Posted by hyperfocus on December 15, 2012, at 9:20:15
Hello Babblers. It's been a while since I posted here...and there hadn't really been much to report on my condition since my last post here, till only one or two months ago. Essentially I've discontinued everything I was on except for low-dose amitriptyline. I haven't taken Lyrica in quite a while but it did help me when I took it briefly and I keep it in reserve as something I know can help manage acute symptoms in the short-term. For 15 years I went nowhere with my meds..., and almost nowhere with my life to be honest. Then at the start of October this year I started with Lyrica (pregabalin). I took Lyrica for a month, moving up to 300mg daily. The PTSD severe social anxiety and dissociation improved noticeably. Lyrica, in the short-term, was by far the best drug I had ever taken for my social anxiety -- much more effective than benzos or ADs or APs -- but I was still near-totally disabled. But perhaps as a consequence of my positive reaction to Lyrica, I began to reconnect somehow with my memories of the extensive abuse I endured in school, and my own deeply buried reactions to it. I did intensive reading on psychological abuse, dissociation, and the psychological consequences of any type of trauma on victims' models of the world and systems of meaning. Somehow I began to map my own illness to what I was reading. I began to see, literally see, my social phobia not as a true phobia of all people but as a reaction to extensive and prolonged abuse I had endured at a young age at the hands of only a few people, and the formation of a broken cognitive model of myself and the world and social relations that I had not grown out of. I am now somehow able to recognize the cognitive model I use for social relations as as an extremely dysfunctional and immature one. I also now, finally, understand why this model has persisted for so many years, and why the memories of past experiences still traumatize me and fragment my consciousness to such a terrible extent.
I have not been officially diagnosed by a therapist, but I am as certain as I am anything in life that I have Asperger's Syndrome -- or the pervasive developmental disorder formerly diagnosed as Asperger's Syndrome. Reading the detailed descriptions of Asperger's Syndrome by professionals, authors, and the individuals diagnosed with it, was like opening a door that had been closed for my entire life. For my whole life I have wondered why was I so different from other people; when I was growing up why was I so clumsy and uncoordinated, why did people pick on me so much for my appearance and posture and social and physical awkwardness, why was it so hard to make friends and more importantly avoid enemies, why could I never understand or follow the rules of certain things, or be organized and not bored and frustrated and overwhelmed with schoolwork. Most importantly it explained why the negative emotions and thoughts and behaviors that I experienced and developed at such a young age have persisted for so long. All Asperger's kids are hypersensitive to criticism, for several cognitive and emotional reasons. I will write a separate post on Asperger's, but basically all aspies, like all autistic people, suffer with severe deficits in social cognition abilities like theory of mind, empathy, non-verbal communication... and equally as debilitatingly, with severe deficits in processing emotions, dealing with interpersonal conflict, adapting behavior and seeking out new solutions to emotional and social problems.
I have pretty much every symptom of prolonged chronic abuse. Abuse survivors share behavioral and emotional and cognitive and physical characteristics that are 100% identical to mine, down to the trajectory of my life into my 30's. Asperger's kids, just like all autistic kids who are in the mainstream school system, are bullied and beaten for years if intervention doesn't take place. For Asperger's kids the psychological abuse is internalized in very specific ways:
"The person can have intrusive memories of the traumatic event that are very difficult to .block.. An adolescent with Asperger.s syndrome explained to me that the intrusive thoughts (about being the target of very malicious bullying) appear almost to argue wth him. He explained that his inner voice .does not let me calm down easily. It keeps on going on about what happened and going on how wrong the other person was to me.The original event was obviously traumatic but intrusive thoughts and mental re-enactments will cause the person repeatedly to experience the same feelings of fear and distress."
--Tony Attwood "The Complete Guide to Asperger's"I can't describe my inner experience any better than this paragraph. I suffered the after-effects of abuse which left me feeling for two decades that I was simultaneously neurotic and psychotic and led every psychiatrist I have ever seen to pronounce different diagnoses. All of my psychological trauma and psychiatric conditions are rooted in the abuse I suffered in school and in the unique neurodevelopmental situation I am in. I have pretty much every classic symptom of prolonged extended psychological abuse -- terrible social anxiety and avoidance of other people, dissociation and fragmentation of consciousness, severe depression, emotional dysregulation, dysfunctional and disorganized attachment in personal relationships, a seriously flawed cognitive model of the world and people and social relations, predilection to abusing others, even if it was just by neglect. For a lot of years I've hidden and compartmentalized the terrible trauma I went through -- which is in fact classic and pretty typical of abuse victims. I know a lot of this sounds very theoretical and people who might have had social phobia and depression and dissociation for years or decades will feel like nothing I say is unknown to them or practical in helping their condition -- I would have said the same. I really don't know how much the Lyrica has allowed me to start altering these broken cognitive models and processing traumatic memories. I think Lyrica might be an excellent med for people with Asperger's to slow down a bit the emotional hyperdrive that aspies tend to be running 24/7, especially when with other people, which for my whole life has felt uncomfortable and overwhelming even before social phobia. Amitriptyline also seems to help with the innate tendency towards depression and things like skin sensitivity and inattention that cause aspies difficulty in everyday life. With the knowledge I have about my innate hypersensitivities and vulnerabilities and deficiencies, I've had to do a lot of cognitive restructuring in how I see the world and my place in it, how I view and manage and monitor my emotions, how I view and interact with people, figure out what I really want in life. For example, I no longer try to get up in the morning and work for four hours on some task -- which 95% of the days I'm unable to do and spend the rest of the day feeling terrible about it. Some days I do absolutely nothing and I work very hard to accept that this is OK and not a reflection of anything in my personality like laziness or stupidity. I have to write another post about abuse and its consequences, and dealing with the world from the viewpoint of Asperger's but I just want to describe what my recovery path is like right now.
What we consider being well or remission is a very complex set of cognitive emotional behavioral and physical processes and habits that meds may be necessary but not sufficient to achieve. Remission is not something that we feel or even the clearing of memories or intrusive obsessive thoughts. I suppose you could define remission as figuring out how to love yourself again, and we all know love is not a feeling. I think for many people any goal of trying to attain euthymia or hypomania or dissipation of anxiety or recovery of energy and motivation to do tasks through meds is pointless and ultimately does more harm than good. Our pain and negative symptoms -- even the black hard anguish of biological depression or the reality-warping, emotion-freezing distortion of dissociation -- is still part of our own mind, still our own way of coping with life as we have always done since the moment we were born. Trying to compartmentalize or treat these things as foreign invaders akin to cancer cells or bacteria is futile, in my opinion. To me the best mix of meds is the set that allows you some basic level of day-to-day functioning even if that functioning is done with severe emotional pain or dysfunction and limits; but most importantly, the set that puts you as close as possible to the source of that emotional pain and dysfunction and allows you to process it. It is absolutely necessary to understand what your illnesses are. People with severe dissociation meet and exceed every diagnostic test for major depressive disorder, SAD and GAD, paranoia, obsessive thinking, even bipolar...that doesn't mean that traditional meds for these conditions will be able to treat these people. When you factor in neurodevelopmental disorders like Asperger's with its inherent hypersensitivity to negative emotional stimuli and severe deficiencies in being able to observe and describe internal experiences to others, it seems like there are way too many variables or factors to make labels like depression and anxiety and psychosis anything close to being diagnostic.
For a long time I would use metaphors like nuke or zap or kill to describe what I wanted my meds to do to my depression and anxiety; this to me is a mistake. I think that emotions and memories and behavior exist in a very complex feedback loop -- the only way to heal is to firstly understand them and then secondly to create processes that can change them to what you want. I think that this inability to make new processes is a big part of the reason people's meds may poop out or decrease in effacy over time. Meds might nuke or zap your emotional pain but if the same cognitive and behavioral processes and vulnerabilities and deficiencies are there then your remission might just be temporary. The only words I use now are process, resolve, cope, change, understand. I try every day to process the trauma I went through, to cope with Asperger's, to know and understand and accept the person I am and to change myself for the better. And I am making progress: I was able to start exercising and lost all the weight I gained since university and I feel good that my clothes fit me properly and I don't feel so self-conscious about my appearance anymore. There are several other small areas that I am making small improvements in -- most notably in dealing with ADD level inattention and how I view and interact with other people especially my immediate family. All these things have created new pathways and responses in my brain that I don't think meds alone would have been able to sustain. I still deal with severe pain everyday and I have started to do some mindfulness meditation exercises which also help with the dissociation. Pain is something that I am learning slowly to understand and deal with, to not allow it to trigger the downward spirals into dysphoria and catatonia I am prone to. The same for loneliness, shame, regret, frustration, anger. It is, obviously, a very long road and I still struggle very much with understanding and acceptance. But I have come to believe that yes what I was born with and went through might have been for a a reason, that I am a much better person for all I went through, that I do have a place in this world and a real chance to contribute and help others.
Which brings me back to this place. You know we all have periods where we go through contention and feel anger with each other and about unfair things that we see being said done. But I have never found a place either online or in real-life that has granted me the knowledge and wisdom to cope with this very difficult time in my life like PsychoBabble. Apart from the technical knowledge about meds and psychiatry and psychology which has always been first-class and second-to-none, just observing other posters in what they write about themselves and their difficulties and how they live with their illness and seeing how they treat others here has inspired me to believe that for all the evil that we went through it was not for nothing, it only made the good things inside us stronger. For that reason alone clunky contentious unfair archaic PB needs to stay alive. I know for a fact I wouldn't have gotten as far as I have without it.
C-PTSD: social phobia, major depression, dissociation.
Asperger's Syndrome.
Currently: 50mg amitriptyline single dose at night. 75mg Lyrica occasionally.
Significantly improving.
poster:hyperfocus
thread:1033042
URL: http://www.dr-bob.org/babble/20121130/msgs/1033042.html