On Disruptions, Delays, and Depression

Hey everyone, I've had a rough week thanks to things getting really fucked last weekend. Things are working out, but I wanted to walk through what's been going on as of the last few months and why this entire year has had periods of boom and bust on my artistic capabilities and (by extension) success in keeping myself financially viable with patreon and commissions. This is a long article, so I'll include a TLDR and some quick acknowledgements and stuff first.

TLDR: 

• After a lifetime of untreated depression symptoms, I am finally arriving on direct action to help me. 
• I learned a lot about my disorder these last few months, and thanks to review of some records and some literature, I think I finally can treat the issue directly.
• I hope to start new medication in November which should resolve issues far more pervasive than "I feel sad and unmotivated". 
• I hope to be back to a functional state sooner or later, but we may not see me claw out of this hole until end of year, or well into next year. 
• Next May, I finally have my Bachelor's degree and can go back to work in my field unimpeded.
• If I don't manage to push this furry thing into a much higher per-month income, I will have to give it up and return to work.
• I have until June 2022 to recover from my illness and concentrate on my business. If I can't hit my goals, I will have to return to the workforce.

Shout-outs: It deserves to be said that ya'll who have or are backing me are the only thing keeping this art thing viable. I hope to make it up to you all somehow, and I hope I can keep this thing going for some time.

Full Version:

Disruptions: As many folks are aware, I managed to claw together a group effort to split rent between four people (Myself, Drake, Jack~D, and Lyle), and that took two months of intense house-hunting and misery to make happen. Even once we all got under the same roof, constant issues plagued the place we lived, as well as problems with our jobs / random bad shit happening. The most consistent crisis is everyone's cars literally falling apart, then usually catching on fire shortly after. Jack's car lost the Transmission Axel while it was driving casually, Lyle's PT Cruiser was lost when he swerved on a mountain road to avoid an idiot doing nighttime photography in the middle of the road, and most recently Drake's Jeep after a long life fraught with mechanical malfunction finally caught on fire from a faulty wire coil. Each of these things have resulted in me spreading myself thin to try and help out with various things.

I am on the Autism Spectrum somewhere. The more stressed I am, the more I both have physical ailments (somatic externalizing and stress-sensitive conditions like IBS) and psychiatric issues. I can't handle emotionally intense interruptions ontop of regular mundane interruptions, I'm battling my brain for focus and attention so much so that most of the days I don't work, I spend them dreading how behind I will be. Worse, I have to ritualistically "dope up" by consuming large amounts of sweets/ junk food, engaging in long conversations, and playing games to feel well enough to work. Just last night, at 4am, I felt fully able to work... when I needed desperately to fall asleep so I could make a doctor's appointment today. Unfortunately, I then slept until 3pm and missed the appointment. Adding to this mess is that I'm doing a class that mostly wastes my time, and requires me to be up at 7am to make it to class on-time. I can't skip the class, its so I can get my Bachelor's degree.

Delays: Things get pushed off far too often in my life. Just the examples above are only small portions of interruptions to my operating rules for my brain to work. Everything on my plate (commissions, patreon rewards, personal art, helping my roommates, doing housework, taking care of my increasingly poor health, doing school work, etc) is pushed routinely back plural days thanks to my condition and random events. Because my resilience to stress is totally tapped out thanks to damage from 2020 and the ongoing financial crisis I can't seem to shake (due to disrupted income), I'm also putting off important things like getting fillings in my teeth done or having my knees ultrasounded so I can have them treated for serious damage I got in college. I can't even stay timely on things I really desperately want, like talking to lawyers about possibly having zoop move to the US.

Ultimately, the delays in everything include that I might meet criteria for Delayed Sleep Phase Disorder, a sleep disorder commonly caused by ADHD. I've got medication for ADHD, but sleep is so disruptive in my life that it's a game of roulette. Briefly, when my ADHD medication was very new in May, I had some of the most productive sleep and a stable sleep schedule for nearly a whole month. My financial records also match this, with the best timely production of artwork and best sales occurring during May and June. But by July, the honeymoon was over and the stress was up, delaying things until August. August, again, was a highly productive month. Until Zoop came over, and my day-to-day was disrupted a lot. Zoop's sleep apnea results in very loud snoring, and my sleep quality was so bad that towards the end, I was wearing ear plugs and over-ear headphones to sleep. After he left, things I didn't manage during the month he was here came up, and I was crushed again under stress, anxiety, and disruptions. The result of which being this month, where from September 25th through to October ~15th, I barely caught the Patreon backlog up, and am still unable to complete paid for commission work.

Depression: Ultimately, this circles back to the reality that is my life. I have at any time since age 6 met criteria for treatment resistance Major Depressive Disorder. I bomb depression measures so routinely that it is clear I need treatment. I've known that the depression is existential in nature, that my internal motivation for seeking out things in life is poor, and that I am most motivated by wanting other people to like me / by helping other people / by doing service to a community. I wasn't healthy in my rehab job, but I always had an obligation to my team and my patients, and that made it easier to fight through the post-sleep delirium caused by excessive daytime sleepiness and cataplexic symptoms. As I type this, my sleepy sensation is at about a 5-6 of 10 (0 = perfectly awake, 10 = moments from sleeping), and I've had 20mg adderall, a tall ass ice coffee, 20 oz of caffinated soda, and a small amount of food. I've been awake for only 5 hours, and feel like I could lie down right now and sleep.

The disruption this week from Drake's jeep catching fire not only caused my sleep schedule to get absolutely pulled out of shape so I could drive Drake to and from his work this week, but also my stress over the sheer impossibility of some of the financial elements of getting him rolling caused at least two major panic attacks. My panic attacks are existential depressive episodes where-in I hyper fixate on the utter impossibility of accomplishing goals when accounting for my present economic and functional impairments. Because Autism interrupts with my comfort and working mind, and depression and ADHD impair my ability to both work and tolerate stress, and the habits I use to appease my brain have caused me to become overweight and make worse my IBS and joint injuries, I've snow-balled into teetering on functioning in any adult capacity. Lyle's made it clear that I'm taking on too many responsibilities and need to take care of my health this week (in addition to everyone else close to me).

Dopamine Disorder(s): Dopamine is a neurotransmitter which is critical in the brain's function. We associate Dopamine with being a reward chemical, but Dopamine is naturally produced by your brain at all times in varying levels. When your Dopamine levels are low, the most typical result is depressive states. However, long time Dopamine Disorders are different in how they behave biochemically, and can be mistaken for "routine depression", resulting in misdiagnosis of the malfunctioning chemistry. Because most humans have Serotonin as a deficit brain chemical when they experience anxiety and depression, Serotonin Selective Reuptake Inhibitors (SSRI's) are used to artificially increase Serotonin levels in the brain by limiting their re-absorption. Dopamine associates with Norepinephrine, and thusly, Norepinephrine and Dopamine Reuptake Inhibitors, (NDRI's) are used to do a similar thing to SSRI's, except with different neurotransmitters. 

Typically, you need to "fail out" of several Serotonin targeting medications (SSRI's, SNRI's, etc) before you can skip to NDRI's and other medications. However, due to having a failed SSRI treatment in fall of last year and now multiple reasons to suspect a Dopamine Disorder, it appears that the "household antidepressant" Welbutrin (Busproprion) is the most likely medical candidate for treatment. You see, when Dopamine is low, it can exacerbate a number of conditions. My post-sleep "fatigue limp" is resolved by doping up, indicating motor impairment caused likely by low dopamine levels. In ADHD patients and Hypothyroid patients (of which, I am both) poor sleep quality caused by low dopamine levels causes production to level off, resulting in unusually low dopamine upon waking. Routinely, I "slingshot" between being awake and asleep, with periods of consciousness where I experience near full body paralysis, inability to internally motivate myself to sit upright, and crushing feelings of my life being pointless.

Sleep is so traumatic because of this post-sleep delirium that I genuinely prefer to be fatigued by sleep deprivation over sleeping normally. Much of this makes sense when contextualized by Dopamine Disorders, because not only is the quality bad, but my brain is in desperate need of Dopamine to the point that my motor function is meaningfully impaired. It is uncommon, but when motor function is implicated in depression symptoms, it almost always means Dopamine is what is at fault. In Parkinson's disorder, Dopamine levels in the brain decline over time, as production simply fails. Eventually, Parkinson's victims develop neuromuscular tremors, loss of control of their posture, unusual walking, loss of balance and symmetrical movements, muscular rigidity, and eventually even full body paralysis. Parkinson's victims often die of infections, falls, or heart disease; all of which are usually sped up thanks to Parkinson's overall impact on their bodily motility.

Light exercise (such as walking a mile casually, on a cool night) can sometimes be so exhausting that I immediately need to lie down or do nothing but sit and rest for hours on end. Lifting weights is aggressively hard, joint pain I shouldn't have at my age is unusually ominpresent, discouraging exercise. As of late, my knees hurt so much I got a stationary treadmill because exercise biking hurts too much. All of these symptoms as it turns out are made worse because of low Dopamine, explaining why on days when I both feel productive and capable of exercise, I often can exercise without much impairment. However, I can immediately regret the exercise the next day thanks to feeling completely unable to exercise, or feeling sudden and intense pain associated with even mild exercise. A combination of dopamine disorder symptoms and anxiety make it hard for me to leave the house most days, and if I'm especially fatigued from the syndrome, I can have sudden and unexpected falls. I thought the falls and my odd gait/posture issues were only explained by fatigue, but the distress and odd severity of them is associated with other clear indicators of depression.

Since my depressive symptoms are at their worst and most unregulated due to stress, sleep deprivation, and disruption, it was easy for many years to write this all off as Autism, bad sleep, being grumpy, and being just plain unhealthy. However, despite having a heart rate of 87BPM last night, my blood pressure was picture-perfect. That doesn't make a lot of sense, but I was so exhausted for most of yesterday that it could make some sense. My body temperature, heart rate, and blood pressure have all historically been known to dip well-below healthy metrics, with one heart rate measure when I was in my early 20's showing that I had 39 BPM and was just a few points over hypotensive crisis. My body temperature can sometimes dip as low as 96 degrees Fahrenheit, for no reason seemingly. The bias for these measures: I'm always having just woken up from sleep, often without any breakfast or coffee. The metrics trend upward a little if I've eaten / had caffeine, but because of their remarkably low baseline, I still end up in the normal range.

It's entirely possible that treating the Dopamine Disorder directly with a NDRI will cause me to both have better sleep and motor control (which both may alleviate my extreme body dysphoria, along with other difficulties), but also to relieve many symptoms caused by unhealthy living (sleep being normal for one would make it easier to exist with the rest of society). If this works as it may seem to, I might finally have a chance at participating in the 9-5 world the rest of the US labor pool does. The only reason I held the rehab job is because my 11a-7p (+/- 2 hours on either end) fit our assessment and office schedule roughly enough that my productivity at end-of-day made up for it. I also was a great clinician and researcher, so my boss didn't care if I had days where I came in late as long as I showed up for my obligations and got my work done. Sadly, very few jobs will even flirt with that idea, even with a sleep disorder diagnosis.

I hope that by December of this year, I've trialed the new medication and am showing improvement. I really want to make the Zevash Codex happen, but part of the delays to that have been this ongoing and catastrophic knock-on effect syndrome. I might also be already at serious risk of prostate cancer, and thanks to a testicular torsion, I'm supposed to have my testosterone levels monitored actively... and never have had that done in the literal decade since the injury. It's possible that my inability to build muscle mass, sex problems, and sleep disruption might also tie into that. Low T is bad for a statistically normative male, because it is involved in a lot of your body's processes. Related to prostate cancer and low T, I also lost a lot of respect for my family this week. Not only have they minimized my issues directly to my face and insisted "you just need to work out more", they also didn't fucking tell me until tonight that my father was on Welbutrin! FOR TREATING HIS DOPAMINE DISORDER. My father *also* had prostate cancer in his mid 30's, *also* has hypothyroid, and *also* has IBS. That all happening to him really scares me, I don't have a nice DOD job with a cushy 250k/year paycheck... I have like what? 3-5 years to get 80k ready for a fight against fucking cancer.

Suffice to say, I'm scared. I'm scared about a lot, and can't do anything about it until I'm healthy enough to just barely exist with the rest of humanity.

I'm sorry that I have to explain this all, that its caused such delays to my work, and that it ultimately is probably too much for anyone to really get beyond "shits fucked".

I really, really fucking appreciate everyone here on the Patreon. This financial support is all I have at the moment before I start begging.

Thank you if you read this all. I hope to have good news for you all in December.

PS: I'm 6 or 7 weeks away from finishing the last class for my degree. Then I have to wait until graduation in May of 2022 to have the paper.