Night trains

In anticipation of tonight’s Merseyside Derby, I was thinking of previous instances of this fixture at Goodison Park. My mind first went back to the game in the 2013-14 season, which was a see-saw 3-3 draw, with the Liverpool backline being incredibly troubled by Romelu Lukaku, and Daniel Sturridge scoring with a header immediately after coming on to make it 3-3 (and Joe Allen had missed a sitter earlier when Liverpool were 2-1 up).

I remember my wife coming back home from work in the middle of that game, and I didn’t pay attention to her until it was over. She wasn’t particularly happy about that, but the intense nature of the game gave me a fever (that used to happen often in the 2013-14 and 2008-9 seasons).

Then I remember Everton winning 3-0 once, though I don’t remember when that was (googling tells me that was in the 2006-7 season, when I was already a Liverpool fan, but not watching regularly).

And then I started thinking about what happened to this game last season, and then remembered that it was a 0-0 draw. Incidentally, it was on the same day that I travelled to Liverpool – I had a ticket for an Anfield Tour the next morning.

I now see that I had written about getting to Liverpool after I got to my hotel that night. However, I haven’t written about what happened before that. My train from Euston was around 8:00 pm. I remember leaving home (which was in Ealing) at around 6 or so, and then taking two tubes (Central changing to Victoria at Oxford Circus) to get to Euston. And then buying chewing gum and a bottle of water at Marks and Spencer while waiting for my train.

I also remember that while leaving home that evening, I was scared. I was psyched out. It wasn’t supposed to be that way. This was a trip to Liverpool I had been wanting to make for the best part of 14 years. I had kept putting it off during my stay in London until I knew that I was going to move out of London in two weeks’ time. Liverpool were having a great season (they would go on to win the Champions League, and only narrowly lose the Premiser League title).

I was supposed to be excited. Instead I was nervous. My nerve possibly settled only after I was seated in the train that evening.

Thinking about it, I basically hate night trains (well, this wasn’t an overnight train, but it started late in the evening). I hate night buses as well. And this only applies to night trains and buses that take me away from my normal place of residence – starting towards “home” late in the night never worries me.

This anxiety possibly started when I was in IIT Madras. I remember clearly then that I used to sleep comfortably without fail while travelling from Madras to Bangalore, but almost always never slept or only slept fitfully when travelling in the opposite direction. While in hindsight it all appears fine, I never felt particularly settled when I was at IITM.

And consequently, anything that reminds me of travelling to IITM psyches me out. I always took the night train while travelling there, and the anxiety would start on the drive to the railway station. Even now, sometimes, I get anxious while taking that road late in the evening.

Then, taking night trains has been indelibly linked to travelling to Madras, and something that I’ve come to fear as well. While I haven’t taken a train in India since 2012, my experience with the trip to Liverpool last year tells me that even non-overnight night trains have that effect on me.

And then, of course, there is the city of Chennai as well. The smells of the city after the train crosses Basin Bridge trigger the first wave of anxiety. Stepping out of the railway station and the thought of finding an autorickshaw trigger the next wave (things might be different now with Uber/Ola, but I haven’t experienced that).

The last time I went to Chennai was for a close friend’s wedding in 2012. I remember waking up early on the day of the wedding and then having a massive panic attack. I spent long enough time staring at the ceiling of my hotel room that I ended up missing the muhurtham.

I’ve made up my mind that the next time I have to go to Chennai, I’ll just drive there. And for sure, I’m not going to take a train leaving Bangalore in the night.

Using ADHD to combat anxiety, anger and everything else

Sometimes I find that documenting thoughts can really help for later on in life when you’ve forgotten certain workflows. As you are well aware, I document pretty much everything here. However, some things sometimes get left out, and the problem with not documenting those things is that you end up forgetting what you had made.

In some way, it’s like the Guy Pearce character in Memento – who has extreme memory loss to the extent that he needs to take polaroid photos and make tattoos on his body as notes for himself. It’s not that bad for me, but I find that when I don’t document stuff adequately, I tend to forget thoughts. And even when I forget thoughts and ideas (that happens all the time), having documented them somewhere means that I stumble upon it sometime (yes, I randomly read my old blog posts from time to time), and that surely helps.

For example, I know that when I go through a prolonged period of depression (most recently happened last December), reading the first chapter of Jordan Peterson’s 12 Rules For Life helps.

Anyway, this is one thing I’ve followed from time to time since 2013, but have never really documented it. As long-time readers of my blog might know, I was under medication for both anxiety-depression and ADHD for the large part of 2012. I discontinued most of it in early 2013, but have occasionally gone back to taking ADHD medication (it’s a pain to get that medication – being highly controlled, you need doctor’s prescription in triplicate, etc. to get it. In the UK, the entire process through the NHS took a year and a quarter!).

Part of the reason why I’d been able to discontinue the medication was the realisation that it was in some way my ADHD that had contributed to anxiety and depression (making lots of small mistakes -> some of these mistakes proving costly -> fretting endlessly about these -> random pattern recognition based on small samples).

The other reason I was able to step down on all the medications was that I could actually “use my ADHD” to combat anxiety. The thing with ADHD is that while you can sometimes be incredibly distracted and unable to focus, you are also able to go into “hyperfocus” when you are doing something you are interested in. This thing you are hyperfocussed on could be work, or watching certain kinds of TV, or even getting lost in old cricket scorecards (or reading my own old blogposts!).

So the method I developed to combat times when I was anxious about something was to find something quickly that I could get hyperfocussed about (there are plenty of those) and use that to fully distract myself from whatever my thought process was at the time. Having ADHD also means you  can let go of whatever thoughts you have in your head rather easily. And so once you’re done with your hypefocussed task, you don’t usually return to the earlier state of high anxiety, and you can get on to normal life.

It’s a simple enough process, but ADHD also means that you very often forget simple solutions you’ve found to problems earlier, and keep reinventing the wheel. And hence the need for this documentation.

Recently I discovered that this method works for other forms of mental instability as well. For example, the common advice given to deal with anger is to “walk away from the scene” or “take a break”. This has largely worked really badly for me. I get angry. I walk away. Obsess over what just happened. Come back angrier.

But I have a secret weapon to deal with this – ADHD! Just walking away doesn’t help. I just end up hyperfocussing on what just happened. Instead the trick is to find something I can get absorbed in. A rabbit hole I can get into and get out of without remembering what had happened just before I got in. And there’s no way the anger can survive this kind of an experience.

The only problem is that when you’re angry with something, and that’s resulted in a “live fight”, walking away to do something totally unrelated can get the counterparty even angrier. I didn’t say I have solutions for all the problems in the world, did I?

Mental health triggers

My ADHD seems to have become much worse over the last couple of days. Like this morning I had this episode where I couldn’t decide whether to go back home to get an umbrella, and thus turned around twice while I was in the middle of crossing a road.

In part, I blame this on having just read a book on ADHD – the second such book I’ve read in the last week (I found this book from the bibliography of previous one). While this book told me the impact of ADHD on relationships, and helped me understand what someone married to someone with ADHD goes through, in the course of doing so it reminded me of all the problems that one faces when you have ADHD.

So in some way, as I read through and “revised” the list of problems that one has with ADHD, all these problems have started surfacing (more likely I have noticed these issues every time they’ve come up). And this has led to a positive feedback loop, and thus much shorter attention spans and massive distractions and even mild addiction (to online chess).

This is not an isolated incident. In the past as well, when I’ve read material related to mental health problems that have affected me as well, the precise problem gets triggered. So when I read some stuff about depression, I’m likely to have a depressive episode after that. Similar with anxiety.

Interestingly, there is no impact when I read something related to a problem that I myself have never faced – like I once started reading Siddhartha Mukherjee’s essay on bipolar disorder and it had no effect whatsoever on me.

It wasn’t always this way. Long back, before I got diagnosed, reading stuff about mental health issues which I later got diagnosed with would make me feel hopeful – hopeful perhaps that there was in fact a diagnosis for what I was going through and it wasn’t simply “laziness” or “ineptitude” on my part that was causing me all that I was going through. But once I got the diagnosis, and figured out lifestyle changes to deal with my issues, reading more has only triggered the respective issue.

I guess the solution for this is simple – unless absolutely necessary (say there is a specific issue for which I seek help on) I shouldn’t read stuff about mental health issues that I might be facing.

I won’t spare you, though – here is an essay about ADHD that I had written three years ago (which I dug up after a conversation on ADHD with a friend yesterday).

 

Mental Health: Update

It’s been over six months since I got off my medication for depression (venlafaxine) and ADHD (methylphenidate), so I thought I should just provide an update. The immediate trigger for this post is that I’m reading Nassim Nicholas Taleb’s Antifragile, in which among other things he rants against excess medication, and explicitly picks on medication for depression and ADHD.

Overall, I must mention that I’ve managed pretty well these last six months. Yes, there are depressive bouts. Yes, there are times when I can’t concentrate and I get increasingly restless. Sometimes it is perhaps as bad as it used to be before I started seeing a psychiatrist. But it’s ok. The most important outcome of going to a psychiatrist for a year has been that I’ve gotten diagnosed.

You might have heard this in several places – that ninety percent (or maybe more, or less) of treatment of a disease is diagnosis. And in case of my mental health I find that to be absolutely true. Yes, I took medication for a year. Yes, it helped back then. Yes, as I’ve written before, having those medicines provided me the necessary stimulus to get myself out of the depths I’d gotten into over the last few years. However, I’m certain that I don’t need them any more. But the diagnosis helps.

Two years back my biggest concern was that I wasn’t able to explain my life. There was no story. I had done a lot of things that were seemingly disparate and there were a lot of things that I’d done which I would later regret. So I had a lot of regrets, and I would expend a lot of my idle processor time (in my head) dwelling on these regrets, and wondering why I did certain things the way I did, or why I took the decisions I took. Every time I tried to come up with an explanation for something, I would get the “but everyone deals with that, why can’t you” response.

The biggest advantage of having diagnosed is that it now all fits in. I now know why after getting into IIT with such a good rank I drifted away and completely lost interest. I now know why so many of my initial crushes didn’t work out (ADHD among other things makes you impulsive and blurt out things you aren’t supposed to). I now know why I chose to literally run away from my first job (that’s a long story in itself. Will save it for another day). And I precisely know why I went in and out of three more jobs in the five years after that.

Yes, I might be overfitting in some things (you can see that I’m doing that in the previous paragraph to explain why no relationships worked out). Nevertheless, after a long and ardous search for that one variable or set of variables that would explain a large part of who I am or what I did, when I all I found was noise, I think I’ve found the signal. Till I was close to thirty, I led my life without having fully understood myself. And trying to blame myself for being inferior to other people in certain ways, and constantly regretting my decisions. The diagnosis changed all that. Yes, after a discussion on a mailing list on ADHD some three years back I’d posited that I might have it. Yet, a formal diagnosis from a qualified psychiatrist helped.

So you may ask why I discontinued medication if I know that I have some problems. Two different reasons for the two medicines I was taking. As for Venlafaxine (which I used to take for anxiety and depression), I had a harrowing time in November of last year when I ran out of supplies of the drug and couldn’t find it in any store near my house for a couple of weeks. During this time I would feel weak, have a fever and feel extremely numb in the limbs, but had no clue why that was happening. Later, the psychiatrist told me that these were withdrawal symptoms for failing to take my drugs regularly. I panicked. i didn’t want to get addicted to mind-altering substances. More importantly, around this time I got the feeling that the drug wasn’t doing much help. I would still have the same old bouts of depression. The psychiatrist agreed that I had plateaued in response to the drug. So she recommended a rather slow taper off from the drug (to prevent withdrawal symptoms), which I followed and got off it.

Methylphenidate was useful, and wasn’t addictive (some literature has likened it to wearing spectacles. It affects you only when you’re taking it). Yet, I found that it changed me. Yes, I know that I’m attention deficit and possibly hyperactive, but I  refuse to believe now that it’s a ‘disorder’. The problem with the drug was that it was changing my mind. Yes, it made me concentrate so much better. Long strings of meetings when I would visit the client’s office were a breeze thanks to the drug. My concentration levels shot up. Yet,  I found that it had impaired my creative thinking. I’m extremely proud of my ability to connect disparate things, but I felt that this drug was impairing my ability to do so. I just wasn’t being myself. And I had found that on days when I would forget to take the drug  I would be more capable of creative non-linear thinking. And I figured that with the drug I wasn’t being myself.

So yes, I’ve been off the drugs for a while now and have adjusted to life with it. Yes there are days when I’m constantly fidgety and can’t concentrate to get work done. Yes, nowadays  work that takes long bouts of intense concentration gets delayed. But I’m back to being myself. And I’m back to being good at what I thought I was always good at – big picture thinking and making disparate connections.

Yes, one important factor that has helped me to deal with my condition (no, it’s NOT a disorder) is my work. As a freelance management consultant who mostly works from home (and visits client once every couple of weeks)  I can set my own pace. If i’m feeling particularly fidgety some day, I can take a break till I’m doing better. I don’t have daily or sub-daily deadlines to bother me (this was my biggest issue with most of my jobs). More importantly there’s no one looking over my shoulder to see what I’m doing, so I can freely switch between my work screen and twitter. And trust me, this helps. Immensely.

Since I visit my clients once in 2-3 weeks I end up having lots of meetings during these visits. But I simply draw up on my energy reserves during those times and buckle down and concentrate. Yes, last two or three times after I’ve visited the client I haven’t got much work done for the following three or four days – since I’d be recuperating from that intense expense of mental energy – but again I’m okay with that.

I plan to write on this again in the near future after I finish reading antifragile. I find this to be a rather important concept for me given that I’m prone to making errors (I’ve now accepted that). I think I’ve already started designing my life along antifragile principles. But more on that in another post.

Meanwhile, some other posts I’d written earlier about my mental condition.
1. How ADHD is like being perennially doped
2. On the importance of admitting mental illness and going to a specialist
3. On anti-depressants being like an economic stimulus
4. On mental illness in elite colleges in India
5. On anxiety being like a computer virus
6. On how ADHD can sometimes be advantageous

Anxiety and computer viruses

I think, and hope, that I’ve been cured of anxiety, which I was probably suffering from for over six years. It was a case of Murphy’s Law taken to its extreme. If anything can go wrong, it will, states the law, and in those six or seven years, I would subconsciously search for things that could possibly go wrong, and then worry about them. And worry about them so much that I would get paranoid.

Let me give you an example. Back in 2008, after a four-month spell of unemployment, I had signed up with a startup. Two days after I signed, which was three weeks before I was going to start work, I started worrying about the health of the startup founder, and what would happen to my career in case he happened to croak between then and my joining the company! It had been a major effort on my part to try and get back to finance, and that job was extremely important to me from a career signaling standpoint (it played a major role in my joining Goldman Sachs, subsequently, I think). So I started getting worried that if for some reason the founder died before I joined, that signaling wouldn’t happen! I worried about it for three days and broke my head about it, until sanity reigned.

This wasn’t a one-off. I would take ages to reply to emails because I would be paranoid that I had said something inappropriate. When I landed in Venice on vacation last year, my office blackberry didn’t get connected for an hour or so, and I thought that was because they had fired me while I was on vacation. It would be similar when I would look at my blackberry first thing in the morning after I woke up, and found no mails. I needed no real reason to worry about something. It was crazy.

When a virus attacks your computer, one of the ways in which it slows down the computer is by running “background processes”. These processes run in the background, independent of what you intend to do, but nevertheless take up so much of your computing power that it becomes extremely hard to function. Anxiety works pretty much the same way. Because there is always so much going on in your mind (most of it unintended, of course), a lot of your brain’s “computing power” is taken up in processing those unwanted thoughts (the brain, unfortunately, has no way of figuring out that those thoughts are unintended). And that leaves you with so much lesser mindspace to do what you want to do.

So you stop functioning. You stop being able to do as much as you were able to. Initially you don’t recognize this, until you bite of more than you could possibly chew a number of times in succession. And then, having failed to deliver on so many occasions, you lose confidence. And lesser confidence means more worry. Which means more background process. And means diminished mental ability. Things can spiral out of hand way too quickly.

I’ve been on anxiety medication for over seven months now, and the only times when I realize how bad things were are when I happen to miss a dose or two, and there is relapse. And having been through it, trust me, it is quite bad.

On the positive side, the impact a well-guided medication process (administered by an expert psychiatrist) can have on anxiety is also tremendous. For the six years I suffered, I had no clue that I was under a cloud of a clinically treatable condition. I didn’t know that it was only a virus that had attacked my CPU, which could be got rid off with sustained dosage of anti-virus, and I had instead thought my CPU itself was slowing down, maybe rusting (at the ripe old age of late twenties). After I started responding to my medication, I was delirious with happiness, with the realization that I hadn’t become dumb, after all.

It was sometime in March or April, I think, when I realized that my medication had come into effect, thus freeing up so much mind space, and I started feeling smart again. When I met the psychiatrist next, I told her, “I feel exactly the way I felt back in 2005 once again!”.