Mahabali’s day

August 31, 2020 § Leave a comment

It was Onam today, the biggest festival of the year for my wife’s folks from the southern Indian state of Kerala. The highlight of the day is a ‘Sadhya’, the festival’s lunch. We had planned on ordering a good one from one of the various restuarants that were offering these meals, but alas we couldn’t get any delivery service today.

So lunch actually turned out to be rice and noodles from a place called Singapore Street. For dessert, however, my wife made ‘Paalada paayasam’ a mix of milk and tiny chips or bits made of wheat or rice (I’m not sure) that are soaked in the milk and the whole thing boiled until the bits reach a certain consistency. This paayasam is often the main dessert in the Onam lunch or at least an important component of the dessert where there’s more than one.

We all had nice baths, lit an oil lamp — a brass one with a wick in it — and said a simple prayer before lunch.

She’d made batura (a flat, pliable Indian bread that’s deep fried. Very yum) for breakfast and I experimented with soaking one in the paayasam and eating them together — very delicious.

I sent off the story over which I was really stressed out last week, but actually ended up finishing early. And made ‘upma’ with vegetables in it for dinner — it’s a savoury dish made from what we call ‘rava’ (broken wheat) and has the consistency of a thick porridge or even a bit thicker or drier. We ate the remaining paalada paayasam for dessert.

The Hindu mythology of Onam is that it celebrates the rise of a great demon king Baleendra or Mahabali, from the depths of the earth where he was sent after the gods in the heavens became jealous of his glory and might and conspired his downfall. There’s a lesson in that for all of us, for even though the demon king was actually just and righteous towards his subjects, the jealousy of the gods prevailed.

#mythology #Onam #sadhya

Discussion with my therapist

August 30, 2020 § Leave a comment

My therapist said today she felt I should temporarily stop trying to taper off of my anxiety drugs. The point is the very thing that I was worried about yesterday. Once I’m off the drugs, I’ll still have to be functional, make sure my work is done on time and still manage my anxiety at a time when we will still be stuck in the Covid situation. And now there’s talk of reopening the schools.

So her advise is for me to wait until at least some of the negative factors turn positive. For example until I feel a lot more confident and a lot less anxious about work or until the Covid situation eases up with vaccines becoming available and so on. With some companies just entering phase 3 trials with their vaccine candidates, we should probably have them available by Feb-March if the vaccines work and are deemed safe.

On the work front, now that I’ve found Descript, at least some of the transcription work will become easier, so to that extent I’ll be less anxious or prone to procrastination. And as I become more engaged again with my wife and son, becoming more involved — as I’ve gradually done over the last three months especially — the tensions with my wife should also ease. The last two weeks, for instance, have been much better.

We also spoke about my depression, for which my health anxiety is an important trigger. And the health anxiety took root over two and a half years ago when an intermittent fasting programme went totally wrong I ended up with a series of scary heart palpitations. My therapist’s view is that it is possible that I learned to become more depressed with each of these episodes because of the feeling of helplessness that the palpitations brought.

So she asked to look up the work of Martin Seligman, who’s famous for his work on something called the theory of learned helplessness — which he later found was incorrect — and something called positive psychology, which he is credited to have pioneered. Authentic Happiness is one of the books he’s written and another more recent one is The Hope Circuit, which is biographical.

I have witnessed the transformation of psychology, and at more than one pivotal moment, I led the transformation. Psychology in my lifetime rejected these premises in order to remove four huge blind spots. First, the discipline abandoned behaviorism to embrace cognition and consciousness. Second, it realized that evolution and the brain constrain what we can learn. Third, it ended its fixation on only curing what is wrong to include building what is right and positive in the world. Finally, it discovered that we are drawn into the future rather than driven by the past. Together these make up the new psychology of hope. — Martin Seligman

#anxiety #depression #authentichappiness #martinseligman

 

What after the tapering off?

August 29, 2020 § Leave a comment

One thing I haven’t thought through is, what will I do to manage my anxiety and depression on my own, once I’m off the medicines. Let’s say it will take me two or three months to completely stop taking the medicines. In that time frame, the Covid situation will not have begun to ease, and so will continue to be a source of worry in addition to my anxiety. We’ll still be couped up in our houses a lot.

Will I be able to manage on my own, with only meditation and walking to help me because that is all I’m able to manage at the moment. There are the therapy sessions, of course, which will become even more important, but therapy is a long-term solution.

Will I be able to manage my anxiety without the drugs on a daily basis, successfully enough to get through a work day or the days of extra stress that invariably come with deadlines, surprise demands from the boss or other colleagues and so on?

There is also the health-anxiety component of the overall anxiety experience. And already, today, with just a quarter pill reduced, I felt a couple of skipped heart beats in the evening — withdrawal symptoms.

So in the short to medium term, meaning anything from two to six months at least after getting off of the medicines, I will have to manage not only my anxiety and depression on my own, but also the withdrawal symptoms. And in the case of clonazepam, I know from previous experience that the withdrawal symptoms will invariably include skipped heart beats and heart palpitations. Those are scary.

Will I be able to cope? I just don’t know, and the only way to find out is to get off the drugs.

#anxiety #depression #taperingoff #clonazepam

Tapering off 3

August 28, 2020 § Leave a comment

So I’ve been trying again to taper off my clonazepam intake. My total dosage isn’t high, at just one 0.5 mg pill for the day — half each in the morning and evening. I started slow enough, by reducing the dosage by just a quarter pill in the evening and staying that way for about five days. It would have been better to have stayed that way for two weeks, but I got a tad overenthusiastic and reduced the dosage by another quarter pill yesterday and today got my first bonafide withdrawal symptom by way of a nice heart palpitation.

I should also have given it a bit more thought and instead of cutting the second quarter pill again in the evening, I should have cut it from the morning dose. That way, my intake would have been better distributed and stayed morning and evening. Now it’s concentrated in the form of the half pill taken in the morning and nothing in the evening. The heart palpitation was also nicely timed in the evening to coincide with about the time the evening dose would have started taking effect.

Anyway, I’m going to be way more careful going forward. For starters, I’ll complete a full two weeks with no further reductions. For those of you interested in a study on tapering off of clonazepam, there’s some interesting and useful information here: https://pubmed.ncbi.nlm.nih.gov/20473065/

And for those of you interested in a withdrawal timeline, showing how long the drug stays in the body’s system and so on, there’s a nice infographic and a lot of other information here: https://americanaddictioncenters.org/withdrawal-timelines-treatments/clonazepam

My general physician has always said that what he’d prescribed for me, at 0.5 mg a day, is a baby dose and psychiatrists would have prescribed much larger doses. In fact the study above involved a reduction of 0.5 mg per two-week period until 1 mg was reached and thereafter, a 0.25 mg per week reduction. In comparison, my total dose itself was 0.5 mg a day, so the second reduction of the quarter pill, which would have been 0.25 mg should have been okay after five days.

But then these are drugs that mess with your brain chemistry so any dose could be a dangerous dose if not taken under medical supervision and the same goes for tapering off. And that I’ve been taking this drug for more than two-and-a-half years could also have been another factor. My brain and body would have become used to the presence of this drug in my system.

The palpitation didn’t last long, maybe half a minute or less, but it scared me until the realisation hit me that this was a withdrawal symptom. I was walking at the time — my usual walk up and down the living room — and should have gone and lay down. But the realisation that this was a withdrawal symptom filled me with a strange sense of elation that I kept walking. The palpitation stopped and didn’t come back and I expect things to get better in a few days time.

#anxiety #depression #taperingoff #clonazepam

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