#executive dysfunction attacked me for like 4 days straight

[astro-nomaly]

Posting memes ab my fic that’s due in five days instead of writing it

[flimsy-roost]

Day 8 update:

The main reason I decided to try medication is to temper executive dysfunction issues. To preface, here is a general model for my brain starting a new task:

I have to remember the task that needs to get done

I have to determine the steps involved in the task

I have to decide to do the task (can pingpong between 2 and 3 many times if the task is particularly important or time sensitive)

I have to hype myself up to get over a nebulous hump, best described as a moderate brain-body disconnect, manifesting as a gravitational pull towards inertia; even if I really want to do the thing, and am only thinking about how I really need to get up and do the thing, I have a last-mile roadblock between me and doing the thing that I need to overcome

Using this model the preliminary guide, here's a general overview for week 1 on 18mg methylphenidate-ER (concerta):

-Positive direct effect on step 1: Mild to moderately improved memory, things like the tiny task that I need to do or the extra thing I didn't write on my grocery list, that would usually disappear into the void, will now more often return from the void when I need them

-No direct effect on step 2: multi-step and complex tasks are still a struggle to plan for, and have been repeatedly pushed back like usual

-No direct effect on step 3: correlated heavily to the no direct effect on step 2, I can't decide to do a task if I don't have at least a basic plan of attack

-Extremely positive direct effect on step 4: When I decide to do a thing, I can just... do it. The hump is imperceptibly flat. I don't need to argue with myself to make a sandwich or check the mail. I can just pop up and do it immediately! I had to make a phone reservation two days ago, and I did it within 10 minutes of remembering I needed to do it! This alone is amazing!

-As a result of step 4 improvements, I've suddenly freed up a lot of energy and brainspace that was previously reserved for getting over humps, resulting in mild indirect improvements to steps 2 and 3 (more brainpower for planning!) and mild to moderate energy boost (by 6pm I'm reasonably tired instead of communicatively catatonic) (and if we're being honestly likely contributes to the better memory, but unsure if I'd ever be able to tell if it's mostly direct or indirect)

-Possibly because of energy increase, I have a mildly improved attention span, though this applies only to things I'm actively participating in (ie conversations and tasks), and not, as I decided conclusively by hour 2 of a soils lecture, to things like passive listening of uninteresting topics

-Does not prevent me from getting tired- I'll still crash a bit after a long class and insufficient sleep- but I stay fairly awake and alert while tired instead of, again, catatonic

-Byproduct of above, has not significantly impacted my need for caffeine, only change is I'll sometimes turn down a third cold brew at 6pm, but continue to have second 6pm cold brews, this wasn't something I was hoping would change, but it's an interesting litmus test for effect on overall energy

-I'm starting to understand the advice of exercising to help with insomnia, I always would think "how can I possibly when I don't even have the energy to do the exercise in the first place" which was the genuine truth, now after a couple of days of getting a lot of things done (including a day with a dance class), the physical tiredness is new and actually does help me sleep better, like the mental tired is not enough help me sleep and also prevents me from getting physical tired, now that I have the opportunity to get physical tired it can overpower the mental energy and force me to sleep, if that at all makes sense

-The step 4 hump also often prevented me from hyperfocusing on things, now that it's gone I've been doing it more often, which is net neutral; on one hand, I spent five hours on a nitpicky design assignment, on the other, I played marvel snap for six hours straight last Saturday, kind of nice to have it back tbh

-The ear ringing/sensory sensitivity calmed down a bit by the weekend, had a smaller crash on Thursday evening but not nearly as bad as the first, definitely overall more sensitive, but because I now have no hump that prevents me from helping myself (like I'd suffer in silence if my headphones were across the room because I couldn't make myself go get them), at time of writing I consider this an acceptable tradeoff

Overall happy, it hasn't been the magic blast that some people experience, but it's absolutely helping with what I want it to help with, meeting with the psych in a week and I may consider bumping up the dose, because I'm unsure of the extent of what it's "supposed" to do

Had my second appt with my (I guess he's "my" instead of "a" now?) psychiatrist, he looked at the "do you really actually for real show ADHD traits" questionnaire I filled out and basically said "woah, those are some gnarly symptoms you've got there," and now I supposedly have a prescription incoming later tonight (despite the shortages???)

Liveblogging for my own ass (posterity)

[catboyfurina]

Best to worst vibes

1. The spiral: tie dye AND uzumaki Yestm. Also straight up imagine being afraid of ur brain lying to u? That is normal why are u afraid of normal every day happenings?

2. The stranger: they are full of funky cool people (clowns) heck yes

3. The slaughter: it's like murder and violence and shit but both u and the other guy are having a blast and theres rad music. Like u totes die but in a fun way

4. The hunt. This is just higher stakes hide and seek

5. The flesh. Meat is meat they are correct and valid. Kind of want to meet one of these guys and get some extra leg bone or become a human octopus

6. The buried. This is hide and seek but u pack stuff around u and try to become one with the environment and also dont breathe

7. The desolation: their end goal isnt rad but arson is kind of rad

8. The vast: in theory hell yeah good vibes but in practice I get very alarmed when there arent mountains on all sides so yeah 😔 also dont particularly like Falling which would get better after the acceleration stops once I'm at max velocity but I dont think I would be having very much fun before that

9. The web: spiders are cute and fuzzy and I feel like I should have some goodwill there due to actively avoiding spider murder my whole life. Not incredibly wild for the mind controlled and eaten aspect and I dont actually like touching spiders tho. But back to the first hand it would be kind of nice for someone to mind control the executive dysfunction out of me. It is neutral vibes it's just that so many have such great vibes

10. The end: it happens. These vibes are also neutral I feel like people get very dramatic about death but that's just like evolution shit cus a species wont last long without a fear of this so it's understandable

11. The eye: I would rank them lower cus they are mean awful killjoys and the unknowing sounded rad and cool and like a very cool way for the world to end but alas not the worst possible vibes

12. The dark: I dont remember much about this beyond creepy things attack u in the dark and as someone who lives in the middle of nowhere who knows exactly what is in the dark and does not like it (coyotes) these vibes are 'wild dog attacks me' vibes so they are not great

13. The lonely: these vibes are rancid like i am prime feeding material for this dude and do not appreciate it

14. The extinction: we r living this and I do not like it

15. The corruption. Worms NO. mold NO. this is bad.

[dynamic-instability]

In one of my classes we have to write weekly personal narratives about an experience with illness. This week, mine turned into this. It’s probably too personal, and too... immediate?? to turn in to a professor without cutting out a lot of stuff, but not too personal to post online I guess lol

_____________________________

It’s November again.

In 2009 the lights were too bright. Mid-October one morning I woke up to my dad turning on my lights and it was like having to look into the sun while posing for a photo—my eyes wouldn’t stay open, if I forced them to, they couldn’t stay pointed in one direction, they spasmed and hurt. When the light was dimmed, I still saw double. That morning, I showered in the dark, and I remember being scared. They gave me eyedrops that paralyzed my accommodative muscles. In November my pupils were giant discs and I wore reading glasses over sunglasses to look at the computer, and when it was all said and done, the lights were still too bright, and I still saw double.

In 2011 I was tired. There’s fatigue and then there’s fatigue, I learned that Fall. In May of that year I had pulled two all-nighters in a week, and that was the only other time I’d felt this kind of tired, a sensation in about the 30th hour of the second time where it’s like my brain itched. I once saw someone else online describe it as “nausea, but in your head and eyes instead of in your throat and stomach” and that’s the closest anyone else has come to describing it. By November this was happening more and more often. I remember laying down in the corner of the room during a break of Citywide choir and thinking what the hell is wrong with me? I got a cold the next week, and I thought that maybe that was all it was. It wasn’t.

In 2013 I went to the ER for the fifth time in three months of college, and when I wanted to leave before waiting another couple of hours to eventually see a doctor who would tell me once again that they couldn’t do anything to help me, the woman from student life who was there to drive me back to campus made me call my parents on speaker phone and get their permission to leave before she would turn on the car. I had missed more chemistry labs than I could afford to miss without failing, passed out in a voice lesson, was asked by the director to drop out of choir because watching me was distraction when I looked like I was in pain, and if I passed out it would have ruined the concert for everyone. I remember leaving calculus in the mornings mid-class to go to the bathroom and lay on the floor and cry. I remember not being able to lift my hand off the mattress of my dorm room bed. I withdrew from half of my classes on the Tuesday after Thanksgiving, and took the Spring semester off.

In 2014 I had made a promise to myself that I would come back to college full time for that Fall semester just to see if I could do it, and then if I couldn’t I would drop out for good. There was one week where I thought that might be happening. Mid-November. The girls in my dorm had made a fort in the lounge out of sheets and blankets and colorful scarves and I remember laying on the couch through the green-filtered light and feeling the world spin and thinking oh god I still can’t do this. The door opened with a rush of cold air and my friends came in with food for me, since I’d been too sick to go to dinner. They sat with me and helped me with chemistry, offered to type up a paper if I dictated it, told jokes and made me laugh. I took an incomplete in one class, but I passed everything else, just barely scraped through, and came back in January.

In 2015 I just wanted to sleep. I passed out in an elevator and heard familiar voices, concerned voices, as I came to, and I stayed there laying motionless for another minute longer, because as long as I wasn’t awake I didn’t have to keep pushing. I wrote whole pages of completely unreadable ochem notes because my hand wasn’t working any better than my brain, and woke up on the floor and was wheeled out on a stretcher crying. It was dark all the time. My cane slipped on wet leaves and I felt my wrist crunch and there it was, one too many missed organic chemistry labs. I couldn’t stand for an entire choir rehearsal because breathing to sing made me lightheaded. I slept for 16 hours a day. The week before Thanksgiving, I called my mother to tell her I had decided to take another hardship withdrawal, and she sighed. I had applied to transfer schools during my much more optimistic Spring semester and Summer, and the week I left was also the week I found out I’d been accepted.

And so okay now it’s 2019, and it’s October and now November again, semester plan again, dark again. My reading is piling up again, feeling overwhelmed again, laying on my kitchen floor again. But here’s the thing—my health is… fine? Midterm week I didn’t sleep, and yes I passed out twice, but no ER. For the past 18 months, I can count on one hand the number of mornings I’ve been unable to get out of bed because of fatigue. My heart still pounds too hard but my head doesn’t swim every time I sit up. I walk the streets of New York City like mobility has never been a problem. I always take the stairs. My brain doesn’t itch until it’s been 30 hours no sleep.

I couldn’t go to class last week. I lay on the floor of my kitchen and stared up at the ceiling and tried to get up, tried to type out an email to my professors, and I couldn’t do it. I was not too tired. I was not too weak. I was not in pain. I could not move. I try to write and try to write and try to write and the words don’t come. I eat instant oatmeal at 9 PM because I haven’t been to the store in a month. I have lost nearly 15 pounds since moving to New York. I clean the stove for two and a half hours but can’t bring myself to take the dead spider off the side of the bathtub. I check the door lock one-two-three times, pace the floor, sit back down. I do not read Austerlitz. I write a Canvas post for Self and Other but it’s nonsense. I do not write a Canvas post for Accounts of Self. I do not write a Canvas post for Applied Writing. I write a Canvas post for Illness and Disability and somehow forget to post it, the one thing I’ve actually done, because I’m too busy feeling sick at everything I haven’t. I shadow a doctor for the clinical witnessing assignment and everything is fine but when I try to write it up I have a panic attack that leaves me sobbing on my couch and the assignment nine days late and counting. It takes me eight hours to write two pages. I watch 18 hours of YouTube video essays discussing drama about creators I don’t even watch and play a stupid game on my phone for an entire weekend until I’ve spent $25+ in a labyrinth of microtransations and every time I close my eyes I see the moving dots.

In November of 2015 I had three overdue essays for Global Literature, and two more due in the next two weeks. More than half were on books I had not read. My pre-lab wasn’t done for organic chemistry, and I wondered for a moment, if I pretended to pass out, if that would be easier. I stayed up until 4 AM laying on my floor and listening to Hamilton. I was sick, that much is true, but when I felt okay I still sat at my computer and could not bring myself to write.

In 2011 I had so many unfinished assignments for my college-level English class that I resigned myself to failing and I went to school the morning of the final class, but I hid in the stairwell by the choir room until I heard the bell, and I never went back to that class.

2009 was the year my dad stopped being able to yell at me for not doing my homework, because no one, including me, could tell whether it was actually my eyes stopping me.

In 2008 I wrote 6 essays in the 5 days of Thanksgiving break because I had not done any work for Intro to Lit all semester. I pulled it off, somehow, even aced the class because of an unusually lenient late work policy, but what I most remember is the sick feeling of dread as I lay on the floor in the living room staring up at the Christmas tree and feeling invisible sand slip through an invisible hourglass and a vice tightening in my chest.

In 2006 I stayed up almost all night writing a paper and crying my eyes out because I couldn’t find the words to explain to anyone why it had been so impossible for me to get the work done, that I wasn’t being lazy or distracted, I just couldn’t do it. I wasn’t necessarily reading YA novels or watching TV or IMing my friends instead of working, I could sit and stare at a blank word document for 6 hours straight and still it would not get done. Everyone talked about potential, talked about how smart I was, but a gradebook that is half 100’s and half 0’s still averages out to an F. No one, including me, could explain the discrepancy. The logic of that simple math was not lost on me, the knowledge that turning in half-finished or not very good work was mathematically better than not doing it, but that didn’t mean I could do it. Words failed me when I tried to explain the illogic of my particular suffering.

I didn’t hear the term executive dysfunction until I was in my 20s. In retrospect I was tentatively told at 16 that I had “probably some ADHD and OCD”, but that psychiatrist was someone I’d been sent to by a neurologist because he thought she could fix my eyes, and when she said she couldn’t, I stopped making appointments. After I got sick, physically sick, the lines blurred between what was causing what, to the point where even I have no idea. Two of the Novembers missing here are ones I spent at CC, on the block plan where I only took one class at a time. My physical health arguably improved a little after transferring in January of 2016, but mostly it didn’t, not until Spring of 2018 at least. And you can see that evidence in dropped blocks, concussions from passing out onto hard surfaces, a couple of incompletes taken when viral illnesses (or concussions) compounded my other problems. What the block plan changed was the way things pile up, lessened the struggle of constant task switching between classes. (Admittedly, I also had fewer papers when taking mostly science classes. Writing takes much more energy, and it’s much harder to convince myself it doesn’t have to be perfect to be worth submitting.) At CC nothing ever really reached the level of catastrophe. Some of that is purely the ability to drop a single block, meaning when it was my physical health that was the problem, I didn’t lose a whole semester, just one class, then reset. But I should have realized sooner that the block plan wouldn’t account for the level of improvement if my physical health had really been the only barrier.

So we’re back to now. Grad school. November again. Dark again. Semester plan again. Too much writing again. Crushing dread again. Dysfunction again. Panic attack in the middle of the night increasingly elaborate organizing rituals scream of the subway tracks in my mind can’t stop can’t start can’t breathe can’t move burnout again. This time without the explanation of chronic fatigue to fall back on.

I have my tricks, have actually learned somewhat to cope in the past 18 years. Schedules help, break tasks into pieces that are as small as possible. Mindfulness meditation. Forgive yourself when it’s not perfect. Get started with something easy, set a timer for 20 minutes and only work for those 20 minutes and then let yourself stop if you want to (and surprisingly often, you won’t want to, sometimes that momentum is all it takes). If you work better in the night, work in the night, who cares what society says your sleep schedule should be. When switching tasks, physically get up and move to a different location. Allow yourself to procrastinate on work with other work if that’s what you have to do. Delete the stupid games from your phone. One or two missed assignments are not actually the end of the world, if you let yourself view it as piling up, you won’t be able to get anything done, so if you absolutely have to, just move through and move on.

It’s not a catastrophe, this November. It’s a fight, but it’s not a catastrophe. I read Austerlitz and forgive myself for skimming it. I write a Canvas post and forgive myself when it’s only 500 words and doesn’t make complete sense. I read Toni Morrison and Édouard Louis and classmates’ discussion posts about Deaf culture and identity and remember why this matters in the first place, that it’s not just a series of assignments to overwhelm me, it’s a series of interesting complicated exhausting important thoughts and questions. I get it done. Some of it. Most of it. I let myself sleep. I breathe. I remember to be grateful because I can get out of bed in the mornings and take the stairs. I am okay.