conversion disorder – Amanda Salisbury

Wakeful

A while ago I wrote about being sleepy. I now have an answer, a reason for all that sleepiness: sleep apnea. It’s not sexy, but it’s also not conversion disorder, which was my big fear.

So there’s something actually wrong that the data supports, and you cannot imagine how exciting that is to someone who has dealt with conversion disorder. It’s a sort of validation. That my anxiety is not so all-powerful that it is changing the way I sleep or forcing me to sleep throughout the day.

My CPAP machine has not yet been delivered, but I’ve been coping for a little while now on a new medication. In my Sleepy post, I mentioned a sample. I since received a prescription for a medication called Sunosi. I first took a sample dose in late November and began a prescription in December.

I cannot tell you whether anyone else should ever take this medication, but I can tell you my experience. Precious little is written anecdotally about this medication on the internet as of today, as I found when it was first prescribed for me.

If you want to read about Sunosi and its mechanism for working, its risks, and all that, go here. If you want to know what it has been like to take the medication, read on.

The medication begins at a small dose and increases at intervals until the patient is taking the highest indicated dose. During that transitional period, I had my first passes with being awake, really awake, in a long time. But I also experienced crashes. A few to several hours after a dose, I would crash and all my sleep pressure would tumble down on me with force. However, once I settled on my highest dose for a couple of weeks, the crashes disappeared. The medication granted me about nine hours of alert wakefulness, which was amazing, truly, but I thought there might be a way to extend my day.

I asked and was given permission by my doctor to take half of my dose in the morning and the other half six hours later. This was when a switch flipped in my life. I went from sleeping 14-16 hours every day to being awake 13-15 hours. Most days, no naps.

Now when I am awake, I am alert and capable. I don’t see life through a haze. I am engaged with the people in my life and with my work. I arise in the morning and go to bed in the evening, and it feels terrific.

For a long time, sleeping, particularly daytime sleeping, has felt to me like my own moral failure. Now I see that morality has nothing to do with this situation. My depression is in as small a place as it’s been in years, maybe ever. My anxiety doesn’t overwhelm me often; I’ve had one panic attack in two months. Despite feeling like I went to sleep in my thirties and awoke in my forties, I am more positive, motivated, and assured than I have felt in so very long.

I look forward to getting the CPAP machine. I look forward to oxygenating my brain and body throughout a night of sleep. I am eager to see how that impacts my life. (And, yes, I know it may be a bumpy road.)

But, y’all, being awake is nothing short of inspiring. If you’re struggling with oversleeping, see your doctor. See a sleep doctor. Get help, because help exists. You do not have to sleep through all of your life. You can carve out times to be present and available and awake.

Everyone Converts But Not Everyone is Disordered

On World Mental Health Awareness Day, I don’t wish you happiness but wisdom. Not joy but understanding. Not abundance but empathy.

Years ago now I was diagnosed with Conversion Disorder, which I talk about on this blog often, along with Depression and Anxiety Disorder. I capitalize those here, though I don’t think I always have.

My husband is a mentally healthy person as far as anyone knows. I’m so thankful for that. But he often struggles to comprehend how Chronic Depression differs from sadness. How many shades removed Anxiety Disorder is from anxiety. And, yes, everyone converts. But what makes Conversion Disorder?

When an otherwise healthy person gets a tension headache, they are converting. They convert emotional turmoil, pain, or strife into muscle tension, which results in a headache. When that same person feels edgy after a near-miss on the highway, they experience anxiety. When they lose a beloved belonging or pet or person, they feel sadness.

So when that person comes face to face with a person like me, with Chronic Depression, Anxiety Disorder, and Conversion Disorder, they can both understand and wholly not. They cognitively comprehend sadness, loneliness, anxious feelings. They recognize tension headaches, nervous stomach, and passing out during a moment of intense stress. But they don’t usually understand what elevates these really common feelings and experiences to disorders.

I’m not so sure of the mechanics of it myself. But I know the difference is one of both magnitude and scope.

In re Scope and Magnitude

Anxious feelings tend to behave like a story. To begin, an inciting incident occurs. In the middle: difficult, uncomfortable, or unsavory events happen in real time. At the end, the potential bad thing has happened (or hasn’t) and that happening (or not) releases the anxious feelings. No matter how often a person experiences this type of anxious experience, it is a closed loop.

My experience with Anxiety Disorder doesn’t resemble a story process. There was no discernible beginning. No event ever happens to release the feelings. Instead, the scope of anxiety is untethered from specific events. Its magnitude is expansive, covering me and all my thoughts, actions, and experiences as a single whole.

Sadness differs from Chronic Depression in scope and magnitude similarly. Sadness comes after something occurs. It may extend into the future, but it does have a recession. In my own Chronic Depression, the scope wraps all time and space. The magnitude exceeds emotion and can impair cognitive processes.

Coverting. Well, that one’s a mite harder for me. I don’t like to ask whether every pain or illness relates to my mental status. It feels…less than. I want to just have a headache. Or a cold. Or whatever. Without analyzing the source as purely physical or physical by way of mental. But Conversion Disorder, regardless of my liking or disliking, will not be contained. It cannot be massaged away. It cannot be persuaded away. It claims every molecule of the body as owned by the mind. The scope: everything. The magnitude: consuming.

I imagine this is true for other diagnoses. Obsessing over the flatness of your sheets does not mean you are a bit OCD, because of magnitude and scope. Having a tumultuous day does not mean you should feel bipolar, because the magnitude and scope are all wrong. And on we could go with any mental health topic.

You cannot fully comprehend a clinical experience you have not had. You can, however, understand that the scope and magnitude of that clinical is fundamental different in scope and magnitude than your non-clinical experiences. It covers more area. It controls more, longer, harder. Never, ever the same.

So, please, enjoy a wise, empathetic, understanding remainder of World Mental Health Day!