Boisterous stimulation

28/10/13 08:06 [Monday]
I am in a bit of a condition of excitement, or perhaps a better word is urgency, which without a doubt has developed (or the propensity for it has) over the months I have been on the lower dosage of Risperdal instead of the higher dosage (in fact the dosage I was on was the middle one of three available dosages, and I am now on the lowest). One major point I wish to make is that this condition - an elevated turnover of dopamine, doubtless - has taken many months to work itself up and does not correspond hour by hour (or even day by day) with the reduction in Risperdal in the metabolism. I presume the condition has come about through some sort of slowly effective positive feedback by which the dopamine turnover has ratcheted up. One alternative hypothesis is that it has come about so slowly because it depends on changes in the synapses, that is synapses altering in the sort of way they do when memory traces are laid down, to gradually allow more transmission of dopamine. I believe there is evidence that people on dopamine-blocking drugs over an extended period develop some slight tolerance, as the synapses adapt and allow more dopamine through despite the dopamine blockade. So one would guess the number of receptor sites in the target plate increases as some of the existing ones are rendered ineffective by being blocked constantly. (Of course the trouble with that theory is it might lead one to expect the opposite on withdrawal or reduction of a dopamine-blocker, that is for the number of receptor sites to decline as a greater proportion of them become effective.)
I did not get a lot of sleep last night. I slept from about 8 pm to about midnight, and this is a feature I have in my nature, to get sleepy early but also to wake up early and what one would have to call disproportionately early many mornings. I have been logged into Twitter most of the hours since midnight, and I was finding that slight stimulation (which you can understand mostly disconnected fragments such as get through from Twitter provide) was capturing my interest and keeping me 'on the hook'. However, the interest I find in explaining myself here was enough - the foreseen interest, that is - to persuade me to turn Twitter off and start writing down my experience and my interpretation of it.
I have to say some nights I do catch up on my sleep and the following day feel refreshed and able to cope easily with any stimulation I need to process for. I suppose it strengthens what I think of as the positive feedback if I am tired (not having had enough dreaming sleep to post-process during the night) so that in the daytime I rush at things without adequately preparing. Deliberately removing stimulation (turning Twitter off) and taking time over what needs to be done surely is a method which despite the electrochemistry of the brain (versus the pharmacology) will improve matters. To be honest, that's one thing which hospitalisation has always provided - even before effective drug treatments - that is removal of factors needing processing in a version of a holiday, hopefully to interrupt the positive feedback loop. That was the ideal of hospitalisation, although on first arriving at the hospital finding a weird and unlearned milieu (and quite possibly unanticipated, if the patient was Sectioned) would worsen symptoms by giving more to process on.
As regards my situation today - I mean today Monday - while I was on Twitter I was not planning what I need to do, to make sure I cope efficiently and effectively; and I am not even planning adequately now, as I am writing this. If I had had more sleep (to show up with more exemplary detail how it would work) I would be doing the planning at the same time as doing other 'processing', on Twitter or composing what I am writing. Without adequate planning I will rush from place to place, from activity to activity, and tire myself out more than need be, and worsen the 'positive feedback' cycle of having to cope with more and more but having fewer and fewer resources (especially if I keep missing sleep).
What I actually need to do today is fairly simple, when thought through explicitly, and certainly is less taxing than if I were in a position where I needed to go to work and also cater for my home life. I need to go shopping, and the only slight complication is I need to go to two different towns, and what I call planning for efficiency and effectiveness comes down (to a large degree) to going to the towns in the right order, and (I suppose) at the right times. I am better off, in some ways, with spending my time writing this, as it is not actually costing me much physically - in terms of energy or money - and at least it is related at one remove to the genuine planning I would be well to engage in.
When I was awake in the night - possibly this was caused by the numerousness of the distinct stimulations on Twitter (separate Tweets, put simply), or more likely by less time having passed since the physical stimulations of yesterday at home (even if the additional passing time has not seen me sleep a lot of the hours) - I was feeling active and as though I might go out very early (say as soon as buses started running) which would have been a cost in money (because my Concessionary Bus Pass is not valid before 9.30 am) and a cost in worsening positive feedback from exposing myself necessarily to more stimulation out and about. (Incidentally, readers will see that getting into that sort of cycle is the very antithesis of leading the empty worthless life I lead on too high a dosage of medication.)
I think all I have to add now - before thinking more thoroughly about what time to go out and where to go first - is that mentioning 'physical stimulations at home' I had in mind the fullness of the house this week, my grandchildren (step-grandchildren, anyway) having come to visit their mother who with her dog is herself a semi-permanent fixture in our home now. What I mean is, my elevated level of mental activity, which risks turning into an elevated level of physical activity and elevated in the sense of variety requiring processing (not going for a brisk walk every day on a regular route at a regular time, which might be a beneficial increase in activity), could well have come about substantially because there are more people now in my day-to-day life, and they are more boisterous people.

What good is Risperdal to me?

07/09/13 07:01 [Saturday]
I have thought on and off about making a diary entry (with the intention of uploading it to my blog) and asking myself (in the introspective way natural to me) why I am setting pen to paper (electronically) now, I note that yesterday I converted my Twitterings for August into a form suitable for publication and uploaded the result to my website colinbrough.co.uk.
For several months now I have been waking up early, on and off: in contradistinction to the way things were when I was on the higher dosage of Risperdal through 2011. I was on 37.5mg of Risperdal Consta injection every two weeks from the time I was in hospital early 2011, but from Thursday 03­-Nov-11 it was 25mg every two weeks. The changes I have noticed since coming off the higher dosage - changes which I suspect professionals in the field might deny derived from the drug dosage but would attribute to something within my own nature - have occurred over a period of many months, that is (in fact) over getting on for two years. One of the changes, as I say, is in my sleeping pattern. On the 37.5mg dosage through the summer of 2011, I recall, I was sometimes awake in the night - suffering discomfort in my tummy as often as not - but (having in mind something along the lines that there was no point) I just lay there. This is an example of the effect of dopamine-blockers (which Risperdal is) of reducing the activity level in a manner parallel to the way in depression the activity level is reduced, sometimes to near zero. What I think to myself now in the night when I suffer discomfort in my tummy (or when I wake up for other reasons) is in complete opposition: what I feel now is that it is too boring to lie there so I should get up if there is anything at all I could find to do.
The point I am mainly making, though, is that in this recent period I have been sleeping fewer hours overall and seemingly not suffering any ill effect. In the earlier period I had come off the higher dosage I did wake up early and frequently got up early, but also I went to bed early and if I had not had enough hours of sleep would be tired in the daytime (and would catch up on sleep subsequent nights). I suppose it is still the case that if I get very little sleep I feel tired and catch up as I have just said, but it is also the case that I do not (usually) go to bed so early but still get up early, and get fewer hours of sleep on average while still feeling satisfactorily rested. I put this down to what in my terminology of a few years past I called ‘processing capacity’: that is on the lower dosage of Risperdal I have higher processing capacity and can take in and use more information through the waking hours without the need for such lengthy ‘post-processing’ during dreaming sleep.
I can see that being on the dosage of Risperdal I am on is a help to me, and it interests me to understand - if the lower the dosage of Risperdal the higher the processing capacity - what is wrong with a zero dosage (and I used to be convinced a zero dosage was best, certainly in my own case, and that any dopamine-blocking was negative and a horror). The answer is that with so much dopamine in my head as was in it on a zero dosage of dopamine-blocker, I did do a lot of processing while requiring relatively little sleep, but the fact is I was making mistakes in the processing without in the least suspecting they were mistakes (if I had suspected, then that itself would have elevated the ‘processing requirement’ which I suppose - striving to sort out my suspicions - would have required me to sleep more: indeed would have ensured I slept more, because it would automatically have made me tireder and I would either have slept at night or had to sleep in the daytime). To give a concrete example: when my computer went wrong, instead of understanding the real reason - or guessing and then checking until I found the real reason - I dismissed it with hardly any ‘processing’ as some organisation - ‘the Authorities’ - trying to steal and perhaps succeeding in stealing information from out of the computer, by introducing non-standard software that is some sort of spyware. Looked at from a more global, top-down perspective which I was not capable of in the years before 2011 because of the flood of data from the environment (and from my memories) taking up my processing resources in other ways, it is easy to see that no organisation with such influence and capabilities (able to interfere with the postal system, for one thing) would have any reason to want information from me.
I think I’ve explained that well enough (self-congratulatory preening here: I am lucky to have high natural levels of serotonin so I don’t castigate myself at every opportunity as some with my diagnosis do) and I don’t want to tax readers too much so I will close and defer until another time an exposition more focused on the events in my life the past few weeks.