How Engaged/Anxious/Depressed Does This Article Make You Feel?

There’s a lot of history to unraveling my mental health, which most recently culminated in a brain scan at the Amen Clinic. Scans are controversial, but there’s one thing that Dr. Amen said in his Ted Talk that rang true for me:

“Did you know that psychiatrists are the only medical specialists that virtually never look at the organ they treat? Think about it. Cardiologists look, neurologists look, orthopedic doctors look, virtually every other medical specialties look — psychiatrists guess.”

My diagnosis pre-scan has generally been depression and A.D.D., but I am high functioning and without recognizably severe symptoms. In other words, no one has ever gotten too worried. Lots of my friends characterize me as “neurotic” or “stressed out”. Any new psychiatrist might recommend a few drugs, most of which I have tried. Or some talk therapy, which I’m less interested in after 20 plus years practice. At this point, I’m more interested in channeling my acute self-awareness into behavioral change. Usually, I think I am my own worst enemy. But when “I” is your brain, it’s hard to ascertain whether the fault lies with you or your biology. Or both!

Before I lose you — because who isn’t coming clean about their mental health these days — allow me to share my hidden and generous mission. I’m terrified most of the time, and find myself stalling, failing, or stewing and tend to feel unfixable and alone. I have a friend who is incredibly intelligent, legitimately and academically accomplished in math and science. On her wedding day, before walking down the aisle, she could not locate her shoes. For this reason, she is one of my favorite people. In that spirit, I am gifting you with my own discrepancies. If you can relate, then maybe I’m not a terrible person. Just a co-dependent one.

So back to the brain scan, which sounds dramatic, and possibly a little crackpot, and potentially terrifying. For me it was a dream come true. Getting the scan, with photos that revealed the inside of my brain, made me feel like a teenager getting a driver’s license. I was official. I was free. I had proof!

There’s a ton of information I can share about the scan, but I prefer to dole out the details over time. The summation of the report reads “the most significant findings are moderately to severely increased perfusion to the bilateral basal ganglia and thalmus.” Without getting into clinical detail, there’s a significant intersection of anxiety, depression and A.D.D. reflected in specific parts of my brain.

How curious that the findings did not state “She’s neurotic. Case closed!” I have always hated being called neurotic because it implies a flaw within my control. I did some research on the word and here are a few definitions:

- a relatively mild mental disorder, characterized by symptoms such as hysteria, anxiety, depression, or obsessive behavior. (in what world is this mild??? This definition alone is making me hysterical, and is obviously structured to be a manipulative and self-fulfilling prophecy)

- Also called psychoneurosis, a functional disorder in which feelings of anxiety, obsessional thoughts, compulsive acts, and physical complaints without objective evidence of disease, in various degrees and patterns, dominate the personality. (I much prefer the word psychoneurosis. Thank you.)

Fun Fact: The Diagnostic and Statistical Manual of Mental Disorders (DSM) eliminated the category “neurosis” in 1980, because of a decision by its editors to provide descriptions of behavior rather than descriptions of hidden psychological mechanisms. This change has been controversial.

Do not call me neurotic. I have overactive basal ganglia. Wanna see? And that’s just the tip of the neurological iceberg.

My current psychologist is trained by the ways of Dr. Amen. His job is to interpret my brain scan and prescribe a course of action. I’m generally late to our appointments, but he is never upset. Because he is the one person intimately familiar with the inside of my brain and knows that being an overall wreck comes with the territory. Even though I am a “successful executive”, I have trouble GETTING THINGS DONE. I started seeing Dr J. in April, and was tasked with getting blood work done for comprehensive medical history to compliment the scan. That took me 3 months to complete. In my defense: you can’t have any food or coffee prior to the appointment. All I have to do next is my taxes (not sure why anyone would ever file by April 15th when the “real” deadline is Oct 15th ).

But I’m also not one of those people who has an otherwise fantastic life, and just cannot fathom why they suffer from depression and anxiety. I am factually more alone than many people I know. I am an only child, single, my mom passed away a few years back, and my once promising career has limited social interaction. Most of my friends are married with children and my social life is pretty limited. Historically, I’ve been social and spirited, but I’m genuinely lonely at this point in my life. Devastatingly so. I have gotten 2 texts today, and one is from my dog walker. The other was from my Dad “I have had a stiff neck for over 3 weeks now and I’m in the doctor’s waiting room now”. Totally true.

Dr. J asked me to start doing a daily chart where I rate how engaged I am, how anxious I am, and how depressed I am to help sort out which ailment is most predominant. It’s important to treat the predominant symptom first and foremost. Here are some recent entries:

ANXIOUS — This morning I went through a list of items for my substitute boyfriend Alex to help me manage. (Alex is an ex boyfriend whom I recently reconnected with and who is willing to be a part time Annie Sullivan to my Helen Keller. Fret not — where I suffer from delusions of inferiority, Alex suffers from delusions of grandeur, so it’s a highly effective co-dependency. Alex and I met through a mutual friend, and at her birthday party years back, he noticed me off in a corner reading a magazine. For some reason, he thought that was cool. What Alex didn’t realize, and neither did I at the time, was that seemingly sexy aloofness was just a classic A.D.D. symptom rearing its ugly antisocial head.)

One of the items I assigned Alex was researching drugs — like SSRI’s and anti-depressants — and noting patterns for the few drugs that worked for me. He got pretty over the top about pharmaceuticals causing more harm than good, and we started fighting. My other friend was in the living room and I grew very concerned about her well-being, because she is the nicest person I think I know, and sort of like a living angel. So our fighting made me anxious, not because the fighting itself was anxiety provoking, but because I considered that it might be anxiety provoking for her. It was also exciting to have a few friends in my house (after complaining about loneliness, I promise this was an unusual occurrence)! So, while that was positive anxiety, it was still anxiety.

ANXIOUS — Spent Saturday by the beach. By all accounts, should have been a lovely weekend day. I was anxious, and later at a party, very bored. I have been to a lot of parties and I don’t think they’re so fun anymore. I think I’m supposed to be doing different things, like raising a family and evolving as a human by contributing to others’ growth. Having to compensate for that loss is a difficult, labor-ridden journey that involves a lot of books, notes, and hi-lighting. I think the circumstances are relevant and contribute to my mood overall. It makes sense that I am anxious on this Saturday, when I am confused about how I’m supposed to reconstruct the second half of my life. I’m convinced that if the circumstances were different, I’d be happy. Regardless, my biology doesn’t offer a “go with the flow” disposition.

Also got triggered by a friend’s email — he got a new job and got to pick up his kids at camp. I haven’t grieved the process of that not being my reality (having children). Or I guess I grieve it every day. Something about the wide-open ocean and beach made me feel more lost instead of less. That’s anxiety that turns into…

DEPRESSED — pretty depressed by that email. Why is it so heartbreaking that my life is so different? Why can’t I mobilize to find more ways to be of service?

ENGAGED — Went for drinks and dinner with a friend. And I was ENGAGED. S and me were plotting the potential demise of her relationship, and re-initiating contact with my ex (not Alex) who pretty much could have saved my life. I know that it’s no one’s job to save my life, but he still could have, a little bit. That’s a longer story, but in brief, his reasons for ending things with me were due to divorce PTSD. And as S said “I doubt he’s with anyone. I saw him at A.O.C. (fancy restaurant), and he was alone. I could ask him what it would take to get his shit together.” Trust me, I’m not one to consider a crazy plan like this unless my crazy friend is in the same crazy camp that I am — that P not being with me simply because he is scared of a relationship makes no sense whatsoever, and someone (not me) has got to be able to talk some sense to him. So that was a pretty ENGAGING conversation, yeah.

I brought this all up to Dr. J.

Why couldn’t I enjoy Saturday at the beach? Why am I so anxious? “You are always anxious. It’s your underlying physiology. We need to calm that down so you can enjoy your life.” “Is it A.D.D. that I’m bored at a party? Sometimes I think I’m really smart and just get really bored because the situations and people aren’t stimulating enough for me. But then I think maybe it’s just A.D.D. and I’m not smart at all. “You are very smart, but most smart people are easily stimulated by everything around them to discover in books, on the internet… it’s harder for A.D.D. people to engage.”

Is the awareness of my issues, laid out in a brain scan, helpful in having me manage them? A little bit. We are working with medications, and the first one didn’t work, so the jury is still out.

My brain scan was really expensive, but I have no regrets. It’s colorful and super sexy, if I do say so myself. It’s like owning a fancy designer handbag that announces your entrance into a room. That girl has class, one might say, or in my case, that girl is mentally ill. And I’ll take mentally ill over neurotic any day.

The brain scan is also multi-purposeful. The question isn’t, “what should I do with these brain scan photos?” It’s “what don’t I want to do with these brain scan photos?!” How about superimposing my brain images onto business cards? Or uploading the photos into a digital frame to display them proudly in my living room? How about a 2018 calendar? I’m pretty sure there are 12 images to divvy up, and as Dr. J said, my basal ganglia is lit up like a Christmas tree! And how about adding some of those beauties to my online dating profile — slipping one or two brain shots among a few come hither poses will surely prove an aphrodisiac for the right male suitor.

When it’s not attacking me, my brain can be filled with creativity and delight.

And my brain scan is going to make the best holiday card, ever.