Monday, 26 September 2016

me et mentis morbum

Fig 1. What I aspire to be ...

This morning, I want to talk about mental illness ... and apologize.

The preceding sentence was rewritten 42 times, and contains the words from the first revision.

In some sense, it is difficult to use the words "mental illness" when we are talking about ourselves.

There is a kind of stigma attached to even thinking the words. Before you can think the words, you must first have the revelation that there is something wrong with the way you behave and or feel.

Some or all of the following things happen when I have to mix with other people in real life:
  • I will try to avoid it, completely.
  • I can't remember where I am, or where I am going, and appear and feel lost.
  • I struggle to recognize people, or remember names.
  • I don't move among humans like other humans do; I bump into them in closed spaces (for example, supermarkets) because I can't read their behaviour.
  • I become outwardly awkward, developing ticks (for example blinking), stuttering and repeating myself. 
  • I become inwardly slow, results in not being able to join in conversations properly:
    • Struggle to figure out if I agree or disagree with any statement.
    • Wonder if it is worth saying what I want to say.
    • Wonder if I might be stupid.
    • Fail to form a response before the conversation moved on.
    • Malform a response, with stuttering and repetition abound.
If I become conscious of any of the behaviours above, my physiology changes; I begin to radiate heat and sweat profusely. This always results in my ending it early and just leaving, often without announcing my departure.

There are a few people who make me feel somewhat at ease, just by their presence. People who are physically large (I am rather small), and attentive (go out of their way to patiently interact with me). I can't really explain this, but they seemingly have some immunity.

To compound the problems I have with social or stranger interactions, and possibly even as a result of it; I cannot remember, in any detail, for any appreciable amount of time, what has been said. With the occasional exception where the interaction resulted in a changed or new understanding of something I am interested in, I will normally have forgotten, everything, including the detail of where I was when anything happened, and usually how I got there (having driven, or ridden a motorcycle to the location), by the next day. I retain new technical information, or more generally ideas, usually, sometimes incorrectly. Of course I could be wrong about that, since I don't remember what I don't remember, but it feels that way. In the mundane, I might retain the price of a thing I'm interested in buying, or where to get it from, but may not remember where the information came from. I will eventually have some familiarity with a face, but it takes longer to remember the correct name, and doesn't always happen. I might never remember any particular location, and don't seem to posses the intuition I see others exercising when navigating the world, or even any particular building, or location of a certain size.

That memory problem might sound quite comical, even advantageous given our profession, but it results in a person that may give the first or persistent impression that they can't remember you, your face, your name, if you have children, or are married, or anything else about you. It creates a person that seems incapable of paying attention to other humans, that will deny having even met you, or having had that conversation which you really enjoyed, or I enjoyed.

For most of my professional life, I have been isolated from the real world. Communication with non familial humans has been mostly electronic, and while it may be a tempting explanation to invoke, it's not correct. These symptoms and behaviours pre-date my professional career, some existed as a pre-teen child.

Most of the time, I have a way above average output, not to boast, but I (usually) live to code ... my children have been late for school before (not by much) so I can finish writing or testing a bit of code - because driving to school while thinking about code is, of course, impossible. When I'm given a task, especially one that involves my doing stuff that hasn't been done before, or is exceptionally challenging, it consumes me until it is done. My enthusiasm delivers my above average output.

Twice now, the enthusiasm has been sucked out completely, and replaced by such a strong feeling of dread and worthlessness, that lethargy takes over and prohibits normal function in every area of life.

Many of you will be quick to label this as "burnout": When you can't find the enthusiasm you require to take your kids anywhere, or go to a school event for them, or go shopping for food, or make love to your wife, it is not burnout.

In our technical world, it's all too easy to dismiss behaviours that are symptomatic of mental illness as a product of our geeky-ness, and our working environments. I think this is one of the reasons why these behaviours have been accepted as normal (or normal-for-geeks) and then ignored, even by those closest to me.

The first time the enthusiasm disappeared, life pretty much fell apart, I had no idea what was happening.

I think, I am just recovering (with life intact) from the second time ...

It was extraordinarily difficult to approach my wife, and soul mate of more than a decade, and say out loud "I think I have a mental health problem". They are the words I used, I needed to be direct, unambiguous. By the time I had finished the sentence, I could see the understanding written on her face, the relief ... I'm lucky to have her.

Doctors appointments and diagnosis (acute social anxiety and depression) followed, and treatment is ongoing.

The antecedent factors that lead to these difficulties don't interest me very much,  and are shrouded in the blurriness of my memory whatever. Getting at the reasons seems all but impossible. What concerns me is how to live and function with these symptoms today, not the days or months from my childhood that may or may not have helped to form or exacerbate them.

Compared to the discomfort of telling my wife, telling my manager was easy. My manager has a beard, 
which obviously helps ... while my wife has no beard. In all seriousness, it was only easy because of the understanding nature of the response I received.

I'm not back to normal yet, there are good days and bad, but none of them are normal. I don't fully understand why this has happened, and tend to think it is not fully understandable in principle whatever.

I'm saying all of this in public for two reasons: I think I owe the community an explanation for my recent absence, an absence which may well effect your ability to do your job properly. Most importantly, I feel obliged to speak in order to normalize talking about it, and directly encourage anyone who thinks "that's me" when reading this, to get some help.

Even the internal dialogue that lead to the realization that I have to tell my wife anything at all, was, in some small way, liberating. Surely this helped to provide whatever I needed to first utter those words.

I can't apologize for being unwell, but I can and should apologize if I let you down without explanation; I'm sorry.

2 comments:

  1. I don't really know how to react to this post, nor if I should, I don't know you, you don't know me, I have a bare idea of what you can live... the past weeks I asked myself "no activity for months, is he ok ? no one seems alarmed on twitter or internal, that's weird" .
    It is good to hear from you, even more when you come back with such courageous (from ancient "cor", meaning "heart") words.
    I can't do much except wish you the greatest recovery a man can have :)

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  2. I have clinical depression. I've had this since high school. I just turned 50.
    Anyway, this is being treated by some medication, and very occasional exercise. As well as having a handful of friends and family who are VERY understanding.
    Best wishes to you. Best thing that ever helped for me was going to a doctor and getting treatment (for years I went without treatment). There's not currently a "cure" for this, and I still have episodes of depression, but these are far far fewer than they used to be.
    Also what helped was to let my close friends and family know about my illness, and they have been very supportive even on my occasional episodes.

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