a survivor’s guide to anhedonia+anxiety and getting anything done, ever.

So this particular twitter thread came up on my feed. And I tried a few times to figure out how to do a thread-response, but eventually gave up:  instead, I’m going to put my response here, and then link it.

I’m doing this because I recognize so much of myself in the description there, and the thing is that I’m pretty sure other people are going to come up with all the easy-quick things – all the things that can help if it’s a minor issue, a minor glitch, and what’s needed is a fresh way at looking at how you organize a life. And so on.

And those are great, and fit nicely in a twitter thread, but they also would have been close to useless to me at a point of trying to figure out a similar level of Brain Crap, because I’d . . . basically tried them all. Or variations of them all. And they hadn’t worked.

This is because the problem was, well. A lot more ground in, and I didn’t need a fresh look at organization, I needed a whole new way of looking at how this stuff even works.

So underneath the cut are the things that nobody told me (at least not when I started trying to figure it out), but which actually were crucial in figuring out how to deal with my version of the things the twitter-thread describes. Some of them come with some pretty solid and uncomfortable reshuffling of how one looks at, well, one’s entire life and what one wants to get done.

If they don’t apply to you (especially if you’re @LunosNocturne!) then all I can say is sorry for flinging a lot of words at you! Also, that’s great! So glad to hear it.

If they do, then maybe all the words will help.

Beneath the cut discusses depression (particularly anhedonia) and anxiety pretty frankly, so there’s a note for that.

The first and foremost thing I’m going to say is that if you’re feeling all of what’s described there, and you have tried the solutions that get handed to anyone who’s struggling a bit with what we call “productivity” these days, and they haven’t worked?

If you’re not already seeking treatment for anxiety and/or depression, or possibly ADHD (or something else that kills executive function), then please, please speak to a healthcare person you trust about it.

And if you are seeking treatment, talk to your healthcare practitioner about the fact that it’s not working well enough.

I’m going to get into why as I get into more specific targeted things – at least “why” in depth – but the short version is that you really can’t fill a tub with a sieve. If your brain is literally not allowing you to feel satisfaction, to feel positive stimuli, to control your focus, to cognitively grasp things, if depression, anxiety, ADHD, whatever, is actually eating holes in your capability to do these things, that’s not actually something that can be wholly overcome with clever life-hacks and strategies.

And there are almost certainly more concrete treatment options that you can pursue. They will not, in and of themselves, probably Fix Everything; what they will most likely do is make it possible for you to do all those neat techniques that everyone else comes up with.

So first off let’s talk about motivation because my hand to gods people really don’t understand what that is.

There’s a symptom of depression and of just the straight-up exhaustion that can come from high anxiety that’s called anhedonia. It translates to “lack of joy”, and most people interpret it as “I’m never happy” and that is one aspect of it.

But what it tends to mean at a more fundamental level, and long-term level, is that your brain loses its ability to register positive stimulus.

This difference in thinking about it is actually important, because people who haven’t battled with this symptom have no real concept of how crucial positive stimulus is in being able to do anything, and also how simple and basic a thing we’re talking about when we talk about “positive stimulus.”

Anhedonia is one of the symptoms I struggle with the most, and when it was at its worst it basically made eating healthy impossible, because not only did food not taste good (the very best I could hope for was “well this doesn’t make me gag”), but the feeling of not being hungry didn’t even register as relief. I didn’t care until I hit the point where hunger was interfering with my ability to think or process (when I get hungry I get nauseated and headachey), at which point I could not bring myself to eat anything that took any work, because even cessation of headache and nausea was really not going to be that great.

So eventually I’d feel so gross that I’d wander into the cafeteria in the building I was in at school and get a milk and a rice krispie square because the square was the only thing that even vaguely appealed, eat that, and go back to whatever I was doing.

In the life of a person with a normal brain, life is full of small burst of positive stimulus. Sometimes even the “something awful STOPPED HAPPENING” itself counts as a positive stimulus on a brain-level: relief is itself a positive stimulus.

This is brain work at a very primitive level: you can have all kinds of cognitive, frontal-cortext (as it were) level reasons to want to do something, but if you literally can’t find a way that the steps involved are rewarding, it’s gonna be just about impossible to get yourself to do it.

The way I described it to my psych at the time when I finally got in and went “okay this is not working” was that I could be given a full-ride luxury cruise to Disneyworld, first class transport all the way, and three thousand dollars spending money, and the only thing I’d be able to think would be “oh god packing is going to be so much work.”

Because my brain could not actually make good feelings happen.

This is the biggest one of these things where I really do mean it: if you’ve tried everything and it still doesn’t work, please look in to more direct treatment. Depression can cause this, other mental illnesses can cause this, the sheer cognitive and mental exhaustion of anxiety can cause this (exhaustion is a really big crossover with depression).

If you’re not quite as bad off as I was, there are some things you can do about this stuff. And the big one is find, and FOCUS ON, the moments of reward.

I do not actually mean “bribe yourself with food, or treats, or objects, or whatever” – I don’t do that. It doesn’t work for me. But what I will do is finish something and then just sit there and be really aware of the fact that it’s done.

For me one of the biggest rewards of accomplishing something is that it’s now done. I don’t have to worry about it anymore! I don’t have to worry about failing at it anymore! I don’t have to think about it, I don’t have to plan my time around it: it’s over! I’m all done!

Literally: having finished something I care about is the reward, not for any twee warm and fuzzy reasons, but because it’s done.

So for instance when I finished cleaning my apartment yesterday I had like a half hour where I just sat there and Existed and petted my cat in A Clean Home. I Cleaned My Home. Look at it there, being clean. I don’t have to do that again for another week.

Things that can get in the way of trying to use this tactic are the fact that we’re hyper-trained not to be pleased by things we ourselves have done. We are in fact always trained to downplay accomplishments lest we seem self-satisfied or arrogant or whatever.

Which sort of relates to the other thing, which is triage.

Especially if you were a Gifted kid, but to some extent it applies to everyone – we’re taught that we “should” be able to do anything, if only we worked hard enough. And that definitely applies to things we want to do! If something appears to be in the way, we just need to find a way around it!

Sometimes, though, we have limitations. At this point most people have learned about spoon theory which is a crude metaphor but basically gets the idea across. I tend to think of it more as things like HP or spell slots or whatever: there is a limit on how much I can do, or how much of one kind of thing I can do, and as such, things need to be triaged.

The less dramatic word is “prioritized”, but “prioritized” tends to evoke some busy office and also tends to imply that everything can be done, just some things will be done first. And the flat fact of the matter is that sometimes, things won’t be done. And sometimes that will suck, but is also not avoidable.

I like “triage” because “triage” actually acknowledges that, and also because what exactly triage means is going to change given context.

For example, in certain circumstances – like a disaster where there’s little further threat, or in an ER waiting room – triage means one set of things. The CTAS guidelines identify 5 levels, with 1 the most acute (resuscitation) and 5 the least (no concern). And in an ER, level 1 is going to be seen first, and everything else is structured around that idea.

On the other hand, on a battlefield or in a situation of ongoing continual danger? On the same scale you’re going to be prioritizing level 3 and level 4 – that is, the walking wounded, the people who can get off the battlefield but just need a little bit of help.

You only spend time on the 2s if you have nobody else to help, and honestly level 1s are probably just fucked, because your resources are limited and for every time you prioritise a 2 (let alone a 1) you may be ending up with multiple 3 and 4s decompensating and/or dying.

Obviously, things like “my creative projects and also my adulting” are not the same as human life, but I use “triage” as a concept because it admits and acknowledges that sometimes what’s going to get prioritized is arranged more like a battlefield than like an ER.

So working out how to actually do things when I’m struggling is a process of assessing several different factors:

  • what are the consequences of this not getting done (or, in my internal reference language: “what’s going to blow up in my face?”)
  • what am I actually capable of doing
    • this one is sometimes modified by “what I am capable of doing if I get help doing it”, but that then requires that I factor in the cost of getting help (which is a non-zero cost for me, as I’m terrible at this)
  • what’s most important to me, based on outcome
  • what factors are going to come up in the next little while in terms of “blowing up in my face” and other stressors
  • what things are going to give me some recharge, vs what things are just going to be cost
  • how much time I have to rest

 

It’s exactly like budgeting money, and in the same way that sometimes budgeting out one’s money leads to D: and other sad faces at the end of it because things don’t match up with what one wants, so does energy/capability triage.

It also requires honesty the same way that budgeting money does. Just like budgeting money doesn’t work if you lowball expenses and highball incomes and fib about things you’re spending money on, the same thing applies to energy.

That means being aware of, for example, how much energy I happen to be spending on answering questions on Twitter. *cough* Or how much energy it costs if there’s a family emergency. Or how much it actually costs to do creative work, vs how much it costs to be a supportive friend, vs how much it costs to wrangle my own crazy.

This can be totally harrowing, and also counterintuitive. Right now, I’m electing to spend brainpoints on this – because I think it’s useful to a lot of people, potentially, and also it’s useful to me to lay it all out in as many words because it reminds me about things, plus I also think it’s useful to people who are lucky enough to have such high numbers on all these stats (so to speak) that they mostly never have to think about this calculation set what it looks like when you don’t.

But I’m still spending brain-points here, and it may change some of my calculations for later on, depending on how the rest of my day goes.

(Don’t worry: I’m looking at pretty good numbers. That’s part of why I’ve chosen to do this.)

Sometimes things have high costs but also high rewards and are important (like seeing my family). Sometimes things have high costs and no rewards but huge consequences if not done (like doing one’s taxes, or job-hunting).

Being the kind of honest one often needs to be with this stuff is really hard, because absolutely zip about any culture I’ve ever encountered (so not just “ours”, which is to say mine and that of North America in general, but any others I’ve encountered) has much sympathy for realizing that costs and benefits are not universal, and sometimes things that “should” be easy, or trivial, are not and remain not, no matter how much you try to suck it up.

 

Basics are another thing to keep in mind. Basics are, well, basic:

  • are you eating enough of actually nutritious food? I am leaving the definition of “nutritious” open here and DELIBERATELY SO: people have different needs, and I don’t know what your body needs. But eating the food you need, in the amounts you need it – whatever that happens to be – is actually a basic! and one we’re usually shitty at.
  • are you drinking enough liquids? Again, “liquids” here is open, and literally the only thing that doesn’t replenish your body’s hydration a bit is alcohol. (Nota bene: please do not anyone bring up “but water is best” – I don’t give a shit, don’t start. Anything other than alcohol still makes you more hydrated, and that’s the only level I’m interested in discussing here.)
  • are you getting enough sleep? This is so critical and to be honest I’m betting that just about anyone who is struggling with this kind of thing, the answer is “no”.
  • are you getting some kind of positive social-tactile interaction in your life? That does include with pets! (hanging out with your dog counts!) but pets are a little bit lower than humans. And I know this is so obnoxious and trust me if I could just not do this it would get cut off, but the reality is, it’s also critical. Humans are social mammals.
  • are you getting at least some movement/doing things with your body during the day? Again, like nutrition and hydration I am framing this SUPER BASIC – note that I’m NOT actually saying “do you exercise?” or “are you walking?” or any of that shit. But moving the body around, including just rolling around on the floor or stretching for a bit, is both good for you and necessary.

 

These things really are basic, and if you’re in deficit on any of them it will have the unfortunate side effect of fucking with your motivation, your stamina,  your executive function, and increasing anxiety. It’s a bitch.

Which sort of brings me to the last bit, which is anxiety fucks with everything.

Because I feel the description so hard of the “I need to do this thing, but I can’t” in the twitter thread. Like oh god, my liiiiife.

There’s this wonderful place where anxiety and executive dysfunction cross and shake hands, and it’s the worst. And it’s that place where it does exactly what the twitter thread describes.

Mine also adds the great wrinkle of making me literally forget about things I need to do but which are making me anxious until it is impossible to do them. So for instance, cue up weeks of me remembering I need to book a haircut only after the salon is closed and I can’t actually book the haircut. Including if I write it down.

😐

Deconstructing this shit is hard, and again it’s an area where if you’re not in treatment for anxiety, you probably should be, or if you are, it probably isn’t working well enough and needs to be revisited – whether that’s in a CBT context or a meds context or what the fuck ever.

For me, one of the big elements in this kind of stuff is almost always perfectionism: this stuff happens when I want whatever it is that needs to happen to be Perfect, I know it’s not going to be Perfect, so deep down I don’t want to start, I don’t want to do it, because I know I will disappoint or screw up.

Fixing that becomes a delicate balance of having a lot of compassion for the fact that that’s what I’m afraid of, and also kicking my own ass, and that IS a hard balance.

So for instance, the process goes “I need to do a thing, but I need to do this other thing first” – okay, brain, fine. Let’s do that other thing.

“Oh but….that’s hard.”

Yup. Sucks to be us, but let’s get it done.

“Oh but I can’t.”

Why not?

At this point the brain usually comes up with reasons and I have to either bust them as bullshit, or find answers to them.

Eventually, it comes down to either I can’t actually do this (or I can’t do it without help) or I can, but it’s A Process. And in the latter case, one of the most important things for me to accept and deal with is this is a process that’s hard for me.

I am terrible at phone calls. There is no universe wherein any time I have to pick up the phone actually counts as “just pick up the phone and do it”. I would often rather drive for two hours than make an audio phone call.

Often I do have to make a phone call anyway. But at that point, I also need to treat this like something it’s hard for me to do.

Like okay fine: I need to make whole pot of tea, I need to write myself a script for when the other person picks up, and afterwards I need to get someone to pet my hair and tell me I didn’t fuck up. Fine: that’s what making a phone call consists of for me.

This is hard because, of course, society says phoning is easy: even when we all joke about hating phones, there’s not usually much sympathy for anything like the above, and most people would be embarrassed to admit that’s the process involved. I’m just cussedly devoted to “no screw it, this is what living with my mental illnesses and neuroatypicality is like.”

But that means that when I’m making my triage list above, and on that list is “make a phone-call”, I do have to just accept that it takes a lot of brain points.

Another thing worth doing is identifying that kind of response as an anxiety response and going: okay, why is this causing me anxiety. Why would my brain rather self-sabotage than, say, write an essay.

For example, when I’m writing, it works best for me to have a couple of people I can send snippets of draft at while I’m working. I’m not looking for editing, and in fact part of the criteria for being one of these people is a general feel for what it is I am looking for which is, in effect, to be told that what I’m doing is not shaming my ancestors. To borrow a phrase from Ursula Vernon.

I need a baseline reaction that indicates that the story is not so laughably bad that I should hide in a cave, that it basically is provoking the right emotions, in general, and that, you know. My sentences work. I need to know: does this work shame my ancestors?

It’s something I’m struggling with right now because out of no fault of their own, both of my alpha-readers (what I tend to think of them as) are busy and overwhelmed with life-stuff that means they don’t even have energy to do that, and suddenly every time I open a word document is fraught with peril: WHAT IF THIS STORY SHAMES MY ANCESTORS?

There are also a lot of tips out there for the straight-up “executive dysfunction” angle – for breaking tasks down into smaller tasks and acknowledging that that’s part of what makes them hard, all of that stuff. And I strongly recommend looking them up.

But part of the important part for me has always been realizing: okay why am I afraid of this? Why would my brain almost rather suffer the consequences of not doing this, than suffer through the process of doing it?

And the last secret is: sometimes, I just realize that something isn’t worth it. And I’m allowed to just quit at a thing.

I’m allowed to look at a story I started and go “meh, not worth it.” And just . . . stop with that story and never come back. I’m allowed to decide I really don’t care enough about learning to sew to spend the brain-points necessary to do so. I’m allowed to decide I don’t care about Cooking Nice Meals for myself and do what I’m currently doing: putting together home-made equivalents of Starbucks’ “protein boxes” (cold meats, cheese, crackers, veggies, nuts) for lunches and having nice grocery-store pre-made soups etc for supper.

I’m allowed to accept: I don’t like cooking! I JUST DON’T. I don’t enjoy it, and I am allowed to find ways to get basically nourishing food without “cooking”, and that doesn’t mean I’m “not a grownup.” I’m allowed to own the fact that while I enjoy the results of having a garden, I hate gardening and always will.

So there comes a point where one has to assess the “tasks” around one and go “do I really actually need to do this? Is doing this important to me? What are the consequences of doing this the easy way, and are those consequences a problem?”

Like yes: if I did everything right and invested time, energy and thought into it, I could probably have brilliant meals for 20$ less a week. But there’s two problems with that:

  1. I don’t care about the results that much.
  2. I won’t actually do it. And even if I do, it will cost me my ability to do things that are actually more important, more rewarding, and more critical to my enjoyment of my life.

Now there are some circumstances where that 20$ is a make or break issue and I’d have to reconsider but right now, I can afford it, and there is no moral virtue to not affording it, so the hell with it.

The improvement to my life is worth that 20$. And it’s allowed to be. Which is another thing we’re not really taught to consider well at all: to value and evaluate peace of mind, enjoyment of things, as potentially as important as financial frugality. Or whatever.

 

So for me, those have been the things that have been most important to work around, to think about, to fully get to grips with, in my life, when it comes to the issues that thread describes. I don’t know if those are useful to anyone else, but in case they are, I offer them. And if not, I just offer “good luck” because this stuff is hard.

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