Subluxation of Reality

I keep being swallowed, or I suppose, more accurately, I keep unemerging from the swallow.

I have nothing to say except to say that I have said it. I have said how little I care about life, I have said how I don't want to leave the apartment, I have said how tortured I feel, I have said how much I want to cut. It's all the same. Depressions have seemingly innumerable symptoms but after more than a decade I suppose it all becomes just reruns.

I look at my life and I really don't understand it, don't identify with it. I can't image what possessed me, what drove me, what allowed me to accomplish all the skydives, all the paraglides, all the travel. or even clean my apartment. I don't understand my life. I don't get how it happened. How I did it. I can't really believe I ever left my apartment. Or my bed.

People tell me that I get better. That I cycle. That I have been better, and that I will again. I suppose it's the only thing that explains the facts. I must have been better at some point. That has to have been true. The evidence requires it.

It's just that I don't believe it, I don't feel it, and I don't know how to do it again. It all feels like a lie I told. A story I fabricated. And not very believably either. Inconsistent imaginings. Delusional rantings. As realistic as claiming I can fly.

I've been thinking about delusion and psychosis. These are basically states where your belief is so contrary to reality to be damaging. People in these states see the same world around them as everyone else, and yet they are incapable of interpreting it in the same way. It makes sense to them, but only to them. And often they are very troubled by their interpretations and beliefs. Maybe it's because no one else can see life the way they do, maybe it's just because what they see is so disturbing, I don't know, but they do tend to be troubled.

Like me.

My beliefs tend to be contrary to reality. I read everything as black. I read everyone as hateful. Stimuli makes me sad. It makes other people laugh, it makes other people smile, it makes other people swear, but it all just makes me sad. I can't get to the place where everyone else is. I can't see what they see. I can't react how they do. And of course it is damaging. It is tormenting beyond belief to see what I know isn't there, to see what I know others don't.

And it only makes sense to me. How I think that people no longer love me when they leave the room, how I know that everyone sees me as an infection, how I think that everything I do proves more and more how valueless I am and how no one will ever want to wake up next to me. Other people don't understand how I come to these conclusions after failing to gracefully parallel park, or not completing a desired blog post. But I do. My brain does. My brain seems to think the links are there, even if no one else does.

And troubling. Yes, troubling. There isn't a word big enough to say how troubling my flawed, contrary, and illogical thoughts are. The thoughts rip through my flesh leaving jagged maws and I can't seem to stop them or even slow them down.

Psychotic. I don't match the clinical definition, no doubt about that, but seems like a loss of contact with reality. Reality confusion. Reality sublimation. Reality dislocation.

Caffeine and Crazy

Caffeine is the world's most popular psychoactive substance. So many of us love it a la Starbucks, Tim Hortons, or just out or our home coffee machine. Me, I love the stuff. It's the nectar of the gods, and nothing will convince me otherwise.

It seems though, that caffeine can actually hurt you. I know, I never thought my beloved coffee could harm me, but I suppose anything that you abuse, will abuse you back. So, here is everything you ever needed to know about caffeine but were afraid to ask:

Caffeine Psychiatric Disorders

There are four recognized caffeine disorders in the DSM-IV: caffeine intoxication, caffeine-induced anxiety disorder, caffeine-induced sleep disorder, and caffeine-related disorder NOS (not otherwise specified).

These disorders are pretty much just like they sound, they include symptoms like restlessness, nervousness, insomnia, anxiety, and tachycardia, they produce significant harm, and they are not explained by another disorder. There is no surprise here. These disorders tend to appear in people consuming large amounts of caffeine. "Large" varies by person, but is generally at least 6 cups of coffee per day (many times much, much more).

These disorders aren't very interesting to me, I'm mostly interested in how caffeine impacts other disorders. (Oh, and yes, it is possible to die from an overdose but you'd really have to work at it.)

Caffeine and Depression

This is a bit of a contentious subject. There seems to be large numbers of people online claiming that caffeine can severely impact depression, but they say this without any real supporting data. I have yet to find a reputable study that show a significant causal link.

However, that being said, caffeine is thought to be an adenosine receptor antagonist (stay with me) which likely indirectly increases norepinephrine, dopamine, and serotonin activity. These are the same neurotransmitters that many antidepressants target. This might explain why some studies actually find that caffeine improves mood:

These benefits seem to be related to adaptation of mental energy to the context by increasing alertness, attention, and cognitive function...and by elevating mood. Accordingly, moderate caffeine intake

No, I'm not suggesting you try using coffee as an antidepressant.

Caffeine and Anxiety

This is the one real bad news part of the story. Basically if you're suffering from anxiety, caffeine will make you feel worse. People who don't normally feel anxious generally do not report anxiety from the effects of caffeine, but those with anxiety disorders do.

Patients with panic disorder and performance social anxiety disorder seem to be particularly sensitive to the anxiogenic effects of caffeine...

Interestingly, the same study states that people with OCD, which is part of the anxiety disorder spectrum, actually can benefit from caffeine intake. It's really all very confusing.

It's also worth noting that if you're anxious and intaking caffeine, benzodiazapines (like Valium) don't work as well, so the anxiety created by caffeine can't even really be treated. You have just get off the caffeine. Sorry.

Caffeine, Psychosis, and Antipsychotics

Very large amounts of caffeine have been known to destabilize bipolars, and schizophrenics, inducing mania or psychotic episodes. This isn't terribly prevalent but is known to occur.

Caffeine is also known to interfere with some antipsychotic medication, generally first generation antipsychotics, specifically clozapine. Antipsychotic dosage has to be increased to account for this interference.

This interference isn't present in second-generation antipsychotics but caffeine can increase the blood level of these drugs which can increase side-effects.

No matter what, if you're on an antipsychotic and like your coffee/tea/pop, make sure your doctor knows about it.

Caffeine and Suicide

There is an interesting link between increased caffeine and nicotine intake with suicide. This is not a causal link (caffeine and nicotine do not cause suicide) but there is a correlational link. It seems that if you see someone injesting large amounts of caffeine and nicotine this is warning signal for suicide. 1 2 This was found in both bipolars and schizophrenics.

In Short

Basically, unless you're already anxious, caffeine is just fine for you in moderation. There is even evidence to suggest it helps with certain tasks. So I say, ignore the freaked-out internet people and enjoy a morning latte. I do.

Gobble Gobble

I never do anything. I don't go anywhere, I don't see anyone, I don't do anything. Yeah, sure, there are classes and work and writing and homework and occasional sex, but really, nothing. There are lots of reasons for this, of course, but there's really only one that matters: I don't want to do anything. I don't want, anything. I have no want, at all.

A sweet guy that I know called me this morning and invited me to dinner with him and his wife. We're having turkey. He invited me because I like turkey. It's sweet of him.

I don't want to go. I don't want. I'd rather just sit here. Watch TV. Wait for death.

I complain about being alone. I complain about being lonely. And yet I still don't want. To do anything. That might help. Because I don't want. Because everything, the problems and the solutions, feels wrong. Everything garners an absence. My own entropy seems to swallow me whole. All those parts of people that makes them get up and do things are missing. Nothing is worth it. Nothing seems worth anything. I suppose because I know that nothing will help. Nothing will make me feel better. Nothing will make me feel good.

And it's the same whenever I think about leaving the house. There's nothing out there, that's going to mean anything, that's going to do anything, that's going to help anything. Go to dinner. Talk to friends. Bat false laughter, smiles, and jokes. Make them believe. That I'm doing well. What else is there, but to lie?

So I'm lonely, but I don't want to be around people. How nice. How stupid. How illogical. How circular. It's what happens when you have no want, I suppose. It's what happens when there only problems without solutions. It's what happens when you don't respond to a situation like everyone else does. It's what happens when your brain is this fucked up.

So I guess I'll go, and see the happy couple, and eat the not-so-happy turkey. Because that's what I'm supposed to do. Because that's what humans are supposed to do. Because that's what you do when you're lonely. Because that's what you feel not to be lonely. Because that the solution to the problem. True, it won't work. True, I won't like it. True, I won't care. But it seems the motions are required anyway. To approximate want. To approximate life.

It Was Good To See You

I think that naked flesh should always be pressed and intertwined with mine. Your chest against my breasts, your thigh grinding my pelvis, your hands pressing weight into my arms. I feel completely encased. Wrapped. Cocooned. Protected I suppose. I'm not sure how your body fits mine, quite that well.

I look up to your shoulder and your back. Your head is down breathing heat onto my neck. I see tanned skin accented with tattooed lines stretched on top of strength. I think how beautiful you look at how perfect the view is. I want to tell you that you're beautiful but my searing hunger and screams take up all the space in the room.

And the purple, the blue, the pink, and the red pain pinpoints my focus. I forget for a moment how much I hate being alive and just feel where the lump is forming on my thigh. Teethmark takeaway.

It was good to see you. Come again.

Why Doesn't Someone Just Love Me Already?

I'm lonely. (Yes, I know I keep saying it, but it keeps being true.) And I'm alone. Both these statements have been true for most of my life. It's pathetic, yes, and true.

But honestly, I'm an OK person. I'm not great, I'm not superwoman, I leap buildings in more like three or four bounds, but still, I'm OK. I'm kind and giving and generous and intelligent and creative and great in bed. Not such a bad person really. In spite of all the other obvious faults.

But still, I am alone. Still, the other humans shun me. Still, I tend to beat myself up about it.

And I sometimes fantasize about what it would be like to have someone special in my life. I think about why it would be great. Why it is I want it. I think about lazy mornings in bed taking turns between having sex, drinking coffee, and just lazily talking. I think about having someone to call when I'm having a bad day and having them give me a hug. I think about someone surprising me at my door because they have been thinking about me all day and are happy to see me. I think about planning special dinners, or weekends away just to see the smile on their face when I tell them about it. I think about romance. I think about passion. I think about garment-rending, blood-dripping, uncontrollably screamy sex.

Yes, I think about this relationship that doesn't exist.

And then I remember something. I remember something sneaky, and key, and cruel. I remember that I can't be happy. I remember that all of the above sounds like a nice idea, or like a pleasant dream, but would likely be wasted on a person like me. The reality would really be more along the line of tear drenched mornings, and phone calls, and weekends. Dinners I'll be too tired to make. And a person that grows very weary of seeing me.

I know that the reason that people want things in life is because they have the impression that those things will make them happy. If they didn't, they wouldn't want them. Some idiotic, illogical, unlearning part of me thinks that having a relationship will make me happy. That emulating the behaviors of others around me, or books, or TV will somehow make me feel like those people. If they're happy, I'll be happy. Monkey see, sick-little-bipolar-monkey do. (A rare type, that last monkey.)

But tragically I know, deep down inside, that it won't make me happy. Nothing will. Not friends, not lovers, not chocolate cake. Nope. Nothing. I'm not wired that way. I would feel empty. And sad. And maybe even worse with the realization that I would finally have thing magic that I had longed for only to find out that it does absolutely nothing for me.

And it honestly is tragic. The reality is tragic. The knowledge is tragic.

It's just another dimension of the torture. It's just another way in which the disease is unfair. It's just another example of how my own life is out of my control. Another example of why I'm not like everyone else. And it makes me sad. It hurts my heart and it wounds my soul knowing there's nothing left to want. No reason left to want. Yes, I wish it were, different.

But if I could, I would want to be happy. I would give up love for happy. I would give up beauty for happy. I would give up building bounding for happy. It's an unfair thing to ask a human to do, to make those kinds of trade-offs, but I would do it, for the happy. If I could. If only I could.

Do You Love Someone?

In just a few short hours it will be Valentine's Day. Hope you have lots of chocolate on hand: if you have an other you'll need it, and if you don't, you'll need it.

I haven't had an other in...um...well 6 years? Maybe more. Not sure. A lot. Like, a lot. What can I tell you? I'm not very likable.

Today someone asked me what I was doing for said day and I told them I might contemplate how no one loves me and no one ever would. They laughed. Yes, it's terribly funny.

Sigh.

Of course many people are alone today. Hi. How are you? Don't worry, you won't be alone for 6 years running. You're not me. Promise.

And the funny thing about it is that people who actually do have someone often rile against the idea saying it was invented by a greeting card company. This is maybe true, but not really the point.

Nope, I would say that Feb. 14 is a reminder, or perhaps simply an excuse, to tell someone that you love them. You don't have to buy a card or flowers, or even chocolate if you don't want. Just tell someone they matter to you. Make them smile. I can't tell you how much I would give to have someone do that for me.

Shocked Therapy

Electroshock therapy is barbaric. It just is. Running electricity through a person's brain, inducing seizure, not knowing what it will do is absolutely horrific.

The problem is, it often works.

In fact it works not just often, but it works more often then any other treatment for intractable depression. That's right, shock therapy (electroconvulsive therapy, ECT) works better than any antidepressant available. Barbarism sometimes pays off.

Now, it's true, I have undergone an index series of ECT and failed dramatically. And I rather hated it. Every minute of it. And I don't care what the experts say, it did cause cognitive dysfunction for weeks, and I still can't remember much of what happens the month around the treatment. It causes brain damage. Of course it does. You're running electricity through you. You're inducing a seizure. In any other case these things would be avoided.

However, now, months later, I can say that me, and my brain are back to normal. Yes, there's a piece of time missing, but I don't really have a desire to remember the moments around the treatment anyway. And I can also say that while the treatment itself is awful, the health care workers that provided the treatment were actually quite amazing. They were much nicer than almost all the other health care professionals I have met in the last decade. They treated me very well. And they took my concerns, and my health seriously, allowing me to cease treatment when I wanted and not pressuring me into increasing the treatment.

Online there is a pretty heated debate around this treatment. Some people are viciously against it while others feel is a viable treatment that can prevent further suffering for people.

I, myself, land in the middle, as I tend to do on such things. As I've said, it's barbaric, but as I've also said, it works. Like any treatment it's an individual choice. The risks and rewards have to be weighed by each person. People need to think rationally about this as an option, and not automatically dismiss or embrace it.

And while I'm at it, I'd like to say, very loudly, and very strongly, that no person, no matter what their experience, has the right to tell others what treatment they should or should not be getting. Yes, we all have opinions, but unless you're the person that is ill, or their treating physician, you do not know the details and you have no right to make a judgment. One treatment is never "good" or "bad" for all people. Try to maintain perspective. Your opinion is just that, an opinion. Chill.

Tricks and Treats

I love to look at my writing, all printed out in front of me. I know its masturbatory, but I fondle the pages, admire the layout, and covet the words. Creating them is a magic trick for which not even I know the secret.

I'm doing writing for school. Stories and personal essays. Children are dying, I'm getting kinky with canvas and all is right with the world. So far my desire to be inspired to write of new subjects in school has been realized. They have given me topics and I have written. Even fiction, which is harder and less known to me.

Fiction seems to hold secrets that I don't understand. When we look at fiction in class every word seems to have a double-meaning and every scene seems to mean something it doesn't. And the brilliance. Sometimes I see it and am dazzled by it, wondering if I could ever broach it, and sometimes I miss it entirely and wonder why anyone bothered wasting the paper on it at all. I think I don't get it. The secrets of the stories people tell.

But that's OK. I'm OK with just pondering. Just thinking. Just focusing on writing. Just watching the words roll around on the page. That's enough for me. That's joy for me. Well, if I could feel joy, of course, that is.

And while I haven't seen yet any brilliance from the instructors I do get inspired here and there by an idea, a quote, or a concept. Show don't tell. Don't tell the reader what a person is thinking, show them. Don't tell the reader how to react, show them. Obvious and basic, to be sure, but sometimes being so concise is inspiring.

I write in a way that is instinctual. I don't practice or outline or plan. I just sit down and write. And write and write. And somehow some things just seem "right" while others seem "wrong". That's how I decide what goes where. It isn't theory or rules or guidance or texts. It's just instinct. I have no idea how it works any more than I know why my cat insists on drinking water from the tap making his head constantly wet. Instinct is a mystery.

But still. Instinct is only so good. Instinct goes only so far. At some point I've found myself void of ideas. Devoid of the desire. Devoid of the instinct to write. And all these people around me. These "writerlings" as a friend of mine said, give me new ideas and new reasons to write. And even textbooks, as trite as they are, contain ideas with possible spawn. It's good for me. It's good for my brain.

None of it makes me feel better, and school generally stresses me out, but still I think it's worthwhile being here. A writer writes. And so that is what I'm here to do.