Prior episodes of burnout and other cautionary tales
Flashing back to moments of sensitization in the before-times
There is an inclination among many folks—my former self, included—to believe that there must be “some underlying problem” to explain what happens to folks in my situation. As if some neurological deviation from “normalcy” might explain away the suffering.
There’s no doubt that my nervous system was highly vulnerable to “medicines” that knocked it into sensitization and dysregulation. There’s no doubt that I experienced a few warning signs that went unheeded, which I’ll cover in a moment. But let’s start by thinking about the “underlying problems” narrative and why that explanation might be useful for some, but why it can also lead to some pretty hopeless dead ends.
Claire Weekes, an Australian general practitioner, is famed for her work on “nervous system sensitization,” which we tend to cast aside as “anxiety” in contemporary parlance. In Hope and Help for your Nerves (1962), she refers to “sensitization” as a life circumstance which destabilizes the nervous system into dysregulation. This can happen any time your body senses danger, whether that’s by putting your finger on a burning stove element one too many times, or by ingesting a mind-altering psychotropic drug. Weekes’ work properly acknowledges that everyone, from time to time, finds themselves in a sensitized state if they’re overexposed to danger. It’s your body’s way of trying to tell you something.
Many folks in my family and inner circle are highly sensitive, whether that be to medications, to their environments, or to the ideas and feelings of other people, but it’s usually seen as more of a strength than a weakness as long as it’s accompanied by self-awareness, a great deal of careful choice-making, and, consequently, success in life.
The trouble is that highly sensitive people or “HSPs,” who often strive to be high performers and perfectionists, are only a couple of knocks away from an overly sensitized, dysregulated nervous system. The term was coined by Dr. Elaine Aron, and applies to between 15-20% of the population.
Strengths as weaknesses
Are there other underlying explanations? As any psychologist would have me do, I’d start by considering my nuclear family. Well, sure, they’re a bunch of sensitive high performers and perfectionists, each in their own unique way, and close friends would sometimes make jokes about how “spectrum-y” the household would feel—as a kind of back-handed compliment. I’d laugh. The house was compulsively clean and orderly, and people around me (friends and family alike) tended to be more interested in systems, ideas, and structures than the fine details of people’s lives. I’ve generally been drawn to people of a similar nature: orderly, smart, capable, highly focused, a bit contrarian, having narrow, specialized interests, lack a “filter” about many things (or are completely mute about others), introverted or don’t always relate well to other people, and by mid-life, they often wonder aloud if they’re neurotypical.
The “autistic” label could apply in some of those cases, and psychologists love to look at these patterns for answers, but I’m not sure that it’s useful for me as I try to find my way out of this mess. Curiously, Lyme symptoms also overlap with autism and hypersensitization, and the more I read about it all, I can’t help but wonder if this intersecting symptomology all points to a common set of brain networks or functions.1
For my part, some underlying “thing” might be an interesting piece of the puzzle, but for now, I’m filing it away for later exploration. It might have been useful to know something like that well before any of this happened, but things always seem “normal” (or normal enough) until they’re suddenly not anymore.
And, after all that speculation, perhaps they are “normal” after all, but just tilted toward eccentric.
Explaining away adversity justifies suffering
The other, more important truth here, though, is that nobody knows the rates of adverse reactions among folks who have sensitive nervous systems, regardless of any underlying pathology. There is no robust reporting system for folks with medication injuries to their brain and nervous system, and practitioners are so poorly informed that they generally put sufferers back on drugs with other inaccurate diagnoses, which only keeps the spiral going without any real insight.
The amount of suffering this causes through the healthcare system should otherwise be criminal, especially since those trapped in the loop have a terrible time advocating for themselves. Once the spiral is over, if they’re lucky enough to get out of it, many would rather avoid re-hashing their prolonged traumatic experience than engage in a long, energetically draining campaign to inform the world, distracted as it already is, about this injustice.
The habit of seeking another explanation simply excuses practitioners and lay people alike from addressing (or least of all acknowledging) real, profound suffering. The nightmare of a chemical-induced brain injury becomes a prolonged traumatic experience that slowly morphs into an “invisible disability” as it interferes catastrophically in the fortunes of lives. People with brain injuries inevitably find themselves hiding from society, where they feel alien, judged, and punished for things that are well beyond their control— and that’s over and above any other chemically-induced dark thoughts that might cloud the person’s perspective.
Perfectionism, including the compulsive propensity to explain some underlying pathology, is then interpreted by the sufferer as threatening behaviour when what they’re really seeking is hope and health, which can’t begin without acceptance. Suddenly, high achievement—characteristic of many in my inner circle—is turned upside down. Its dark side is revealed.
2019: Burnout, or “when things weren’t quite right”
Like anybody, I’ve felt “burnout” before. When life was busy, I might complain about being overloaded, but I knew that was a cliché. I would always find moments to escape or find peace: to do a hike, sing, or go out with a friend. If life didn’t quite feel “okay,” I’d keep reaching for it and it would even out. Normal, I thought. Life kept moving upwards.
But things changed just prior to my need to self-tranquillize with sleep medication. I found myself in the midst of a prolonged “rough patch,” including pressure to pursue a costly PhD—at 1/3 the pay—in the midst of a difficult relationship, following an amicable divorce. To save money for awhile, I would live in my cottage, two hours from the city, which I thought might be fun if it was temporary, and then I would invest my energy in this new relationship. I was solution-seeking, and trying hard to hold on to everything I had left that gave shape to my life.
But frankly, I had never been in a relationship that posed so many unique problems, and I was totally unprepared for some of the things that would emerge, including career-interrupting blackmail. I’d never been blackmailed before, nor did I ever think that I would ever have to endure it, certainly not from someone close to me. I began the situation with hope and optimism, but soon found myself confronting a hard reality: I was constantly appeasing a highly unstable person just to keep my life in order. I didn’t know the emotional toll that this could take on someone and I underestimated the level of stress this put on me. This unprecedented drama eventually opened me up to the idea, indeed the need, to tranquillize myself.
On a few occasions during that time, I remember having more difficulty concentrating, reading, or engaging with other people. My nervous system was indeed becoming “sensitized.” I found myself crying occasionally, usually due to the sense of powerlessness that would emerge when I was being blackmailed. I would, as I do now, feel tingling in my limbs. I also recall feeling a bit trapped from time to time—a cognitive-emotional precursor to the feeling of being trapped in the woods during the depths of successive pandemic lockdowns just a year later.2
In September 2019, I went to Montreal to begin the PhD program, and I thought had enough enthusiasm left in the tank to study and learn new things. It might be a break from the drama back home. I needed to be sociable and focused. I would be doing a study on how perceptions of ecological decline influence individual and collective decision-making, which I thought was kind of interesting. At least it might provide some insight into why people do the things they do in this day and age.
My expectations were once again out-of-alignment. I had to invest so much energy in providing care and reassurance for my partner that I had very little energy left for myself. I could keep up appearances, but I found that I had far too much sympathetic energy stuck in my system. I was always “on alert.” I would need to be constantly moving, walking, talking, or riding my bike to “burn off steam.” I’d scarcely felt this way before. I would often be sad, and yet I didn’t want to vent to the people around me for fear of being overly negative. I started drinking a bit more than usual. The only thing that would really settle my system would be to ensure that my partner was settled and stable, but as this became increasingly impossible, my body kept sending me signals that I was in danger. I couldn’t sleep.
Medicine, or something like it
So, I saw a psychologist and explained the situation. I remembered feeling like this twice in my life previously: once when I was working in a high-pressure political job, and another time when I was living alone in Korea and had weeks of holiday time ahead of me. In that high-pressure political job, I recall asking for a sleeping pill then, too. I think I only used it twice. I asked for the same thing this time. I got what I asked for, and was assured that the mediation was “very safe,” “prescribed all the time,” to young and old people alike.
I came back to Winnipeg a few weeks later and, for one final round, invested all of my energy in providing a settled, secure environment for this person I cared about. It worked for awhile, and I stayed on the sleeping pill for those days when I couldn’t manage the anger and occasional compulsive threat. She was unwell. But sometimes, for my body to recover, I would have to stay away for days at a time.
Of course, this was an untenable situation, and the pattern would repeat on and off for days or weeks at a time, until I finally found myself marooned at the cottage for so much of 2020. And in the vacuum of space, time, and human interaction, I would soothe my sensitized body with a pill. Once a night. Until the nightmare was over.
Here is an interesting recent discovery of mitochondrial dysfunction in the anterior cingulate cortex for folks with autism, which was uncovered with a PET (positron emission tomography) scan.
Luiz Pessoa refers to "the Cognitve-Emotional” brain because decisions are often as much emotional as they are cognitive; they’re “deeply intertwined at every level.” This insight has implications for decision-making as well as social and political phenomena.