I've had a shitty week. Lots of tears and gritted teeth but a lot better after seeing the compassionate Dr S. He told me I should be writing stuff down more (I think he meant writing good stuff about myself down so I could go back to it in moments of self-loathing) but making notes for myself and diary writing have always had a whiff of make-work about them to me, so I will write here. Also, writing good stuff down about myself makes me nauseous, so I'm going to write other stuff.

Dr S asked me where I thought my crazies came from and I have no doubt that for me there is a genetic and environmental component. I am not a geneticist, psychologist or neurologist. I have not seen inside anyone else's brain and I have not studied theories of the mind. I have a working knowledge of undergrad sciences, a smattering of anatomy and physiology, and I've read some pop-psychology books, including the wonderful 'Brain that Changes Itself' by N. Doidge about brain plasticity. And I know that a cigar is sometimes just a cigar. All that being said I want to explore where my crazy comes from (disclaimers: This is about me, not you. I'm not a doctor. Blah blah blah).

Lets see how far I can stretch my little marble-run analogy. At my conception genes were reconfigured and I got my own set of blueprints, part of this was the plans for an amazing marble run that would become mind. Genetics used the building blocks available, from my mother, to build the marble run. It was so complex that a marble could barely get from top to bottom - too many options, too many connections, inefficient. But genetics had a plan - it knew that after it had built this complex structure, it would start getting used, and as that happened the connections that weren't useful would start getting dismantled, or at least have blockers installed so marbles (thoughts) would take the more efficient way, thus the thing could actually work (so far this is OK, it's just my understanding of basic neuroscience). Unfortunately, in the plan for my mind, my genetics included a bunch of things that are not very helpful. Some were probably included in case they could be helpful and some are probably attached to other things that are helpful in ways that I certainly don't understand. 

For instance worrying is a useful adaptation. It allows us to plan for the future and keep ourselves safe. Anxiety and panic attacks are unhelpfully overdoing worry, and making it difficult to manage normal things, like putting on pants and getting out of the house. I have always thought that anxiety and creativity were also linked - as in, you have to be creative to make up that many scary scenarios in a mundane world - but apparently research backs up my hunch (admittedly, I haven't read the research paper, but that article makes me feel like I have a superpower!).

More unsettling than the anxiety is the depression. Why did the plan include whole sections of the marble run that for some reason colours all marbles blue and slows them right down, takes them in circles and drops the marbles off the edge of the table rather than neatly into the velvet lined box? Why weren't those bits pruned off in the early days? Worse than that, some of those blue sections were somehow encouraged by my early experiences. Some of the splits where a marble can either roll, unimpeded and cheerful, to its destination or head down the blue and tangled depressive path have had the happy option blocked. 

Triggers? For some people, healthy people, who maybe only have one tiny offshoot of 'blue' can weather life's ups and downs. They may get depressed, but there is usually a trigger - major life changes, losses, identity changes, that kind of thing. Once they recover, and they almost always do, their depression is in their past. For me the triggers are often untraceable, some tiny switch that was triggered long ago that means that random marbles will end up in the tangled mire of depression. I have major depressive disorder and my depression is always in my future as well as my past and when it is really bad it is almost impossible to live with (as a friend said to me once, urging me to get some help - you have an illness that is trying to kill you). Sometimes there are triggers for me - lifestyle factors like alcohol (specifically binge drinking), lack of exercise, toxic people, being in situations where I feel my options are curtailed or (more usually) a combination of the above can be problematic. Add normal stressors on top of those things and my thinking can go off the rails.

The next question becomes how to manage things when the marbles are travelling through a blue section, is it possible to avoid the blue sections or can I make the blue sections less blue or even unblock routes so the marbles can exit the rough parts. Sometimes I can avoid triggers (still doing 100 days sober without any problems, still having issues with exercise), often I can use CBT style thinking to interrupt my patterns and divert a marble* sometimes therapy can help divert those marbles. Medication helps massively to keep my brain chemistry in order. Hopefully this combination, including having to mess around to get a good stable medication regime going can help me get back on track and then stay there.

..... and if you made it this far you deserve a punchline - now you know why I smirk whenever I talk about losing my marbles ;-)

Question of the week: is it weird to send your therapist your blog posts?

* Like yesterday when I attempted my clinical skills exam - I did something wrong and need to resit, but managed to halt my catastrophising feelings of 'I swabbed a wound wrong, clearly I'm not cut out for nursing. I can't contribute to society I may as well be dead' and get back to 'drat, I have to re-sit the test on Friday')

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