Day 277: Back on track

OK, time to get myself back on track. I knew when I woke up today that I had spent enough time convalescing, that the worst of the depression was passed, and any more time on my back would cross the line into self-pity and self-indulgence.

But still I lay in bed wallowing. I got trapped in a social media loop on my phone, scrolling and scrolling, bingeing on empty novelty, finding nothing nutritious, repeating the same actions anyway. The equivalent of eating through a sharer bag of Doritos, avoiding pain with repetition, the addictive behaviour bringing up guilt and shame, sadness, helplessness, but burying all that with yet more of the addictive behaviour.

Finally I realised I had to move. I thought about what the most important step was right this moment - out of all my worries and issues, what was most pressing right now?

It was getting out of bed. So I forced all my energy into doing this. Then, once up, I made my bed. I took a shower, put on clothes. I tidied my room. It wasn’t exactly messy, but I did what there was to do, put books back on shelves, lined up shoes and slippers, threw food wrappers away, put my camera in its bag and put the bag where it belonged. I meditated. Went downstairs and made coffee, ate a banana, had cereal. Put clothes to wash. Did some reading about depression - know thine enemy - and did some CBT work - know thyself.

- - -

Often, in the depths of depression, one thought above all others ricochets around my skull. “Is this my fault?” Regardless of what I know about the very real and external causes of depression, when I’m suffering and the pain overwhelms me I can’t seem to shake the constant nagging fear that maybe it’s just me being weak and pathetic, maybe I’m bringing it all upon myself by giving up.

I don’t want to get into too much detail here, but suffice it to say my conclusion, which I have arrived at many times before, and need reiterating for myself now, is this: The entire universe is to blame for depression. Every blade of grass, every atom, you, me, God, all the gods, the whole cosmos, it all swirls together in sometimes beautiful ways, and sometimes ways that lead to immense suffering. Depression is part of this. Don’t worry about why it happened and whether you were at fault. It’s here now. It is real.

And yet victimhood is not the correct response either. The locus for change, the pivot point, is the personal self. Your depression will not improve simply by understanding its etiology, nor by blaming others, nor yet by changing laws, by making society more just - you cannot remove past trauma, re-engineer your genes, prevent troubled childhood experiences from causing skewed schemata in your brain from forming. These things need considering, understanding. But they are not the hill upon which you must fight. That hill is the present moment, and the manifesting of all your problems in it. Avoid negative behaviours, ingrain positive behaviours, and you will slowly change your brain chemistry. This is a fact.

As a general rule, action is better than inaction. Even the smallest, most stupid sounding goals can have profound effects when continued over long periods. Don’t stay in bed. Always shower. Eat a piece of fruit. Walk round the block. Do 20 press-ups. Meditate for five minutes. Write a paragraph a day. Create to-do lists for the day and cross them off one at a time, put yesterday’s unfinished tasks at the top of today’s list. 

Doing things helps.

But while doing things, problems will arise. Here, to help me, is a list of some of my problems, and what I can do about them:

Automatic negative thoughts (ANTs) are one of my demons. They arrive suddenly, from nowhere, crashing in. “This is pathetic. You’re worthless. What a waste of time. You're ugly. Repulsive. Stupid. Talentless.”

- What to do: CBT helps here. Catch the thoughts. Notice them. They arise, exist independently for a moment, then I swallow them, digest them, assimilate them, and they are part of me. Note down every time I become aware of one, and it gets easier to catch them in that moment before they dissolve into me. “Aha, that was an ANT. I see you.” That is all that is needed. Make tally charts of every time they arise. For ones with more force do CBT work to challenge them, question their validity. For example: “Do I know with absolute certainty that this blog post is worthless? Can I think of any examples why it is not worthless?” Brought into the light of awareness ANTs tend to shrivel away into nothing.

Rumination is another demon. Related to ANTs, but not quite the same thing. Sometimes it’s an ANT that starts up the ruminative process, but the process itself is the obsessive worrying, round and round, about problems, without coming to any conclusions. Obsessing over why I’m like this, rather than how to fix it. 

- What to do: As soon as I notice myself ruminating it is vital to disrupt the pattern, to get out of that neural network. Concentrate on anything else. If it is necessary then write out everything I’ve been worrying about, put the worries into order of importance, and brainstorm simple plans to tackle the first items on the list. Later worries can be shelved for the moment.

Learned helplessness is something I’m not sure I’ve written about before. It’s a major component of depression, in some models in fact it essentially is depression, the perceived lack of control of situations learned through previous uncontrollable stress and trauma. You can instil learned helplessness in a rat by shocking it or dunking it in water randomly and continuously, until eventually it won’t try to escape even when escape is possible. 

For me learned helplessness manifests as that “woe is me” mentality, overly dramatic, wanting to fling myself on my bed at the first sign of difficulty and tell everyone to leave me here to rot, that it’s too late for me, it’s all hopeless.

- What to do: Again, mindfulness is important. Noticing the thoughts as thus. “This is learned helplessness I’m experiencing right now.” To ask whether past experiences are clouding my current judgement. “Is there actually no way over this obstacle, or do I just feel that way because of learned helplessness?”

(I just felt it then. “There’s no way to finish this blog post. It’s sprawling too far. It's too long. I can’t do it. I need to give up.” So - note it down. Recognise it for what it is. And get back to work.)

Learned helplessness is a system broken through trauma and stress. But the system can be fixed. What was learnt can be unlearnt.

Self-esteem is yet another issue. A far-reaching and wide-ranging sense that I am not good enough, a sort of shadowy lack of confidence leering behind all things.

- What to do: Small actions help. Make lists of accomplishable tasks, and accomplish them. That builds pride. When the feeling comes on, know that it’s a demon, that action is called for. Do not sit and think about the low self-esteem, do not let rumination start up. It’s addictive and ingrained and feels like the right way forwards. It is not. The way forwards is to recognise the danger and immediately act, rather than ponder. Tidy my desk. Do some press-ups. Read a page of whatever non-fiction book I’m reading, to learn something new. Write mindfully about what the low self-esteem feels like, where in the body it is located, how physiology changes. Accomplish even the smallest thing, push forwards a millimetre rather than stay and be pulled back by the demon.

Full depression. And then there are the deeper symptoms that manifest when those others have shunted me fully into a depressive episode. Anhedonia, grief, psychomotor retardation, restlessness, sleep problems, all the rest. That’s where I’ve been the last few days.

- What to do: When this happens think of it like coming down with a bad case of flu, like breaking my leg. Accept the severity of the situation. Drop all other concerns and focus only on allowing myself the time to get better. Treat myself gently and kindly. Call or message people I trust. Go gingerly, but gracefully. Do not reach for pain-relieving vices that will cause more harm than good. Do not drink or do drugs. Do not eat junk food. Shower, if possible. Take short walks, if possible. Watch things on TV I would have liked as a child, guilty pleasures. Give myself little treats. Expect almost nothing, but try not to run to harmful things either. The dark clouds will pass. The sky will be clear once again.

...That's all a loose list, and there are things I've left off, but it's a good start, to help me get back on my feet. Do the things I need to do, stay active, keep ingraining positive habits and behaviours, and when those specific demons show up, as of course they frequently will, deal with them in the ways that have been proven to work.

I am doing so much better than I once was. Healing is not linear, but, wobbly, in spluttering fits and starts, it happens nonetheless. Upwards!

Day 273: Blue skies

Trying to avoid negative rumination, though feel vulnerable to it, “primed” is the term I’d use. Tough to write when I’m like this, because it’s precisely the act of opening the brain up to pondering, to thinking deeply, that initiates the rumination. In fact it’s like the wide open beautiful mulling aspect of the brain that makes writing even possible, but taken and twisted by negativity, poison entering the system, travelling around and around, until everything is tainted.

Trying to disrupt the ruminative process every time I catch it. Force thinking away from that swirling maelstrom, onto anything else. I’ve been literally forcing myself to read shop signs and say the colour of cars in my head and go over the types of coats everyone is wearing, to wrest attention back from rumination. “No, don’t go down into it. Back here. Back here. Back here.” Snapping my fingers at myself, pulling myself away.

At home I’ve been playing OutRun on my Switch, the 1986 arcade classic racer, which is good distraction. Blue Sega skies, luxurious breezy chiptune music, chunky sprite-based worlds rolling by around your bright red Ferrari, and always having to focus on this moment, on the curve of the road, the cars ahead, the timer ticking down. The timer, the cars, the road. Curving road. Cars. Timer. On and on, the sprites spat into existence at your wheels and burning into oblivion just ahead, the acid trip ever-flow, the past gone, the future not arrived, pivoting your car, the chiptunes in your ears, the Sega sky vast above, roaring forwards until the timer runs down, and then one more go, maybe just one more go.

...... 

Music: Lay My Love, by John Cale and Brian Eno. 

Day 270: Rumination

I was not in a good way yesterday. Not at all. But I spent today before work researching and reading, and I've got a better handle on an aspect of my suffering that has until now eluded me.

That aspect is something called rumination. It's something that I knew bits about already, but I had never looked into it in detail, and now I see that it has affected my life for such a long time.

Rumination is when you continuously and obsessively think about the same upsetting or negative thoughts, swirling on in your head, spiralling down, unable to stop, but also unable to reach any useful conclusions. It is a key component of depression. A bout of rumination is a good predictor of the onset of a depressive episode.

People tend to ruminate, according to Healthline, if they have a history of emotional or physical trauma, or if they’re facing ongoing stressors that can’t be controlled. And people with certain personality traits are more at risk of rumination - traits including “perfectionism, neuroticism, and an excessive focus on one’s relationships with others.”

Which, like, Hello.

So rumination is obsessing over something, usually something negative. But then that thought pulls in a whole bunch of other thoughts, because of the way memory and association works, the neural networks we create, once you’re trapped in negative thinking you find yourself remembering all the other times in your life that corresponded to this negativity, and it becomes all the harder to pull yourself out.

Ung, I’m struggling writing this, you know. A bout of rumination, which is what I was going through yesterday - it’s what I always go through in my depressive episodes - makes me feel so wiped out the day after. It’s like all the synapses of your brain squeezing tight, it’s like your face being pressed against some horrific cosmic grindstone, and it goes on and on and nothing gets solved.

Well it really fucked me up yesterday. And today I couldn’t get up. I’ve had so many mornings like this, the feeling of being run over by a tank, of having a brain totally wrung dry and twisted in knots and just utterly fatigued - looking back it’s always after periods of rumination - which before I just thought of as “being depressed”, it wasn’t something I’d separated out as distinct from the rest of the symptoms.

But while it is inextricably linked to depression, is a key pillar of depression, it isn’t the same as the anhedonia - the inability to feel pleasure - or the grief, or the psychomotor retardation - the slowing down of all your muscles.

Rumination is its own thing, that nevertheless goes with those other things to make up the vague larger thing we call depression.

So, what is it? It’s the pathological dysfunction of the problem solving mechanisms of the brain. It is going over a thought without completing the thought, without solving it, without finding closure and solace.

If you have a lot of trauma and stress in your life then you will think about these things, how to solve them. But thinking about trauma and stress makes you traumatised and stressed. It engages your stress response system, floods you with cortisol, tightens muscles, increases heart rate. You get anxious. Thinking becomes narrow, as happens in stress response, to focus you on fleeing danger.

And all of this makes it harder to solve whatever problem you are thinking about. It’s like PTSD - you don’t process thoughts, they stay in your brain, stay current, continue making you traumatised and stressed. And that interferes even more with your problem solving ability, and that makes you more stressed, and on.

It’s self-perpetuating, because when you think about trauma and stress your thinking becomes more inflexible, and when your thinking is inflexible you can’t see a way out of your trauma and stress, and that makes you more traumatised and stressed, and that makes your thinking more inflexible…

……

I can’t write this now. My brain fucking hurts. I can actually feel it trying to start up into a ruminative state, I can feel the gears grinding, feel it searching for all the instances that correspond with the negativity (“this writing is crap. All your writing is crap. Remember the other day when your writing was crap. And a few days before that. And BLAH BLAH BLAH.”

And it really hurts. My poor brain is exhausted - stress is exhausting, the release of cortisol, the high alert, the jangling nerves.

But it’s so important to do what I’m doing now. Because here’s how you combat rumination, according to everything I’ve read:

1) You disrupt the negative thinking. Focus on anything else. Get out of the loop. Play a nice game. Read a passage from a favourite book. Colour something in. Watch a TV show. Do a crossword. Something you personally find enjoyable, and something that takes your full attention, because otherwise your thoughts will wander back.

2) Go back when you’re calmer and write out the problems you were ruminating about, be specific, break the problems into all their component pieces, look at which parts you can do something about, and make realistic plans to tackle them, and for the things you can’t change downgrade them from problems to worries, set a date in the future to check in on them and see if anything has changed and if you now have the ability to affect them, and until then, forget about worrying.

So right now, in the danger zone for rumination, it’s imperative that I disrupt those negative thoughts every chance I get.

So I’m sorry, this blog post is loose as all hell, and probably makes no sense, but it is me fighting back. I can’t stop and plan it out and rewrite it, because it’s taking all my focus to simply pull myself away from the whole sticky addictive pathways of negative thought that are trying to swirl up and overwhelm me.

But it’s real progress. My brain feels like mashed potato, but it's good understanding why it feels this way, and that there are very real and practical steps I can take to work on making this better in the future.

Just got to go gently, avoid the swamps of rumination, and make gradual plans face all the problems in my life. Easy.