Intellectual existence

[alasdayr]

I have been living the treadmill for a while now.  I have a nice house, a stable job, a faithful wife that cares about me and our family and an adult daughter.

Following a bout of major depression, I have anhedonia (avolition, but no anergia).  I have energy to get things done that I see need doing.

Nothing makes me feel good more than momentarily.
Most pleasurable activities make me crave discomfort (or worse).
My mood is generally flat and I do not feel much in the way of emotion (happy, sad, angry, jealous, etc..).
I have nothing I want to achieve.
I have nothing that I want to do.
I have nowhere I want to go.
I have no people I want to meet.
Helping others does not make me feel good.
Achieving things seems hollow.
I have no fear of dying.
I have no fear of pain (also a very high pain tolerance).
About most things I truly do not care.

I have an entire alphabet of mental health conditions diagnosis (ASD, CPTSD, OCD, BPD, MDD, PDD).  I have had another alphabet worth of treatment (CBT, DBT, EMDR, ACT, Schema, TMS).  Some are still ongoing.

I have an upbringing of care for family and self sacrifice.  I take care of myself so I can do things for family so they remain comfortable.  Its all done by rote.  I have been taught/trained over my treatments not to self harm.  I often think about it...  These thoughts do not worry or disturb me.  I keep busy so I don't dwell on them.  My family wants and needs me.

I have been in constant mental health care over the past 4 years.  I have been in hospital numerous times.  I have been on (and am now off) antidepressants.  I regularly see psychologists and a psychiatrist.  I will ask my psychiatrist for another round of TMS next time we meet.

I have a lot to be thankful for.  I have more than a lot of people.  I am in good physical health.  I seem to avoid misfortune.
I don't feel worthy of my good fortune.



Is this as good as it gets?
 

[alasdayr]

Thank you again for your response.

Discomfort for me (apart from a lexical way of not triggering the auto-moderation within this forum) provides both sensation over the numbness and a sense of relief.  When I turn the shower from warm to cold (stop the hot water entirely), my body literally relaxes into it as the chill sets in.  I stop before I start to shiver, but even after the water is off I wipe down the shower before drying off to let the cold water continue to cool me.  It's a feeling that has become familiar and is associated with progress towards some kind of goal.

When I see myself in the mirror, I cannot but help see all the places I seem (to me) to need improvement.  To me it looks (and feels) like excess weight.  I know it's wrong.  I know it's my brain playing tricks on me.  It's almost like a form of hallucination.  I just cannot seem to correct it.  As such, the problem solving and obsessive parts of my mind work of solving the issues they perceive.  With stomach emptiness and the sensations associated with losing weight being a discomfort, they feel like progress and relief to me.

Just this morning (5:15am) I had a leg cramp in my left calf muscle.  It woke me and I put my hand over the muscle and felt the knot.  The pain felt welcoming.  After a couple minutes the muscle released, normal blood flow returned and the pain subsided.  I did not even wake my wife who was sleeping peacefully next to me (no sudden movements, no crying out, no sound at all).  I did have to spend additional time this morning stretching the muscle out as it had not fully recovered by the time I usually get up. 

I have found nothing that "soothes" me as much as discomfort.  To add insult to injury, the underlying thought process seems to be along the lines of "I deserve what I get".  I know my family, friends and work don't think that about me for those situations.  I very much feel the same way as you when you mentioned "But in my heart I don't truly believe what they say".  Like you, I think its a a side-effect of developed beliefs.  I do think that if I can somehow change these beliefs, then the feelings from, and the craving for, discomfort will fade and more gentle, body friendly, things will "soothe".

I will be making an appointment with the doctor this week to discuss the information sent through by my psychologist.  Hopefully this may pave the way for a more affordable way to access to the professional help I know now that need (at the frequency I need it).

I'm still looking for hope.  Still trusting in my commitment to family to keep me from doing anything limiting.

Alasdayr

[alasdayr]

Just a quick update.

Appointment with GP this week did not really go as planned.  They know very little about cause a treatment of eating disorders.  I wonder if they have ever had a patient that has had one.

Their first response was to ask if I would take an antipsychotic medication with a known weight gain side effect (that also causes drowsiness).  However, I am fearful of addiction, fearful of gaining weight, my work relies on alertness and my hobbies rely on alertness.  There was no way I was going to agree to medication; especially not that one.  (My doctors initial reaction to my refusal was "Well then I can't help you").

I directed them to look at information from Eating Disorders Victoria and look into the Medicare requirements for an Eating Disorder Plan (EDP).  Follow up on this is scheduled for Tuesday.

All information I can find online about those that recover from an eating disorder, true recovery revolves around discovering a reason to want to live.  Something that makes them happy.  Something to look forward to.  When I had eating disorder issues in my 20's it was meeting my now wife that pulled me mentally out of that downward spiral.  Physical recovery started to happen once I believed I had a future.  I think I have slipped back into that ED state because I cannot see a future and most other forms of self deprecation have been closed off from me.

The first rule to solving any problem is to understand that problem as fully as possible.  I think I understand my problem.  I just cannot yet see a path to a solution.  For my family's sake I MUST continue to try.

It's only been 2 weeks since finishing my previous round of TMS.  I am still feeling some emotion.  I'm trying to hold on to that as much as I can and not suppress uncomfortable feelings.  No real pleasant feelings yet though.  I'll keep looking for them.

I re-read my initial post on this thread from February.  I'm not sure I have made much progress, if any, since then.  Not much seems to have changed except now the ED and I'm 16kg lighter.  I'm still here.  Maybe I should view that as progress.

 Alasdayr.

[smallwolf]

With what happened with your GP.... that would be majorly frustrating. And what level of experience they have with people like yourself? From your post, I can see how you would question it.

I won't go into any detail here except to say that I had suggested to my daughter to speak with my GP about a mental health plan. One of my reasons here was they have plenty of years of dealing with me and know the GP has the knowledge. 

Sometimes I feel that you have to find the specialist with the necessary knowledge to help or assist you. Well, having said that, that is also what my GP does... once something has been worked out, without be rude, will farm me off (refer) to someone else with that knowledge. And the best part is they share information about me. 

Last comment, and on making progress or not ... beginning of this week, I had an appointment with my psychiatrist, and one of the things I said to her was that when things are so ingrained, it is hard to change the way how you see things. Just one day at a time, chipping away at the rocks that make up that mountain. Each pebble moved is progress.

[alasdayr]

smallwolf, sorry I did not see your Tuesday reply till today.

Update on GP and eating disorder plan.  My GP's clinic got their act together by the Tuesday appointment and plan is now in place.  I was able to make an appointment with dietician and psychologist.  I will likely change my primary GP to another GP in the clinic (the one that got things moving).  At least then they will have access to my current GP and all my records.

I dread to think how someone with my issues, but without my willpower to keep pushing would cope.  I know I could not have done this 2 years ago when on anti-depressants with suppressed awareness (could not push or assert myself then).

My wife came with me to the dietician appointment, as she is the main one who prepares meals in the household.  Dietician appointment went well.  The main focus is getting me eating enough to stop losing weight.  My nutrition is passable, just not enough kilojoules per day.  I am currently at my lightest weight since age 20.

Psychologist appointment set a broad plan for future sessions.  Still focusing a lot on on schema and why I feel the need for self punishment.  Also my psychologist highlighted that by denying others that care about me, that I also care for, the ability to care for me I am likely causing them distress.  I have spent an entire lifetime working to not need anyone's help that I when I really do need help (like now) it's hard to lower my defenses long enough to allow anyone to help.  That realization hit me very hard.

I feel I have a good grasp of what my largest problems to work on are (how and why they developed).  Knowing what I need to work on them is only the first part of the solution.  Doing the work, that will likely be the hardest thing I have ever attempted.  It currently seems overwhelming.

Still feeling like I'm at square one, but at least now with the first part of a map.

Enough for tonight.  Thank you for listening.

Alasdayr

[smallwolf]

When there is no-one around to punish you... you do it to yourself?

As you get better at things with age, the perfection bar goes higher?

The higher the bar, the greater the punishment?

In my youth... statements about how bad, useless, stupid etc. can all have an effect on you over time. So that when you, say, move away from home ...

But enough on the negative... it sounds positive that you worked this out

"I feel I have a good grasp of what my largest problems to work on are (how and why they developed)"

... to me, this is the half the battle. That you are willing to put in the work and continuing to do this shows a persistence and courage you will get there. And this is the first part of the map, maybe you are arrived at a new zone in an MMO. If this is the start of the game with the map, then perhaps the start of the hero journey? (I hope you know what this refers to)

[alasdayr]

smallwolf,

"When there is no-one around to punish you... you do it to yourself?" - Yes.  In my twisted psyche, mistakes mean punishment, punishment deters future mistakes, therefore punishment equates to progress and progress is good.  By this bizarre logic, punishment becomes both good and soothing for me (as it means I am expecting future improvement).

"As you get better at things with age, the perfection bar goes higher?" - Also yes.  Another twist of the psyche is along the lines of "A better tomorrow relies on exceeding the standards of today."

"The higher the bar, the greater the punishment?" - This one, not necessarily.  Only if previous corrections have not been sufficient or effective would escalation be required.  Unfortunately as methods of harsh/soothing corrections have been blocked or deterred, new ones (or previously abandoned, non-blocked, ones) have taken their place.

The challenge, for me, now that I know that my brain uses this cycle is to actively find a way to break it.  Two parts need to come into play.  Neither are easy.

First is to become content with "good enough" so that mistakes are tolerated and correction (self-punishment) no longer feels necessary.

Second is to find an alternate way of soothing when an expected standard is not met.  A way that does not involve punishment or discomfort.

I understand the reference to the hero's journey.  I feel anything but a hero at the moment (pre-threshold).  I acknowledge that I need to walk my path, but as I am now, I am almost certain I am not strong enough to walk it alone.

I know now that I need to accept help, even though my entire upbringing has been steered towards building capability to do everything without assistance.  Feeling helpless and vulnerable, to me, signals extreme danger.  When growing up, these dangers were very real.  My immediate responses are to fawn, flee, freeze or fight rather than accept vulnerability.  These responses, literally, gave me the capacity to survive, then even thrive.

I fear I will no longer be me by accepting help (the hero is always changed by the end of the journey).  However, now, not accepting help may lead to no me at all.  My own personal "Kobayashi Maru".  I hope that all makes sense.

Alasdayr

[smallwolf]

On helping ...

from your latest reply, you mentioned help a few times. I wonder how it might feel if what you actually needed or perhaps looking for is support, which can be even more powerful in the long run.

Support means a person be with you, encouraging you, guiding you, and (maybe) providing the resources you need to navigate a situation. Rather than just solving the problem for you (helping), these persons walk alongside you as you find your own way through it. You are still doing the work to get from point A to point B.

I had a idea of giving you an example from my own life, but wouldn't come out right. Maybe in the next post. Suffice to say that, and using your wife as a example, would not be solving the problem. Hopefully, by supporting, they are listening to you get things off your chest or whatever. And perhaps rather than letting stress and hurt build up inside you?

This approach can help you build confidence and resilience, knowing that you have the strength to overcome challenges.  Somewhere in here there is also trust?

And you do make sense.

[alasdayr]

smallwolf,  I cannot thank you enough.

Support, as well as help is what I am needing.  Fortunately my wife is a great support.  So are you.

Most things I feel I can share with my wife, she has been with me through it all and never given up on me.  What I struggle to share with her are things that I believe would undermine her confidence in me being able to support her (and my daughter).  My wife says I can talk to her about anything, and I believe that she believes that to be the case.  There will always be some things I am unwilling to share.

My father and sister are aware of my problems.  Both, however, do not know a lot about mental health.  They really try to understand and I try to explain the best I can.  They care for me and mean well but struggle a lot with seeing me go through what I have so far.

I also do have two friends outside the family that have been great supports.  I can talk to them about most things.  They helped me get to medical help when I was actively suicidal.

smallwolf, you seem to have walked a number of miles in my shoes.  I find your listening and your advice invaluable.

I know I need to find my own way through.  Having others hear my story and support my efforts is incredibly encouraging.  In a way I more want to get through for them more than me.

Having most of the professional help lined up has taken a lot of effort, but I think that will pay off in the long run.  The real trick is keeping everybody communicating so each is aware of any progress and can give the required assistance I need at each stage.

Todays struggle is both a physical and mental one.  Trying to consume enough energy to stabilise weight with making me feel ill.  As much as I try, it feels more a mental battle than a physical one.  I know what I need to eat, but I literally have to fight to make myself do it.

Anyway, I must sleep.  Lots of things planned for tomorrow.

Thank you again for listening.  And for your insights and advice.

Alasdayr

[smallwolf]

thanks for the kind words!  Having people who can listen to you tell your story is very helpful! Being able to retell the story is good also - each telling reduces the pain a little - at least for me. 

Me ... feeling a little flat tonight. And I cannot explain the why or what happened. So I feel unable to reply to your post properly. I'll be back tomorrow. I have a psychologist meeting tomorrow. Mind you it could also be related to changing jobs? 

Ride/Riding the waves...

[alasdayr]

smallwolf, I am always grateful for your replies.  Even when you do not feel you cannot devote as much effort to them as you would like.  Just knowing someone is listening makes a world of difference.

I hope your meeting with the psychologist goes well.  Also changing jobs can be very difficult and stressful as you work out all the new expectations.

Keep riding the waves.

I had a long chat with my wife on Tuesday explaining what I understand of my situation, how I struggle with food and self punishment, where I believe all this started and how she can support me.  She was very receptive, happy to know what is going on and how she can help.  It took a lot of effort to find the way to explain it and courage to even start.

My weight this week has not changed significantly since last week.  I know this is a good thing.  However it has taken a lot of effort, and in some ways I feel disappointed even though logically I should not.  I still have things about my physical shape I don't like and want to change because of the dysmorphia.  It's going to be a long battle.

I'm trying not to suppress my feelings.  I still have issues coping with them in a health way, but I'm working on it.

Alasdayr