Friday, September 25, 2015

Focus (or the lack thereof)

I've been having a bitch of a time writing lately. I've no shortage of topics to write about - dozens of posts for this blog, ideas I have for my neuroscience blog and my Worldly Bush Ape blog (which is where I put my more op/ed pieces), along with various works of fiction I started but ... 

Focus. I can't focus. 

This only came to me this morning when I couldn't sleep. Yes, this is also related to having difficulty in focusing. 

This is going to be very familiar to any of you who deals daily with living with a psychiatric disorder - the dreaded scatterbrain feeling. Mind all over the place, first over here, then over there. This is the big priority. No wait, it's that. No, no, no, it's none of that, it's this new thing that's just popped up. Ghah, shit, no. Can't do that until X, Y and Z are taken care of first. Oh, wait! Look at this cool video someone posted on YouTube! Oh! So 'n' so is pinging me on Messenger. I'll just chat for a while. 

Okay, now back to work. What was it I was doing again? Aaahh, right, it was this project. Oh, shit, the cat's made a mess. Now where was I again? 

Oh fuck, I'm exhausted. No, can't sleep, must at least get started on this. I'll make some coffee. Shit, look at the kitchen, what a mess. I gotta straighten this out at least a bit.

Okay, now where was I? I had a good idea going there, now where the hell did it go? You know what? I think I need some fresh air. I'll go for a walk first. 

Phew, that felt good. Oh! Look at all the notifications I got! I'll just check those quick while I relax a bit after my walk. 

Then - just as I'm about to finally sit down to start getting something done - the dreaded brain fog descends. Nothing moves. Okay, just lie down a bit. Try to read. Stare at the same page for ten minutes, nothing gets absorbed. 

And on and on it goes. Days, then weeks and then into months. 

A year or two years ago, I'd have been in a great panic by now and probably on the verge of a massive suicidal breakdown. I am one of drive and ambition. I'd gotten so used to my mind working at a great pace (the great manic year of 2013 when I wrote hundreds of thousands of words, most of which came to me seemingly like magic out of thin air). I have great dreams for Taming the Polar Bears. I have books I want to write. I have photography projects I want to complete. I want to leave all this as a legacy to my daughter of who I was. I therefore find it very difficult when things grind on like this without any productivity. I find it gets enormously frustrating. 

If nothing else, I've moved on from allowing it all to plunge me down the rabbit hole so badly like in the past. Nonetheless, my own internal generated pressure begins to mount. Darker and darker thoughts begin to percolate and dominate. My mind gets more and more out of touch with my goals and ambitions. Ideas that seemed so clear not long ago seem distant or like dissipating mists. Things begin to break down. 

I'm sure this all sounds quite familiar to many of you. Bipolar minds can especially be like this because of the enormous amounts of mental activity they create and at times wildly varying mental states (bubbling optimistic energy here, dark melancholy there, much in between). 

So let's have a look at what's going on.

The basic issues are:

  • difficulty in focusing and maintaining attention
  • that ever delightful "scatterbrain" feeling
  • brain fog (brain freeze, mental mud, mental molasses, etc)

The first issue probably sounds to most people like a condition for which there is either a three or four letter acronym. According to some literature, this condition and bipolar very often go hand in hand and it certainly has with me, especially during my worst periods. This is a topic I generally don't go anywhere near. I have my own views on focus and attention issues but if I've learned one thing in nearing three years of researching and writing on mental health issues and the brain, if you want to be a lightening rod for angry comments and being vilified, dare challenge anything about this condition. It seems I can talk about and challenge any other mental health disorder, but this one is off limits. So I just don't go there (though who knows, I might some day).

Attention and focus is controlled by a network of brain regions, the most important of which are in the frontal lobes (the details of this will have to wait for another day and a dedicated post). One thing I learned very early on in my research about the brain was to do with its "energy economy". In times of stress, the brain will generally redirect energy to key core regions that are more vital for our survival (which are the more primitive areas of our brain). The frontal lobes are the first to get energy scaled back when the brain reallocates energy due to stress so poof, there goes most of the essential areas of the brain for regulating focus and attention. 

The brain, as I've said numerous times in my posts on the brain, is the single biggest energy consumer in our body, taking up a whopping 20 percent of all reserves (while accounting for only perhaps 1 to 3 percent of our total body weight). When energy from caloric intake runs low, the brain also reallocates energy to core regions, once again dialing back energy to the frontal lobes and other (what it considers to be) "non-essential" circuits and regions. Poof again.  

So, with that in mind, what (I ask myself) have I been going through lately? Starting from early June, mega stress involving living arrangements and moving (long story, but for me these are major stress and anxiety triggers). I've found a new arrangement but at this point it is looking neither stable nor long term. As well, it's shared accommodations and getting used to living with other people and the noise has been stressful and difficult to adjust to (though I've been doing everything to put my best foot forward). 

For a wide variety of reasons, I've been eating like shit or not eating at all, having totally fallen off the wagon of my good eating habits (not terrible, mind you, I'm not eating junk or fast food, but certainly not as good as it needs to be). 

So, high stress, grinding anxiety (asides from bipolar, borderline personality disorder and major depressive episodes, I met all criteria for major anxiety disorder and social anxiety disorder as well) and piss poor eating habits. I can virtually guarantee you that that's going to challenge the ability of anyone to focus and maintain attention to tasks. That's going to challenge the ability to think, period.

Which takes us to the scatterbrain feeling. My mind can be a cacophony of snippets of songs, past conversations (from anywhere from those that took place that morning to some from decades ago), wild ideas, dark and distressing thoughts, ideas of all kinds coming and going in a constant revolving door, imagery of all kinds, haunting voices, visions of past mistakes and so on sometimes swirling around like the vortex of a roaring tornado. When it's all going full blast, you couldn't shoehorn an important task in there to focus on to save your life. 

Stress and anxiety are the big culprits here. Stress and anxiety (which is sort of a subset of stress that becomes chronic) have this troubling propensity to do a couple of things to our thought processes. One, in times of stress the brain is disposed to start "rapid firing" looking for answers, looking for things in our minds and memories that might help. Unfortunately, and here we go back to that "energy economy" thing again, higher cognitive areas and better emotional control areas tend to get deprived of energy and go "offline", while more primitive subcortical regions get higher priority. And these lower regions are exactly where more panicked thinking originates, where memories of past mistakes are stored and emotions are generated. It all adds up to creating the kind of chaotic cacophony of thoughts and mental messiness described above. 

write about sleep and the brain here, but without making you go over there (though I quite recommend it), I can tell you that neuroscience has been uncovering tremendous amounts of evidence for how important sleep is to brain function and for memory consolidation. Chronic lack of sleep will greatly impact sharper brain function and contribute to scattered thinking. Sleep too has been an issue for me recently (more in a minute). 

If it's not rapid fire scattered thoughts and mental chaos, it's mental mud. You can't think, you can't read, you can't process anything. Memory seems inaccessible. Very, very disconcerting, I can tell you (and for those who know what I'm talking about, I don't need to tell you). If not downright terrifying. You're also going to tend to feel clumsier and process sight and sound slower. Every freaking thing seems overwhelming. Getting out of bed seems like a monumental task. This used to be guaranteed to send me into a panic. 

To understand this, we need to go back to energy (the whole universe is about energy and so it is with our brains). Now we must look deeper than short term caloric energy intakes, and even beyond that provided by sleep. We need to look into the very "energy engines" of our cells - mitochondria. For those of us who are bipolar and have been through many cycles of mania and depression (or during the depressive phase of any cycle, be it the first or the umpteenth one), or those who have been living with long term chronic anxiety and/or depression, we are going to have suffered damage to our mitochondrial function. 

I write about this in quite great detail in a three part series starting here (links to parts two and three are at the bottom of that post). Mitochondrial function is something I've looked very deeply into in order to understand the chronic fatigue that has come with living with bipolar for so long (and following the mother of all manic-depressive cycles). We needn't get into great detail here, but to understand times of mental molasses, let's have a brief look. Mental functioning of all kinds means neurons communicating with each other on massive scales (remember, you have somewhere around one hundred billion neurons, all with important jobs to do in your noggin and mental processing). Mitochondria are absolutely essential for every step in the processes of how neurons themselves function and in how they communicate with neighbouring (or even distant) neurons to form thoughts, call up memories (or create new ones), and process every single thing your brain must do (including coordinating physical movement and visual and auditory input, which is why something as simple as even holding a conversation or reading a book is so challenging).

So with mitochondrial dysfunction, everything the brain must do is going to grind to a slow crawl, focus and concentration will suffer. 

Now, on to a personal note. 

While I manage all my conditions drug free, there are times when I do need something. Stress and lack of sleep are the two main factors that will prolong and exacerbate the crippling fatigue that I live with. So sometimes after a particularly stressful time or event (like being evicted from my previous residence because of my condition and the resultant big move to another town and starting over yet again) and if sleeplessness is getting to be more than I can handle on my own, I know it's critical that I do something to really rest up and "power sleep" for a few weeks. It is during that time that I will temporarily go on the anti-psychotic Seroquel. There are no good drugs in my very well researched and founded view, but I know from prior experience with Seroquel that it will knock me out in the evening and let me sleep through the night so that I can get some essential restorative rest and sleep.

The trouble with it - and this is one of its numerous side effects for many users - is that it leaves me with a persistent grogginess through the day (especially in the morning) which in my case at least, also has been contributing to the brain fog and mental mud. 

The several week period I'd set aside to use it to help recuperate has passed and I've been trying to go off of it but, for the first time, it's been proving very difficult and sleep has been very hard coming without it (I've been on it for far too short a time to being going through true withdrawal, however).

So this has been a factor for me as well. 

Add it all up and I've been having a bitch of a time writing or focusing or reading or accomplishing anything mentally. 

Meditation has been demonstrated to greatly help with sleep, focus and concentration and improved mental states but I haven't been doing that either. 

So no wonder I've sort of fallen apart lately!

The good news is that I have been getting out for lots of walks or long hikes in nature. No question things would be even worse if I weren't at least getting a good amount of fresh air and exercise. 

So what to do? (the sixty-four thousand dollar question, after all).

It's pretty simple, really (do not, however, mistake simple for easy). 

For one, I must not allow myself to panic about it. This is a lesson I've learned over and over and over again. Whatever a difficult situation or crisis is, panicking is like throwing jet fuel on an already burning fire. Easier said than done, however. But this is where all my study pays off, plus by now lots of experience with going through this numerous times in the past few years. I know that if I do things right and get back to all my basic fundamentals, my mind will come back, focus will improve, my better mental functioning and somewhat improved energy will return. 

Two, and you regular readers have to know that this is coming, I have to rededicate myself to my Positive Difference Making Fundamentals. That means making more effort to stay in the now and the day, getting back to my various (and very simple) meditative practices, devoting more mental bandwidth to practicing my approaches to spirituality (and I can't tell you what a difference simply focusing on gratitude can make to one's mental states). 

Three, get back to my nutritional basics, starting with simply having a nutrition and brain energy packed fresh fruit and vegetable smoothie every morning and get away from the crap that's been creeping into my diet again (like the all you can eat fish and chips I had the other day. Yummy, yummy, yummy, but so not good for my mental states and energy). 

Four, and this very difficult in our 24/7 connected world, reduce the amount of unnecessary "input of data" most of us allow into our brains (and thus minds). Another thing I've repeated and tried to hammer home is that in no way did our brains either evolve for or adapt to the kind of sensory input we subject them to in today's modern world. So turn off the news of distressing events that you have no control over, reduce the amount of online interactions that are overtaxing your abilities to reasonably handle and probably reduce the amount of interactions in your "real" (read: not online) day to day life. I understand that reducing all this input can create a paradoxically uncomfortable "hole" in what occupies your mind but this is precisely what I designed my music therapy programs for (calming, soothing brain building "sensory input"), my brain training exercises and daily mindfulness practices of simple things that Need to be Done around your home (from cooking and baking to simple cleaning and so on). 

Lastly, and probably the hardest of all for me - patience. I know the downward spiral took time and it'll take time to get the spiral going back up. But I know good lifestyle and diet habits will always work, even if I get a bit grumpy sometimes about having to practice them. I've searched the world over looking at how to restore mitochondrial function and the best I can find is what I've listed - rest, rest and more rest, as much quality sleep each night as possible, better nutrition and fresh air and light (not strenuous) exercise along with regular meditation (to calm stress). And as my brain health improves with better diet, habits and sleep, my focus will improve, the mental chaos/scatterbrain will diminish greatly and the brain fog will lift (for the most part).