Creativity and mental illness – or me and my demons

I saw this article, Secrets of the Creative Brain, on the blog Side by Side in Mental Health. It took me some time to read it, because it’s a bit long, but I found it curious. Although it didn’t answer some of the questions – the study is ongoing – it does shed some light on the type of research and techniques that are being used to find out more about creativity and mental illness.

For me the link between creativity and mental illness has always been there. I grew up in a family whose members were all intelligent and creative but also suffered from different mental illnesses. Me, I’m no exception. I always saw myself as very creative and smart. I taught myself to read and write and at 4 I wrote my first poems. Yes, they were full of spelling mistakes, but they rhymed. In elementary school I started writing a collection of books much like the Nancy Drew mysteries. As I reached puberty, I created a magazine for teenage girls and started writing “serious” novels. At 15 I convinced my mother to buy me a guitar and find me guitar lessons. So until I finished college I wrote dozens of songs and hundreds of song lyrics. College was very prolific. I wrote poems in Portuguese, English and French. I decided I had a very short breath when it came to writing and went on to write dozens of short stories. I’m still proud of some of them after all these years. After college I started working full time and realized I missed being a sweet child who did ballet, so I went back to dance classes. Sometimes I still fall asleep making up dance routines in my head (that I obviously don’t remember anymore when I wake up the next morning).

I took my bachelor’s in Literature, but I could have taken anything else as long as it wasn’t anything related to design and graphic arts (I couldn’t draw a decent picture even if I had a gun pointed at me). But I was good in Math and Sciences. I used to solve equations much like I solve Sudoku puzzles now – just for entertainment. I’m fascinated by Physics, Biology, Neurosciences, Psychology, History, Philosophy, Cinema, Photography, you name it. I could be talking about the Higgs Boson one minute and the other minute I’m talking about Freud.

But of course there’s this whole other side. Anxiety consumes me. In the 9th grade I remember spending most of the mornings crying. It was the first time ever that most of my classes were in the afternoon and I realized that unless I’d wake up early in the morning and turned on the autopilot, this inexplicable darkness would fall over me. I think this was the first time I experienced being depressed. Shortly after that I started suffering from insomnia. Some years later when I was 20 I got so depressed I thought about killing myself. This thought would haunt me again at least twice in the following years. During my 20’s I also worried about my needing alcohol to relax. It ended up being just a phase but it was scary. I wasn’t drinking a glass of wine or two because I liked it, I was drinking because I needed it. And of course, there was that weird memory loss I wrote about earlier.

I live with many ghosts. My grandmother had paranoid schizophrenia and so did one of my uncles. My other uncle is an alcoholic who also lives with bipolar disorder. My mother and her older brother both suffer from severe depression. My sister lives with social anxiety, and falls in the borderline category. Today I found out my neuro described me as bipolar to another neuro. My first reaction was, “Why has everyone kept this a secret from me all these years?” Then I realized she probably just mistook my anxiety for mild mania. I’m anything but bipolar because I just don’t have the energy for euphoria. I don’t steal money from my relatives to spend on god knows what and I don’t disappear for days and end up calling people to tell them I’m in some city many miles from home. My uncle does this and more. But my first reaction was to doubt myself. My first reaction was to think my psychiatrist, my therapists, my mother suspected I was bipolar but didn’t tell me. And then I realized there’s maybe a little paranoia in this thought. Just a tiny word written on paper, and suddenly all the demons I’ve been living with waved at me.

But you know what? Maybe I have a little bit of all these conditions living in me. And maybe they’re adaptive, as in one of the characteristics is more prominent during a specific time in my life, only to fade away and make room for another characteristic as I go through something different. Lately it’s like daydreaming and dissociating are helping me cope with stress, but I remember when I bought my apartment and moved in by myself compulsive behavior helped me deal with the fear of whatever might go wrong before I got used to being on my own. As the author of the article recalls, “Heston and I discussed whether some particularly creative people owe their gifts to a subclinical variant of schizophrenia that loosens their associative links sufficiently to enhance their creativity but not enough to make them mentally ill.” Maybe this will prove to be true in many areas, and my demons will finally be able to rest.

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More medication changes?

I saw my psychiatrist today and I obviously had to update her on the latest developments about my health. So from there we started talking about what this all means in terms of my mood and sleep. I haven’t been sleeping well since those steroid infusions, but I’m confident my sleep will be back to usual patterns as soon as the steroids wear off, which, according to my neurologist (and my weird nights) hasn’t happened yet. So for now I’m going to keep taking trazodone at night.

Now for my morning pill. I’ve been taking escitalopram for some time and I’m quite happy with it. In fact, about a year ago, when I felt better and more stable and suggested my psychiatrist should take me off of it and see what happens, what happened was I stopped sleeping again. Escitalopram, being an antidepressant designed to treat anxiety as well, has been doing wonders for my insomnia, which has a lot to do with anxiety.

However, I haven’t been feeling anxious lately. At all. Instead, I’ve been dealing with everything by hiding from the rest of the world, feeling demotivated and generally more sad. So she thinks it might be a good idea to try something more uplifting, as in fluoxetine. That is, Prozac. Oh dear. 😦

Survival instinct kicks in

The first time I actually felt my survival instinct running in full mode was when I was diagnosed. While I was trying to keep my head above the water, get used to injections and side effects, and manage the overwhelming amount of info about multiple sclerosis I would have to become familiar with, I looked around me and everything seemed superficial, futile and vain. I knew I was being unfair, but people’s worries, problems and troubles irritated me. It all seemed pretty meaningless. I resented the fact that people were carefree enough to look for mindless entertainment. I was focusing all my energies in being well while everyone else was on Facebook talking about the latest random video or trend. Another funny thing that happened was that my creativity was gone for a while. I’m always full of ideas and there are constantly voices in my head playing parts in short stories that I sometimes like to write. Suddenly the voices were quiet. Imagination thrives in empty spaces, and there was no room inside my mind for anything other than MS and being fine.

Although at a much smaller scale, I’m getting hints of that feeling again. Right now I have to decide between a drug that might give me progressive multifocal leukoencephalopathy and another drug that might give me heart problems, knowing that both will shut down key functions of my immune system and thus I won’t be protected against infections and possibly tumors. At the same time people want me to engage in the usual office gossip of who’s backstabbing who, ask me if I’m counting the days until I see my infatuation again (who?) and expect me to remember about a concert or show I wanted to go to? I just feel like screaming.

Meanwhile, my mother has made clear that she isn’t happy about me taking any of those drugs. She didn’t need to tell me though, because two years ago we had the same discussion when I switched from Avonex to Copaxone. My mother has a cure for my multiple sclerosis: if I never leave my house again, only eat what she cooks and spend my time doing yoga, meditation and acupuncture, I won’t need anything else. She just forgets this isn’t very practical – or worth living for, for that matter.

So my survival instinct has been obsessively listing everything I’ve been doing for the past three years – and some of them for longer – to prove that I really can’t do more or better than I am already doing, and that this disease is simply unpredictable, random and not my fault. I have been:

  • Eating the best I can. I have a varied Mediterranean diet, that includes a lot of fruits, vegetables, soup, nuts, and fatty fish. I started drinking 2 liters of water a day. Though I didn’t eliminate them completely, I cut down on dairy, gluten and meat, as I found I have more energy if I don’t eat as much. I never had a sweet tooth so I never ate much refined sugar. I don’t have pre cooked meals at home. When I eat out, I look for the best options. Yes, I occasionally have a pizza, but I don’t think it’s one occasion here or there that’s going to kill me.
  • Exercising. The past ten years I did cardio fitness, yoga, pilates, contemporary dance and floor barre. This year, as I don’t have much time to enroll in activities due to having classes at night, I go running and I also do stretching exercises at home. They help me keep sane.
  • Meditating. Although I don’t meditate as often and as regularly as I would like to, I notice I’ve been able to improve some of my cognitive functions. I’ve also been sleeping and resting better.
  • Taking more breaks. This was something I didn’t use to do. I now take breaks during the workday, pick an evening every week to not do anything after work, say no more often and try to manage my vacation time in a more balanced way through the year.
  • Taking my vitamin D supplements. Doctor tells me to take them, so I do.
  • Seeing a psychiatrist regularly, and keeping my anxiety and depression as far away from me as possible with a little help from medication that prevents huge mood swings and insomnia.
  • Doing psychotherapy and cognitive-behavioral therapy. Yes, I see two different therapists, but the work they’re doing complements each other. I credit both of them for believing in me and not letting me lose my mind all these years when relationships, responsibilities, work, disappointments and health issues just seemed too much.
  • Looking for intellectual and social stimuli. Since my job keeps me in a bubble and doesn’t give me much room to grow, I have enrolled in courses and seminars that might interest me, meeting new and interesting people along the way.
  • Trying to learn how to manage stress. This isn’t something you learn overnight, but I’ve been consciously paying more attention to the signs my body sends me and trying to worry less, take things less personally and put them in perspective. And also not be too hard on myself when I forget about this and get caught up by stress once again. I will get there slowly.

So, mom, am I missing something?

~Am I running out of resources?

Or am I just trying too hard?~

In the land of what if’s

It started Sunday night. As I was saying goodbye to my mother after our usual Sunday dinner at her place, she mentioned she’d read somewhere that 7 am was the best hour to wake up. Something to do with sleep cycles. I jokingly said something like, “Unless you’re living with multiple sclerosis,” and reminded her that I didn’t use to have any trouble getting up in the morning before, but for the past years I can’t seem to get up. Sometimes the alarm rings every 5 minutes for half an hour and I simply don’t hear it. And then my mother said, “Yes, you changed a lot, but don’t forget you’re also taking things to sleep and those make it harder for you to get up.” I replied I’ve only been taking meds since 2011 and that my troubles started earlier, but as I went home I started thinking “What if?” What if the meds are taking even more of my energy than MS already does? Last year I stopped taking one of them and what happened was that two months later I was insomniac again, waking up at 2, 3 and 4 in the morning unable to go back to sleep again. That means I’m not leaving them anytime soon, but it got me thinking.

And then my what if’s snowballed. What if my fatigue is not solely MS-related? Endometriosis is said to cause fatigue, as well as depression and stress and anxiety disorders. Could my fatigue be the sum of all these causes? (No wonder I’m tired.) And what about brain fog? I spent Monday and Tuesday with a bad case of brain fog. It got so bad that at a certain point I realized I didn’t know how to do my job anymore, the one I studied for and have been doing for the past ten years. You see, among other things, I translate for a living, and after staring for hours at two pages I needed to translate I suddenly found myself thinking that Google Translator is an excellent tool. (If my next post is about me being fired you know what happened.) What if the meds are also contributing to brain fog? Or what if brain fog is simply caused by my lack of motivation, that on the other hand makes me spend most of the days daydreaming of better things and dissociating as a means to escape my normal life?

And what if I made up all these what if’s because I’m still in denial and looking for clues that tell me that after all I don’t have MS (they could have switched my MRI’s in the hospital with someone else’s) or that it isn’t so bad?

Jesus.

My health defies any logic. The only two things that usually lift my brain fog are lying down and resting, or taking a walk, preferably next to trees or water. On Monday, as I was too tired to go for a walk, I lay in bed a little before dinner. It seemed to make it worse. On Tuesday, I didn’t rest and instead went shopping. That seemed to do the trick, as on Wednesday my mind was clear. So the brain fog is either motivation-related, or my MS didn’t like the fall/winter collection and went into hiding.

My behavior also seems to defy logic. Yesterday there was a family dinner, and I suddenly heard myself cutting everyone off mid-sentence to tell them it was getting late and I needed to go. I usually have to think and gather my strengths before being this assertive, but last night it just came out naturally. And I didn’t feel guilty about it. After all, both my father and stepmother are retired, and my sister is taking these last days of August off, so I was the only one who needed to get up early today to go to work.

Last but not least, my therapist thinks I’ve been too focused on my health (seriously? lol) and that maybe we need to work on other areas, such as my social support network. But I’m still on hermit mode, so I’m not sure how that is going to turn out. Will keep you posted. 🙂

The Body Remembers – The Psychophysiology of Trauma and Trauma Treatment

51Iz1JHskkL._SY344_BO1,204,203,200_When my therapist said most of my symptoms were consistent with PTSD, off I went on a shopping spree trying to understand everything I could about it. I ended up only purchasing two books (so much for the shopping spree) and chose to pick up this one first because one of the things my therapist keeps telling me is that trauma is always in the body. It is felt, processed, stored and remembered in the body.

This book didn’t disappoint in explaining how. The first part provides a useful introduction to the mechanisms underlying the experiences of trauma. Being the geek that I am when it comes to all things science-related, I enjoyed learning about the role of brain regions such as the amygdala and the hippocampus in processing information, stimuli, emotions, etc, in regulating the body’s response to them, and their connection to memory, learning and language. 

The second part is aimed at providing therapists and their clients with techniques to alleviate and treat trauma symptoms using body awareness. The idea that the body is an endless resource for healing is certainly one that appeals to me. I’ve been learning for the past years how to pay more attention to what my body is telling me through yoga, contemporary dance and meditation. Now I intend to follow some of the suggestions in this book as well. I actually had the opportunity to try them today when I woke up startled at 5.30 am due to a nightmare. I didn’t think I could go back to sleep, but I remembered some of the exercises in the book and managed to get some sleep before the alarm went off.

Overall I think this book helped me getting more acquainted with what PTSD is about. It offers a nice balance between psychology and neuroscience, theory and practice. I hope the next one on my reading list will provide me with as much insight.

Dear sleep, I missed you

The first night I remember waking up in the middle of the night and not being able to go back to sleep again I was 15. It’s likely my sleep issues started earlier, as I remember always being a very light sleeper, but that was the moment when sleepless nights became something like normal routine to me.

I tried everything I could remember, especially because I didn’t want to be medicated (I’m currently taking 6 different medications every day, so haha, the irony). Medication had side effects. I didn’t want to become a zombie. I didn’t want to admit defeat and ask for help. I thought I could outsmart myself and beat this devil in me that didn’t let me rest. I always had the notion that what was causing this was psychological rather than physical, so I thought I could somehow turn this around.

Then at the end of 2010, when I was 28, I went through a really rough period in my life and became severely depressed. I wasn’t neither eating nor sleeping at all. That’s when I saw a psychiatrist for the first time in my life. I started on an antidepressant (Agomelatin, which didn’t do much for me) and on small dose Cyamemazine for sleep. Cyamemazine is an antipsychotic drug and for some time I thought I was going psychotic much like other members of my family, but later my new psychiatrist explained Cyamemazine is also used to treat anxiety in other cases, so I took a deep breath.

Cyamemazine made me sleep deep and peacefully like a baby and those were happy sleeping times. Funny enough, after a while on it, it occurred to me for the first time that something could be seriously wrong with me. You see, I’d been feeling abnormally tired for years now, but I attributed it to suffering from insomnia. But now… I was sleeping safe and sound and still kept on feeling so awfully tired. Then at the end of 2011 I was diagnosed with multiple sclerosis and things started to make sense.

I had to change medication, because Cyamemazine, being a neuroleptic, can accelerate demyelination, which is not good news when you have ms. I couldn’t go back to not sleeping because not only studies suggest our body produces myelin during sleep but also because I couldn’t possibly handle the subsequent fatigue. I changed psychiatrists (my first one didn’t want me to stop Cyamemazine despite what my neurologists said) and I started taking Escitalopram at breakfast and Trazodone before going to bed.

I immediately felt a difference. On the one hand, Escitalopram really did its job with stabilizing my mood and my anxiety. My chest used to hurt due to anxiety to the point I thought I had some cardiac disorder, but as soon as I started taking Escitalopram I never had that again. On the other hand, Trazodone wasn’t as good as Cyamemazine in making me sleep. I noticed my sleep became lighter and I sometimes woke up a little earlier, though nothing compared to waking up at 2 or 3 in the morning. So as long as I was having 7 to 8 hours of sleep every night, even if it wasn’t such a deep one, I was still happy.

Then last summer my psychiatrist and I decided I was more at peace with my diagnosis and dealing with things much better so we tried to take Escitalopram from my cocktail and see what happened. A month off of it I started waking up half an hour before the alarm, then one hour before, then two hours before, and so 4 months later I went back to taking it. This really seems to confirm that my sleeping issues are all related to depression and anxiety and panic disorders.

Sleep became an issue again these past two weeks. I’ve been waking up before the alarm, sometimes 20 minutes earlier, sometimes one hour and half earlier and anything in between. This isn’t something that bothers me much if it happens occasionally, but these past two weeks it happened every day. My fatigue worsened a lot and my mood became somber. And why have I been waking up? Well, there’s a simple answer for that: nightmares. I wake up after a nightmare (or several, it depends) and I can’t sleep again. Sometimes I consciously decide not going back to sleep, because I don’t want to keep having nightmares and become so agitated.

What do I dream about? It varies. Sometimes my nightmares wouldn’t be considered nightmares by most people. They’re just uncomfortable dreams, but those uncomfortable situations I dream about connect with very deep insecurities and fears I live with, thus resulting in my body setting off the alarms. I’m also very susceptible to everything I read or watch. Working in a publishing company mostly with children and young adult fiction, I read a lot of books that sometimes upset me. I remember having several nightmares after reading The Hunger Games, and when I read Pure I dreamed I was spying on my ex-boyfriend through a camera inside someone else’s head, much like happens with the main character. Needless to say, I didn’t like what I saw in the dream.

And then, like today, I break down. I woke up early as usual, had breakfast, and as I was feeling really dizzy and numb, decided to pick up my e-reader and do a little reading in bed. I don’t think I read a single page – I fell asleep and only woke up at 1.30 pm because I have my alarm set to that time in order to remember to take one of my many medications. I was so so so tired. I don’t even remember the last time I woke after noon, probably back in 2011 during my Cyamemazine days. I’m feeling better, but I wish my sleep would be normal enough so my body wouldn’t have to occasionally shut down like that.

I wish I was (more) dysfunctional

From very early in my life I had many different problems. I started having asthma when I was 2 and a half and I never spent more than a week in daycare with other children. Every year my mother would enroll me but, even though I have no memories of those times, I suspect we both suffered from separation anxiety. I was shy and had a little social phobia. My mother overprotected me and didn’t equip me with the tools to go out into the world, so being away from home without anyone familiar brought me so much anxiety I would soon fall ill with something. When I turned 5 and it happened again, my mother started panicking. The next year I would have to start school no matter what (homeschooling is not really an option in my country). So after talking to my pediatrician, he gave her the number of a child therapist.

From the age of 5 to the age of 10 I went every week to see this therapist. I have very few memories of these sessions (which is weird considering they span for a period of 5 years) but when I try to look back the feeling is that I was generally happy there. And I did make some progress. I had no trouble at all when I started school at the age of 6, I made friends on my own, asthma went away around 7 or 8.

However, all these years later when I look at myself and my “collection” of illnesses I wonder what was it that therapy did to me. I think that all that it did was make me functional, while it did nothing about the underlying problems that had resulted in me being a very troubled child. For instance, I don’t let anxiety and fear stop me from doing things that I find challenging, but I still get anxious, and those anxiety symptoms have been taking a toll, eroding my entire system. Still, I’m the epitome of functional. No one knows I’m sick if I don’t tell them, I work full-time as a copy editor, I study at night, I exercise, I see my friends and family, I have a lot of interests, I keep my apartment as clean and tidy as possible, I manage insomnia, depression, endometriosis and multiple sclerosis as best as I can… I am so functional and apparently so normal that when I do complain about something no one really believes me. Sometimes not even doctors, which is probably the reason why I went for so many years without a proper diagnosis, proper medication and proper support.

But I’m also the epitome of troubled. My functionality has been disguising a lot of issues that date as far back as my early years and go on up until now. And the clues were all there. Coming from a family with a history of mental illnesses such as schizophrenia, bipolar disorder, addiction, and depression should have raised a few eyebrows. But no. They looked at me and saw this gentle harmless young woman who wouldn’t want to be any trouble. And me, I was too puzzled to even be able to make sense of things, too scared to trust people.

So today I wish I was a little more dysfunctional. Maybe people would have taken me seriously. Maybe this wouldn’t have been hurting for so long.

Cure for insomnia

 

 

 

 

 

 

 

The first time I remember waking up after a couple of hours of sleep and not being able to fall asleep again I must have been around 15. It’s possible though that my sleep issues started earlier, as I remember always being a light sleeper and always having agitated nights. 

Nowadays, when I think about insomnia I think about it as a chronic illness, as much as I think about multiple sclerosis and endometriosis. Because since I was since 15 I’ve tried everything you can possibly imagine to be able to sleep well. That included diet changes, meditation, yoga, exercise, not having anything in my bedroom except things associated with rest… you name it. The only thing that seems to work is medication. Unfortunately I need to be permanently medicated for insomnia because, as research suggests, my sleepless nights may have had a negative contribution to the development of my ms.

So, if anyone has suffered from insomnia like me and has found ways to manage it other than being medicated, I’d love to hear your comments. In the meantime I’ll leave you with Alfred Hitchcock’s insights about insomnia. 😉