What follows below is a letter I recently wrote to someone. At their encouragement, I’m posting it here, so I can refer to it in the future, when certain things get hard to hear, and harder to say. It is unedited, except for minor details for the sake of their privacy.
Often writing is easier than talking to someone, and sometimes even when the same words are said, they are better communicated in writing.
I wanted to share the following recent changes in my life with you, as I think they accurately highlight a few very important things: (1) My life is entirely defined by challenges like the one described below; (2) The whole of my actions are to manage and combat challenges like the one described below; (3) These challenges are largely invisible, and I cannot consistently make the time or energy to update the people in my life when they occur—in part because they often occur; (4) My mental health has gotten ‘better’ — meaning, I cope better. In other words, these challenges have gotten less visible. But they’re still there.
The previous week was relatively ‘good’ for me – I experienced relatively little difficulty with my sleep. I was able to focus and get work done. I was able to exercise. I was well-regulated emotionally. I was making progress in my academic goals, mainly, getting a significant amount of studying done.
Then two days ago, something changed. I have no idea what. I didn’t see it coming. And I don’t know how long it will last.
Yesterday morning, I woke up about 1.25 hours later than usual (6:15AM instead of 5:00AM). I immediately felt alert, very restless, and very anxious. My thoughts were moving quite fast. I went through my usual routine. Brushed my teeth. Drank a glass of water. Stretched my right hip. Made coffee. And sat down at my desk to study: One of the most comforting, and safest things I do every day. In the two hours I sat there, I got almost nothing done. My mind was jumping all over the place. Racing. I tried to read the sentence on the Anki card in front of me, but I couldn’t slow down enough to actually do so. I realized I was holding my breath, I was so anxious. My desk lamp was hurting my eyes. I couldn’t sit still. In short, the morning was two hours of a tooth-and-nail battle between a simultaneously physiologic and psychologic disregulation urging me to get up, run, fight, do something! and the calm, rational part of my mind urging me to just sit and get even 10 minutes of studying done.
The effects got a little bit better over the course of the day. Getting out of my house to go tutor a student helped. We found a place to sit where I could tutor standing up, and I paced back and forth a little bit to manage that restless energy. The two hour session tired me out a bit, and that helped. Even so, I went to bed multiple hours late, as I was overly alert, I thus ended up sleeping in even later this morning.
In physiology, there are two related concepts: A negative feedback loop is a process that tends towards reversing a bad outcome. A positive feedback loop is a process that tends towards increasing a bad outcome.
Much of my challenges lie in that ‘destabilization’ for me tends to be positive feedback:
1. I have a stressful day, which makes it harder for me to sleep
2. My poor sleep leads to increased anxiety the next day. I am in fight-or-flight most of the day, and go to sleep even later.
3. This cycle repeats, each time round increasing in intensity and consequences.
Whereas for a ‘normal’ person, a poor night’s sleep might mean a shitty day and the desire to go to bed early, it often doesn’t derail their entire week. The challenge for me is that many little things, like sleep, can have these massive, many factor-multiplied consequences in my life.
Now, to what this means for me: Like most people, I have goals, hopes, and dreams. I want to be a doctor, but perhaps even more important to me is that I just want to get through college with good grades. And doing this requires more from me, than it does for ‘normal’ people.
I can be halfway through the semester, doing quite well, and then wake up like I did two days ago, and suddenly be unable to get even an hour of good work done. Remember my lab partner over the summer who didn’t study, went to see Jurassic World, and then did absolutely abysmally on her exam? Well, sometimes my mind decides that it’s going to go AWOL for a while and see some bullshit movie in Physiologic Disregulation and Insomnia Land, and against my will I can lose a week of my life to simply fighting the positive feedback loop trying to spiral everything out of control.
Perhaps I felt so at-home in Wildland Fire and EMS because in both cases, you’re already in a constant state of fight-or-flight, and so not only did that not cause any additional disruption to my life than anyone else’s, perhaps I was even better able to handle it. In fact, the greater the pressure, the calmer I tend to be. And I think some day I’ll make a great ER physician for this exact reason.
The point is, one little disruption can destroy a week of my life. And that can mean I can go from doing great in my classes to being so far behind I struggle to not simply fail my classes. And there are 10,000 different things that can cause little disruptions that snowball into big disruptions.
The main difference is that, as my coping skills and attitudes have grown more mature, these problems become less externally visible. Now when I wake up, feel awful, and suddenly fall behind, I think to myself ‘Good – this will give me a chance to refine my coping skills!’ But, that makes the damage no less real.
The way I see it, life has dealt me a hand, and I have to live with it. I have two options: I could never aspire to anything great, be content working a stress-free job, something where these disruptions would impact my life less, and then have more time for things like friends, family, hobbies, ‘fun,’ and so on.
Or, I can strive to do something great with my life, despite the burdens I carry, and accept that doing so will cost me much: The ability to have many friends, or to see few friends often. The ability to ever make meaningful time for a romantic relationship. The ability to have ‘fun.’ To have hobbies.
And fundamentally, the person I am, I would rather die than live a life where I take the ‘easy road’ to avoid hardship for the sake of an easier life. On the contrary, every one of the things I’m proud of about myself were born from hardship.
So, I’ve made sacrifices. And I’ve made my peace with them. I may never have many friends, and may often feel very isolated and alone. I may never have a romantic relationship that lasts. I won’t have hobbies. I will rarely feel relaxed. But my life will be meaningful.
It’s not visible to anyone but myself, but these last two days have been an all-out battle between me and my mind, trying to get a handle on my life, and get back simply to a level of stability where I can get more than ten minutes of studying done, or simply get a good night’s sleep. And part of that means that it sometimes takes me an entire day simply to get one email written.
I’ll add in finality: Because these disruptions can come out of the blue, and can be so incapacitating, preventing them is a constant and top priority for me. And part of that might mean spending a weekend exercising, doing laundry, and grocery shopping, instead of seeing a friend who is visiting town for a short while.
But if someone says “David, hang out today” and I say “I can’t, I need to do laundry so that if next week my mind decides to fuck off and my entire life tries to fall apart, I still have clean clothes to wear” — well, they might “hear” it, but they won’t “understand” it.
This is the reality of my life. And the people in my life have to be comfortable accepting me when I’m around, and equally accepting me when I’m not. They have to be comfortable with the uncertainty that I could be doing fine for months and then suddenly be unavailable for months. Because that’s the cards I’ve been dealt.
Lastly: There are people in life who will not be understanding of this, and I have to accept that. The professor, for example, who refused to offer me a makeup exam or give me an alternative, after I spent 8 days in a hospital, despite that being clearly listed to him as one of my legal disability accommodations. And ultimately, even when the school disability office got directly involved, the professor simply ignored their emails. This sinks even further time and energy from my life. And it often leaves me with little else.
I hope this helps in some way. Sometimes in these awful states, though I can’t get any work done, I can write, and find it to be therapeutic.
Please feel free to let me know of any questions, or just your general thoughts on this subject.
This is unedited, so I apologize for any typos.
David