makes 4 papers for my career in JAIR and 6 in AIJ.  10 papers in 25 years since starting my PhD doesn't sound many that many, but actually it is.  I'm statistical enough to have checked and those totals put me in the top 100 authors for each journal.  So if I wanted to boast (which I don't but if you want me to ... ) well I don't want to since this isn't a job application, but you can imagine what I could do with that stat if it was.

It's also a single authored paper, meaning I have a sense of "I've still got it" and knowing for sure I wasn't riding on my colleagues' coat tails.

And I felt nothing. Maybe just a smidge of satisfaction.  But no joy, no elation. That's what I am used to feeling when I get a major paper accepted.  It's not that it made me feel miserable, it just didn't make me feel great.  

I am not going through a bad patch mentally right now. I wouldn't say I feel great. But I don't feel terrible.  It's no problem to get through life and I can enjoy some of it.  But I do enjoy feeling great when I get good news, and I didn't yesterday.

To be honest it is a bit worrying.  I remember a similar reaction - no emotion then worrying - a couple of years ago when I noticed my h-index tick up by one.  Again that's a fairly big deal, and anyone who knows me knows that I obsess about citations.  Feeling nothing worried me a bit.

On the upside, I suppose, I seem to have been taking bad news fairly calmly too.  Though I can worry about that also - as in it's not my job on the line if we don't get a grant.

I don't know if this is the medication (escitalopram) talking. I ran out a couple of weeks ago and that did seem to coincide a bit of bad patch so I'm happy to still take it.  Maybe it evens out the highs and lows. Maybe it's just being older and more blasé.

I know, I know, I know. I'm going on about this good news for me.  And moaning because I don't feel great about it.

I don't want you to feel sorry for me. I just wanted to talk about what I was feeling. Or in this case, not feeling.  Since this blog is "Somewhere you can talk about it." 

I told you it was #FullProfessorProblems. 

p.s. Not quite on topic but a useful tip to pass on ...  I didn't have a rapid comedown when I read reviews (which is common if people misunderstand a paper) because I used a technique I either learnt or deduced from Alan Bundy: don't read the reviews the same day.  (He has often said that reading reviews ruins a day even when the paper is accepted. So if possible it's a neat trick to have a fun day with the good news and read the review the next day.)

Update 8 July 2013. 

This amazing mug appeared in my office today.  I strongly suspect ... well see my tweet about it. But this made my day, and indeed Aaron congratulating me the other day after having read my post was probably the first time I had felt happy about this paper acceptance. 

@aquigley gave me an amazing mug and all he gets is this lousy tweet thanking him. Thanks! pic.twitter.com/gm5Z86k34B
— Ian Gent (@turingfan) July 8, 2013

The outcast dips lower

My parents are older; they had me in their forties. I am in my mid twenties. Many of their cousins are now passing, and recently (maybe last year?) my aunt on my father's side. The notion of aging and disease has been common in our conversations for a good couple years. I am not numb to it, but it just is what it is. This is not to say I don't think aging concerns or even death related notions in terms of getting older are not valid. They are. They are just different than spontaneous death occurrences. 

This is what I mean: I was online and came across a name of a guy who went to grade school with me. He had died last year. At first the name sounded familiar, but it wasn't until I saw the pictures that I remembered who he was. I read through a whole page dedicated to memories from family and friends, and I felt strange.

I would not describe me as suicidal the last couple of days, but recurring urges to hurt myself or to kill myself would float on by like those planes with messages trailing from behind. The thoughts/urges would of course be out of sight soon enough. More of an annoyance than anything. Today's thoughts are different: I should have died and not him. I don't have anyone who loves me as much as him. I did not touch that many lives. I should overdose. 

As I write these things, I can't help but go through my skill check list: 

• What happened to trigger these thoughts? 
• What was I feeling emotionally?
• What was I feeling physically? 

What happened is I tried to reach out to my once closest friend (again) who has been avoiding me because I have been so difficult to deal with. This friend did not get back to me. I felt angry. I felt stiffness in my shoulders.

I didn't at first understand why I wrote I don't have anyone who loves me as much as him. But reflecting on my answers to my skill questions, I feel like it's obvious I am feeling rejected in some sort of way. And not just by my friend. But my family. By acquaintances. 

I feel like I don't quite fit anywhere. I am in transition from going to one university to another university to begin my PhD. It's a really big deal. I am scared. When things get tough, and my mood is low, I can't help but think of escaping. But at the very least, I can sit down and identify my sources of frustration and suicidal thinking. 

Random thoughts... Feel free to ignore

I'm writing this having just had a bit of a cry on my partner A's shoulder. I feel guilty for having done so as he's ill too with food poisoning. In my opinion I should be taking more care of him, than he is of me. 

Life seems ok on the surface... I have my tutoring (one tutee only at the moment), volunteering and accounting study... Relationships with friends and family are also going reasonably well. I've started having driving lessons, in order to make applying for 'proper' jobs easier. 

On paper, I seem to be doing the right things.

But my feelings alternate between sad and empty. I fear that this is the start of depression coming back. So right now, I'm just doing what I can to feel useful. Like not cancelling commitments and appointments, and trying to do more around the house, on a more regular basis. I'm hoping routine will stave off full-blown depression. I'm hoping this episode will pass at some point without further dip. Because right now, I'm functioning. And I don't want to go back to the days when I wasn't.

I found myself awake at 3 am this morning... The dreaded hour in my experience. Throughout my earlier episode of depression, 3 am was a constant companion. I would always be awake at this time.

This post might sound a little flat, after my other posts. I guess that's how I'm feeling: flat and numb

My Left Cheek

Some years ago, nearly 20, I was having a tantrum after what I regarded as bad service in a restaurant.   To be clear, I was late 20s, but it was definitely a tantrum.

We stood near the top of the Mound in Edinburgh, and I grabbed my wife's hand and held it to my left cheek and got her to stroke it.

I've no idea how I knew to do that.  But ever since then, if somebody strokes my left cheek, I can't stop myself smiling.  And even feeling happy while it's happening.   It's a very weird feeling.   It's something like being tickled except I'm smiling instead of laughing.   Unlike tickling, I don't mind it.  I am ticklish but I hate being tickled.  But this is nice. Also unlike tickling, I can do it to myself - well at about half intensity: it's much better if somebody else does it. Since I need it when I am miserable or crabby, I often play-act at not wanting it, which is kind of fun because inevitably I grin foolishly.

It is my left cheek, not my right.  It doesn't work on my right cheek.

Later, when my father died, I found a piece of paper with his very frail writing on it from his last days.  I broke down, and my wife tells me that my mother stroked my left cheek, but I don't know if she knew about it or whether it was instinctive.

Since I discovered this that day on the Mound, it has been a small but significant pleasure in my life.  It's also an oddity: other people may have equivalents but they don't get talked about.

The only relevance to this blog is that it doesn't seem to work well with depression.  For anger, frustration, sadness, it seems to help.   Or just for a small piece of pleasure.   For depression, it doesn't seem to work.  Sometimes I actively fight it, rather than play-act fight it, because I am miserable and I know it would make me happy, which at that time I don't want or feel I deserve. On the other hand, it seems to just be a momentary lift, rather than taking me to another place where I feel better.

This has been a long way of getting nowhere, but I wanted to share this mental oddity with you.

The low self-esteem beast at a networking event

Something I jotted down last week... Wasn't ready to post at the time. Feelings were still a bit raw. No that I've calmed down a bit (just a little bit), I thought it might be interesting for others to read. Only minor editing (spell-checking) since then.

 “The low self-esteem beast bit me today,

That too on a fine sunny day...”

Funny how that happens... One moment things seem to be going okay. Another time it feels like things, i.e. you, are going nowhere. 

Today it was at a networking event. I went to try to get tips to turn my tutoring into a business and get more tutees.  We all had to introduce ourselves. I let my vulnerability be shown: that I had not succeeded in the job market. Another man, trying to sell his business, said that he could tap the unadvertised job market and get people jobs. People, like me. He did that sales pitch, specifically naming me, in so-called alliance, and saying that I could disagree with him at any time.  

He knew how to target my vulnerability, the mark of a good sales man.

When the self-esteem beast bites, it feels like the bottom has fallen out of your whole world. That there is no place for you in it. What is the point of you existing, if you’re of no use to anyone.

The problem is, is that other people telling you there is a place for you, and that you have skills, and are of value, just doesn’t seem to solve the problem. In the end, self-esteem, is just that... *self* esteem... 

The whole process of picking yourself has to begin, all over again. “Again”, because you have had this problem several times over and you have had to do it before. You hope it gets easier. But you never really know.

Low self-esteem has been a personality trait of mine for as long as I can remember. It's got to the point where I wish I could exorcise the demon, and be rid of it forever. It stops me trying new things that I might not be good at, meeting confident people, and even applying for jobs.

I don't necessarily want to kill myself... I just want to become dead somehow.

Warning: this post will deal with suicide, or to be more precise suicidal thoughts.  If that worries you please don't read further.

The title of this post comes from "Depression Part 2", by Hyperbole and a Half.

I do have regular suicidal thoughts, but they seem almost trivial to me.  I regularly say to myself I want to kill myself.  On a good day I can beat it by catching the thoughts and rephrasing them.  On a very good day the thoughts don't occur at all.

I don't want to kill myself.  The thing is, I don't really mind that my brain tells me that I do want to kill myself.  It's an irritant to me.  Like some British people don't like the standard "have a nice day" phrase. That is a bit of an irritant to them, but it doesn't make them suicidal.  That is how I feel about "I want to kill myself".  It's annoying but it doesn't make me suicidal - at least in my own head.

One thing that becoming addicted to naps has helped me with is not being scared of dying.   I love so much drifting off, maybe listening to a nice audio book or podcast in a comfortable bed, that if death was like that I would not be unhappy about it.  But that doesn't mean I want to die.  Every single time I have a nap I want to wake up from it.

On the other hand, if I am having a nap as stress release from being miserable, I can find myself thinking how comforting it would be to have a gun I could point at my head.  Though, maybe oddly, I don't think about pulling the trigger.  Just the comfort of having it there.

I also don't think about means of killing myself.  In as much as I do think about killing myself, it is definitely about just not existing, not about killing myself.  Hence the post title.

Honestly, I feel like I am not suicidal, even though I might tell myself I want to kill myself a dozen or more times in a single day.  

Speaking of correspondence (the most difficult of the most difficult)

I just hit send on the hardest email I ever had to write. I wanted to tell all you depressed academics about it, all the hope I have for it. But underneath the hope there is fear. There is loss. And as always, the depression.......

Yesterday, I saw a man who use to be a friend at a house I lived at. He verbally harassed me on a particular night. There were sexual implications as well as my own perceived physical threat. He was with a friend yesterday. I could not contain myself. I had to say something. For her, for me. I walked over and said what I had to say.

I know I am leaving you at critical points in my narrative. But sometimes it's too hard to hold up. I feel like Atlas, holding up my own celestial sphere of complication. And I want to let go of it. Or I want to throw it up in the air and watch it's sad beauty float far away. But I am finally holding on, with grippers and all. And just seeing what comes from it.

The thing about yesterday's chance meeting was that I could be assertive with myself and others. He tried to hug me. He also claimed he did not remember anything about what happened. His friend-- who was not there-- also chimed in that she could never see him doing such a thing. I was assertive until I gave up. I wanted him to feel sorry. He could not feel that.

The email was straightforward. The pain I feel is hidden in my own body and not the body of the message. These are two very different things. The email for my future. The chance meeting and the confrontation for closing the past. Additionally, there is openings for the future as well. I gained my assertiveness, boundaries and impeccable alignment with my body and mind.

What does this have to do with mental illness? It has everything to do with it. In my experience mental illness correlates to low-self esteem, poor decision making and sometimes neglect or harassment from others. Now the beauty of the manic depressive (and others on the mood disorder spectrum) is that we are not fighters, but healers. We create, we build, we try. We also sometimes hold up spheres of emotions, thoughts, experiences that feel like a punishment.

I am breathing evenly again. I could wrap this up nicely. But like I said, I am holding on. The grippers I have learned to use are coming in handy. And that is all for now.

So THAT's what they meant?!

When I first got treated, years back, I was issued Lamotrigin, an anti-epileptic, and told that its role was to «give me space and a respite from my emotions enough for therapy to work». At that time I'm not sure I understood what my psychiatrist meant by it.

Right now, on the other hand, I spend some time being amazed by how well my current medication is working. I am noticing control over my own emotions for the first time I can remember. I am noticing how I can learn — more or less on my own — not to overreact.

For an example: I have a fear of heights. This means among other things that glass or lattice floors high up are genuinely disturbing to me. It is irrational, and more of an emotional overload than anything else.

The conference I'm at this week is at a conference center in a hotel that has a glass staircase leading up from the lobby to the conference center. First time I walked the stairway I swore over the stupid architects making my life bad.

And then something amazing happened.

Over the course of the 3 conference days here, I have grown to accept the glass floor. I no longer need to look up to keep the transparency out of my field of view. I no longer feel pangs of panic as I walk up or down the stairs.

This was inconceivable back in the day. Utterly unthinkable. But now? I am able to learn to deal with emotional and affective issues I have. Something has unlocked in my brain that makes new information actually take hold and stick around.

Welcome to Depressed Academics, Somewhere You Can Talk About It

This post isn't really a welcome to Depressed Academics.  But today Duuras said this in a comment:

"I also have you all. I think about this blog a lot, actually..."

This really means a lot to me.   A lot.

When we started this blog (Mikael and me), the number one thing we wanted was a place for people to talk about depression in their lives.   From day one the slogan for the blog has been "Somewhere you can talk about it".  This comes from what Mikael said in his beautiful post: "I think it is important we talk about these things." I find it beautiful that people I don't know, like Chantal and Duuras, are posting here and finding it of help.  It is somewhere they can talk about it.

This blog has also meant a lot to me.  When I have a bad day like the other day, thinking about how to express it in a blog post is a help to me.

I can never suppress the pang that comes when I love a post that somebody writes here about their pain.  I think so many posts are beautiful, yet they come from pain.  That's one reason that Duuras's comments means a lot to me: if it helps her then I am glad we can help by providing the forum.

And here is maybe the weirdest reason I love Duuras's comment.   I often have imposter syndrome for this blog, since it has helped me enough that I have had many less bad days than before I started it.  So I often feel guilty for not being depressed enough to be here.  If somebody else finds this blog of help, I can worry less about being an imposter.  (If you're reading this and have no idea how I could contort my mind to make myself feel miserable about feeling good,  all I can say is: welcome to my world.)

As an academic I find collaboration beautiful too when it works well. This blog feels like a collaboration.  Technically, I started this blog but I started it because of Mikael's wonderful post. So we started it together.  Who was more important in starting it?  Who cares?  Not me.  Since we started the blog Mikael and I have literally not talked about it.   Emails yes, conversation no.   But it's a real collaboration and a privilege to work with him.   And now a privilege to work with Duuras and Chantal, and the others who have contributed like Greg and Evgenij.

This is a long post about this being somewhere you can talk about it.  If YOU want to talk about it, please collaborate with us.  We can post for you if you send us text, or we can add you as an author so you can post at any time.  You can post as yourself, as anonymous, or under a pseudonym.  We can even make up a pseudonym for you: the next ones off the block are Dean or Erin.

As I said, this post was not really a welcome.  If you want the real welcome, go to our first post on January 13 this year.

http://depressedacademics.blogspot.ie/2013/01/why-depressed-academics.html

Vignette: Oh, what a perfect day ...

Oops, missed out half the title.

Vignette: Oh, what a perfect day ... this should have been but wasn't

Today was a lovely day in Fife.  That's a very rare thing.  Really gorgeous day weather wise.   Lovely to sit outside.  

I didn't have to go to work.  I could work at home and didn't have that much to do. 

The other day I sent a draft paper to a very senior and highly respected colleague and today he said - among other things: "In my opinion everything is said in Thm13, which is sufficiently beautiful in itself :-)"   Yes, I'm boasting a wee bit here, but honestly there isn't much higher praise one could want from a colleague than to have your work described as beautiful. 

I got time to have a nap. It took a while but I found time to have a long run and that helps me physically and I think mentally. 

What a great day.   

Ha ha ha. 

I've been miserable all day.   I can't put my finger on why.   But the symptoms have been lots of negative thoughts (I am the worst person in the world, I want to kill myself), lots of internal or external swearwords at my poor performance in some area, getting more worried or upset than I should about external things that I should not be worrying about.  Just the usual kind of stuff. 

A few days ago my tablets ran out. Escitalopram. I had been slow to get them renewed (which is a trivial operation.)  Generally I have been doing well but not so much today.   But I think the correlation is less important than it sounds, except that failure to do the trivial task that was necessary is a bad sign. At least I went to get them renewed today so will be back on them soon.

Almost the only time I haven't been miserable today is when I was mentally composing this blog post on my run - but unfortunately that only took up a part of my run.

p.s. if you are new here, here's the link to where I explain that I don't want to kill myself even if I say I do to myself.   http://depressedacademics.blogspot.co.uk/2013/02/i-dont-want-to-kill-myself.html

The manic who forgot she was a depressive, too (and more)

I know when I am depressed. It's in my long hair. It gets tangles and knots. Sweat. Dirt. I know when I am hypo/manic. My hair is perfectly brushed several times a day. Combed clean. I don't know what it's like when I am stable. But I do think it's a little bit of both, maybe on the same day or different on different days.

I was stable. There was a time, yes. When I was eating light, doing light exercises, walks in the mountains. Quiet at times and at other times, connections I never imagined could exist. I did not speak the language well, or barely at all without some notes of some sort. I did not have a phone at all. I had limited access to email, but I was researching.

Research is critical to me. Speaking to the PhD choir here, I know. But you see, I start my PhD in August. I am nervous as heck, I will be honest. Will I start and fail? Will I fail before I start?

Anyhow, back to the research. I was researching important issues to me, deeply personal, deeply emotional, one might even say spiritual whatever that means to me. I was in my element. In all senses of the word/world.

I can't tell you what I was researching. For a time, I had no idea what I was researching. This is a semi-joke, all loving of course. But there was consistency in our spontaneous system of research. There was also consistency in my thoughts and actions. All along, I had wanted to document lowering my medications when I returned home. Because in the mind of my heart, I knew there was a little something off. Now, as I mentioned in my last post, I am documenting my madness. It's all the same. To me anyway. Because with medication withdrawal, there comes some withdrawal effects that can be and are dangerous.

Did I experience these withdrawal effects? I can't say for sure. But there was social pressure. To drink. To smoke cigarettes. There was R with his own issues. There was other systems of instability whether I was in the city of 2 or at my original home.

Also: Am I just someone who needs and should be medicated with high dosages of psychotropic medications? 

I do think I need a medication or two for this transition. To achieve my goal: my PhD studies. Even in madness, it was there. But I don't think I need to be ashamed anymore of my emotions. I don't think I need to coat over the symptoms always.

I am grounded, but angry. Angry at a lot of folks. (The whole lot: docs, people, past partners, old friends) Angry at myself for not taking better care of me. For letting it get this far.

But something I learned from f. Forgiveness is possible. And if I can forgive someone, I can most certainly forgive myself. 

The thing for me right now is that I have to listen to me. I have to listen to what's inside. (And outside, too). I have skills that I have learned from years and years of therapy, from friends, from past relationships, from f. I am an adult. I can take care of me. I will take care of me. Depressed, Manic, Schizo, Borderline, whatever name they throw at me next. Because I am a whole.

Now for you all, whatever your diagnosis may be. I have some questions:

1. Do you have identity issues with the medications? (I.E. not knowing who you are or who you could be?)
2. How do you cope with an illness diagnosis? (Note: I am having to relearn everything.)

Those are my two big concerns/questions. I have more. But I will just see what happens.

Thank you so much for reading. I applaud all of you for just coming to this site. Thanks thanks and more thanks.

The process

Note: Hopefully this is not too scattered. I tried writing this out earlier but due to a Klonopin fog, I became confused. Also, the opinions I have about medication usage are mine and mine alone. I respect your views if you respect mine.

May 2013 (yes, I know the month and year, but maybe not the exact date ha)

Victory moods don't last long. It turns to absolute suckage. Sucakge meaning stigma in my own circle of f. I have been documenting my mental health. On recordings. On notes, receipts, folders. I forget you see. I forget everything I say and don't say. Actions too. Not impulsive ones but movements. I've been moving slow. It takes a good deal of time to write this NOT just because of the klonipin.

I am termed "hyper verbal" "hyper observant" YET and there's always a yet, I am not aware. I am confused, scared....  The partial hospital care I am going to now knows I am doing well because:

1. I am high functioning
2. I can spell world backwards (in an amount of time) -- mostly a joke about this being why I am in partial care and NOT a hospital hospital (Note: there is nothing wrong with a hospital, only not for me at this time)
3. I can recite my medications like nobody's business
5. The higher anti anxiety meds help.
6. I am lowering (doctor's orders) my antidepressant--- This causes mania in me. I am coming out again as a manic-depressive. But manic right now.

Anyhow, some other observations/comments/helpful tid bits:

1. I check with my f & f. I ask "Did I just tell you that?"
2.  The partial care program is great. The doctor is fantastic super fabulous. She is lowering my antidepressant-- because I am too hyper/wound up.
3. Pets are great!
4. Art therapy is great except for when they want to stunt my artistic ability (I use to draw dinosaurs in  grade school)-- person might have been surprised by my art, not because it was great or anything but because it had literary references and said I am not schizo on it or something to that affect. I don't know if I have schizo. I do write a lot and in circles. Memory is returning!
5. Alpha-stim has helped me tremendously: with anxiety, depression, mixed states. I have it on all the time because it is safe to do so. Fine motor skills are coming back too. So is relaxation.

May 30, 2013 (I know the date, the Klon-fog has cleared)

I was admitted into a partial hospitalization program last week due to extreme anxiety, social phobia, paranoia and bursts of panic attacks. Ironically, my note on my art piece about not being schizo might not be entirely accurate; I have acquired a new illness apparently......

Schizoaffective bipolar. 

The result of this partial hospitalization was no one's fault. Not mine--though I sometimes believe that. Just a series of unfortunate occurrences. My usual pscyh doctor was not available over the weekend (which one I don't know). So I became worried and scared. I called everyone. And I mean every mental health resource center until I landed at a prestigious center in 2, and it was awful. I mean stressful, intense, nerve-wracking. For the first time in my life, I did not want to be in a hospital. In the past, hospitals were my safe places. But this time, they did not understand when I told them about my hard-to-find veins and my tardive dyskinesia on my left side so of course, I freaked out when they poked and could not find my vein in my left arm. Needless to say, they released me on the condition I would take Klonopin to "kick out" the mania and they upped my mood stabilizer. The one doctor was amazing and very understanding of my concerns about the hospital, too.

I am not against medication. In fact, I think medication can be an effective treatment. But I also think there are other alternatives that we should consider for our mental health care. I will address this when I am less tired.

The last moments of May 2013 & the start of June

There is more to tell, more to share. But I can say this: The depakote increase (back to my original dosage before a trip to Country Y) is hm, interesting. Doc says it will take four days to be back to my stable self since the other meds did not pull through. What I think? Can I have an opinion Expert Doctors?

I think medications are covering up something. Now this could very well be the paranoia. But there is something to memory loss. I am just beginning to figure it out.

The process: therapy. Therapy in every sense of the word. I am trying my hardest to do every possible thing for myself. CBT (with a DBT concentration). Sunshine. Exercise. Nourishing Food. Sleep regulation (no naps). Connecting to self and others (in safe and harmonious ways).

It is past May now. It is a new day. If the etymology of June is correct, if I believe in those signs (which I do and don't) -- then I can say this: I have a chance to be young again. To believe in the possibilities. To be my own version of a goddess.

I do have hope. Thank you so much for reading.

Morose, pessimistic and self-pitying... sorry...

Caveat: this post is longer than I intended it to be and somewhat self-pitying. I'm sorry for this. Will try to be more objective and less emotional next time. If you want to skim-read it, just read the bold, and italic text.

As a science PhD student there are many things that you should do in order to be a successful researcher:

• Read: journal articles and critically evaluate them, textbooks for extra information to aid understanding
• Experiment: design, do repetitively to get reproducible results, analyse and interpret results, explain how they fit into the bigger picture
• Demonstrate in undergraduate labs, mark lab scripts,
• Write: quarterly reports, transfer (or upgrade) report, literature review, thesis chapters, journal articles
• Exchange ideas: attend conferences: attend seminars, present seminars or posters, network, talk to supervisor/other members of research group or dept

I would say that almost all of the above have proved challenging or impossible for me to do at one stage or another. I have put it down to my depression/ low self-esteem. Feel free to disagree.

When I was depressed, I couldn't always concentrate on what I was reading. I often felt stupid and useless, because I didn't know things.

I sometimes found it difficult to do experiments for more than an hour at a time. Couldn't focus, couldn't get motivated, found it difficult to troubleshoot when equipment broke down, gave up far too easily. This didn't mean I was incapable of doing them, but after have many 'issues' I started to lose hope and give up trying. Then came my fear of being seen as lazy. I would hide from other people in the department, so they wouldn't know if I was in or not. This was made easier by the fact I had my own lab room at one point, which was lockable from the inside.

Again thinking ability hindered by feeling stupid and useless. Especially affected my writing. If you have no good results, either because of bad equipment or low motivation, what do you write about? Bad for quarterly reports. Eventually got some results, I could write about, but by this time I'm pessimistic about whether this could continue. But publications in journals are out of the question. It takes all my time and energy to just do the experiments, and work with the results.

Demonstration vetoed by lack of results. Incidentally, I feel I might have been good at this. I've been told by various sources that I can be a good teacher... well we'll never know.

Conferences seemed pointless to attend, when you doubt your results, your ability to talk intelligently, and your ability as a researcher. All those clever people, all seem to know what they're talking about. I seem fuzzy-headed and stupid. Brain full of cotton-wool. Nothing sensible to contribute, just asking silly questions and giving stupid answers. Feelings about wanting to hide resurface. Don't talk to anyone about research, not even friends and family. Forget that I actually enjoy science.

Then: don't talk to anyone about anything, they ask questions. How are you? When will you finish? What will you do afterwards? How is that relevant in the real world? I don't have the answers. I made something up at the time.

Please feel free to tell me I'm just a useless scientist, who should have never tried to get a PhD in the first place. I'm sorry for making you read this far.

Anchoring :)

Something that has really helped the past two to three days:

http://www.dartmouth.edu/~healthed/relax/downloads.html

Anchoring and nourishment from the past are my two favorite right now.

Cheers, and happy resting!

Note: these relaxation "exercises" are for college aged individuals.

Link: High Functioning Depression on Reddit

Just googled for "High Functioning Depression" and three of the top four links were to my posts on Depressed Academics on the topic.  (Though our overlords Google knew it was me searching so maybe they bias the results.)   In a sense this is dispiriting: it would be better if there was lots of great information on the topic instead of these few posts.  

This is the top link: a thread on reddit.  

http://www.reddit.com/r/depression/comments/19e4gh/high_functioning_depression/

Something leapt out at me as a description of what high functioning depression can be like: "for example, I can work hard all day long, write complex documents, provide legal advice etc. then I come home and I am almost crying because I just cant face doing the dishes."

Also while I'm here, it might be worth mentioning the subreddit (if that phrase means something to you) /r/depression.  It comes with a lot of caveats but does seem to be quite active.

The city of 2

I don't want to appear manic, but perhaps it will be apparent. I have not gone to sleep yet. I have officially been up for 23 hours. This might not surprise the well-versed insomniac, but for me, it is different. This is what I did as an undergraduate. This is what I did for my work, my papers, my professors, but really for me. I might have been burnt out most of my MA degree. But that did not seem to stop me. I worry about stopping. For if I stop, what will happen?

The city of 2 is safe. There is no glass on the ground. There is a quiet neighborhood. But I have seen it get wild on occasions. I have seen it dangerous. But, I must say I feel safe tonight/this morning/now. Yet, there is always a yet. I worry about tomorrow/today/now. I must get some sleep. Because if I don't this could mean a hospitalization. This could mean worse. I am not saying the hospital is bad, I am saying it could get worse than being in a hospital. But this is basic stuff, right? Sleep regulation is so critical to a mood disorder.

The thing is I am aware. But how much better is my awareness if I am to be spinning out of control? I have control, but where is it? I have been doing my breathing exercises. Deep breath 1 2 3 exhale 1 2 3. Regular breath 1 2 3 exhale 1 2 3. And so on.

But I can't stop the raciness. The urge for something, anything to fill my spirits. I am not talking about R's voices or sensations or "thoughts" as they particularly like to refer to them as. I am talking about me. About my stability, my essence. My spirits. How can I attain this? It's painful and brings me much ache to not be able to sleep. To wonder if sleep was ever possible. But of course it is, I have done it on so many occasions. Almost every night of this past six months. Why tonight? Why tonight when I need sleep more than anything--can't I sleep?

I am getting angry now. Angry to a mild degree. But I feel it in my heart beat. That this is not the way. I should be asleep. I get self-conscious, and then angry, and then paranoid. It is rather discontenting (for search of a better word).

I don't want to bore you all. I know perhaps a few of you have been here before. Perhaps not. But I feel like crying, but my tear ducts are dry. I am staring at a screen and typing. This is what I am doing. This is what I want to do on a lighter occasion.

For I know when this mood passes, I will be dried up like my tear ducts. I will not be able to cry with my body any longer. I will not be able to laugh so hard I cry. I will be dull. I will be unmotivated. I won't be functioning and I won't be able to write you.

The anger builds up inside of me now. It is probably making my face a hibiscus color-- purplish red? Can that count for a hibiscus color? Yes, I googled it and the answer is yes (according to google)....

The 2 city is breaking morning mist and an almost sunshine. I try too hard with the metaphors, I suppose. Regardless, I am just so desperate to sleep. I want to drive but I have banned myself from my vehicle as well as coffee and any sort of caffeine.

Maybe I will try again. I feel motivated.

Note: I do take low dosages of anti-psychotics as well as an antidepressant. I just thought I should state that for the record. This was prompted by why thank you paranoia. 

How to manage mania in (more than) a heartbeat.

I could introduce myself. But since there really was no beginning to when this all began, I shall start with today. I am hyper. Or as one might say "hypomanic". I have so much to say, so much in my head but I will start slowly. I will try anyway.

I like things-to-do lists because they are simple. Unlike me. Or my perception of what happens to me on a daily basis. I will discuss the unpacking of the language of mental illness at some point. If I don't crash, fall into a state of depression.

I am young, but old. I have had a mental illness for over ten years. Or rather, I was diagnosed at a really young age. Today was difficult though. But not as difficult as it has been or could be, if I let it get out of hand. They say I might have borderline personality disorder or bipolar. I don't know I don't I don't know.

So some observations about today (hypomania):

1.  Clear-headed, careful, cautious.
2. OCD tendencies (I have been washing my hands repeatedly and "checking" things. This is not usual for me and should have been a flag or a warning.
3. Thinking I am okay. "Knowing" that I am okay. Believing it with my whole being. I am okay, right?
4. An absurd amount of positive affirmations (really, it's okay to have affirmations, but when everything is really dang positive, it's hard to see the imbalance)

Some observations about today (mania):

1. Forgetfulness
2. Repetitive talk, circle speech, jumpiness in my conversations (topic to topic)
3. Fine motor skills lacking, difficult, inadequate
4. Mixed states crop up. I am manic one minute, and then balling the next. I feel destructive, I feel wonderful, I feel impulsive, I feel destructive, etc, etc.

Enough with meta-cognition, right? This is what Person X alluded to today, my paraphrase. I am severely aware of almost every thought, action, sensation, feeling and of course other people's thoughts, actions, sensations and feelings. I "know" they were laughing at me. I "know" they want to be my friend. I "know" they were judging me.

Take this as documentation. Of a person with hypomania. But I am to tell you how to manage right? Well, I can't tell you anything for You. I can only tell myself what to do. This is how I survived the day of days.

1. Support system. Whether this is Person X or my other friends. Whether it's family. Or my pet.
2. No caffeine (AT ALL)
3. No other stimulants such as nicotine (this was a challenge and a fail because I am quitting again and had to have a quit aid)

Those were the essentials. When I was bordering on more severe mania today, I had a lot of other ideas (purified water, smiles, hugs). It was so precious.

Take the list for what you will. Modify it, add to it, ignore it. For me though, this was crucial. Especially the support system tid bit. My friends (and family) were keeping up with me.

Achievement: To tell someone you love someone in a fit of joking, but to mean it nevertheless. For them to tell it back and to mean it. That is when you know it's golden.

They did fall asleep eventually. Which means they must have trusted me enough in my own safety. I was difficult. I cried. Well, sobbed actually. Hysteric bursts of crying and alternating laughter. It was a sight, I can only imagine.

So this is how I want to introduce myself. As a half-crazed, fully articulate hypomanic. Whether it's borderline personality disorder or bipolar disorder or both, the symptoms are there. These are real. This is what I am going through. Thanks for reading.

Link: Hyperbole and a Half

I have been reluctant to post this because I assume everybody will have seen it.  But everybody will only see it if everybody cross posts it.  So here goes.

This is remarkable: "Depression Part Two" at Hyperbole and a Half".   Warning: like many links from here you might not find it a comfortable read since it has a lot about the inside of feeling depressed and some discussion of suicidal feelings.

I particularly empathise with the line "I don't necessarily want to kill myself, I just want to become dead somehow."  Though I don't want to kill myself, the thought of not being around can be quite comforting.  That is even though - as now - things are going quite well and I am only rarely miserable.

Celebrity role models for mental health conditions, and their analogous equivalent in academia

An article I read this morning, may be interesting to some people:

http://www.bbc.co.uk/news/blogs-ouch-22514215

Successful people disclosing a mental health condition can highlight its presence, and remove the stigmas associated. But does this raise expectations, both of those suffering, and those that surround them, that they too, can similarly achieve? And is this a bad thing or good thing?

I guess it's all about managing those expectations. Not everyone can be a Catherine Zeta Jones or Stephen Fry. Comparing this to academia, the role models for me, when I started my PhD were the professors, readers, senior lecturers, anyone in fact with a permanent position. They seemed to be in a different league, and somehow unapproachable. At a conference I attended (just to help out, not to present anything) I remember being starstruck, when I got to put faces to the names I had seen published. I remember having to use alcohol, just to start talking to some of these people, and making a fool of myself in the process.

Would they have seemed more approachable if they had disclosed a mental health condition too? Would their achievements have seemed more attainable? Would that have made me feel less useless about all the difficulties I was having at the time?

At the same time not everyone can get a permanent position in academia. There are so many PhD students for every professorial position. So where does that leave the depressed PhD student, with no role models and low expectations, and useless results?

Adjusting medication routines

My psychiatrist suggested I try changing my routines to deal with the drowsiness I get from combining Fluoxetin and Wellbutrin. Thus, since Thursday I have been taking Wellbutrin in the morning and Fluoxetin in the evening instead of both in the morning.

And as of yesterday, my brain chemistry is hitting back against the change in routine.

Yesterday and today both I have during early evening gone through approximately the same progression. I lose focus on the things I am involved in and grow detached. After a little bit the detachment grows into boredom and then into inexplicable sadness. After some time, or with sufficient distraction, it dies down again; but a return back to daily sadness bouts is not something I welcome particularly.

As for now, I'm going to assume it's a result of changing my medication routines. If this continues beyond a week or so, I'll get in touch with my psychiatrist.

Triggers and solutions?

I've said before that I was diagnosed with depression two years into my PhD studies (2006). Since then, I would have to say I've made a huge recovery. I've gone from not functioning on any level, to functioning on a 'normal' level for about 3 days a week. Right now, I probably wouldn't describe myself as even having depression.

However, I still have 'down' days. For a long time, they would take me by surprise; why is it I could feel ok and functioning at one point, and then, a few hours or few days later, feel completely depressed, and wish to hide away? Why would this happen every few days? Would I ever be able to hold down a full-time job? Or would it always be like this? Up for a few days, down for a few days, never stable, never consistent.

Recently, I've started to make some un-scientific observations: 

my negative thinking patterns get worse when I feel tired... 

Or could it be that having negative thoughts/feelings make me tired?

Not sure what the solution is. 

I've tried doing less (went to part-time registration for the PhD), but then felt useless for not achieving much, or taking so long. 

I've recently tried doing much more (taking on additional volunteering, study and tutoring), to give negative thoughts less air-time, but then have to crash at some point, and feel useless on the days that follow instead. Committing to lots of things makes me more edgy and restless: I worry more about delivering perfection, and I sleep badly because I'm worrying.

Two things that seem to help: 

1) I'm living in the moment a bit more (not always easy), and appreciating simple things like a cup of tea and chocolate biscuits... Today that's my favourite thing.

2) I'm doing more things which play to my strengths which helps. Just for the record, writing a thesis is not one of them. 

Any thoughts?

And every so often, an off day

Yesterday my brother-in-law got married.

Yesterday was also and unrelatedly one of the first bad days in at least a week or two.

Yesterday, families came together and celebrated. Got to know each other. Pleasant times all around.

Yesterday, I could find no joy in anything. I could not mobilize myself. I'd follow along and obey instructions, but doddered around fumbling at tasks when I try to start them myself.

I didn't feel much anxiety, but I didn't feel much joy, or interest, or energy for anything. Eventually S suggested my functionality might improve from my anti-anxiety pills.

Like a flash, the pervasive, crippling sadness vanished. And as the families gathered and the ceremony took place, I was able to be pleasant, have fun, and be involved in conversations and activities.

Yesterday was a great day.

Yesterday was a ghastly day.

Yesterday was an off day.

The Secret Life of the Manic Depressive (BBC 4)

Stephen Fry produced a 2h documentary miniseries for BBC 4 exploring with his own bipolar disorder by talking about his own experiences, and talking with friends, experts, fellow sufferers and relatives about bipolar disorder.

Part 1: http://www.youtube.com/watch?v=y8SVQDKIt3s
Part 2: http://www.youtube.com/watch?v=WeKIm2dUb94

Overdone it?

Past few weeks have been busy... Probably you could say the past few months. Since I submitted the final version of 'that book' around the end of February, I have spent a week abroad visiting a friend, a week visiting my parents, a week on holiday with my partner, taught 14 hours of tutorials, spent an additional 10 days with my parents, while preparing said tutorials, and studying bookkeeping, not to mention doing the odd volunteering hours and applying for jobs, that no-one wants to give me, or even reply or give reasons for their rejection.

Forgive me, if I sound a bit overly dramatic and bitter. I'm not. Just tired. And when tired, I find it very difficult to control my emotions, put on that happy face and pretend I'm ok. I like to retreat into myself, and not face the world... Today is a bit like that. The sun is shining, and I do actually have a lovely treat for today: discussing some educational activities over tea and cake with some volunteer friends. But it's a slow start. And I have to get going, to make it happen. And right now I'm stuck in bed, and want to sleep.

I have overdone it. Tomorrow is also busy with tasks I have been putting off. The weekends also now seem busy, as I try to catch up with the tasks I scheduled in this week, and haven't done. If I don't do them, I start feeling guilty... another trigger on that downward spiral.

Enough rattling on... I'm sorry to have spouted... I'm now going to be late.. It's volunteering, it shouldn't matter, and yet that 'g' word creeps in...

Introducing myself and my depression

I'm a just-finished, soon-to-be graduated, PhD-er in an interdisciplinary science subject. I feel that my depression had a very significant effect on my academic career as it crept up on me relatively soon after the start of my PhD. I'm not even sure a career in academia is possible now. I hope that by being a regular contributor to this blog, I might come to terms with this, or find a solution into breaking in somehow. I still  really enjoy my subject and enjoy thinking about it.

I'm currently looking for a permanent non-academic job but this is proving tough. As my research area was interdisciplinary I'm a jack-of-three-trades and master-of-none. Also, I think any potential non-academic employer sees the PhD qualification on the CV and tends to run a mile in the opposite direction. To fill time I do private tutoring and volunteer at a local museum, as well studying bookkeeping to expand my potential skill-set.

I started my PhD studies way back in October 2004 at a different institution to the one I had done my undergraduate degree, eager to work and study hard, make a good impression and make the most of what lief had to offer me. Two years in, I had lost the will to continue, not just with the PhD, but with any aspect of life. I remember sitting in the car with my partner of 7 months, parked outside of the department. I remember resolutely refusing to go into the building. I remember feeling this hopelessness about life, and wanting to give up. I remember feeling like I'd had enough. That was my breaking point.

Vignette: I think I am getting a baseline…

You know the saying about how when a noise suddenly stops is the first time you can perceive how loud it was?

That.

I have been now on a combination of fluoxetin and voxra/wellbutrin for about 2 months. And I realize thinking back on the recent weeks that I have been feeling… normal. Or at least what I imagine normal might be like.

Gone is the constant work trying to figure out whether there were any subtexts I should have picked up on.
Gone is the constant worry someone, somewhere might not like me and what I do as much as I hope they do.
Gone is the constant conviction that nobody, nowhere, actually likes me particularly much.

I feel now that what I observe is far more in harmony with how I represent it internally. People's emotional states match up better with what I think that they are.

Facebook argument

Today I had a perfectly friendly argument on facebook.   I posted something, a couple of friends disagreed, I argued, that's about it.   I found it engaging, it was perfectly good humoured, nobody was rude or offensive to me.   But in the end I found it a bit depressing.

My facebook usage used to be have a lot of  posts with complaints about things, most often things that annoyed me in the news.   A few months ago I made a conscious effort to be a bit more positive, not bothering to post the negative things and being more likely to post more positive ones.   I don't honestly know if it has helped me, except it's nice sometimes to spread good news when I would not previously have bothered.

This is nothing to this story.  Nobody was mean to me and I hope I wasn't mean to them.   But I found it a bit depressing.

Link: The Elephant in the Room: The Stigma Around Mental Health

The Elephant in the Room: The Stigma Around Mental Health is an excellent article by a young student at Huffington Post Students UK.  

This post happens to be by a relative of a friend of mine, but that's just how it came to my attention on facebook.  It focusses on the difficulties of being diagnosed with depression as a young person, both medical and family.  

One of the points she picks up on is the problems caused by the multiple meanings of the word depressed, which I've also blogged about.  At least on this blog, I try to use a word like "dispiriting" instead of "depressing" if I mean the non-medical type of depressing: e.g. "Getting a paper rejected is dispiriting."

In site news, there's not been a lot of posts recently. I can't speak for Mikael but for me that's generally a good sign. I haven't been feeling depressed but also have had a cough which has slowed me down.  The good side of the cough is that I have had a lot of seriously serious naps.  Yesterday my naps were an hour, 20 minutes, and two hours.  Lovely.

It's Ok Not To Be Ok

The ever wonderful Keelium pointed out this post by Miri on facebook, saying 

"Seriously good shit. Read immediately. As someone who has spent the same decade (14 to 24 for me though) learning from depression, I'm with Miri 100%."

Miri talks about making life decisions - including not doing a PhD - based in part on how it will affect her depression.  She makes the excellent point that if somebody has bad knees, nobody criticises them for not running a marathon.  The same should apply if your mental health precludes certain areas of activity.

image credit: Miri

Vignette: Just what I needed

Of course. This is exactly what I needed today. An anxiety attack out of the blue to really drive home the message that just because I get (quite a lot of) good days from my new meds doesn't mean everything is already solved.

I have a lot of deadlines right now. Two job applications, one 400k€ grant application and one major conference paper deadline with a submission video I'll be rendering and editing myself.

All in the span of about 8-10 days.

So I feel a large pressure to focus. To actually get all these things done. Which in turn means I react without much grace to being forced to focus. Today I got about 30 minutes worth of work done. All day. Last day to prep before I get access to the video editing suites tomorrow.

And the pressure to focus means I paralyze. Freeze up. Don't get anything done anymore.
And the paralysis means I start fretting and eventually freaking out about my productivity in the face of these external pressures.

I was doing remarkably well before. Today I'm not even able to cook dinner, and the thought of having to be involved in cooking and cleaning up after had me panicking.