Triggers and Case Histories

(I’m experimenting with a timed post here.  I’m writing it on Sunday night, but it should post while I’m at work on Monday morning, so I’ve written it as if it were written on Monday.  So “yesterday” is Sunday not Saturday.)

I submitted a job application for a cataloguing yesterday.  I feel pessimistic about it, but I keep changing how I feel pessimistic.  Sometimes I feel my application will be rejected; other times I feel I’ll get the job, but won’t be able to do it.  I have completely lost whatever confidence in my professional abilities that I might once have had.

I spoke to my rabbi mentor yesterday.  I think I sounded more upbeat than I feel.  He said a lot of frum (religious Orthodox Jewish) people feel far from God, struggle get in the right mood for Yom Tov (sombre for Yom Kippur, joyous for Simchat Torah) and that lots of people feel they don’t fit in to the community.  But I feel a bit as if I hadn’t expressed myself well or helped him engage with what I was trying to say.  I know it’s hard for everyone to engage with Yom Tov (a while back I posted here a quote from Rabbi Joseph Soloveitchik, one of  the greatest rabbinic thinkers and Jewish philosophers of the twentieth century, where he said that even he sometimes feels “cold” on Rosh Hashanah morning and has to get himself in the right frame of mind), but I feel that it’s harder for me, although I can’t quantify that or prove it.  I feel that I don’t fit in to the community at all, as shown by my difficulties making friends and talking to people.  I feel that I am having a kind of crisis of faith, as although I believe in God strongly and although I can accept intellectually that one day I might find meaning and purpose in my life/struggles (the two seem largely the same to me and have for decades), I can’t feel that at all emotionally.  What I feel emotionally oscillates between a cool disengagement and lack of desire to daven (pray) or study Torah, and a raging anger at God for letting my life be like this (depressed, anxious, lonely) for so long.  Then I feel guilty that I feel like this, not because it’s sacrilegious, but because other people have it so much worse and I should feel angry for them.

Speaking of not fitting in to communities, yesterday evening I was feeling fine, packing for work, when suddenly I got hit by intense despair and perhaps some anxiety.  This time at least I could work out the chain of thoughts that led to it.  It went: looking at Doctor Who stuff online –> thinking I should try again to be more involved in fandom as it would be fun and good to do something social that isn’t shul- or mental health/autism-related –> a lot of Doctor Who fans are very left-wing and into identity politics –> they’ll hate me because currently left-wing people in the UK are insisting that Jews make up antisemitism for political reasons –> vertiginous despair and loneliness, maybe some anxiety.  I’m not sure how I can cope when even positive thoughts (Doctor Who was really good tonight) can be so triggering.

In attempting to get an appointment with a psychiatrist on the NHS, I was told I could also apply to IAPT (Improving Access to Psychological Therapies) for help.  I’m not quite sure what they can offer me, but I feel I might as well try.  I summarised my condition on the online application form:

I suffer from treatment-resistant depression. I have consistently low mood and despair as well as occasional suicidal thoughts. Very occasionally I self-harm.  This has continued despite medication and talking therapies for fifteen to twenty years. Although I am able to work four days a week, I find work exhausting and struggle to get through the days. I often spontaneously start crying at work for no obvious reason and I struggle to work through intense depression, despair and anxiety. I lack energy and motivation most of the time and on days when I don’t work, I sleep up to twelve hours a day.

I also have social anxiety which may stem from high functioning autism and/or complex trauma. I find it difficult to know how to initiate and continue conversations and to read unspoken social cues. I struggle to make friends and to cope with social situations and avoid social situations as much as possible.

I also have extremely low self-esteem and struggle with negative, critical thoughts about myself as well as intense guilt and shame.

It seems somehow bland and clinical to see it written down like that.  Do I think it sounds whiny and pathetic or is that just the critical inner voice again?  I probably should have put more about my history with medication and therapy (that was supposed to go in a different box, but the drop-down menu wasn’t working properly), although my experience with these questionnaires is that no one reads them, least of all the person who actually assesses you for the service.  And summarising fifteen or twenty years of personal history in 2000 characters is not easy, nor is opening up about your deepest thoughts to anonymous strangers (so not at all like blogging…).  I shall have to wait and see what comes of it.

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The Day of the Great Fast

I really ought to go to bed, as I have to be up early for work, but I need to write to process the day.

Today was Yom Kippur, the holiest day in the Jewish year.  It’s the only fast day I’m allowed to fast on given my current medication.  I don’t fast well, never have done (most of my family don’t either), which always makes the day problematic.  I secretly envy people who can get through the day without so much as a headache, spend the whole time davening (praying) intently in shul (synagogue) and still be in good spirits by the end.

Yesterday night (Jewish festivals start in the evening) was pretty good.  I went to shul and I remember that I had a fairly moving experience, although I don’t remember the details.  I know I felt very, very angry with HaShem (God) at the start.  I have heard that expressing anger at HaShem in prayer is permitted because prayer is supposed to be authentic, that Chana’s (Hannah’s) paradigmatic prayer in Tanakh (the Hebrew Bible) which is the model of all Jewish prayer, was an angry prayer according to the rabbis.  I think after a few minutes it turned into intense sadness and perhaps also anxiety about what kind of a new year I might have.

I was tired afterwards and went to bed at 11.00pm.  Unfortunately, I slept for something like fifteen hours.  I spent the morning drifting in and out of sleep with bizarre dreams (meeting an old friend who promptly treifed up our kitchen; being attacked by gorillas in the garden, who turned out to be people dressed as gorillas; and, most strangely, being a Cabinet minister in John Major’s government.  God alone knows what any of those dreams mean, particularly the last one (which was chronologically first)).  When I was awake, I felt too drained, depressed and anxious to get up.  I could tell that I had low blood sugar.  I knew that all I needed was a glass of water, a bowl of cereal and a wash, but all these things are forbidden on Yom Kippur.  I think for the first time I was tempted to eat on Yom Kippur (fasting on Yom Kippur is one of the most widely-accepted Jewish laws.  Even people who do nothing religious all year fast on Yom Kippur).  I didn’t, but I’m slightly worried by how tempted I felt.  Maybe I’m just judging myself harshly.  I don’t think there was a serious chance that I would have eaten something, but it was strange that the thought even entered my head.

Eventually I got up and went to shul.  I arrived at about 4.30pm; Mincha (the afternoon service) had just started.  I struggled through the next four hours or so.  At times I felt so faint and frail that I had to sit down because I was afraid I would fall over if I stayed up, even in parts of the service where one is supposed to stand.  On the plus side, I didn’t get a bad headache and most of the time I didn’t feel like I was actually going to throw up, so that’s actually an improvement on most years.  But I did feel terrible for missing most of the day, even though I know I was too depressed to get through it.  I know I would have felt less depressed if I had eaten, but I also know that my priorities were right (fasting is a biblical commandment and outweighs the rabbinic commandment of set prayer), but somehow this doesn’t make me feel better.

The rabbi in his drasha (sermon) before Ne’ila (the fifth and final Yom Kippur service – only on Yom Kippur do we pray so many times in one day) spoke of not being an mediocre Jew.  The idea is that ten days ago on Rosh Hashanah we could be judged as righteous, wicked or in between, but on Yom Kippur HaShem takes all the in-betweens and reassigns them to one side or the other.  From now on, we’re all righteous or wicked, spiritually alive or spiritually dead.  No compromises.

The rabbi spoke about taking on one area to improve in, religiously, in the coming year.  I had already decided I was going to focus on curtailing my negative self-perception, ending my “internal critic” as the C-PTSD book I’m reading puts it, or talking lashon hara (malicious speech) about myself as I think of it, to try and make it sound religious and therefore more important to deal with, to encourage me not to back off from it.  (The Chafetz Chaim (Rabbi Yisrael Meir HaKohen) spent his life campaigning against lashon hara and he said it’s forbidden to speak maliciously about yourself too – there’s an amusing story about this which sadly I don’t have time to share now).  I still feel I should do something more overtly ‘religious’ like commit to davening  with a minyan more, or with more kavannah (mindfulness) or saying more of Shacharit (morning service) or studying more Torah… I feel lacking in so many crucial areas, and knowing that it’s largely due to my emotional/mental health issues doesn’t make me feel any better.  But I feel that I’ve put off dealing with my low self-esteem for years and that’s probably why I haven’t succeeded at dealing with these other emotional issues.

The rabbi also spoke about the need to do something that is a kiddush HaShem (sanctification of God’s name – something that makes people think positively about Jews, Judaism and the Jewish conception of God).  I don’t know that I really do that, and I’m not sure that dealing with my negative self-talk will really help with that, but I don’t think I can prioritise that today.

After Yom Tov I checked my emails and saw that the CBT therapist who I saw about my OCD and who I emailed to ask if she could help me with my self-esteem and social anxiety isn’t taking on any more clients right now, so I’ll have to find another option.  I’ve got one potential idea, but I need to make some inquiries.

I never know what one is supposed to wish other people after Yom Kippur.  It seems strange to wish shana tova (good new year) now the new year period is officially over and we’re moving towards Sukkot, but it also seems anticlimactic to wish people shavua tov (good new week), particularly as the week is nearly over.  Technically you can wish people Shabbat shalom (peaceful Sabbath) from Wednesday onwards, but that always seems strange.  Still, whatever it is you’re supposed to have at the moment, I wish you a good one.

Messed Up

I have a somewhat strange relationship with anxiety.  On the one hand, I have had a number of psychological assessments over the years and I often surprised the psychologists at how little anxiety I registered on their questionnaires, considering how strongly depression registered (the two usually go hand-in-hand).  On the other hand, I am no stranger to the gnawing feeling of dread about the future.  When I was at school and university, I used to feel particularly nauseous on Sunday evenings, dreading the coming week, and first thing in the mornings.  It was the latter that brought my mental health problems to light for the first time.  I went to the doctor complaining of disrupted sleep and inexplicable nausea during the day, especially on the way to school.  It turned out, after a number of physical tests had drawn a blank, to probably be my first major depressive episode with anxiety explaining the nausea, although this was not diagnosed at the time.

One therapist suggested that the depression was so strong that it ‘drowned out’ the anxiety except at certain points when the anxiety was very strong.  That may be true, although I think it may also be the case that the anxiety had been present for so long that I stopped noticing it, at least the morning/Sunday evening type of anxiety, and/or that as far as possible I dealt with the anxiety by avoidance, particularly in the years 2005-2008 or so, when I simply stopped functioning and spent all my time in my bedroom, reading and blogging online and watching Doctor Who, only going out for meetings with psychiatrists or therapists, being too depressed to work.

Sometimes the anxiety shades into pure O OCD, where I go from worrying that I’ll be fired to obsessing that I’m going to do something that would get me fired even though I know it to be wrong and have no conscious intention of doing it.  OCD is classified as an anxiety disorder (although apparently this has recently changed in DSM-V, but not ICD 10), so I guess that isn’t surprising.  At other times the anxiety would catastrophise into despair, where I would stop worrying that something bad would happen and just assume it would happen and feel depressed as if it already had happened, particularly regarding careers, dating and recovery.

***

I was a drama queen on someone’s blog again yesterday.  I wish I didn’t do this.  It was about the coming Yom Tovim (Jewish festivals) and setting targets for growth over them and in the Jewish new year.  I just feel that I can’t cope with any of that right now, that I’ve got a lot of anger and resentment issues with God and I can’t cope with the idea of making him my King (which is what Rosh Hashanah (Jewish New Year) is all about) or asking for forgiveness (Yom Kippur (the Day of Atonement)).  I feel, if anything, that He should be asking me to forgive Him for everything that He’s done to me over the last twenty years, but then I feel bad for feeling that.  I’m hopefully speaking to my rabbi mentor on Sunday, but I’m not sure how much of this I will be able to bring up.

***

I just feel tired a lot of the time.  Physically tired and tired of life.  I’ve felt like this on and off for many years.  I just feel that my life is not good, that I don’t enjoy it or have meaning or purpose, or feel that I’m doing anything useful with it.  I feel I have no reason to want to stay alive.

I feel confused too.  I don’t know where my life is going.  I have ideas for what I could do, but I don’t know how feasible they are or whether I would actually enjoy them.  The world frightens me, both on a personal level and, increasingly, on a social/political level.  This doesn’t feel like my world, but I don’t think it ever was.  I don’t know what’s going to happen with me and E. and I’m not sure I really know what I want to happen or what would be sensible.  To be honest, I don’t know what I feel about HaShem (God) either.  It’s easy to say that I hate Him and am angry with Him, but I’m not sure that that’s an accurate picture of what I feel, at least not all the time.  I don’t know if this is alexithymia (difficulty feeling and understanding emotions) again.  It’s hard to know what I feel about HaShem.  I feel strongly that He exists and is omniscient, omnipotent and benevolent.  I’m not doubting in that sense (and I have had times of doubt in the past, so I know what I’m talking about).  But I find it hard to believe that He cares about me and even think that He hates me, which I guess means that I think that I deserve to be hated.

I just wish I could sort out my life somehow, but I’m not sure what a ‘sorted out’ life would look like.

***

Just further to what I wrote here over the last few days, I did a tiny bit of reading on complex PTSD.  I did seem to have quite a few of the symptoms and certainly there was an ongoing situation in my childhood that seems to my unprofessional mind to be potentially traumatic, but in my mind I would not feel confident at all to say I’m a sufferer.  I suppose I feel that I have so many issues that have not been ‘officially’ diagnosed (autism being the big one, as I have had repeated and conflicting diagnoses, but also I was never officially diagnosed with OCD or social anxiety, even though both seem very likely) that I am wary of adding any others, especially as my therapist feels I have a tendency to want to be The Most Mentally Ill Person in the World.  So, I’ll probably shelve that for now, but it is at the back of my mind.

***

I just got back from shopping.  This led to several bad things: the realisation that even walking briskly for five or ten minutes exhausts me; the discovery that there is a supply problem with my antidepressants again, leading me to suspect that they are no longer being produced; and suicidal thoughts.  In just over a week, Jews all over the world are going to be literally praying for their lives, hoping for a good new year, a year of life, and part of me just wants to die.  I do not want to be here any more.  I feel that I’m a disappointment to everyone and that it would be no different if I was never born.  I’m just holding on because a few people care about me, which I don’t understand, but I don’t want to upset them, and because I’m a coward and scared of making a failed suicide attempt and ending up physically damaged, but still alive and depressed.  I don’t feel I have any real hope for the future.  I’ve been depressed for so long now, it’s impossible to believe things can get better.  In fact, I think things will probably get worse.  I just screw everything up.

People tell me I have to stop comparing myself to other people and to learn self-love, but no one tells me how to achieve these things.  I don’t feel I deserve to love myself, I don’t understand how other people could love me, I don’t believe that HaShem loves me and I don’t know how to love myself without becoming even more wicked than I already am, because I’ll just end up ignoring or justifying all the bad things I do.  I don’t know what the way forward from this is.

(I’m not sure how much of the last two paragraphs is true.  It feels true, but it also feels true that there’s part of me that doesn’t want to die, although it’s pretty confused about why, as it’s not much more hopeful for the future.)

Missing a Plan

I was expecting to be burnt out and oversleep after volunteering yesterday, so I was surprised to wake up and get up before 9.30am.  However,  I turned out to be exhausted in a more subtle way.  I was OK doing basic tasks, but tasks requiring brainpower or needing to force my way through poor motivation (such as applying for jobs I don’t want and don’t think I could get e.g. today’s application for a law librarian post that said that experience of a law firm was essential, which I don’t have) were much harder and I even went back to bed for a bit after lunch.  It’s hard to sound enthusiastic about such jobs.  I did manage to fill in a job application, but as I had to do little for this one other than make slight changes to my CV and template cover letter (I wish all applications were so easy), it doesn’t feel a great achievement – it probably only took me about an hour when I’m aiming to do three hours of ‘work’ on job hunting a day.  Still, I had to save some energy for shopping and cooking as my parents are away.

I was going to post this as a comment on this blog post, but I decided I was drama queening again and only posted a shorter comment, so here is the longer version: I haven’t done a cheshbon nafesh (self-appraisal) yet this year and it’s looking like I might not do one for the first time in twelve years or more.  I failed miserably at last year’s targets.  I’m dreading Yom Tov (Jewish festivals) and I’m not sure how much time I’m going to be in shul (synagogue) for due to depression, social anxiety.

More to the point, I feel really angry with HaShem (God) for the way my life has gone.  I acknowledge that I’ve made some bad choices, but mostly I feel I was set up to fail and even a highly competent person (which I am not) would not succeed with the mental health and other issues I’ve been given from childhood onwards.  I have no simcha shel mitzvah (joy in performing the commandments) and have realised I never really have had any.  I’ve asked rabbis about this and been told that I won’t have any until I’m not depressed (which is scary as I don’t think I’m ever not going to be depressed) or that I should be able to get a bit (which just makes me feel a terrible person for not having any as if I’m deliberately stopping myself enjoying my religious life). I feel like I can’t actually do this any more without getting something back from it, selfish and wicked though that is i.e. I know I should be frum (religious) lishmah (for its own sake), but I’m just not that good a Jew.  I don’t think that most frum people are doing what they do 100% lishmah and not because they enjoy or get satisfaction from Shabbat, Torah study, davening (prayer) etc. at least a bit of the time.  Halakhically, there is nothing wrong with enjoying one’s religious life, quite the reverse.

I don’t feel particularly accepted in the frum world and part of me wonders if I really do want to be accepted there.  So, at the moment I’m basically sulking in my room (having left my job recently) and I worry that I’m going to do that over Yom Tov as well and just not go to shul.  I ask myself why should I apologise to HaShem when surely He has plenty to apologise to me for (making me depressed and lonely all my adult life for starters).  I feel like He hates me and spends all His time trying to make me miserable and I don’t know why.  I feel bad just thinking that let alone typing it, and I wasn’t really conscious of it until I wrote it just now, but I think it’s true (I mean, it’s true that I feel He should apologise, not that I think that an objective observer would say He should apologise. I haven’t gone that far yet).  It’s hard to do a realistic cheshbon nafesh coming from this place, where at least part of me feels unable to take responsibility for my actions, rightly or wrongly.  I know I recently quoted Rabbi Lord Sacks as saying that we can see ourselves as victims or we can take responsibility for our lives and he made it very clear that the latter is better, but I genuinely do not know how I can honestly take responsibility for things that seem to have been largely out of my control.  Nor do I feel able to make positive changes to my life.  I feel zero motivation to actually do mitzvot, except that I know I’ll be hit by guilt if I skip anything or do sins.

An analogy: I’ve put on a lot of weight since being put on clomipramine and it doesn’t seem to bear much relation to what I’m eating.  I’ve tried cutting back, but when I’m this anhedonic (unable to feel pleasure) it’s difficult to stop doing one of the few things I enjoy, to the point where it’s hard to care about my weight or health sometimes.  I haven’t gone completely over-the-top in eating, but I just ate a load of corn chips as a mid-afternoon snack more because it was too hard to resist rather than from real desire and that isn’t something I would have done in the past.  Likewise with my religious life, it’s getting harder and harder to motivate myself to follow those 613 dos and don’ts.  Concentrating on reward and punishment or the meaning of life and Jewish history or what HaShem wants from me is difficult when concentrating on anything is hard and it feels like HaShem is trying to hurt me.   It just seems so pointless to expend so much effort on a religion that I’m not good at and which gives me no satisfaction, joy, sense of community, meaning or purpose.

Rationally, cognitively, intellectually, theologically – whatever you want to call it – when I’m using my intellect, I don’t think that HaShem really hates me.  I’m not sure that He really hates anyone.  But I feel emotionally that He hates me, because He hurts me so much.  I know I’m supposed to assume it will be for the best in the end, but it’s hard to accept that anything good can come of this, particularly as my low self-esteem means I don’t think I’m getting any reward in the next world for everything I’ve suffered here.  Even when I say HaShem doesn’t hate anyone, part of me feels I should make an exception for very evil people like Hitler and then I’m off wondering if maybe I’m that evil.

Coming up to Rosh Hashanah without having done that cheshbon nafesh, I do feel that my life lacks focus and drive.  I’ve never really found my mission in life, the thing that is uniquely me, that I can do indefinitely without becoming depleted and that would make a positive difference to the world.  I thought it might be librarianship for a while, but now that looks unlikely.  Perhaps because of that lack of focus and joy, my relationships (in the broadest sense) and my everyday Jewish practice have to bear a huge burden of providing meaning and satisfaction which perhaps they could never realistically bear.

Well, it took just eight hours for me to start having suicidal thoughts after my parents left on holiday.  I don’t feel seriously suicidal, inasmuch as it’s possible to have non-serious suicidal thoughts.  I just feel that I don’t want to be here and no one would be worse off if I wasn’t here.  The people from my Thursday night shiur (religious class) are having a collection for the assistant rabbi, who gives the shiur, as his wife just had a baby daughter.  This just reinforces my feeling that only people with spouses and children really count in the frum community, even though that isn’t the intention.  Also the suggested donation seemed quite a lot to me, given that I’m unemployed, but I don’t like to ask for special treatment or for financial help from my parents, although I’m sure I would get either if I asked.  I have got an invitation for dinner on second day Rosh Hashanah (Jewish New Year) today, so I’m not feeling totally unwanted, but I do feel on the fringes of the frum community right now.

I feel that there must be some secret to being frum that I’m missing.  I’ve seen people I was at school with who were perhaps not the cleverest or the most academic or the most well-behaved students suddenly become super-frum and, in some cases, get smichah (rabbinic ordination) and I wish I knew what the secret was.  It seems like I was academic and well-behaved enough for me to get on well in the frum world, but somehow it hasn’t worked out like that.  My inability to study Talmud, or even to really want to study it, is a massive liability in a community built around Talmudic study (at least for men) and my social anxiety makes community life in general and daily communal prayer difficult.  And then of course there’s the way that my mental health issues and my ‘weirdness’/geekiness/possible autism make me feel alone and uncomfortable around most frum people and make it hard for me to date, even though marriage is, if not the passport into the frum community, then at least the proof that you are a mature and responsible adult (even if you’re only nineteen).