I Drank 6 Espressos And Found An Oasis Of Calm
How can stimulants like coffee actually calm somebody like me down, somebody with a lifelong anxious condition which has devastated my life?
How can ADHD — the H standing for ‘hyperactive’ — translate to feeling tired all the time? So much about this diagnosis seems counterintuitive. I’m trying, intuitively and not very scientifically, to understand it.
I laughed when I found a Nespresso unit in our hotel room this weekend — the aspirational coffee machine fed by shiny, luxuriant pods- remembering this piece by Charlie Brooker. I’m more used to sachets of instant coffee and a tiny kettle, but we’d won a stay in a swankier joint. I selected a pod and inserted it into the machine — a rather nicely designed hole told me where to place it and I brought down the handle with a satisfying ‘thunk’. It produced for me a cute, clean little shot of bitter medicine.
After a couple of strong, electric espressos I felt a little jittery but I also felt a spreading sense of calm. I remembered that in the past I’ve managed to push past this jittery stage, perversely, by drinking more coffee, reaching a kind of oasis of caffeinated serenity. I’ve never thought too much about it but it did seem quite strange — sometimes I’ve been able to have quite a nice nap after a strong cup of coffee. I’ve mentioned it to others sometimes, but they probably just think I’m telling tales. I’ve recently been desperately googling supplements and remedies for self-treating ADHD — it’s going to be a long time before I’m assessed for a formal diagnosis — and I’d come across people self-medicating, to an extent, with caffeine. It’s not Ritalin, but it’s something.
I thought I’d try a familiar experiment — what happens when I drink epic quantities of coffee? — but with a little more purpose, and a Nespresso machine.
That day, I drank 6 espressos. I found a window into executive function for the first time in years. I found some focus. It’s such an alien state of mind for me that I’ve tried to define it here. Focus.
To inhabit a scattered mind feels like this: every thought seems to be of equal importance, flung in a wide arc all around, every thought of equal urgency. A darting attention translates, unexpectedly, to feeling overwhelmed by the emotions of single thoughts, and being caught up in them, painfully and entirely. Drowning in a detail.
This seems to be because each idea is divorced from a more general context, a purpose to my train of thought. I easily lose sight of the finish line and wander off down another path. I can’t hold in my mind both the wider purpose of what I’m doing and the significance of the current detail, so the detail expands and kidnaps me, blots out the larger goal and holds me hostage. In between these hostage situations, I dart from one to another quickly and randomly, searching for stimulation. But with no purpose, no perspective. When I can’t see the framing context of a particular thought time becomes disjointed, it passes without my awareness. My internal clock forgets to tick. Where was I?
Focus lines up elements of my awareness in a purposeful shape, headed in a specific direction, and as I spend time with each element I am not distracted from the overarching path I’m on. Without focus, I hop from one idea to another in no particular direction; no context, no scale. Each idea can loom up and engulf me. I immediately lose sight of my path and become stranded in an agony of choice over the smallest detail. Trapped in a small space with only this single thought for company, I lose all perspective.
This can happen with anything from deciding where to place a logo on a page when I’m designing a document, to answering the question: ‘how are you?’. Over the last few years this paralysis intensified until I could barely function at all. Should I get out of bed? Should I shower now, or later? What should I wear? What am I doing? Who am I? My consciousness has been caught on flypaper.
I haven’t been able to define this dysfunction before now. I’ve been trying. I’ve seen counsellor after counsellor, psychiatrist after psychologist after psychiatrist, one medication after another. Meditation, mindfulness, self-help books, introspection, exercise, writing, talking talking talking. I know I have anxiety and depression, but…it just never seemed to exactly fit, the shape wasn’t quite right. It wasn’t enough of an explanation. I couldn’t find a reason for this inability to function and so I questioned my experience. But I was still stuck.
An awful fatigue of black treacle claimed most of my days. It took a very long time and lots of dead ends seen to their most obsessive and desperate conclusions (like self injecting b12) to finally pinpoint the cause of this strange chronic fatigue that was not chronic fatigue syndrome — medication. I seemed to have only two options: suicidal depression and crippling anxiety or a gross exhaustion which led to… suicidal depression. One after another in the 5 years since I lost my job due to my mental health and deteriorating performance I ran through yet more antidepressants, mood stabilisers and anxiolytics.
I actually began to suspect that serotonin was not the issue for me; it seemed more likely to be something to do with dopamine — the reward hormone. I tried to steer my psychiatrist toward prescribing me more atypical antidepressants with some action on norepinephrine and dopamine. In the case of fluoxetine (Prozac) — both the very first antidepressant I was prescribed at 14 and had since dismissed as a beginner’s drug, and my latest attempt to pull myself out of a tarpit of hopelessness — it is, apparently, the ‘least selective’ selective serotonin reuptake inhibitor. I hoped that this less focused effect would end up adjusting my levels of dopamine, rather than just acting on serotonin, and not cause the awful fatigue and brain fog which had left me unwilling to take citalopram, sertraline, venlafaxine, buspirone or any drugs in their class; nor quetiapine or pregabalin. So I asked my psychiatrist to prescribe my old friend Prozac, on top of the mirtazapine which wasn’t quite doing the job.
I had come to the general hypothesis in the course of trying all of these drugs over the last few years that concentrating on serotonin seems to leave me with a specific, unpleasant, debilitating kind of fatigue. I only found out recently, after I read all the symptoms, identified strongly with them and asked my GP to refer me for assessment, and in characteristically furiously combing the internet to try to gain some holistic understanding of my condition — that ADHD is linked to low levels of dopamine.
As the caffeine wore off I began to return more fully to my default state — an intolerable sense of frustration, a furious craving, dwelling on and raking over painful, shameful memories. Calling myself names or swearing in my head, over and over and over. ‘Why do I do this to myself?’, I thought.
I noticed the heat of shame in my face. Stimulation.
I think I do it to myself because, as awful as it feels to remember all these moments of shame, the pain releases activating hormones — my heart turns over, my blood pumps more wildly. It’s just another form of self harm, like the way I peel my thumbs like grapes, like the way I used to starve myself or cut or drink until my soul seemed to leave my body. It’s self medication for a dearth of stimulation. Could the sense of emptiness I feel so often be a literal absence of adequate dopamine, and/or other chemicals associated with ADHD; could this be the hole I’m always trying to fill as a survivor, an addict, a disordered personality?
I’ve been woefully misdiagnosed over and over. I can’t yet be officially assessed and medicated but at least I know now which direction I need to head in. Not downers, for anxiety, but stimulation and dopamine, for a busy, starving mind.
Brought to you by lots of ginseng, several strong coffees and a counterintuitive serenity