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"... it's about being observed, often from multiple directions, it requires a level of performance"

He goes on to say that processing information is harder because his brain is too busy "looking for the exit, the need to escape."

He wasn't sure if the whole post made sense (I advise reading it all) but I understand where he's coming from.

There are times when I feel anxious in an environment or situation that I would normally navigate perfectly fine and I can't readily explain why. Maybe that sense of performance is what does it but something triggers me and it's often impossible to say what.

I've written before that the only way I can describe it is a feeling of claustrophobia ¹ and the need to get out of the place or situation.

What I think of as my first proper anxiety attack was when in Westfield shopping mall, Stratford. Something previously done without issue both there and elsewhere in other very busy malls. I experienced a sudden sense of panic and being overwhelmed, almost like everyone was watching me, and a need to get away from the people and the noise.

I have no idea what caused it and equally no idea why that time should have been any different to others before and since. All I know is the irrational fear I felt at that moment and the lingering memory it left me with.

While it may not be obvious from the outside that I am feeling anxious, I have a giveaway visual indicator: is fiddling with the hem of my jacket or jumper, even a fold in my jeans. It's not so much a comfort thing but a distraction, perhaps. The only way I can describe it is that the sensation of having the material between my fingers (along the lengths, not fingertips) seems like it's something to focus on, maybe almost calming. I do it subconsciously, especially while driving, and my wife points it out as I just don't know I'm doing it. Maybe it's some form of stimming.

We were watching a programme about autism, fronted by the naturalist and presenter Chris Packham, and were nodding along with so many aspects of what was being described by him and those featured.

Something that came up on the programme was eye contact. I always find it hard to make eye contact but sometimes I'll do so without realising. Then, as soon as it registers, I become incredibly self-conscious and have to avert my gaze. Trying to force myself to maintain eye contact is exhausting and usually ends up with me losing track of the conversation or what I want to say because I'm having to expend my energy elsewhere.

I was shy as a child, insecure, and hated being the centre of attention. I've always considered myself an introvert. I would get flustered and blush when being asked questions about myself. I still do from time to time. I now wonder if, in my younger years, it was actually an early manifestation of anxiety. Or more.

Bix wrote about assembling an "introvert's toolkit" to help cope before he was ever diagnosed as autistic. While the two might not be directly related there is a definite similarity in language surrounding them. How many introverts are actually undiagnosed autistics?

The subject of performance came up in one of my sessions with the psychiatrist. I explained that it might seem strange that such an introvert as myself might want to put myself in a situation where I was absolutely the focus – like when DJing in nightclubs. Not so, apparently. Part of the reaction to these things is the presence or lack of control. By placing myself in front of an audience I was controlling who would see me and when. Most importantly, I was controlling the context – an environment I enjoyed and felt comfortable in, doing something I was good at.

Part of a coping toolkit.

This rings true for me with regards to blogging: sharing as much or as little as you want, at your own pace and, crucially, according to your own rules without external pressure to perform. The author of a blog controls the context within which others get to 'observe' them.

It's there almost all the time and, no matter how well I do something, I always end up believing it and enter negative feedback loops, plummeting into downward spirals.

The cliché is that we are our own worst critics (and enemies) but when you're coming from a position of mental illness that seems to get amplified many times over.

Even when I succeed in something the voice says "but it could still be better." My self-confidence has diminished over the years when it should be the other way round as I grow into certain areas and abilities. This self-doubt is what really annoys my wife most when she says "you're good at X" and I play the ventriloquist's dummy while the voice replies "no, not really."

I had my latest session with the psychiatrist this morning and he was happy with the progress I have been making since stopping the quetiapine. The mood swings have reduced (they're still there, just not as severe) and the promethazine is really helping me sleep. There's less brain fog and I am able to concentrate more (hyblog and everything I've been doing this year is testament to that) so, after discussing the negative thoughts above, he feels that the time is right to refer me to one of the therapists for some CBT.

(b)log-In works (and I'm super proud of it) and hyblog has been fun to experiment with, but my code is messy and inefficient, cobbled together as ideas emerge. The voice says "It's crap and there's no way you could charge anyone for using anything you put together."

I don't do anything online for money – I want to learn and explore and help others. As I naturally discover more I want to share my thoughts and ideas. So, I've decided to take the alternative route of setting up a 'buy me a coffee' account. ¹ Maybe I'll also go the GitHub sponsorship route.

After hearing how things had been going since last time he thought it best I come off the Quetiapine – it obviously wasn't doing what it was supposed to.

I had been taking it to: 1) even out my moods, and 2) help me sleep. It was almost the polar opposite.

Instead of my mood swings going from 0 to 100 they were (according to my family) going from -400 to 400. The highs were over the top and the crash was off a cliff face.

Yes, the pills made me tired but if I went to bed when they kicked in I'd be awake somewhere around 2 or 3 am and struggle from there. If I fought it and went to bed a bit later I would then struggle to sleep at all. Either way I would feel exhausted the next morning which contributed further to the mood swings.

We're now trying to tackle the sleep issues and tiredness as a way to help level things off. I've been given promethazine (an antihistamine) because of its strong sedatory effect.

Last night was my first time taking it. The instructions say it takes about half an hour to work but it took a while longer for me to drop off. But when I did I was dead to the work the whole night. I think I'll take it earlier tonight (about an hour before bed) and see how it goes.

counsellor? therapist? His actual title is psychiatrist but I think there is still a lot of stigma attached to that. I grew up in a time when you'd see a psychiatrist if you were 'nuts' and therapy for mental health issues wasn't a thing. Frankly, mental health itself wasn't a thing.

How times change, eh?

I still wasn't really sure how I was feeling or whether the meds were having an effect so I asked my family before the appointment. The general consensus was that when I was up I was more up but the downward swings were bigger. I think my focus is a bit better (I can certainly concentrate on code more – or, rather, get lost in it) but memory is still an issue. Well, it's not so much my memory but not being focused or present enough to actually take things on board so that I can remember them later.

Apparently, it was like you could see the pills wearing off (even though that's not how they work) and my mood was shifting quite drastically in the evenings. I wasn't aware of it. I think that defines a lot of what's been going on: I'm just not aware of how I am, how I act or come across to others. In my head I'm acting normally but it would seem not – the proverbial 'living in a bubble' of my own making.

So, my prescription of Vortioxetine has been upped to 15mg a day from 10 and I've also been prescribed Quetiapine to complement it. Quetiapine should do a number of things including reduce the mood swings and help me sleep. I take it around 7 - 7:30pm and by 9:30 I'm struggling to keep my eyes open. It certainly gets me to sleep quicker (that's always something I've struggled with) but it's hit and miss if I wake through the night. Still, it's only been a week and I need to let that settle.

I still have PLMS on occasion and the Quetiapine might also help ease this. It will be a relief it that's the case.

My next appointment is 5th January and, if things work out, I'll be more stable by then so that the next phase of treatment can begin. Whatever that is decided to be.

I stopped under the guise of trying to work out exactly where I was going with it all. Having redesigned the architecture and styled it as a quasi-PKM system I felt left with nothing to fill it. Stepping away seemed like the best way to regain some much needed clarity.

I should have realised by now that if I'm not happy blogging then it often points to a wider problem, usually with my mental health. And so that proved to be the case here.

But let's take a step back.

In early July, I wrote in my journal that I was experiencing difficulty reading and writing, everything seemed to be a struggle and I couldn't focus. I had forgotten writing this, misplaced it on the timeline of events – it's importance will become apparent later. Around this time I was starting to think about what I could do to the blog, how I should approach it, but any moves were put on hold when the family and I all caught covid.

Despite being triple-jabbed, I seemed to have it reasonably bad – first being put on some antibiotics due to a chest infection and then a course of steroids to prevent it developing into full blown pneumonia. Each time I spoke to a doctor I was asked numerous questions about my chest and breathing, any worse and they would have probably whisked me into hospital. It's certainly what they were hinting at.

This caused me to be off work for four weeks with ongoing shortness of breath, headaches, lethargy, brain fog and memory issues, among other things. A further visit to the doctor raised the spectre of 'long covid' leading to a series of blood tests and a chest x-ray. The results all came back fine ¹ so, by the start of October, we were looking for other causes for my symptoms.

My wife has been telling me that my personality has changed over the past few years; when you start mixing this with memory problems the shadow of dementia starts to form. After a long chat with the doctor and some memory tests this was, fortunately, ruled out. Instead, my symptoms were labelled as the physical manifestation of anxiety and depression and I was referred for counselling.

Looking back, the memory and focus issues may have been exacerbated by covid but not caused by it. If I had only remembered writing about it before. The irony.

I have private health insurance through work so have gone this route and had an initial consultation a couple of weeks ago. The therapist says there is definitely an underlying depression that needs treating but, due to my memory and focus issues, that's not possible at the moment. I have therefore been put on antidepressants ² to stabilise my mental state such that I am receptive to ongoing treatment.

My next appointment is next month and we'll see how it goes from there.

I'm still a survivor, but it's about time I did more than just survive. This time, I'm taking my mental health more seriously than at any time before. I need proper help and am ensuring I get it.

Part of the reason for returning to the blog is to be almost a journal of my mental health journey. I think I also need it. Having something to focus on, something I can build and control. I miss it.

I don't know what form posts will take from here on out. There will be updates mixed with the normal geekery but, beyond that, who knows.

I'm just glad to be back.