Not knowing what's wrong

I appreciate having my neurodivergence diagnoses because they help me make sense of why so much of me and life has felt 'wrong'. But this week, I'm unsure once more of what's been amiss.

I’ve had over four months now with no days off sick which feels great. Not that there’s any shame in being off sick, but you can become a bit of a bureaucratic headache when no one knows how much half-pay you should be getting, so you’re under- and overpaid in the space of two payslips. But mostly, it feels great because it indicates that I’ve had a good last while. Not too much mental anguish for a change.

Something common to lots of neurodivergent people is poor interoception, meaning we struggle to notice and/or interpret bodily signals like hunger and thirst. But then, simultaneously, we can be hypersensitive, such as to textures of clothes. Make it make sense. Anyway, I’ve felt really off this week. Physically and mentally, and I’ve found it hard to pinpoint what exactly might be the matter. I’ve been sleeping way more than usual - I find it difficult to sleep normally, if anything. My ability to concentrate, even on things I care enough about to give the time of day, has seemed diminished beyond the proportions of my ADHD. Nothing’s happened, especially, so it didn’t make sense to me that after weeks of regular gymming, energy for certain social engagements and going into the office and the capacity to stay up late watching reality TV, I should find those lacking. I’m used to them being lacking under particular circumstances, namely burnout and deep depression. But if I’m not there now, where am?

It’s like I’ve had the theoretical motivation and get-up-and-go, but I’ve blinked and I’ve spent four hours of an afternoon lying down. I usually only do that when I’m consumed by self-loathing, which, for the record, I actually am not, currently. My appetite has been even less dependable than usual (interoception issues), but I thought that if I had some sort of ‘actual’ bug, I might have been really off my food. I’ve had the odd headache, but far from the worst I have experienced. I guess my main physical symptom has been brain fog. I go to bed and it’s like I never really woke up in the first place. Exerting mental effort takes more out of me than it is worth (hence just wanting to lie in bed or on the sofa). Life as a whole these last few days has felt insulated, muffled, muted as if by cotton wool.

There is the minor detail of an impending exam. But I thought I knew exam stress and this isn’t it. I’ve hyperventilated over exams. Cried during them. But this - my first for over five years - while it may be the most meaningful and potentially life-changing one to date, has not sent me spiralling like my A Levels did. Not least because, mentally, I’m much more balanced these days. Marginally less of a perfectionist because I’ve lived more, gained perspective and have a life beyond studying that includes a proper, adult office job. Basically, I’ve been applying myself solidly, but not incessantly, over the past two months and it’s all about to come to a head. Except I don’t think nerves will incapacitate me - far from it, actually. I’ve enjoyed honing the mentally agility that this type of test requires and spending hours in libraries has always been a bit of me. So, why should my physical body turn against me when I’ve been managing (or so I thought) to keep it all together?

I had a big, frustrated cry a couple of days ago because I didn’t feel in control: of my mind, body, intellectual output, mood. All of which I could do with staying onside at least until I’m done with this test. ‘A bit of a headache and fatigue’ is hardly as extraordinary as I am making out and this may all seem like an overreaction. But it’s why I haven’t written until today; my whole schedule had to go out the window as I came to terms with the fact I wouldn’t be able to do as many mocks as I had initially intended…

It wasn’t all that hard to make my peace with ‘doing less’ to prepare in the end. There are many times where I’ve realised, late on, that something will have to give lest I fall apart entirely. It sounds dramatic, but I have a tendency to find myself in psychologically dire straits. (Likely in part due to the neurodivergence, which, thinking back on my past approach to exam revision, I could have done with knowing about at school. But anyhow.) I remember sinking down into the living room carpet with my back against the radiator, overcome all of a sudden by just how hard it was to have an eating disorder that seemed as if it could never be cleaved from my brain. I was tired of my head. Fifteen years on, I am better at accepting my limits (I hope), although a need for control over myself and my life continues to characterise my existence.

Applying for medical school, finally, feels like trying to make hay while the sun shines. I know what it’s like to feel like going to the shops is out of reach, let alone another, more taxing degree and, undoubtedly, further taxing years beyond that. The prospect of sick days down the line is daunting, given how dark the start of this year was; I never want a rerun of those months, though the way my brain is makes some sort of similar episode likely in the future. Self-acceptance is an ongoing pursuit. Maybe I’ll even get to the point at which I can identify my limits before I collide head-on with them.

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