Medication

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My doctors have suggested that I go on medication. This suggestion was made previously but I refused. At the time, I was experiencing a strong impulse to self-destruction. I did not truly trust myself, or my ability to make decisions, and was concerned that any medication might further impair, or cloud, my mind. These events took place in the late spring of 2013.

In the spring of 2014, the situation is different. I still encounter mood swings. I still find myself entering depressive episodes. I still find myself wanting to retreat from the world. I still have thoughts of self destruction. I still ponder the question: is the new me the way I want to live out my life? According to actuarial tables, I have fourteen years worth of sunrises and sunsets ahead of me. Does my present quality of life make those days welcome?

In trying to answer this question, I have come to the following conclusions. These are not hard and fast, objective outcomes.  They are not final decisions. They are essays, attempts to gather my thoughts, to think things through on paper, and to see what is arrived at.

Medication – Change in Thought Style

I am not sure one can alter their thought style in the same way one alters one’s clothing fashions. I may be remiss in attempting to introduce a form of medical haute couture. But my sense is that my present day thought style is different from that of a year ago.

I am not sure what words to employ to characterize this difference. First, the difference is experiential in nature. It is my “sense of difference” rather than an objective measure. If one has experienced love then one understands immediately the failure of language to fully capture, or convey, the experience. I face a similar problem.

In 2013, I felt more overwhelmed by my thoughts, More driven by them. Perhaps more reckless and out of control. There was no fear but there was a sense of being out of touch, uncertain, confused. There was considerable experience of mistrust – mistrust of my own experience, mistrust of my perceptions, mistrust of my ability to engage in the common casual ordering of body and mind in the effortless way the uninjured so easily take for granted.

In 2014, I am less overwhelmed. There are still strong patterns of thoughts but I appear better able to surf these thought waves, to ride through the turbulence, to keep my head above water. There is less sense of being submerged, out of touch, the grasping for reality that was present in 2013.

I have more confidence in my ability to think things through. If it were possible to reduce everything in my life to a set of logical syllogisms then I would be able to operate quite happily, an imitation of Lieutenant Commander Data from Star Trek (I may mean Spock. I have no idea. I have enough trouble keeping track of my own life to worry about confusion between these characters).

Much of this confidence stems from the blog. I use the blog as external memory, as a form of “thought processor.” It forces me into an attempt to commit my thoughts, to fix them to the page, to make them discursive. I believe I am more successful in this than I was earlier and that the blog has been of significant benefit.

Medication – Self Destruction

In 2013 I experienced a strong wish to go to sleep and never wake up. This impulse was expressed in other forms. I feared medication would alter me in unknown ways, might leave me less able to avoid a destructive impulse. The medication itself might provide a means to the end.

Today, I continue to have down periods. I am not sure if these are less, or more, powerful than previously. There is a sense that these questions, questions Camus described as being central to the human experience, are by now routine, like a pair of worn shoes, well accustomed to the shape of my feet. There appears to be a quality of greater objectivity, more distance, less immediacy, less impulse. I seem better able to accommodate my deficits despite the fact that recognition of them remains a strong trigger for depressive episodes.

Medication – Self Perception

I remain concerned that through the use of mediation I might become less, rather than more, self-perceptive. I believe my ability to exercise logic, to analyze, and to write about my experience, has significant therapeutic value. Would medication impair these capacities?

If they were to be impaired, would I retain the capacity to notice?

This last item calls up memories of a stage in my accident recovery prior to the commencement of blogging. I would find myself sitting motionless, staring out into space, devoid of all thoughts and motivation. Acknowledging this vacant state as unhealthy was a key motive driving me to accept the difficulty of blogging. I am concerned medication may place me back in the twilight zone.

 

 

 

 

Feeling Very Uncomfortable

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I have been trying to develop a better understanding of the blog software. As I do so, I rapidly become overwhelmed. I attempt to read the relevant technical material and it does not click. I study the same text again, and again, and it still does not take. I begin feeling very uncomfortable and I start to back away from the work I am attempting to perform.

This worries me.

In the past, in the info-tech sphere, I would totally devour technical information, readily grok it, and have no difficulty in moving forward with the implementation. This was true back when I was teaching myself a new programming language. It was true when learning a new software application. It was true when I worked for Gargantua in the global information factory. The customer wants support on some exotic new technology? No problem! I would just dive in and solve the issue.

Now I appear to become lost, or severely challenged, when making an equivalent attempt. I am trying to interact with one of the easiest to use, most widely adopted, open source software packages available. This is software with training wheels! It is software with all the sharp edges removed! Surrounded with lots of thick padding to protect the user from his own actions. Despite working on a platform with excellent ease of use, and a clear, straightforward UI, I continue to encounter problems. When I seek out additional technical resources, I encounter a similar set of problems. I have been working on these issues for several weeks now. And I acknowledge having made the same attempt months earlier, an attempt abandoned in frustration.

The software itself readily accommodates text input. Creating a blog post is not an issue. Making a post is a very straightforward task and amounts to little more than copying in some text, and pushing a button. Voila! All is done.

But I am attempting to dive deeper into the back end, to get under the hood, so to speak, and acquire a more comprehensive technical understanding. And, when I make this attempt, I quickly hit a wall. I become overwhelmed and discouraged; this is followed by an embarrassed retreat.

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I have been mulling this issue over to get a better fix on it.

I do not believe this is due to any further deterioration in my abilities. I think it has something to do with the level of complexity involved. I have the sense that I am able to operate in a few limited areas. Within those specific contexts, I am able to perform to a reasonable standard. When I seek to extend my operational boundaries beyond a narrow comfort zone, I easily become overwhelmed.

At some level there has been an improvement. One example is found in writing. I am able to hammer out a decent batch of prose. In some instances, I surprise myself by the quality of what I have written; I have not previously engaged in producing this form of written material. I believe I can detect an improvement in my skills from the first few months of the blog, up to today.

My photography has also improved, but for a different reason. With photography, I abandoned some sophisticated techniques. These techniques were not required to produce images for the web. With photography, the improvement has come from a relaxation of standards, or from embracing standards appropriate to the output medium.

Both writing and photography are long term skill sets. If my understanding of brain injury is correct, then well adapted procedural skills are rarely impacted by brain injury.

I am going to let this issue sit for a while, and see if I develop any further insight.

 

 

 

 

Thoughts on Waking

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I do not want to wake. There is a strong wish to continue with the sleep state. Today, I lack any memory of my dreams. When I do remember dream content, it always concerns aspects of an active past, those periods in which I had no injury. My thoughts on waking this morning are that I have a powerful wish to resume an uninjured state. The only way I can easily facilitate that return is via a dream state.

I realize also that my time horizon has shrunk. It is now so compressed it includes only the immediate present. Before the injury, I had a long term outlook. I was planning for a future retirement, I was actively engaged in developing activities that I might pursue as enjoyable interests, and as sources of supplemental income.

Since the injury, my time horizon has contracted to the few hours of the immediate day. In fact it has shrunk to an even smaller dimension. My focus is not just on getting through today, my focus is on the project that confronts me in the immediate now. This is part of the fixation on the blog. I sit here writing this draft post and my sole goal is to reach the end of this sentence, to arrive at the end of the paragraph, to complete a reasonably interesting post.

Beyond this writing activity, there is a dim awareness of major events such as my next scheduled visit to my doctor. I am enclosed within the immediacy of an endless today,  an all encompassing now, punctured only by next week’s doctor visit. Beyond this lies nothing. I once conceived of a future that I should strive to achieve, or to protect. I organized my daily affairs around this vision. It would inform all undertakings, described a set of goals which shaped my day to day activity.

Today, I lack any conception of the future. My chief goal is to get through the day without screwing up, messing up, loosing the car, or performing some other involuntary act of stupid forgetfulness.

I had other thoughts on waking. I realized that I had been involved in a wide variety of projects, and activities. None of these interests appear to have survived the injury. These are the few I can remember this morning:

Thoughts on Waking  – Adventure Cooking

I eat. Therefore I have had a long term interest in good cuisine; Mediterranean food, Asian food, Mexican food, Norman food, the food of Emilia Romagna, Scot’s oatcakes, Wakame, sourdough, hummus, and everything in between. Before the injury, I would spice up the menu by opening a cookbook at random, searching for an interesting dish, making a list of the required ingredients, and then searching them out. Then, as my form of a special Sunday dinner, I would cook and enjoy the meal.

The recipe typically called for ingredients enough for four or five persons. I would take the leftovers, parcel them out among single serve ceramic food containers and freeze them. One of these portions then became my 2:00 AM meal at the information factory.

This interest ceased with the accident. I was not even aware that it had come to an end. This insight has been triggered by last week’s discovery of a fridge chock full of exotic condiments and ingredients, all of them left untouched since the date of the accident. I am now in the process of disposing of these stale, spoiled, antique food items.

I have also recently become aware of my trove of cookbooks. There are several shelves full of them, a collection started when at university (a very tattered copy of one of Elizabeth David’s books. A hefty copy of How to Cook a Wolf. A well stained introduction to Lebanese food). None of these have been touched since the injury.

Thoughts on Waking  – Income Supplements

In order to stay active in retirement, and contemplating the possibility of generating a supplemental income, I had embarked on the creation of a set of photo books. I had plans for a small publishing business, and did a great deal of work on potential revenue streams, and the type of books I wished to produce. Break even points, pro-forma financials, profit margin calculations  —  all of these issues were addressed in a series of digital files, files I have not encountered since the accident. I have no idea where they are.

I had gathered images for use in the creation of a set of sample books. This work was underway prior to the accident and I attempted to continue with it. It quickly became problematic as I failed to remember the required processing steps and the various actions I needed to perform. I tried to manage these deficits by keeping incredibly detailed notes on every action taken, but gave this up when I realized that I was constantly introducing transposition errors. These rendered the documentation useless as a performance guide. The book projects withered on the vine. I did manage to complete a few samples and I gave these to one of my doctors as a small token of my immense gratitude for her assistance.

Thoughts on Waking  –  Art Projects

Prior to the injury, I had reactivated an early interest in drawing and painting. I purchased art materials, and brushes, and spent considerable time experimenting with different techniques and media. This came to a complete stop with the accident. I continue to come across residual evidence of this activity. I throw it out.

I have been up now for a few hours and have spent most of that time writing these notes. When I woke this morning I had a series of insights. The fresh perspective of these thoughts on waking motivated me to exit the bed and complete a record before the thoughts vanished back into the dark silence from whence they came.

It has now been more than three uninterrupted hours at the keyboard. I am encountering difficulties as, in writing these words, I have come to recognize the enormity of the change that has taken place. I had no real sense of this until now. This moment.