Bounded in a Nutshell

“I could be bounded in a nutshell, and count myself a king of infinite space, were it not that I have bad dreams.” Hamlet, William Shakespeare

I felt a huge amount of anger with HaShem (God) yesterday evening.  I’m just so lonely and feel so useless and I can’t see any way out.  It’s illogical to be angry with Him about my own failings, but I feel that if I wasn’t autistic and depressed, I wouldn’t be so lonely and isolated, which leads on to anger with Him for making me autistic (blame for the depression is more complicated).  I feel if I wasn’t autistic, I would be able to function in the frum (religious) world as He wants, but as it is, I can’t function.

I didn’t know how to process the anger, so I ended up hurting myself for the first time in a while.  I hit my legs with my fists while trying to talk to HaShem;  later I scratched myself slightly, but I’m not quite sure why I did that.  I have been fantasising about death again lately too, mainly just thinking that however bad things are here, one day I’ll be dead and unable to feel any more pain.

***

I’m still struggling with what to do about dating.  It still feels wrong, morally wrong, to date while I’m not just unemployed, but not even sure what I want to do with my life any more.  And I can’t face the thought of rejection and it seems there are so many reasons why someone would reject me (autistic, depressed, weird geeky interests, didn’t go to yeshiva or otherwise tick the appropriate frum boxes) even without being unemployed too.  Nor do I look forward to having to turn down someone I don’t feel is right for me.  And I’m wary of thinking that things will be better if I’m in a relationship (although it is true that I have felt better when I’ve been in a relationship in the past, even if I wasn’t “recovered”).

However, I just feel so lonely.  I feel like everyone has their partner except me.  This is blatantly untrue (a number of my friends are single), but reflects how I feel.  I feel that I am mostly self-contained.  I don’t need other people with me all the time.  I have solitary hobbies and even things like watching TV I prefer to do alone (I don’t like watching TV with other people because I don’t watch TV casually.  I don’t channel hop, I only watch things I want to watch and which I think are worth my time, but then I watch them with complete concentration and dislike noise and interruptions, particularly as the programmes I watch tend to be plot-heavy and reasonably complex to follow).  I should really be happy living alone as I’m an introvert and a bit of a loner.  But, as seen when my parents are away, when I’m actually alone, I do get more depressed, even though logically I should welcome being alone.  I do, on some level, need people around me, even if I don’t interact with them much.  I also need to be able to love and to feel loved and I’m rather starved of both of these things and have been much of my life.  My parents and my sister do care about me, but there are so difficulties in those relationships, most probably stemming from my autism and my having different “love languages” to my family.  We probably aren’t very good at showing love to each other in ways the other person can comprehend.

I try to cope with things and be self-contained (“If you are miserable alone, you will be miserable in a relationship” as everyone says), but I just feel so unbearably lonely and unloved that it’s impossible to escape the depression for long.

***

I saw the psychiatrist today.  It didn’t go well.  She focused on my unemployment, repeatedly telling me that I should get a job, which wasn’t terribly helpful.  She did suggest doing voluntary work, which is probably a good idea.  I didn’t feel like she was really listening, nor did I have the confidence to tell her that my depression and social anxiety are just as bad, if not worse, when I’m working, because of issues surrounding autism and mental illness in the workplace.  In fact, I haven’t told this psychiatrist about my autism at all, as the last one said that if I’ve been told I haven’t got it by the Maudsley Hospital, I don’t have it and that’s final.  As my GP has referred me for another assessment at the Maudsley, I’m not going to raise the issue again until I’ve had that assessment.

As well as sounding disappointed with me for not having a job, she sounded disappointed with me for not having friends.  I said I had “one or two” which is a simplification (I have two or three I’m in contact with regularly, but via text as they live elsewhere; I have one or two friends who live locally, but I usually only see them in shul (synagogue)).   I couldn’t really be bothered to explain as she didn’t seem interested and I was struggling to understand her accent; possibly she was struggling with mine too.  She asked if I am in a relationship; she didn’t really react when I said I’m not.  When she asked what I do when I’m not job hunting, I said I write a bit, which she misheard as “write a book” which is basically true so I didn’t correct her.

She asked if I have thoughts of self-harm or suicide and I said yes, because I have had them in the last couple of days, but she didn’t really seem to care as I said I wouldn’t act on the suicidal thoughts, which is probably true, and that I wouldn’t act on the self-harm thoughts, which was a lie because I did last night.  I don’t know why I lied; probably because it was very minor and I just wanted to get out of the appointment room.  I just didn’t feel comfortable opening up to her as she seemed to just want to process me quickly and get to the next patient and seemed to think that finding a job will be a panacea for me.

***

Today’s potential jobs: a school librarian maternity cover job (I don’t want to work in further education again after struggling previously); an “information assistant” that seems to be a library assistant role rather than an assistant librarian and has a lethal-looking commute; and a role billed as “knowledge librarian” but which also seems to be a library assistant role rather than a trained librarian role, judging from the lack of professional skills in the job description and which also requires SharePoint experience that I don’t have.  I was then reminded that I applied for a “knowledge librarian” role a few days ago; I think it was the same job as the job descriptions are similar, although it’s hard to be sure, as both jobs are advertised through different agencies and don’t state the name of the company that is advertising the job (this happens a lot and is very frustrating).

It is probably no wonder that I really want to do something else with my life, something I find more rewarding.  But, just as I don’t have the courage to start dating again, I don’t have the courage (or knowledge and perhaps the ability) to try to write professionally.

***

I feel like I’m coming down with a migraine, so the rest of the day is probably a wipe-out now.

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Depressive Thoughts

(A stupid, pointless title, but I’m feeling awful.)

Last night after I blogged my mood went down quite rapidly.  I felt like I had been going flat out all week with networking workshop, Jewish Book Week, work two consecutive days and my parents away.  I just fell back into despair and lethargy and crawled into bed at midnight hoping I would wake feeling better or at least more alert.

However, I had strange dreams in the night.  First I was on the Tube and ended up helping a doctor who was helping a pregnant woman who I thought was a nun, but looked, in retrospect, like she was wearing a hijab.  I was aware that she had cut herself off from her community by getting pregnant, but I felt sorry for her.  I was worried about not getting home in time for Shabbat (the Sabbath), but was assured by the doctor that it didn’t start until 7.30pm (in reality, that won’t happen until the clocks go forward).  Then things shifted and I was in some sort of classroom (although I think I and the friends/other people with me were all adults).  A huge and intimidating man, about twice my height, stocky and with a long, thick beard was trying to test me on reading Hebrew aloud; I stumbled on this, but couldn’t convince him that this was due to social anxiety stopping me reading confidently rather than poor Hebrew literacy.  We started to daven (pray) the Friday evening service, but the intimidating teacher told us to skip Kabbalat Shabbat as it was too late.  At which point I woke up, I think.

I am not entirely sure what any of this means, although I can see that it was an anxiety dream (which may be why my sleep was not restful) with some obvious allusions: the pregnant “Muslim nun” rejected by her community represents my fears of being rejected by the frum (religious) world for being too worldly, but also by Doctor Who fandom for being too religious (she was still a nun even after presumably breaking her vow of chastity); more prosaically, the motif of being late for Shabbat reflects my fears that I’ll run late tomorrow getting ready for Shabbat by myself, plus I do still get occasional anxiety dreams about breaking Shabbat even though I’ve been shomer Shabbat, at least at a basic level, for half my life.

***

It was fortunate that I woke up when I did, as I had slept for eleven hours, dramatically oversleeping and having to rush out and skip both shaving and davening (praying) to get to my psychiatrist appointment on time, both of which I hate missing.  The radio was on in the waiting room and I found it irritating.  I don’t know why all NHS and social services waiting rooms seem to have TV or radio on these days.  I find it really annoying and it’s not terribly autistic-friendly.  It was a new psychiatrist as the one I saw last time is ill.  The appointment was OK, but I felt that I was just a statistic on the waiting list being processed.  She didn’t ask about my case history or the causes of my problems and didn’t seem terribly aware that I’ve been depressed without cure for most of the last sixteen years or more.  Maybe she didn’t know.  I didn’t say anything about autism, because the last psychiatrist was dismissive of it, saying I’d already been assessed and told I was not autistic.  My GP has sent my autism referral through and I’m on the (very long) waiting list, so there didn’t seem any point talking to this psychiatrist about it at this stage, although I did get vaguely upset when she said that social contact will get easier the more I practise it.  For a neurotypical person, maybe, not for someone whose brain isn’t wired to understand people.  The psychiatrist was also a bit blasé about my work issues, saying I would find part-time work easily.  I didn’t ask for a medication change, as the clomipramine seems to work a bit, sometimes, even though it still leaves me quite depressed and has led to a lot of weight gain.  I don’t think it’s particularly sensible to mess around with medication while I’m working if I can help it anyway.  I have another appointment for three months time, so I’ll see what happens and maybe ask to change things then.

***

In the afternoon I did not do much, but was busy with my job application spreadsheet, which I keep up to date, even though I have not actually applied for anything for weeks and have missed a lot of deadlines, alongside a few other chores.  I was hoping to work on one or both of my books too, but I didn’t get the chance again.  I’m so busy just surviving from day to day that I don’t have time for anything more future-orientated, whether writing books or job hunting.  I didn’t actually achieve much today, but I didn’t really relax and get the rest I need either.  Maybe I will be able to rest over Shabbat, but who knows?

***

Looking at job adverts again today brings back my work worries.  I know I’m over-qualified for my job, which is not too difficult, and although there are harder elements (choosing appropriate material for exhibitions is difficult but interesting, although it would help if I knew the collection better, but my background in history has been very useful here and won me praise from my line manager).  But the whole reason I like my job is because it’s not pushing me too hard right now, when I am struggling with self-esteem and energy and motivation issues as well as confusion about whether I’m autistic and how I should live my life if I am, as well as how to manage my mental health (with or without autism).  I don’t know what to do.

***

The work worries bleed into relationship worries, because I don’t think anyone will date me until I’m working much closer to full-time.  I know that I could still get married at some point, but it seems a long way off, which in turn makes having children (which I really want to do and think about a lot) less likely.  But it’s the loneliness that is so hard, and difficult to survive.  It’s probably loneliness more than anything that has triggered my suicidal times, even if it gets mixed up with despair and hard to isolate.  I don’t know how to survive the ten or twenty (or thirty or forty) years that I might have to wait until I’m functional enough to look for love and to meet someone who can see past my considerable dysfunctionality and all the baggage and drawbacks I come with.

I just wish I had people to talk to who understood me.  It’s been hard to talk to my parents lately, which is probably my fault.  I get irritable and sarcastic when I’m depressed, not to mention focused on catastrophising.  But my parents don’t entirely understand depression or autism entirely, although their understanding is greater than some people’s.  That’s not their fault, but it makes it hard.

I have friends who understand depression and autism and care about me, but they don’t live locally and I can only communicate via text and email, which is better than nothing, but also lacks something somehow, even to a socially anxious and avoidant person like me.  My local friends don’t really know so much about my issues, for various reasons, again, largely my fault.

I just wish there was someone in my life who cared about me and understood me and I could see regularly (and feel comfortable seeing regularly).  I know I depend too much on other people for my self-esteem, but I don’t know how to change that and I get annoyed by people who aren’t lonely telling me I have to love myself before anyone else can love me.  I could just as easily state that other people have to show me I’m worthy of love before I can love myself, because I don’t see myself as worthy.

***

On a related note, my sister phoned tonight to see how I’m getting on without my parents.  I struggled a bit to deal with the call.  I find that usually happens when she phones me.  I thought it was because she usually interrupts dinner/Doctor Who, but I wonder if it’s an autistic predictability thing and I would cope better if she told me in advance that she was planning to phone at a particular time on a particular day.  Still, I think she takes better care of me than I would be able to do if our roles were reversed.  Maybe I couldn’t cope with someone in my life who cared about me and understood me.

***

About 8pm, I was watching Doctor Who and noticed that I was crying.  I thought it was odd, as I didn’t consciously feel depressed.  Then about twenty minutes later, I realised I was depressed, painfully depressed and sad.  It’s strange how out of touch I am with my emotions.

***

I read a davar Torah (Torah insight) sent out by my shul (synagogue) for Rosh Chodesh Adar II (New Moon) upset me.  I felt I was being attacked and to some extent deserved to be attacked.  I don’t really know what ‘spirituality’ or ‘Jewish spirituality’ means any more, if I ever did.  I try to study some Torah every day and pray at least a bit of the three daily prayer services (although I often miss Shacharit on non-work days like today).  I want to be a good Jew, but I don’t really connect with HaShem (God) or Torah much these days emotionally.  I certainly can’t find “authentic spiritual joy” for Purim.  It’s just a struggle to get through Purim in one piece.  I want to be a good Jew, but it’s hard enough trying to perform the mitzvot (commandments) in my situation without worrying about kavannah (mindfulness), spirituality, meaning or connection to HaShem.

Then shiur (religious class) tonight was about genuine joy being connecting to HaShem via Torah, but we get distracted by false pleasures.  This might reinforce my feeling that I’m depressed because I’m a bad person and God hates me, which I hadn’t felt quite so much recently.  I think I might have missed the point of the shiur, though, or wilfully misinterpreted it to make myself feel bad.

Whether I misinterpreted things or not, I feel that I’m a bad person and a bad Jew who doesn’t connect with HaShem through davening, mitzvot and especially not through Torah and who is wasting his life on meaningless transitory pleasures like Doctor Who and writing (despite this I am still thinking of cosplaying (dressing up as a fictional character) the fourth Doctor for Purim, but I might not have the guts to do it).

So much of Jewish religiosity is tied up with community, which is problematic for me because of social anxiety and low self-esteem (it’s feeling that people would reject me  if they knew the real me that keeps me away more than actual experience of rejection), and with family, which is difficult for me because my parents don’t connect with Judaism in the same way as me and because when Jews say “family” they primarily mean spouse and children (maybe most non-Jews think like that too).

The silly thing is that I really believe intellectually, I just can’t connect emotionally with my religion, perhaps through depression (or autism?).

***

I can’t believe anyone reads this rubbish I write.  I shouldn’t write it, but I need to vent and here you go.  I suppose it’s better than hurting myself, at least assuming it isn’t just a very clever and complicated way of hurting myself, which might in fact be the case.

You Don’t Have to Be Neurotypical to Work Here – But It Helps!

I struggled to sleep again last night, despite not feeling consciously anxious.  I did my usual trick of eating porridge as a way of ingesting soporific warm milk (I don’t like the taste of milk ‘straight’) which worked, but I wonder how much of my weight gain is due to things like this.  Although the dark chocolate Kit-Kat I had for dessert at dinner because I was so depressed was probably worse.  The result was that I overslept this morning and rushed out to my networking workshop and got the Tube rather than the bus to save time, only to discover I’d been overcautious and arrived half an hour early.  I was too embarrassed to go in straight away and paced up and down outside for quarter of an hour.  I was still the first person there.

The workshop was quite good and, to my relief, didn’t involve too much interaction.  We did have to sell ourselves with an ‘elevator pitch’ which I struggled with.  The whole morning just underlined for me, if I could have forgotten, how vague I am on my career aspirations (not least because I really want to be a writer and librarianship is a time-filler while I work on my first books or second-choice in case I can’t write), how few people there are in my social network, how few professional contacts I have in the sector I work in and so on.  I did feel that with all the emphasis in the workshop on building networks of people, using casual conversations to build careers and using body language to put across meaning that the world of work is built for extrovert neurotypicals, not introverts or autistics.  The whole experience did make me feel somewhat negative about my career prospects.  At least I’m not a salesman like one of the people in the workshop.

I got home minutes before the torrential rain, which was good.

***

A strange thought this morning: when I had my first ever psychiatric assessment, at the university counselling service at Oxford, the psychiatrist was surprised that, at the age of nineteen, I’d never had a girlfriend and asked if I was gay.  When I said I wasn’t, he asked if he was sure I wasn’t gay.  (Goodness knows what he would have made of the fact that I didn’t even go on a date until I was twenty-seven.)  I hope that nowadays something like that would flag up high-functioning autism as a possible explanation as well as non-heterosexuality (and that non-heterosexuality would include asexuality as well as homo- and bi-sexuality).  To be fair to him, high-functioning autism was a lot less well-known sixteen years ago, but you would think that a mental health professional at Oxford would encounter more high-functioning autistics than the average person.

***

Another thought this morning: because of the way my mental health issues interact with my religious practices, I have to make an at least semi-conscious decision to remain Jewish frequently, whereas many Jews, frum (religious) as well as non-frum, can coast on autopilot.  But I constantly have to choose to put my energy into prayer, Torah study and being part of the community, just as I have to constantly choose to artificially limit my already limited (because of depression and autism) dating pool to the frum community.  This has disadvantages, in that I’m much more likely to go off the derekh (stop being religious), I am not well-integrated into the frum community and Judaism is not as organic a part of my life as it should be, as well as the fact that my issues interfere with my mitzvah observance to a significant extent.  However, perhaps it makes me more thoughtful about my beliefs and practices and more understanding of other ‘fringe Jews’ (as a now-defunct blog used to refer to Jews on the edge of the frum community, by choice or otherwise).  I do feel guilty that I invest such a small percentage of my time and energy in prayer, Torah study and communal activities, but this is the only way I can function right now.  It helps to be neurotypical here, too.

***

This evening I’m out, doing something cultural/religious, listening to Robert Alter speak about translating the whole of Tanakh (the Hebrew Bible).  I’m going by myself as I don’t know anyone currently in London who would like to go to hear someone talk about academic (as opposed to frum) Bible translation, although I’m not sure it would have occurred to me to ask a friend even if I had one.  I tend to assume that I should do cultural things by myself, whether from habit or because my friends don’t share my interests, although I do sometimes go to art galleries with my sister and try to see a ‘straight’ play with my Mum once a year, usually at the Open Air Theatre.  It will be a late night and I’m worried about getting up in time for work in the morning, so I’m doing as much of my evening routine as I can beforehand.  Hence blogging now.  Other than that, I hope just to relax and recuperate from the stresses of this morning before going out, which will doubtless tax my autistic self in various ways.

Realignments

I was quite depressed and very sluggish on waking and I had to go to my mental health class without having shaved, which I don’t like doing.  The class was OK, more CBT stuff really.  I still struggle with CBT, despite wanting to try it again for my low self-esteem.  It always seems so fake to challenge my negative thoughts when there seem to be so many objectively true reasons for me to worry about the state of my life.  One psychiatrist said I was too clever to be fooled by it.  But I took some blank sheets for setting out and challenging negative thoughts in the week ahead and will try to challenge my thoughts.  We did an example in the class, which happened to reflect my job fears, and then I privately tried another example with my dating fears.  To be honest, I was still quite pessimistic afterwards, but perhaps slightly less so than before.

***

Related to this, I phoned to try to find out how long I’m going to have to wait for CBT on the NHS to deal with my low self-esteem.  As with the last time I phoned a week or two ago, there was no answer (typical NHS efficiency and customer service).  This time I left a message, but I doubt anyone will get back to me.

***

While I was in my mental health class, my parents were down the road at a workshop for families of people with autism.  I think they understand me better now they have been to the workshop.  At any rate, they said they felt they could understand me more.  They also wondered if my maternal grandfather was on the spectrum.  I think it is impossible to tell at this distance, but I guess it would explain why, as I grew up (he died when I was nineteen) I felt that he was more on my wavelength than other family members.

***

Despite this, I feel a bit better about the world today.  Maybe it’s the possible political realignment in the air; as someone in the centre, I’ve felt stranded in recent years as the political world has polarised to the extremes of right and left.  On the other hand, the extremes aren’t going to just go away without a fight, and third parties and centrist parties tend to do badly in UK elections because of the way our voting system works, plus, as the BBC news website says, the cross-party nature of the new group could put off as many people as it attracts.

I once heard it said that conservatives believe that people are inherently bad and need laws and traditions to keep them in check, whereas progressives believe that people are inherently good and if they do bad things it’s because they’ve been corrupted by bad laws and traditions or other systemic social issues.  To be honest, I don’t really believe either of these things.  I don’t think people are really inherently good or bad.  They probably are closer to good than bad most of the time, but then there are times when almost anyone is capable of being bad, when they’re tired, hungry, angry or scared.  Maybe this is why I struggle to locate myself politically.  I don’t really feel tribal feelings for any one party and I haven’t for many years.

Anyway, enough politics!!!!

***

I finished another chapter of my Doctor Who book in second draft (or ‘revised second’ draft/draft 2.5).  I only added 400 words, which, considering I spent fourteen and a half hours watching Doctor Who for research seems like a poor return BUT I think the chapter would have definitely read as sub-par, hurried and lacking in detail in places compared with some of the later chapters had I not made the revisions, so I will continue on to draft 2.5 of the third chapter.  After that, and possibly some very slight work to chapter four, it’s a big jump ahead to chapter fourteen, the final one… unless I get forced to write a chapter on last year’s episodes, which I’d rather not do, as I don’t think I have the necessary distance from them or a sense of where the series is going at the moment, but I can see that a publisher might want it.

***

I’m very tired though.  I don’t know why my mental health group leaves me so tired when I get so little out of it, and largely feel too anxious and overwhelmed to participate (unlike the previous course, where I participated a lot).  I think I dozed off for a few minutes in the afternoon.  I did a few minor chores, but didn’t try to do too much and I’m trying not to feel like I wasted the day.  I’m a bit upset I didn’t really feel up to doing any real Torah study, but I was just too tired.

Stresses and Social Anxiety

My mental health group was a little better today.  I didn’t really learn anything I didn’t already know, but it did make me decide to try to be better at catching my negative thinking, although I’m not quite sure how I’m supposed to do that in practical terms.  I think I just have a mismatched personality to get on with most of these people, which is unfortunate, but there isn’t much I can do about it.

One person said something she said she feels inferior to people she was at university with who are all now running the country, which made me wonder if she was at Oxford like me, as that’s something I feel a lot.  Usually I would have let that go, but I asked her afterwards and it turned out she went to Cambridge, so I was close.  I’m glad I’m not the only Oxbridge person who feels like a failure, though.

Someone at the group said I’m intelligent.  I get weirded out when people say that to me.  I’ve hardly said anything on this course, having been too socially anxious and overwhelmed by the noise; how can people think I’m clever?  Maybe I just give off ‘vibes.’  More prosaically, he probably overheard me tell the other person that I went to Oxford.  He did say that if you’re high functioning and mentally ill, you don’t do fewer “stupid” things, you just realise that you’re behaving in a stupid way, but don’t still know how to change it.  The course was supposed to help with that, but I’m not sure that it has…

***

Today’s bad news: my psychiatrist appointment at the end of the month has been moved to 6 June, despite the fact that I’ve already moved my work days around so that I could keep the appointment.  I think it’s appalling the way the NHS treats patients like cattle.  Yes, they’re short of money.  But the charity sector is even more short of money, and they don’t treat people like this.  Indeed, the private sector doesn’t have infinite funds and they also don’t treat people like this, despite the supposed “inhumanity” of treating people for “profit.”  It doesn’t cost anything to treat patients like human beings.  The NHS has messed me around like this so many times over the last seventeen years, costing me time, energy (which is precious to me) and, on occasion, money.  But they have a virtual monopoly over healthcare in this country so they’re isn’t much anyone can do about it unless you happen to be super-rich and able to be seen privately (to be honest, when I was in psychodynamic psychotherapy my parents were paying for me to be seen privately, but we were only able to do this because we were fortunate to find someone who charged means-adjusted fees, which isn’t always possible).  A lot of people don’t have health insurance because, in theory, you aren’t supposed to need it (or you pay it in your tax, depending how you want to look at it).  And monopolies, whether in the private sector or the public sector, don’t have to care about bad customer service, because where else can you go?

Anyway, I calmed down and phoned to ask why my appointment had been changed.  The psychiatrist is ill and they were assuming she won’t be back for months.  They offered me an appointment with a different psychiatrist a week after the cancelled appointment.  As I didn’t feel the previous one really listened to me, I was not upset about this, but the appointment they offered was on a day when I work, right in the middle of the day so I would have to take the whole day off and this was after having already changed one work day because of the cancelled appointment.

I decided to take the appointment for now and see what my line manager says next work; if the worst comes to the worst, I’ll cancel the new appointment and go in June.  But it does reinforce my current feelings of fatalism over recovery and work.  I have fallen back into pessimism after feeling better for a few days.

***

I have also booked for the networking class that is on the same day as the Jewish Book Week talk I’m going to.  I suppose this is work-centric, but I’m terrified that I simply won’t be able to network even in practice settings (role-play).  I hope I can relax enough in the afternoon to get to work the next day.  I would really like to see a careers advisor who understands about autism and mental illness, but I’m not sure how to find one.  I was told at the class today that I could raise work issues with my key worker, which I may try to do.  To be honest, I’m only vaguely aware of what my key worker’s job description is and what things I can talk to her about, but I think she’s a social worker who is supposed to direct me to courses like the class and other mental health and social services in the area, so perhaps that will help.  Reading this back, there are some positives in it, but I’m still in one of those depressive moods where everything just feels awful.  I’ve given up on ‘recovering’ (whatever that means), but I want to achieve some degree of day-to-day functionality (work, family etc.).  I just don’t know how.

Virtuous Circles

22 Shevat: Yortzeit of the Kotzker Rebbe

I’m still feeling quite good.  I’m waiting for the depression to come back, as it always does, but I’m trying to enjoy it while it lasts.  It’s interesting that my desire and ability to study Torah and to daven (pray) with kavannah (mindfulness) grows when my mood is better.  There probably is a virtuous circle of good mood –> more engaged with Judaism –> better mood.

***

I want to work on my books on non-(paid) work days (Mondays and Wednesdays; Fridays, at least when Shabbat starts later in the day; and potentially Sundays when I don’t volunteer.  Maybe also Saturday evening after Shabbat in the winter, although that’s hard).  I actually feel like a child in a sweetshop, getting to write about my special interests: Judaism, Doctor Who and mental health (OK, analysing my own psyche).  It’s just difficult to know where to start.  A while back I said I wanted to get paid for writing about my special interests; I’ve got some way still to go for that, but at least I can set aside some time aside in the hope that one day I will get paid for at least one of them.

Unfortunately after having gone to well-being group (see below), done some chores and spoken to my rabbi mentor (again, below) today, I was too tired to do much writing, but I did twenty minutes or so of working on the structure of the Jewish book.  I oscillated between excitement at writing and anxiety at the scale of the task and whether my book would be distinctive or well-written enough to compete in the marketplace.

***

I had the last session of well-being group today.  We looked at how far we have come and how to continue to grow.  It was a bit disappointing for me.  I have achieved things since starting the group, not least that I’m now working again two days a week; smaller, but potentially longer-lasting achievements include getting back into meditating daily and finding an affirmation that works for me when my thoughts get out of control, one that handily works for depression, OCD and social anxiety.  However, I feel there is so much more to do.  In particular, I haven’t been to shul (synagogue) on Shabbat (Saturday) morning for a year or more.  I don’t know how to get to that goal.  I can’t see a way to break it down to smaller steps as we have spoken about in the group.  I think part of the problem is that there is so much anxiety, guilt and self-loathing around where I fit in the frum (religious Orthodox Jewish) community that I don’t really want to go to shul.  On Friday afternoons and Shabbat afternoons I go from habit or I can psych myself up to go if I have to, but on Saturday mornings the temptation to sleep through my alarms is too strong.  I’m not sure what to do about this.  I need to find a way to build up to it in small steps, but I can’t think of any.

We also spoke about self-care in well-being group.  Everyone else seemed to think they don’t do enough, whereas I suspect I do too much, but it doesn’t really help me to cope better.

***

I have an appointment with the psychiatrist booked for 28 February.  This was booked before I was working, so is on a Thursday.  As I only work two days a week, it seemed a bit much to ask for a morning off to go, so I just tried to book a replacement appointment on a Monday, Wednesday or Friday, only to be told that the earliest free appointment is in May!  This is ridiculous.  To be fair, in this instance, unlike some (many) previous problems I’ve had with the NHS, this isn’t really their fault.  It’s basic economics that zero price means infinite demand, in theory.  Obviously there isn’t going to be literally infinite demand for psychiatric services, but demand is still going to far outstrip supply no matter how well the NHS is funded.  It’s still pretty awful service, though.  At least the receptionist was polite and apologetic, which isn’t always the case (something less justifiable by hard economics).

***

I spoke to my rabbi mentor about some of my recent experiences.  He said I sounded very positive and that my book ideas sounded interesting.  He was a bit concerned that my Jewish book idea sounded too much like this book, but I see mine as being less academic and more about explaining Judaism from the point of view of questions non-Jews actually ask me, based on how we appear to outsiders, rather than the things you would need to know to do a degree in Jewish Studies or Comparative Religion.  So, less on the history of Jewish theology and more on why we wear strange clothes and use unusual words when ostensibly speaking English.  But it might be worth trying to get hold of a copy of that book and one or two others before I get too involved in the project to nudge it in a different direction.

My rabbi mentor was also supportive of my decision to try dating again.  He agreed with me that there probably won’t be a time when I’m not dealing with my mental health on some level, so waiting until I’m “better” is pointless.  He felt that when I was in a relationship with E. that had a positive effect on my mood and that even going through relationship breakups has been a learning experience for me, so that it was worth trying again.

Writing this post, I wonder if dating will give me an incentive to go to shul on Shabbat mornings again?  Not for practical reasons so much as so I don’t have to explain to dates why I don’t go.

***

I emailed one of my colleagues from my further education job.  He replied saying they were just wondering where I was working now.  I always feel funny when people say they were talking about me.  It’s not paranoia, but a sense of, “Wow, people actually remember me when I’m not in the room.”

Bleargh Again

I thought I only cried at work, but I started crying while davening Shacharit (saying morning prayers), or at least the tiny fragment of them that I say, about ten minutes out of forty or so.  Then I did it again during Ma’ariv (evening prayers).  I don’t know what triggered it.  To be honest, I don’t think there usually is a clear triggering for my tears.  Just a general sense of pervasive awfulness in life, in my personal life and in the world.

***

Psychiatrists don’t always seem to really believe me or worry about my being suicidal, because I don’t have a plan.  I don’t think I really need a plan.  Because of the clomipramine problems, I’ve ended up with three months worth of antidepressants.  I don’t need a plan just to swallow all my pills, particularly with my parents away for the next week or so.  I’m not feeling suicidal, just to clarify.  But I could become suicidal easily without spending ages working on a plan.  I have strong suicidal ideation/fantasy at times, but because I don’t literally have a plan, I worry I don’t get taken seriously, especially now I’m moved back in with my parents, even though I sometimes get very strong visual images of overdosing, which would be easy enough to act on (unlike other suicidal images/fantasies I have, about jumping off tall buildings or shooting myself, which would probably be impossible to act on in my situation).  But psychiatrists on the NHS don’t always seem to take me seriously in general.  A few have, and one took me seriously for a long time (the one who said I’m autistic), but then flipped and started treating me like a problem patient and bossing me around and not really listening to me.  To be fair, it could be that they do take me seriously, but don’t want to show it.  And I don’t know what they could do anyway.  Changing my meds could make suicidal thoughts worse in the short term, although I think it needs to be done (I must assert myself more next time) and I don’t think I should be in hospital right now.

***

I’m just feeling depressed today and unable to put it into words.  I think my depression has been underestimated by medical professionals at times because of my difficulty even understanding how depressed I am, let alone putting it into words for other people (the same probably goes for my autistic difficulties).  I’m good with words, but not with expressing emotions.  It often seems that outsiders underestimate my depression because I mask it well and try to keep functioning, while other problems are more visible.  When my religious OCD was at its worst, my father in particular thought that that was the main problem, more than the depression, because it had effects he could see (e.g. me preventing my parents using crockery that I thought had become treifed up and contaminated until I checked with a rabbi that it was OK), whereas the depression was in my head and he couldn’t see it.

***

I’m worrying about finding a job.  The jobs I find seem to be ones that I fear I can’t do (although that generally doesn’t stop me applying, but I feel sure I won’t get called for interview) or for which I’m either over-qualified or under-qualified.  Worrying about getting a job (a job I can actually do, unlike the last two) seems to be moving up to rival worrying about getting married, although the two are connected, as my experience with E. convinced me that no one is going to date me until I find a long-term, stable job and some kind of career plan.  I’m worried about just drifting through life, that I’m going to become one of those people with mental health issues or autism who can’t handle careers or relationships and just end up dependent on other people.  I worry what will happen to me when my parents aren’t here, because I don’t see myself being settled even in twenty or thirty years time.

***

I’m still procrastinating about getting guinea pigs.  I feel they would be too much work, and it would be too social anxiety-provoking to go to a pet shop and ask to hold them, but then I feel depressed and lonely and wish I could play with a tame animal.  I wish I didn’t procrastinate so much about things.  I’m pretty sure it’s my worst character trait.  It’s certainly one I wish I could get rid of.

***

I tried to apply for some jobs today.  I don’t think I’m really doing a good job of editing my CV to suit the different jobs I’m applying for, but I don’t really have the energy or concentration to do it properly. How could I actually do a job?  Maybe I’m unconsciously self-sabotaging.  It wouldn’t be the first time.  Or I’m just procrastinating again, to avoid or because I’m too depressed.  The thought of actually getting an interview terrifies me, maybe even more than the prospect of being depressed for the rest of my life.  I’m probably taking too long on finishing my Doctor Who book in order to delay considering it completed and sending it to publishers – the fear of rejection slips (like Snoopy…), but also the technicalities of getting it in the right format, finding publishers’ addresses, sending the manuscript and so on.

I started applying for a job that seemed interesting, but halfway through the form I found a more detailed job description than I had originally found and it requires training and experience with archives than libraries (very different skill sets, although not many people realise this).  I don’t know if I missed the detailed job description initially from my incompetence – or at least depression-induced poor concentration – or if the layout of the job description was poor.  In the end I decided to avoid the sunk cost fallacy and cut my losses; I’d wasted a couple of hours on it, but there was no point continuing to labour over an application for a job I clearly wasn’t going to get and probably couldn’t do if I did get it.  I wanted to start another application, but felt too depressed.  I had at least managed one job application today, for a research assistant role, although I suspect they will say I’m over-qualified as it’s intended for recent graduates.  I don’t feel much further up the careers ladder than most recent graduates, though.

Applying for jobs would be much easier if employers just wanted a CV and a cover letter; instead, most of the jobs I’m applying for have a unique application form with slightly different questions and/or lots of boxes to be filled in manually.  Google Chrome’s autofill helps a bit, but not with unusual questions, and sometimes it puts data in the wrong boxes.  Maybe it’s a deliberate way of weeding out depressives with poor concentration and motivation and low energy?

And how can I take seriously a Russell Group university that doesn’t know how to use an apostrophe on its forms?  About as much as all those over-educated lawyers I come across at work who also don’t know either.  Or the university which apparently wanted to know the names of all my employers down to 2029.  I’d like to know that too.  That university also got the names of both the universities I studied at wrong on their form.

***

This article is very moving.  I wish I could move on from my own negative self-perception like that.  Also, I posted a link to this article last week and I still think it’s a good article, but I still can’t do any of the actions.  I don’t think that I’ve accomplished much worthwhile or contributed to the world, or that I have worthwhile attributes, or that I deserve to cut myself some slack or pamper myself (yuk).  I don’t know how to surround myself with people who reaffirm my value and I don’t think there is anything that I’m good at that I could do.  As for challenging myself to do what’s hard, at the moment everything is hard.  I suppose I could imagine myself doing good, but I wouldn’t know how to convert it into action.

***

I was feeling nauseous just now, which is how anxiety manifests in me.  I don’t know why I feel like this.  Doctor Who (which has just finished) was good, but about unrequited love and coping with difficult workplaces, so was possibly triggering.  I need to force myself to eat something, though, especially as I cooked pasta earlier.

***

People say to hang in there and things will get better, but they just don’t get better for me.  I can’t see things ever getting better for me, long-term.  Things have been bad for so long, it’s difficult to believe I could be happy and competent as an adult.

NHS Woes

I’m just back from the psychiatrist.  It was not great.

The doctor had a thick Eastern European accent and I couldn’t always understand her.  She couldn’t always understand me either and I worried what might get lost in translation (she certainly misheard ‘autism’ as ‘OCD’ at one point).  She said I should stay on clomipramine even though it’s not doing much and the pharmacy is finding it hard to get hold of, as she thinks my OCD will get worse if I come off it (clomipramine helps OCD as well as depression).  She said she will write to my GP and tell him what to prescribe if they can’t get any more.  I think she said sertraline or venlafaxine, neither of which, to my lay knowledge, are like clomipramine (they’re new generation drugs, SSRIs; clomipramine is an older tricyclic) and both of which I think I’ve been on before (I’ve been on so many antidepressants I can’t remember which ones I’ve had.  My notes should say, but my experience is that my notes are incomplete, if not outright wrong, (“We love the NHS!”)).  The psychiatrist said that medication won’t help me much anyway (a previous psychiatrist said much the same) and encouraged me to get some CBT.  She did at least tell me how I could have that on the NHS with a relatively short waiting time.

I did ask about alternative diagnoses.  She said that if the Maudsley Hospital assessed me and said I’m not on the autistic spectrum, there isn’t a lot else that can be done, as they are the experts.  I was rather afraid of that.  I did ask if there is anything else that I might have to explain my condition, but she was pretty insistent on it just being treatment-resistant depression.  I feel that the psychiatrists must have missed something.  I guess I feel like I have psychiatric man flu.  I feel like ‘mere’ depression shouldn’t go on this long, or be this painful.  Maybe I just have as many prejudices about depression (and myself) as non-sufferers.

That was that, really.  She said she could discharge me or see me again in three months.  I opted for the latter, as I’m worried my condition will worsen when my contract ends in two weeks time and I remembered how hard it was to get into the system to get this appointment.  I reasoned that cancelling an existing appointment if a miracle happens and I feel a lot better will be much easier than getting a new appointment if I feel worse.  The receptionist who I was supposed to tell about the appointment hadn’t got a 2019 diary yet (don’t ask why they’re still using hardcopy diaries.  “We love the NHS!”) and wrote my name in the back of the 2018 diary.  My Mum, mindful of the problems I had getting this appointment (the phone calls and missing letters), was worried that I would get forgotten.  Unfortunately, the receptionist became angry and the confrontation became heated, making me feel uncomfortable (OK, making me wish the ground would swallow me up).  I think my Mum might write to complain.  I’m not a libertarian, but if I was the whole incident would seem to confirm a view of the NHS as an inefficient, under-equipped, unhelpful and bureaucratic organisation.  We love the NHS!

My Mum reminded me that I’m apparently supposed to have a meeting at The Network on 5 December.  So far as I can tell, this is a slightly Orwellian-named service for occupational therapy and support with work or other community-based activity for those with mental health issues.  It is perhaps worth pursuing, if they ever send me a letter telling me about my appointment.

I was so upset by the everything that happened that it didn’t occur to me for another hour afterwards that the appointment had finished early enough that I could have gone back to work for an hour or two.  I’m paid per hour, so it doesn’t make much difference to my employer, but the money might have been useful to me.  Now it’s too late to go back, which is probably just as well, as I still feel tense.  Tea has been consumed (if chicken soup is Jewish penicillin, then tea is English prozac), but retail therapy will probably be required after the stresses of yesterday and today (regarding yesterday’s events, my boss emailed me back from honeymoon saying I should just leave the data as it is.  I still think that she must regret hiring me, but my Mum told me not to mind-read).  I plan on buying cheap second-hand box sets of some of Sherlock and Jonathan Creek and possibly a volume of The Complete Peanuts as I fancy crime dramas to alternate with the Doctor Who episodes I’m watching for the book I’m writing (one could probably make the argument that Jonathan Creek is closer to the spirit of the prose Sherlock Holmes stories than Sherlock).  Other than that, I should use my free afternoon to try to self-refer for CBT and to catch up with emails, as much clearing out my inbox than actually writing to anyone.  I hope to get to shiur (Torah class) tonight too.

Crazy Cat Lady

My letter from the psychiatrist arrived, so I now officially have an appointment on Thursday!  It’s annoyingly at lunch time, which means I will go to work in the morning, come home at noon and go to my appointment, but – unless it’s over very quickly (which has happened to me before with NHS psychiatrists who just want to ‘process’ their patients ASAP) – I won’t be able to go back to work in the afternoon because by the time I get into town, it will practically be time to come back.  As I’m paid hourly, that is a financial loss, but to postpone the appointment would have meant waiting until January for another one.

On the whole I felt better today.  I got through over 130 records at work, which is an improvement on most of last week.  I think I mostly got through the morning by thinking about whether I could own guinea pigs in the back of my mind while working; in the afternoon I was a bit more down and began to doubt whether I could keep them and whether my parents will agree to my getting them (thus far Mum has cautiously expressed abstract approval and Dad has said nothing at all).  I’m glad that my rabbi mentor thinks that my owning a pet is “a wonderful idea” as, while he’s not infallible, he is usually right and he makes me feel a bit more confident that this isn’t a crazy idea.  We’re not really a pet-owning family, though, and I don’t think my parents really understand why this idea has suddenly gripped me.

Reading The Complete Guide to Asperger’s Syndrome at lunch brought me down a little, as I worry again that I won’t be diagnosed on the autistic spectrum – or with anything else unexpected – and will be left floating again with treatment-resistant depression and no help from the NHS other than drugs.  I feel there must be something going on other than pure unipolar depression, but I’m not a psychiatrist and I don’t know what it might be, other than guessing at autism or trauma.  But I’ve been wrong about things like this before.  I wish I had a psychiatrist I trusted and knew well, but the NHS doesn’t work like that.  I had one for a while, but only because she broke the rules by continuing to see me.  She thought I was autistic, but didn’t give me an official diagnosis and I think she came to see me as a frustrating problem patient.  She certainly seemed to stop listening to me after a while.

On the way home I felt a bit more down, probably from tiredness and hunger.  I found myself thinking of the wave of recent engagements of people doubtless ten or more years younger than me in my community.  While I try to be open to the idea that there might possibly be someone female out there of compatible age, religious outlook and personality who can at least tolerate my geekiness, borderline autism, social anxiety and depression, however improbable that seems, it is difficult to imagine how I could ever meet her and get talking to her.  I know someone who insists that there is nothing proactive whatever one can do to get married; it is completely up to God when and how you will meet your mate, but you will meet eventually.  I find this hard to accept.  Some people simply don’t get married and, in any case, in Judaism we are supposed to be proactive with our lives, at least up to a point (she accepted proactivity only in accepting arranged dates, but, as I’ve said, people aren’t arranging dates for me).  In any case, without a well-paying job that would let me support a family, talk of marriage seems pointlessly premature.  And without finding out what is wrong with me and finding a way of coping with it, it seems unlikely that I will ever manage much in the way of a career.   I guess this is the problem: that my issues are interlinked and it’s impossible to deal with one at a time.

Well, I seem to have brought myself down pretty well now.  I’m very tired and still somewhat hungry even after dinner.  I want to go for seconds, but I’ve put on a huge amount of weight on clomipramine and am wary of eating too much.  Life can be very frustrating.  I fear I’m going to turn into the male equivalent of a crazy cat lady.

End of the Week Bits and Pieces

I forgot to mention yesterday that I changed where I was sitting in the office (we hotdesk), so that the two people who pace up and down while on the phone were in front of me rather than behind me.  This seems to have helped.  They’re just as audible, but not so distracting.  It seems that noise behind me makes me more alert and anxious than noise in front of me.  Unfortunately, there is no guarantee about where I’ll be able to sit over the next three weeks.

I just got phoned by a variation on this scam.  Luckily I was suspicious and googled them rather than phoning them back.

I wish I could be as non-judgemental of myself as I am of others.  That said, I am judgemental of others, but then I make myself think about things and realise that what they have done isn’t so bad and they probably have extenuating circumstances.  But I can’t even do that with myself.  I feel that I know that I’m a bad person and that while it isn’t my concern what other people do, it is my concern to make sure that I do the right thing, so I should beat myself up until I change, which never works.  I don’t know what a better method is, though.

Before my meeting with the new psychiatrist on Thursday, I’m trying to write two lists.  I don’t always remember what I want to say and I’m worried I’m not going to be confident about talking about alternative diagnoses, so I want to have something written I can give him/her.  One list is of the depression symptoms, the other is other problems I’ve been having and other things that make me think I’m on the autistic spectrum, although I’m not sure whether I’ll say that I think I’m autistic.  Please let me know if there’s anything I talk about here that I’ve forgotten.

The depression list is:

  • Very low mood.
  • Despair.
  • Occasional thoughts of suicide or self-harm.
  • Anxiety, especially social anxiety and anxiety related to work.
  • Lack of energy.
  • Poor concentration.
  • Lack of motivation.
  • Easily and frequently exhausted.
  • Inability to experience pleasure.
  • Loneliness.
  • Disrupted sleep at weekends, albeit primarily on non-work days.
  • Panic attacks on the way to work the other week.

The other list of symptoms is:

  • Difficulty understanding and describing my emotions.
  • Difficulty making eye contact.
  • Difficulty reading body language.
  • Body language and voice tone that makes others think I’m angry or upset even when I’m not.
  • Intense interests.
  • Difficulty moving from one task to another and multitasking.
  • Poor spatial awareness/get lost easily.
  • Difficulty holding a conversation without a prepared ‘script,’ especially small talk.
  • Sensory overload from noise at work, in restaurants, etc.
  • Fidgeting and stereotyped/repetitive movements (spin on chair, move feet and hands, stroke face, deliberately press on fingers or put in desk drawer).
  • Tactile – I like feeling certain objects with my hands or even lips.
  • I can’t always tell when people are joking.
  • Difficulty remembering or understanding long and/or implicit instructions.
  • I tend to stick to routines.

Some of these could be depressive, some I think point towards autism, but it’s hard to be sure.  I’ve been told that I didn’t experience all of these as a child, which is one reason why I wasn’t diagnosed with autism in the past.

For some of these symptoms I know the technical terms (alexithymia, ideation, anhedonia etc.).  I’ve been to so many psychiatrists and therapists and read so many books I’ve picked stuff up.  But I was worried that if I used the terms, I would seem pretentious and showing off and maybe would make the psychiatrist think I was telling him/her what to do.  But on the other hand they might be helpful and show that I have done some research.  What do you think?

Man Out of Time

You find me on the horns of a dilemma.  After yesterday I felt I should spend my downtime after work in a quiet, not-over-bright room, avoiding excessive stimulation, because of autism (or whatever it is that makes working in a noisy, electric-lit open plan office staring at a computer screen all day so painful for me).  This is to improve my mental health.  Unfortunately, my mental health also requires me to write about my feelings to try to deal with them.  So I’m caught between autism (stay off the computer) and depression (blog).  Hmm.  At any rate, if you write one of the blogs I read and my comments and likes become less frequent, then it’s nothing personal, I’m just trying to cut down on internet time (which should also help with depression, as internet time becomes procrastination until I see something that triggers depression, usually about politics or religion).

I had a very stressful day.  I had some minor changes to my routine because of the evacuation of Moorgate Station, but while changing trains at King’s Cross instead, I decided it would be quicker to walk up the stationary escalator as if it was a staircase rather than deal with the slowness and crowding on the moving escalator (there were three escalators, up, down and stationary).  About halfway up I suddenly had a panic attack, or something approaching one, and felt I was going to fall off and plummet to my death or at least severe injury.  I somehow forced myself to keep climbing, while having visions of being stuck halfway up, unable to go up or down and I did eventually get to the top, but then on the platform overcrowding meant that I was standing right on the edge and I nearly had another panic attack fearing that I was going to fall in front of the train.  I don’t know what triggered all of that.  Usually anxiety for me is tied strongly to either social interactions or OCD thoughts, not straightforward fears like these.  I was still shaken when I got to work and didn’t really calm down until nearly lunch time.

I remained anxious much of the day.  I did not cope any better with the noisy environment and wanted to shout at people to shut up.  There are a couple of people who pace up and down the office while on the phone, presumably on the grounds that if they sit still and make a call they annoy a few people around them, but if they walk up and down they can annoy the whole office.  I really want to pace up and down behind them making exaggerated imitative gestures like Harpo Marx, but so far I have lacked the courage to do so.

I felt overwhelmed all day.  It’s hard to tease out what made me feel so bad; I would guess noise, social anxiety, fear that I was doing my job badly and going to get in trouble with my boss and maybe some other things (I’m trying to work out how I feel about the fluorescent lighting, autistically-speaking.  I’m not sure).  As it went on, it got worse, because the more depressed and anxious I got, the harder it became to work, which increased the fear that I was going to screw it all up and get in trouble, which made me more depressed and anxious.  I ended up wanting to self-harm and biting my fingers, although that may have been autistic stimming/attempted self-soothing as much as self-harm.  I did think some masochistic thoughts about being hurt.

My boss is now on holiday until after my contract expires, so if my work is bad, she’ll only be able to complain behind my back.  Unless it’s really bad and they sue me for my wages.

On the way home I reflected that I don’t fit in to the world.  I feel like a man in the wrong time.  I don’t think this is my world, but, realistically, I don’t think it ever was.  I’m not nostalgic for a real or imagined past.  I used to think my utopia lay in the future, but now I’m not sure.  As an Orthodox Jew I believe in a utopian future, but it is hard to see how we could get to it from here and even if it happens, I can’t see myself living in utopia, being happy and carefree.

I also reflected that I envied the wicked, but then corrected that thought.  I don’t envy the wicked, I envy people who are joyous and content.  I’m not entirely convinced that there are many wicked people among the truly joyous.  I think joy comes from meaning and love and I don’t think the wicked have that (hence they chase money, sex, power, fame and other inadequate substitutes).  I don’t really have meaning in my life.  I thought I did, but I don’t.  I don’t regret keeping the mitzvot (commandments), but they don’t bring me meaning and joy the way they are supposed to.  I know the Midrash and the Talmud would say that this is my fault, but I don’t know what I’m supposed to do differently (“If it is an empty matter, it is from you,” “If someone says ‘I sought and did not find,’ do not believe him” – I’m quoting from memory, but that’s the gist).

I guess I do have love, but it’s always fraught with difficulty.  The friends who care most about me are the furthest geographically and I rarely, if ever, get to spend time with them.  I don’t think I will ever experience the special loves of marital love or the love for children.  As for my family, they do care about me, but there is a barrier of communication between us.  I’m not sure if it’s autistic vs. neurotypical or very depressed vs. more mentally healthy or just plain old personality and communication differences (it’s not male vs. female as I have trouble understanding and being understood by my Dad as much as my Mum and my sister), but it’s hard to understand them and to make myself understood by them.

So, that’s where I am tonight.  Not really very different from every other workday night.  Overstimulated, exhausted, depressed.  Not anxious, but I will be in twelve hours.  Oh, and I still haven’t heard when or where my psychiatric appointment is other than “some time next Thursday (8 November).”  I just sent another letter, not as angry as it should be, but I used bold italics.  I somehow kept a straight face when typing, “Thank you for your help.”

Going Round in Circles

I managed to phone the private clinic where I’d like to try and do some CBT to work on my self-esteem and social anxiety.  They said I need to be seen by their psychiatrist first who would assess my needs and the most appropriate type of therapy.  When I said I was seeing an NHS psychiatrist in two weeks, they said to go to that appointment and try to get a referral.  I phoned the NHS psychiatrist too, twice, to have another go at finding out when my appointment is, but I got voicemail both times.  I didn’t bother to leave a message as I know they won’t get back to me.

I’m nervous about being pushed down the wrong therapy path at the private clinic or having my understanding of my needs ignored by either the private clinic or the NHS psychiatrist.  Worried about being told something about myself that doesn’t fit my self-image, although that image is so confused that I’m not sure what being told something that doesn’t fit would entail.  (I think I have autism, except when I don’t.)  There’s something horrible about being told you aren’t who you think you are.  It’s why identity politics is so much more explosive than ordinary politics.  I guess I identify myself on some level as being depressed and autistic, which makes it hard to move on from the former and from my non-diagnosis of the latter.  I guess the only thing I would feel as strongly is if someone said I wasn’t really Jewish.  I’ve had some good psychiatrists and therapists over the years, but also some who have blundered around telling me what they think is wrong with me and what I should do without listening to me (plus one or two who have moved from one group to the other).  It’s quite scary not knowing which category the next appointment will be in and, in the case of the NHS, not easily being able to change and find someone else.

I’m trying to work on the job application for a librarian role at an major public institution that I started last weekend and have not had enough energy to finish yet.  It’s hard.  I feel pretty useless and unlikely to get the job, but I feel I ought to try now I’ve started, even though I’ve subsequently found other potential jobs I have (marginally) more chance of getting.  I hate questions like being told to show I have “Demonstrable enthusiasm for the Library and Information Management profession and an interest in the information needs of a … Library” or show an “Aptitude for enquiry work using a range of information resources and tools, including the ability to find, evaluate and explain information”, both questions to be answered with relation to specific tasks and situations and with reference to the required characteristics for the job.

The Great Clomipramine Shortage of 2018

The Great Clomipramine Shortage of 2018 is continuing.  To cut a very long and boring story short, I should be able to get a repeat prescription tomorrow, but not the 50mg tablets I want and had been prescribed initially or the 10mg tablets the doctor prescribed as a ‘here’s one I prepared earlier’ fallback, but 25mg tablets.  The pharmacy are at least saving them for me while the surgery comes up with the requisite paperwork.  But I think when I see the psychiatrist on 8 November (if the NHS ever deigns to tell me when my appointment is…) I need to talk seriously about changing meds, because these aren’t available and aren’t doing much when they are available.  No idea where we go from here though.  MAOIs?  ECT?

The other thing I need to talk to the psychiatrist about is alternative diagnoses.  I’m still going back and forth in my mind about autism and social communication disorder.  Tony Attwood writes in The Complete Guide to Asperger’s Syndrome that diagnosis is like putting together a jigsaw puzzle.  When it is 80% complete (enough diagnostic criteria are met), the jigsaw is considered completed, BUT only if the corners and edges are in place too (certain criteria have to be met, regardless of how many other criteria are met).  I have the 80% complete, but I don’t have all the corners and edges, there are some symptoms I just don’t have, or not at a high enough level, to count as autistic.  I can see the autism picture, but because I haven’t got the right pieces, no one will give me any help with it.  So maybe social communication disorder is a better bet, or going to a CBT therapist and trying to work directly with self-esteem and social anxiety.

The other thing I get from reading the book at the moment is gratitude.  I thought my childhood was not great, but it could have been so much worse.  The bullying could have been even more intense and violent, I could have been unable to defend myself in any way except violence (which would have got me in bigger trouble) and, most of all, I could have been without my “mentor friend” who guided and protected me (literally protected me – he was tall and strong and even though he was a geek, he wasn’t bullied as much as I was).  No wonder I used to get upset and maybe even anxious if he missed a day of school.  My Mum wanted to split us up, because she thought he was holding back my social development and I would make more friends in another class or school, but I suspect I would just have been even more alone if that had happened.

Speaking of mentor figures, Attwood says of romantic partners sought by people with autism, “The partner they seek is someone who understands them and provides emotional support and guidance in the social world – someone to be a ‘mother figure’ and mentor.”  I’ve realised this before about myself.  It makes me pessimistic.  I’m a weird enough person to be trying to matched up as it is, without putting pressure on women to mentor me and even mother me (even without getting into the complexity of my far-from-straightforward relationship with my actual mother).  This seems like asking too much.  I can’t imagine anyone ever consenting to marry me on those terms.  But I worry about what will happen when my parents are gone.  Complex though my current relationship with them is, they are still doing a lot of mentoring and guiding, e.g. today, when Mum came to resolve the clomipramine prescription confusion at the doctor’s surgery, when my social anxiety/autism/social communication disorder/shyness/whatever was just making me shutdown and run away.

I just got back from shiur (religious class).  It’s become quite difficult.  I really enjoy the content, but the number of people going has gone up and I feel uncomfortable with the number of people in the room, especially as some are noisy and constantly interrupting with questions and interjections (Jews don’t really do quiet listening).  I don’t really cope very well with people who like to talk for the sake of talking, or because they like the sound of their voices, doubly so if I’m trying to concentrate on someone else talking.  Plus just being around so many people is anxiety-provoking for me – Attwood says that for autistic people the difficulty of being around people, in terms of energy needed in alertness, anxiety and reasoning out the correct social interactions on the spot, increases exponentially (rather than linearly) with the number of people.  At shiur, as well as normal fears of a social faux pas, I’m worried about a religious faux pas too.  Just to make things worse, I’m juggling more balls because some people at the shiur know a bit about my mental health issues and some don’t and some have been acquaintances since childhood and some have not, so there is a lot to think about.

I’ve been thinking again about pets.  Attwood recommends them as affectionate and understandable companions for autistic children (unlike neurotypical children, who are difficult to understand).  I’ve see them recommended for people with depression too.  As a child I had a couple of goldfish, but that was it.  My family aren’t really pet people.  But now I wonder if it would help me to have a pet.  It would also let me see if I can cope with responsibility, given that I want to have children one day (although, as I say, that seems unlikely to happen).  Small mammals seem the best bet, guinea pigs or rabbits (both are social animals and should ideally be kept with at least two – I’ve done some reading on this already).  But I haven’t got the confidence to mention this to my parents (who in any case think the pet will die and leave me even more depressed), not least because I worry whether I am non-depressed enough to look after a pet, especially when I come home from work exhausted.  And then there’s the financial cost.

In other news, my contract isn’t being renewed at work, if I happen not to have finished the work by the end of my current contract (23 November).  I was told it was because of internal problems and bureaucracy, but I worry that it was secretly because I was a disappointment and they aren’t happy with my work and the mistakes I make.  It’s rather academic, as I strongly suspect I will be more or less finished by 23 November anyway.  To be honest, I think I might be self-sabotaging my job hunting.  I don’t really feel capable of working, at least not until I have dealt with my self-esteem and social anxiety issues and the autism/social communication disorder/whatever issues, plus I’m just plain exhausted from two months (with another to come) of constant alertness and anxiety to deal with social interactions and noise at work.  I need to stop for a bit and calm down and get my bearings.  I know that sounds lazy and entitled, but I feel like I’m at breaking point and I need time out – more than the three day weekends I have (which tend to be spent on chores and job applications and sometimes volunteering).  Although I was tempted by the job I saw advertised for Information and Records Manager for MI5 and MI6.  I want to be licensed to kill people who talk in the library or bring back books late.

Planet NHS, Planet Autism

On Planet NHS:

Me: 

Hi,

I was referred to the psychiatrist by my doctor some weeks ago.   In early October, I spoke on the phone to Mr …. who referred me through the … Team.  However, I have not been sent an appointment letter yet.

My mother phoned last Tuesday and was told I have an appointment for 8 November, but the person she spoke to would not tell her the time of the appointment, saying it would be written in the letter.  However, I have still not received any letter.

Please could you let me know as soon as possible when my psychiatrist appointment is, as I need to arrange time off with my employer.

Thank you and regards,

Luftmentsch

Him:

8th November with Dr …

Me:

Hi …

Thank you, but please could you let me know the time of my appointment on 8 November with Dr …

Regards,

Luftmentsch

Him:

A letter will be sent to you with all the details once booked on the system.

Me: 

Please could you let me know when this is likely to be as I need to clear the time off with my employer.

Regards,

Luftmentsch

Him:

8th November will be the day.

Me:

[Stunned silence.]

This is why I get so annoyed at the idolatry of the NHS that goes on.  If, as someone said, the NHS is the religion of the British people, then I’m definitely agnostic.

Meanwhile, back in the real world:

Work was OK today, or at least not unbearably awful.  It was hard, but I felt a bit more together and I got by without any coffee at work (although I had one at home at breakfast and a couple of cups of tea) and without crying.  I did shake slightly when talking to my boss, and when drinking tea (both of which were completely due to psyching myself out by realising how bad it would be to start shaking).  My boss goes on honeymoon on Tuesday and will be away until after my contract is due to finish and her boss finished working there today, so my boss from next week will be someone I know slightly, but not well.  Change makes me anxious (another autistic trait).

A previous psychiatrist, the one who felt I was somewhere on the autistic spectrum (but didn’t give me a proper assessment or diagnosis) once told me that “You can’t understand people, so stop trying.”  It’s possible that my whole life has been trying to understand people, like the robot Commander Data in Star Trek: The Next Generation.  At any rate it explains why I ended up on the humanities/social sciences side, unlike many autistic people, despite being good at science at school.

Other autism-related thoughts today: I mentioned yesterday having a few geeky but non-autistic friends at school.  One very much fitted Tony Attwood’s idea of a non-autistic mentor friend who helps with socialisation.  We were friends from age five and are still occasionally in touch, although we haven’t seen each other in person in some years.  We were best friends until we were about fourteen, when we drifted apart a bit.  I remember being upset when we were told to write a passage about our best friend in Hebrew class and he read his out and it was about someone other than me.  It would be an exaggeration to say that that was a key moment in my life, but it probably was another step down a very long road.  As Attwood suggests, once the mentor friend is gone (in my case this really happened when I went to university and he, although going to the same university, went on a gap year first), social integration becomes much harder, particularly as in my case it coincided with living away from home for the first time.

I realised today that I had such limited social interactions in my first job, that it was no wonder that I found it so much easier than my current and immediately previous one.  I rarely had to deal with more than one or two people at a time, my boss was understanding, I rarely saw other staff members, library users were mature adults and the library was quiet (perhaps too quiet as I could get lonely sitting in the basement all afternoon).  Plus I did three days a week of three hours each, very different to my hours in my other jobs which are much closer to full-time.  Even so, I sometimes went off to cry in the toilet or didn’t get to work because I had a panic attack on the way.  This, I think, disguised my autistic socialisation problems and made me think I had workarounds until I got to my previous job, especially as university was also a somewhat protected environment.  It was only in my previous job, when my socialisation problems became more apparent, when I started thinking seriously about being misdiagnosed when told that I was not autistic, and thinking that the misdiagnosis could matter rather than being an abstract problem.  In particular, it became obvious that I have problems with certain types or levels of noise and with interpersonal interactions beyond simple shyness and that I’m not great with vague or implicit instructions or dealing with grey areas.

I also think my sensory sensitivity has been greater than I realised previously.  As a child, I found wool uncomfortable.  I often find wearing my watch uncomfortable (sometimes at work I take it off and put it in my pocket) and I’ve gone through periods of thinking that way about shoes.  I think mostly I’ve just soldiered on until I get inured to these feelings, although I still avoid wearing wool against my skin.

Sukkot and Stress

Today has been stressful and isn’t over yet.  I had to phone someone to make an appointment with a psychiatrist.  I phoned at lunch time and was told the person I needed to speak to (I assumed the psychiatrist) was with a patient; he would phone back later.  I wasn’t brilliantly happy about being phoned at work, but I consented.

I was phoned near the end of the day, when I was rushing to finish the work I was set (I was set more than usual and as my boss was off sick, I wasn’t sure if I was supposed to do all of it or not, so I rushed the last bit to get it done (although I was still late) and I am now worried that I made mistakes; the other temp said she sees it as an ongoing project and doesn’t rush to finish).  Because I was stressed, I was not in a positive state of mind to start with, but it quickly became apparent that the person I was talking to was not a psychiatrist, but some type of administrator (the NHS is full of administrators).  He also clearly had no idea of my case history.  One might think that one advantage of a huge socialised healthcare system is easy sharing of information.  One might think that.  It never happens.  I don’t think there are actually accurate records of all the medication I’ve been on over the last fifteen years, which scares me.

He seemed horrified that I haven’t had CBT (actually I have, I clarified, but fifteen years ago).  I got the impression that he seemed bemused that a quick burst of CBT and some antidepressants hadn’t sorted me out long ago, because obviously no one could have serious depression.  He suggested that I access the IAPT and self-refer to some local group that offers… well, I’m not quite sure what it offers as the guy was not talking clearly and I had half switched-off when I realised that he had no idea of who I was and what my problems are and was trying to fit this very square peg in a round hole.  (The other half switched off when he admitted he was phoning me from his car.)  But I think they offer occupational support and group work, although I’m not sure if that’s proper occupational therapy and group therapy.  I don’t need the former as I’m working at the moment (the guy browbeat me into saying that I could go on my day off as I only work four days a week; I couldn’t be bothered to tell him about Shabbat and early winter Fridays) and I don’t really need a therapy group as I have depression group and autism group.  But I said I would self-refer, because it can’t hurt and because I felt it was the only way I could get my real prize, a referral to a proper psychiatrist and maybe some CBT on the NHS (rather than privately) to work on my self-esteem and social anxiety, which would be a win if I can get it to fit with work and Shabbat.

I feel bad that I was a bit short with this guy, but I was at work and had nowhere private to go (it’s an open plan office) so I was in the toilet, with other people, with the cleaner going in and out, trying to be heard on the phone but not by other people, talking aloud about really private stuff, realising I was talking to someone who had no idea who I am or what my problems are and who is just trying to tick a load of boxes that are either unhelpful or which I ticked over a decade ago without result.  (I actually really hate the NHS and half hope someone will have the guts to privatise it, which is not what long-term NHS users are supposed to say; we’re supposed to be all, “Oooh, Jeremy Corbyn, save the NHS from Evil Tories!”  I don’t think a privately-run system will be any better, but at least it won’t be a political football any more and we might get rid of some pointless bureaucrats.)

Anyway…

The other news is that on my lunch break I finished the complex PTSD book (albeit that I skipped some not so relevant bits).  It was a useful description of trauma and emotional flashbacks and makes me think that there probably is an element of trauma in my history and it might be why I struggle to make progress with traditional depression treatments.  I have, however, already mentioned my fears that the attitude of “Your parents were abusive and you have to stop wanting to please them” isn’t terribly helpful for someone who wasn’t actually abused.  Also, while the book keeps talking about the need for unconditional self-love, it doesn’t always make clear (a) how to do this (although it did make me realise that my catastrophising about being single forever is a form of self-criticism) and (b) how to self-love without becoming a narcissist.  I have fears that if I stop beating myself up, I will inevitably end up like Donald Trump.  Plus, it doesn’t tell me how to love myself when I feel that I have genuinely done terrible things that are not deserving of forgiveness, or at least not until I have improved my ways a lot more than I have managed until now.

But my ordeal was not over.  I came home exhausted and hungry, but my father’s oldest friend was coming over to eat in the sukkah (the temporary hut Jews eat in on Sukkot to remember the Israelites in the wilderness).  I get annoyed at the way that my parents make me say hello to their friends generally, as it always seems awkward (I don’t know what to say or do), but at least I know their local friends.  Their non-local friends are harder to talk to, but this friend is hardest of all.  I have always found him overbearing, both in size (he’s well over six foot tall) and manner.  Frankly, although I can only remember one or two concrete instances, I always think of him as teasing me in a way that feels less friendly for me than he probably thinks.  (And this was before he spent a couple of years in a German prison for drug smuggling – seriously.)  I said hello from a distance, and disappeared.  He made a comment about hearing me from a distance and my parents were annoyed, but these days I have not got patience for difficult people.  Plus, I suppose my father’s oldest friend being here just reminds me how I’ve drifted from my own oldest friend, who I am still vaguely in contact with, but who I haven’t seen for years and who forgets I’m not on Facebook, so I found out about the birth of his children late, through my sister, which upset me, although I suppose it’s not his fault.  My father’s friend is still here and I can here him and my parents through my window, which is depressing me and making me worried that I will still  have to speak to him.

Shiur (religious class) also upset me.  The usual self-critical thoughts about not being holy like everyone else, not having simcha shel mitzvah (joy in the commandments) or simcha at all, not being married… plus everyone else got there early (I’m guessing there was a WhatsApp message I missed because my phone is not working properly) and was seated in the sukkah and eating before I got there, so I missed the social side and I didn’t get a drink because the plastic cups ran out and I was too shy to ask for another one.  I was too shy to answer any questions too, although I knew the answers to a few and could have showed off, although I suppose that’s no great loss.  Someone there was very rude, pressuring people to go to a fund-raising event and to bring whisky to shul on Simchat Torah next week when he doesn’t know people’s time and financial commitments (and some may, like me, avoid things due to social anxiety or some other legitimate reason).  This was the same person who, on finding out that I’m single, responded that it was “time” for me to get married, as if I was overwhelmed with offers of marriage and was foolishly wasting my time in hedonistic pleasure seeking (which is the exact opposite of my depressive anhedonia).  (To be fair, he did also offer to have me over to his house for Shabbat meals while I’m single.)  This shouldn’t have upset me, but obviously it did, because I’m still angry nearly two hours later.  This person is probably very holy (at any rate, all he seems to do is “learn” Torah), but perhaps he is so holy he forgets how ordinary people have to live.  Maybe that’s something I can take from my misery, that at least it has made me marginally more empathic and non-judgemental than I might otherwise have been, although if this is me with empathy and tolerance, I worry what me without them would look like.