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Living with Schizoaffective Disorder

Pain and Suffering

Do I possess The Holy Grail?

Michael David Crawford, Baritone,

Friday, August 21, 2009

Copyright © 2009 Michael David Crawford. All Rights Reserved.

I promised you what I grandly claim will be An Essay for All Humanity. But I haven't said any more than that it would have the solution to a puzzle that I have pondered for decades, that many others struggle to solve this same puzzle, but that it would take me some time to write because of all the research required.

And that is all true; I remain convinced of my essay's significance, and I have been doing this research. But I no longer believe I can write it all on my own. I ask for your help.

I am convinced that I can write down a method by which anyone may recover from even the most severe mental illness. Further, I can tell others what they can do to help us mentally ill folk.

But I am sure it comes as no surprise to any of you that when I try to actually write this essay, I am...

... completely...

... unable...

... to find the words.

I have struggled to understand why. Could my inspiration be simple delusion? Believe me, I spent quite some time considering that possibility.

My hope is just that I might reach some readers where other writers have failed. My methods have largely been understood for thousands of years.

Consider pain and suffering: they are two very different things. One of the ways out of Madness is that one can learn to feel pain - even severe pain - without suffering.

Inside: An Apology, And A Secret.

My hope is that if I outline for you what I understand so far, our discussion might yield some insight that enables me to actually write that essay.

Despite what some here may claim, I have largely recovered from my own Madness, so at the very least I ought to be able to write down what I did to recover. More significantly, throughout my years of therapy I have worked to understand what I experienced and learned, and to generalize it in ways that could help others.

Most who seek therapy want little more than to feel better. But some of what I experienced was so awful that I became determined to do whatever I could to ensure that no one would ever have to endure what I did. It took many years, a lot of hard work, a lot of money and a lot more pain for me to recover - but the whole time I worked at my own recovery, I also labored to understand the nature not just of my own illness, but of mental illness in general, and not just how I recovered, but what was essential in my own recovery that could be applied to anyone else.

It's not a simple problem. Even if it were, the device one must use to understand how to recover - one's brain - is the very thing that is broken. It wouldn't be enough for me to make my case to a sane man; I can only succeed if Madmen can understand me too.

Quite commonly the very hardest part of treatment is to get the patient to even believe that they need help. I'm very sorry to say that was the case with me. We aren't just being obstinate or unwilling to take responsibility for ourselves; recent research has found that it can be caused by damage that mental illness does to a structure in the brain that gives us insight. It's known as "Anosognosia".

To Err Is Human

I have done the lot of you wrong. I understand this now in a way that I did not before. I apologize, and ask that you forgive me.

I'll do my best not to do it again.

Several times over the past couple of years I have told you that I had some sort of secret, that I would only reveal to you when the time was right. It seems that I've done this so many times that you have claimed I was grandiose, delusional, or fearful that whatever special secret I had would turn out not to be special at all, to be insignificant or even a fraud.

That was never the case. My reason for keeping all these secrets is simply that I take a great deal of pride in my work. I generally intended to reveal these secrets in K5 stories; I just wanted to do the best job I could before I submitted.

Whatever you may think of my writing or of me as a writer, surely you must accept that I take my writing very seriously, and that I work very hard at it. My hope has always been that before I gave you the first clue as to what any of these secrets were, my essays would be submitted, like Venus on the Half Shell, not merely fully formed but in an exquisitely beautiful state.

That's why I've been so secretive, but I understand now that that was just not right.

I realized this not because of your complaints, but from all this research I've been doing. Most of these books are about psychology, the human experience or the human mind. I'm afraid some of what I have read recently has struck uncomfortably close to home. I have learned a great deal, but I have found the whole experience of reading these books very humbling when I considered how they might apply to me.

You will recall that I had a dispute with my previous psychiatrist, the one I met in the hospital a year ago. At the time I had every intention to file a complaint against her with the California Medical Board - and I still might. Without a doubt she is intelligent, educated and expert in her profession - but she has a character flaw that leads her, I am convinced, to commit medical malpractice.

I remember very well I letter that I wrote to some of the staff at the hospital. This character flaw, I wrote, "is her pride. Pride is the Achilles Heel of every intelligent person."

People that aren't so smart, you see, are taught through endless humiliations to understand that they have limitations. But us smart people, well we get it right so often that we are naturally - if erroneously - led to believe that we are infallible.

Pride, I understand, is the Deadliest of the Seven Deadly Sins. It's Deadly nature was known long before Christian Theology ever studied it; Odysseus had such Pride as to believe he owed no fealty to the Gods. For his crime, he was condemned to spend decades journeying home from the Trojan War, as well as to lose the lives of all of his men.

Pride is my own Achilless Heel. Perhaps worse, there have been times that I have understood that Pride was at one time my fault, but was too Proud to admit that that could still be the case.

I'll have that Slice of Pie now.

Better Living Through Chemistry

I'll tell you one of those secrets now, because I need to discuss it in this Essay for All Humanity that I've been promising you. I'll tell you the others in some upcoming diaries.

I expect though it's just going to piss you off, or lead you to accuse me of just making excuses or being lazy and irresponsible. That's actually quite a common experience - it's not just me that gets such a reaction.

Last July I became suicidal. I've been suicidal lots of times; it's an awful experience but not as dangerous as you might think. But this time was different; I became quite convinced that if I didn't get myself to a safe place, a place where someone else could look after my safety, I could not be responsible for it myself.

I was getting ready to jump off the Golden Gate Bridge. I am absolutely serious.

I wasn't stopped by any concern for my own life. By then I had given up all hope for myself. My concern was for Bonita; she was just starting out on her art career and was not yet able to provide for myself. My life insurance wouldn't pay if my death came by my own hand. Not just Bonita but our two dogs and my cat Cricket would be destitute.

So instead of leaping to my death, I got in my car and drove myself to the Emergency Psychiatric Service at Valley Medical Center in San Jose, California. The following afternoon they sent me in an ambulance to the Mission Oaks Campus of Good Samaritan Hospital in Los Gatos. That evening I met the psychiatrist who gave me a simple bit of information, just a few words, but that all by themselves were able to change my life profoundly, and for the better:

For many years, I told her, I had begged all manner of medical and mental health professionals for help with my productivity at work. It was so bad that when I was self-employed as a consultant, Bonita and I came close to starvation and homelessness. Whenever I worked on a fixed-bid contract I would make what seemed like a reasonable time estimate, yet the actual project always took at least three times as long. One would think I would overestimate sometimes, but I never did.

And all these medical and mental health professionals prescribed treatments that all seemed reasonable, that ought to have helped, but really never did.

Over the years this got worse and worse and worse to the point where I could easily see that there was no hope that I could make any kind of career as a computer programmer. All I could envision was poverty, homelessness, hopelessness and death.

So here is that life altering information: when I related all this to my new doctor, she just said:

I think you have Attention Deficit Disorder.

While ADD is very well known to the medical community, it is commonly - and incorrectly - thought to occur only among children, never among adults. While many children do outgrow it, some don't.

I didn't.

ADD isn't really just one illness. The medical community's understanding of it has evolved over the years. It is also known as Attention Deficit Hyperactivity Disorder or just Hyperactivity. It manifests in many different ways - I am anything but hyperactive; most people who meet me in meatspace are surprised that I even have a pulse. But that hasn't always been the case.

When I called my mother from the hospital to tell her the news, she said "When you were six years old, your doctor thought you were Hyperactive. He gave you Dexedrine. It seemed to help."

It was everything I could do not to go through the phone at her. "Why Oh Why Oh Why," I wanted to scream, "didn't you keep giving it to me?" "Why Oh Why Oh Why," I wanted to scream, "Didn't you ever tell me."

My doctor asked me to read a book that was in the library there on the unit, Driven to Distraction by Edward M. Hallowell and John J. Ratey. She wanted to know whether the experiences and symptoms described in the book rang home with me.

As I read it, with increasing excitement - but increasing dismay as well - so much of my life that had never made much sense to me, that likely never made much sense to anyone else either - started making a lot of sense. A whole lot of awful sense.

I won't go into detail just now, but I will illustrate it by an experience that brain damage patients sometimes have. David Shapiro wrote in Neurotic Styles that one can teach someone with brain damage to count starting at one. But if you then ask them to count starting at two, they are unable to. Apparently counting from two is a whole different skill than counting starting at one. If you ask them to, they won't refuse, they will struggle mightily, until in frustration they give up and count starting from one.

I experience many of the symptoms of Attention Deficit Disorder. Not all of them are troublesome, and some of them are actually adaptive, even beneficial. But there is one that you will surely understand gives me a great deal of grief:

I have trouble starting.

If I can start a task at all, and continue for just a little bit, I have no trouble carrying on against obstacles that others might find insurmountable, and can continue to work for days without breaks or even sleep.

But just to get started... absolutely stymies me.

It's not a matter of any kind of laziness or lack of ambition or work ethic. Something in my brain, the part of my brain that is responsible for getting me started, is as best I can understand, fundamentally broken.

The reason a whole year has passed since that diagnosis, in which I have been unwilling to tell you what the diagnosis was, is that I have been unwilling to do so until I understood my condition well enough to explain it. My hope has always been that by doing so, I could help others as that doctor so profoundly helped me.

But I have never been able to find the words. Here is the best I can do:

Suppose you were to ask that brain damaged patient, the one who can count starting only at one, just why he cannot count starting at two? He won't refuse, he will want to tell you, but when he tries, he will simply be unable to find the words. The best he will be able to come up with, I am sure, is "I don't know why. I just can't."

Friends, when you want to know why I can't get started at things, why Ogg Frog didn't ship years ago, why I am not wealthy as a result of my expertise as a software engineer, why the State of California is still after me to file my year 2000 tax return, the very best I can tell you is that I have a hard time starting.

The clinical term for it is "task initiation". It is a common symptom of ADD.

But as to why I can't initiate tasks? Or what makes the difference when I am able to?

I'm sorry. I cannot even find the words.

There are several treatments for ADD. It can often be effectively treated with stimulants. There is a stigma against stimulant treatment - quite commonly it is claimed that we are "drugging our children" by getting them high just so they can make it through the school day.

It's not that way. People who have ADD don't get high when we take stimulants - not even cocaine. It calms us down, and helps us focus on our work.

Ritalin is most commonly used. I take Adderall, a ten milligram tablet four times a day.

The Dexedrine I took as a child is dextroamphetamine. Adderall is a mixture of amphetamine salts. Amphetamine has a very short half-life in the body, so Adderall combines compounds with different metabolism rates, to make the effect last.

That's right folks, for over a year now, each and every day, the way I have been able to make it through my work day - and to get started at that work - is by taking Speed.

The Spice of Life

Quite commonly I am criticized - harshly so - for starting projects that I never complete. I'm sure you can come up with many examples.

That's quite a common trait of people with Attention Deficit Disorder. And you're completely correct, that I do announce and embark on many a project that gets off to a roaring start but then just... stops.

But I don't see that as a bad thing.

Having so many varied interests, trying out so many different things, starting on so many different projects exposes me to all manner of experiences, information, ideas and insights that would be completely unavailable to me otherwise.

How dull and dreary must be the lives of those who only start projects they will complete.

I must address bride of spidy directly: he claims that I cannot possibly be any kind of competent software engineer, that I couldn't possibly hold down any kind of real job or ever complete any kind of software product.

My friend, you're just flat-out wrong. I am quite confident in claiming that I am one of the very best engineers in the entire industry.

Very early in my career, it was sternly impressed upon me that the single most important skill a software engineer could ever have is the ability to ship. That is, to carry out product development to the point that one's product actually makes it into the hands of paying users.

There are lots of killer coders who aren't able to make that claim. But I can. I am just shy of twenty-two years in the industry. I have never been out of work longer than a few months. Surely you don't think I'd still have a job if I couldn't ship?

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