This is thus far my best attempt to communicate this deep seated, and possibly hard to see or understand fear. Whether anybody else at all has a problem which is qualitatively like this problem is a question I cannot answer. If I do describe it, and others understand my description, then perhaps others who have this problem will see something similar, and be able to open up. But that is beyond what I am personally capable of: it is all I can manage to write things such as this.
Now, before I eventually let the services treat me as they thought appropriate, with Olanzapine and Lamotrigine, I had the nagging feeling that letting them do so would mean effectively signing my death warrant. I tried to explain this to a private counsellor when I was having weekly sessions with her.
Due to the breadth and depth of potential anxiety associated with these things, it was hard even then to get anything out, and what came out didn't get the message across as well as it ideally would. When I was admitted for the first time in 2017, she wrote a letter about our time together, indicating that there was a fear that anti-psychotic medication might lead to suicide. That was an genuine fear, in many ways though less now than then, it still is. But the fear was, and is, far more abstract and general, as is typical with the nature of a mind which thinks easily in abstract generalities as mine does.
The fear is this:
- On medication I have a reduced capacity to make myself do things; many things I could just about make myself do with some mental effort, but on medication all those things become inaccessible to me.
- My instinct to avoid sources of potential anxiety were a problem even if unmedicated. On anti-psychotics, my capacity to swim against the direction that Anxiety Avoidance pushes me in is massively reduced.
And so this is the problem: I may see my death coming, or some other disaster, perhaps health-related, perhaps financial, but be unable to taking avoiding action because Anxiety Avoidance is triggered by potential anxiety-related consequences of taking such avoiding action. So avoiding action is not taken.
- Communicating to others is one such example of 'avoiding action'.
- Seeking help is yet another such example.
To take a random example, consider financial hardship. Consider a hypothetical businessman who fears bankruptcy, and has a similar Anxiety Avoidance mechanism as I do. Thinking about financial issues of the business involves contemplating problems such as perhaps poor sales or increasing costs. Because of these potential problems, Anxiety Avoidance kicks in, preventing him from approaching such thoughts. Thus he becomes incapable of thinking about the day to day running of his business, for fear of the business failing. By not thinking about it, he becomes incapable of taking avoiding action, and so the business goes under. While the 'intent' of the Anxiety Avoidance mechanism may have been well-intentioned, the consequences of its actions were disastrous.