The Invisible Prison · 4:21pm Oct 14th, 2016
I had to really think hard about exactly what was worth saying. It should be of no significant surprise to say there is an awful lot going on with my mind right now, but it makes sense to me to talk about the thing most important to where I am at this exact moment, as that is where i can be the most specific and give the most detail.
The vast majority of what I gained has now been lost. I could focus on the small amount of practical, assumedly physiological change that remains, but I don't actually think that's where the real work lies. Instead, I find myself drawn to examining what is and what was with the added perspective of my short experience.
You will no doubt have seen many little posters, comments, and memes regarding mental health that essentially exist to remind us that we don't know what another person is going through: no matter what you see on the outside, you can't know their struggle on the inside. This is a fair and valuable message, but it is also missing something important. There is a reasonable chance that they have no idea either. I didn't. Now I do. But the ability to recollect that difference is dwindling along with my increased functionality.
I said before that I was surprised by the subtlety of what I was experiencing. I would like to try and impart at lest a little understanding of that. After I left the recovery room and walked back to the car, I stopped and just looked around. It hadn't really struck me what was tugging at my mind, but something was different. I looked up into a sky far bluer than the cold chill in the wind might imply and drank in the celestial glow surrounding each cloud. "Do the colours seem any different," my lift asked me, obviously guessing what I was doing.
I wanted to say no – that was my first thought – but the whole experience of observing my mind splintering into its component functions had showed me how easy it was to conflate a difference in what I saw or felt from a difference in the person experiencing it. The colour was the same, no doubt, but the experience of it was different. There was a duality in knowing that the colour was both exactly the same as I was used to and yet more vibrant and fantastical at the same time. The sky wasn't different, but I was. It was a nice blue, and I want you to understand how much of a profound thing that is: the exact same blue had a different effect on me because it was an experience rather than just a datapoint. A whole new way of experiencing the world had switched on, and I smiled in a way that didn't feel plastic and alien.
It wasn't nice: it felt nice.
Think of all those times that someone has asked you or someone else to close their eyes and imaging something that makes them happy. Think of how it feel as that smile creeps onto your face – the kind that warms the edges of your mouth as your skin tightens and you know you couldn't hold it back for all the tea in china. Now think of doing that and feeling the physical details but having no emotion. The smile creeps in and you feel your face stretch, but it's like someone is controlling you. Why are you smiling? Imagine you feel fake, out of control, beholden to a physical response happening beep in the brain where you can't see it. Imagine knowing that other people do it and have this sensation that some might call happiness. It's a bit of a lazy catch-all term, so substitute another word if it helps. You can see that it's normal, but what other people describe is alien to you. How would you know for certain that you don't feel what they feel? How can you compare yourself against something that seems completely outside of your experience?
Well, it involves a lot of second-guessing and hedging, for starters. I think that takes its toll on a person – always speaking as if you're not quite sure of what reality is. It breeds instability and uncertainty. So having that missing experience one day isn't just about the extra sensation; it helps to undo years of uncertainty and solidify one's sense of reality. And now that it has gone, that certainty stays with me.
One of those certainties is the verification of something I have long suspected about memory. On Tuesday morning, I thought back to that moment where I looked up at the sky and the whole scene came back to me, emotions and all. I smile, broadly. I felt better – happier. I can remember many things that had a strong emotional content and they do not have the same effect. I do not feel what I felt at the time because I wasn't truly experiencing the emotion at the time for it to be encoded along with sights, sounds, and physical feelings. Even without the functionality I briefly had, I can still feel the emotion in the memory. But I also know enough about how memories work that without full connectivity between my reward centre and my pre-frontal cortex, that memory will fade each time I think of it because the re-experience is dulled.
Think about that for a second. If you suffer from long term depression and your neural pathways degrade sufficiently, not only can you not experience joy fully (or perhaps even at all), but it may be editing out the joy from all of your memories permanently. But, it does show that even where I am now, that emotion state is still possible. Naturally, I had to have a bit of a play with the function and find out where the limits were. What I learned is that the emotions cannot be sustained without concentration in any way. The moment I start thinking about anything else or try to combine it with some kind of action, I lose it completely. Which is to say that I have physically lacked the ability to be satisfied with life in any meaningful way. Since Monday, however, I haven't thought about death or non-existence once. It's amazing how even the smallest drop of accessible happiness makes literally all the difference in the world.
On a more mechanical level, I always suspected that these emotions were physically occurring somewhere in my brain that I couldn't actually perceive. Aided by the psychedelic effects of my ketamine infusion and the data I have accrued since, I am now certain this is the case. I'm not saying that I know it as a fact, but I have enough evidence to assume that it is true until something contradicts that model. This is the invisible cage. the place in my brain that generates joy is working just fine, but it wasn't going anywhere. I mean, maybe a thin veneer escaped from time to time, notably strengthened or weakened by how much anxiety I was feeling at the time, but overall it hasn't been enough to get by on – presuming that mere physical survival is not the same as actually living. With the knowledge I have now I can get more of it than I could before.
It's about anxiety, at this point. Specifically, it's about reducing it, and being able to clearly define what has, was, and is going on inside my mind/brain has brought me to a place of being much less anxious about the prospect of these problems existing. There is no longer any doubt that the kind of anxiety that has rolled back in over the last two days is so utterly and completely absurd that it is no wonder that it is debilitating. It doesn't feel like I'm wasting everyone's time like a whiney little bitch. If there's one think I'd want people to take away from this, it's that having an anxiety-based disorder is not just having more anxiety, it is utterly incomparable with 'normal' functionality. Everyone has doubts, everyone has fears, everyone has anxiety, but anyone with a disorder is dragging around a weight in chains that you may, quite justifiable, be incapable of even conceiving of.
Because I was living it and I didn't really know. I couldn't know. the dumb thing is, now that I do now, I have become instantly more able to fight back. Just seeing it for what it really is changes the experience completely. But there is no way I will ever be able to truly impart that knowledge to anyone who hasn't lived it. It would be grossly unfair to expect anyone else to understand – like inventing a 4th primary colour.
Compassion goes both ways. have some for those who cannot see your chains. Have some for those who have the chains. You cannot see another person's struggle from the outside, but bear in mind that maybe they can't see their own struggle either.
Infusion #2 on Monday. More after that.
—M
(apologies for any typos – I'm in a bit of a rush and don't have time to edit)
Thank you for the blog post and these insights.
Is that how these emotional reactions have been working for you? That sounds pretty terrifying, and I think I can see now how it took you experiencing both sides before seeing the difference.
I'm wondering, though: Does it feel like your anxiety disorder is a result of the inability to feel positive emotions, or is it actually the cause for said inability? Or asked differently: Does it feel like the ketamine created a breach in the prison, or did it mute the anxiety to a level where it could not run interference? Your mentioning of getting glimpses of the positive emotions when your anxiety quieted down made me wonder.
On the topic of memories and the decay of the associated happiness due to lacking connectivity between reward centre and pre-frontal cortex - I believe what you say is true that the intensity might fade due to the memory being altered each time you recall it, but I also think that there should be some learning effect: The stimulation of the reward center with help of the pre-frontal cortex should lead to a strengthening of the connection. At least that's what my knowledge of neuroplasticity tells me (only had two courses in neurobiology, though).
4255809 Generally, no, my glancing experiences of joy haven't been like that. I brought it up because it's something I started to notice more and more as my general awareness and knowledge grew. Sometimes I'd just notice myself physiologically reacting as if I was happy, but there was no trace of the actual feeling to be found. I suspect that I actually was feeling it while I was feeling particularly relaxed, but noticing the physical reaction probably disrupted my tranquillity enough for it to vanish.
But mostly, joy just hasn't been a thing.
I'm pretty sure that excessive anxiety caused the suppression of joy and not the other way around. Anhedonia is the result of aneurological defence strategy. It's not the brain malfunctioning, but the adaption that outlives its purpose. My heightened anxiety is present in the very earliest memories I have. It's fair to assume that my amygdala is significant overgrown due to excessive use, meaning that too often a small trigger can elicit a 'freeze' response. It wasn't until several years into my counselling that I realised I had been in a permanent state of panic, and that knowledge has allowed me to be working on controlling it for years before now. Without that preparation, I do not think I would have gotten as much out of this experience as I have.
Joy is a natural state. Bliss, for example, was once described by philosophers and being the state of having no unmet needs. My guess would be that when joy can no longer surface naturally, anxieties tend to fill the void and get amplified greatly by the lack of a counterpoint. When there is no positive, the negatives can seem many times larger that they have any right to. I was very aware that for as long as that sense of joy was there, the ideas of tranquillity, motivation, confidence, control, and focus seemed utterly instinctive and, frankly, just plain easy. Without that joy, even the smallest fear can seem insurmountable. In fact, I'd go as far as to say that it is, after a fashion. When you're missing half the scale, you can't balance anything.
And yes, added stimulation of the pre-frontal cortex and deepen the emotional value of a memory, but this is only relevant when the PFC is successfully being stimulated at all, which it only barely is after the K's effects wore off. But it is a technique that mentalists and psychologists have used to connect positive feelings with discrete physical actions to reverse engineer a positive mood on command. Essentially, you perform a physical trigger while thinking of something that makes you happy until such time that performing the actual directly causes the happiness out of sheer habit – the emotion gets connected to the memory through repetition.
It's a handy trick, but sadly useless for anyone who can't feel that joy to begin with.
I'm very interested to hear if the effect of dose two builds on the success of the first or has a lesser effect.
Thank you for sharing your experience. Not many people would be willing to talk something this personal.
I hope your next two doses will help to make that feeling a little more permanent. Good luck to you.
Glad having something to compare to is helping.