Earlier I mentioned  that there are difficulties when people try to describe themselves as insane because they only prove themselves to be more sane by making the attempt. Here, hopefully, what I meant by that will be clear. Three times in my life I have been diagnosed with mental illness, all of the illnesses being related to each other as well as to my early child abuse, and in addition to that various ways that I behave have been noted as likely belonging to other possible diagnoses that simply have not been made yet. In discussing the fallout for the accident report, it is necessary to do a task that I find deeply unpleasant and personally embarrassing, and that is to discuss my own record of mental health, which I will try to do in the most clinical way possible, so as not to make this discussion more emotionally laden than it already is.
At the age of four I was diagnosed with Post-Traumatic Stress Disorder (which will be shortened for convenience to PTSD in future references here) . At that age, both the diagnosis and I were in our youth. Although the symptomology of what became labeled as PTSD was recognized in ancient history, notably in the Bible, the disease itself was not called by that name until the time after the Vietnam War, when what had previously been labeled in an ad hoc way mostly to veterans of war as “soldier’s heart” or “shell shock” or “battle fatigue” in different conflicts became viewed as being a general set of responses to being overwhelmed by trauma. While much of the effort at describing this disease and its effects has focused on soldiers, it should be noted that the disease can come from such events as rape or a sudden change in life like a dramatic move or a job loss or the death of a loved one or close family member, or even being in a stressful situation where fear and terror are present. While the exact susceptibilities of people to PTSD vary from person to person, for reasons yet unknown, my own experiences are not unusual and I am a rather textbook case of PTSD.
Based on information provided by the Veteran’s Administration  of the United States Government, people are advised to seek help if symptoms last longer than three months, cause great distress, or disrupt home or work life. Note the or; only one of these has to be the case for a diagnosis of PTSD to be made. All of these have been the case for me. There are four types of symptoms: reliving or re-experiencing the events through nightmares, flashbacks, and triggers; avoiding situations that trigger memories, including by staying busy as a way of not having to think or talk about what happened; negative changes in beliefs and feelings such as struggles with intimacy, forgetfulness about what happened, and a belief that no one can be trusted and the world is completely unsafe; and hyperarousal, including having trouble sleeping, concentrating, being easily startled, and wanting to have one’s back to the wall or a waiting room (or an office) so that no one can come at you from behind. All of these types of symptoms have been present in my life as long as I can remember, and they remain so more than three decades after the abuse. It should go without saying that they have caused great distress and continue to do so.
Concurrent with the PTSD, and likely springing from the same etiology, has come a life-long and pervasive anxiety. Surprisingly, I was not diagnosed with Generalized Anxiety Disorder until I was twenty-five years old, when I visited a doctor in order to diagnose my first gout attack some months after the death of my father. The symptoms of Generalized Anxiety Disorder are fairly straightforward: muscle tension, gastrointestinal discomfort, irritability, fatigue, edginess, restlessness, and sleep difficulties . Most of these have been lifelong areas of struggle , with some overlap with the previously diagnosed PTSD. All of the following criteria must apply in order to make a proper diagnosis of Generalized Anxiety Disorder: Excessive anxiety and worry, occurring more days than not for at least 6 months, concerning a number of events; difficulty controlling the worry; the anxiety and worry are associated with at least three of the six symptoms of restlessness or feeling keyed up and on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension, or sleep disturbance; the anxiety, worry, or physical symptoms cause clinically significant distress or impairment in important areas of function, the disturbance is not due to the physiological effects of a substance or medical condition, and the disturbance is not better explained by another medical disorder.
It scarcely matters that there has been much to be concerned about in a life like mine, or that being as anxious on such a continual basis tends to trigger anxiety in others. Sometimes people are in situations where all of them are in great distress, not because anyone wants to inflict great harm but because all of them are so sensitive to those around them that harm is caused by people simply being their own awkward selves. When it comes to being anxious and making others anxious, often what we are struggling with is not a problem in motive, but rather in execution. All too often as well, it is not the thought that counts but its result, and so incompetence with clear motives is not a help at all in avoiding and overcoming stressful situations that exist. Where high degrees of anxiety and the pervasive feeling of being unsafe exist, even where it is not warranted by the facts, it can become extremely difficult to engage in the normal business of communication and social interaction that make normal life possible and that encourage cheer, leading to the immense use of internal energy simply to get through the day, with difficulties concentrating and focusing as a result of being in flight or fight or freeze mode continually. Knowing such matters painfully well from personal experience, I cannot but have compassion on others who have the same difficulties.
It may also come as some surprise, given the early recognition of my gloominess and melancholy taste in literature and music , that at the same time I was diagnosed with Generalized Anxiety Disorder I was diagnosed with major depression because I had only had one day that was not black over the period of about five months after my father’s death. The period of major depression would last about five years in total, and the full effects of it are matters of such gravity and importance I will discuss them on their own later. What I would like to discuss is that at the worst stage of the depression, which lasted for months during the later parts of 2010, it was a difficult matter for me to even get up out of bed and struggle to the bathroom to take a shower, or to eat anything at all, even if it was something as simple as homemade pasta. Any day where these things could be done, and where I was able to wake up before noon and go to bed somewhere around midnight was a great success. Rather than being the result of sheer laziness, as was thought by some people who watched my struggle, they were the signs of a soul trapped in the blackness of deep despair. As soon as purpose could be found for what was going on, and some modicum of success and encouragement, there was a gradual lifting of the mood until in the middle of 2011 the gloom lifted and I was back to my normal anxious and nervous self once again, if deeply changed by the experience of having been gloomy so deeply for so long.
Aside from these various mental illnesses which have all been diagnosed by medical professionals, it has been almost a pastime among friends and family to label my many eccentricities in some sort of psychological language. To give but one example of this, I went to a recent dinner and after the dinner a couple of the other guests noted that my somewhat fussy tendencies appeared to them to be evidence of Obsessive-Compulsive Disorder with its obsessive preoccupations and repetitive behaviors. To be fair, there is a fair amount of justice in such matters, for once a few things are wrong it is fairly easy for a lot of other things to go wrong as well in interrelated systems. Even if our brains are not a machine, we are beings full of interconnection, and trouble tends to spread far beyond its original confines. It should be little wonder that a small child of such extremely anxious disposition should, under the weight of a lifetime of trouble and torment, be greatly affected as a result, to the point where normal existence is both an immense challenge and also a significant achievement. Whether it should have been this way or not is irrelevant. What is simply has to be dealt with because it is.
And yet, if I am candid, I worry about the cost of admissions such as this. I worry that my own longings and ambitions are made more difficult by being candid about such horrors, in that they would discourage others from making any effort to get to know me, or to deal with my many quirks and eccentricities. I worry that people would be too quick to assume that I would do that which has been done to me, and thus burden my life with even more anxiety and trouble over how I relate to others, and how honorable of a reputation I have in the eyes of my peers and fellows. Whether such worries are reasonable or not is beside the point. Whether such worries will come to pass is also beside the point; different people will likely respond differently, with some viewing such open and honest admission of one’s struggles as a sign of strength and moral courage and others a sign of great weakness, worthy only of contempt. One cannot do very much about the opinion of others, after all, and it is upon that opinion that one’s reputation lies; one simply has to live in such an honorable way that others are without excuse for hostility or negativity. That is enough of a task to fill an entire lifetime. But, if that were not enough, there are many other tasks to fill a lifetime that I have heaped upon myself, and it is the difficulty of these tasks that I wish to discuss next.
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