light-and-dark-blue-in-close-up-of-glacial-ice

The Subtleties of Water: The Ketamine Chronicles (Part 27)

I’m always looking up at the sky when the water closes over me. This time, it was cold, and an eggshell-thin layer of ice formed above me while I watched. Gentle waves followed one another, freezing over the previous layer and leaving a frosty texture on the surface. Darkness spread from the periphery of my vision until I strained to see through the last window of light, the only notable image being the shadow of a person standing above me on the ice.

I didn’t put a lot of effort into remembering this infusion. I know there were graceful, disembodied hands dancing amid blue and red lines, swirls, and dots. There was more water – ripples and waves, mostly. There was a pyramid with a circle above it, which turned into a blinding white light. I’m certain that there was a lot more, but it’s faded away from me by now.

My mental health is declining. I’m not sure why. Ketamine doesn’t seem to be working as well for me, now. Every day, I have to rate my mood on a ten-point scale. It’s hard to capture how I feel in numbers. Potatoes are easier, but still not quite enough. Honestly, sometimes words themselves seem too limited. How can I describe how I feel? This morning, I woke up at 4. I got dressed in the cold – same clothes as yesterday – and went to the kitchen for some food. I walked the dog when the sun came up, but we came home quickly because of the sharp, cold air. My eyes feel heavy. Not the lids – the actual eyeballs; they sit heavy in their sockets, like wet marbles or enormous caviar. I wonder, if I tip my head forward, will they fall out? When my depression is worsening, I often notice this feeling in my face. Everything is heavy and hard to move, and I’m sure my expression is grim. I think the clinical term is RDF – resting depression face. At least my pandemic mask covers most of it.

Maybe the person above me on the ice in my ketamine dream is me. I’m on thin ice. Skating across a just-frozen lake in my wool socks at 4am. Someone else is waiting beneath the surface, straining to see through the darkness. Is she also me?

__________

My recent ketamine infusions have all featured water, and I’m often drowning in it. It’s not scary – it’s peaceful. It’s soothing. I’ve never stayed up by the surface before; always finding myself sinking into the dark, quiet depths. But this time, I was floating – pressed against the underside of the ice, trying to see through it to the person on the other side. I was curious about this person, but the darkness closed in before I could begin to unravel what was happening, and then I found myself in a different scene, which I do not remember.

I’m fascinated by this recurring theme of water, especially because in my regular life, I’m not a big fan of it.

I have sensory processing disorder, and as a young child, I flat-out refused to swim. I was overwhelmed to the point of tears by the splashing, the echoes in the pool, the temperature change from air to water, and most of all, the fear of people touching me. I eventually came around to the idea, but never enough to take lessons. So, having never properly learned how to swim, I nearly drowned at a friend’s birthday party when I was 8. I remember being uncomfortable going into the deep end, but my friend was insistent. I lost my grip on the side of the pool and began to sink. When people say that drowning is not a dramatic event – there’s no splashing or screaming – they’re right. My head tilted back instinctively as I went under, and I could see my hand, extended above me, slip under as well while the rest of my limbs flailed uselessly underwater. A panicked hopelessness overtook me as I choked on chlorinated pool water. Then, my friend’s hand broke the surface, reached down, and grabbed my wrist.

I have never felt relaxed on or in water, and it’s not just the near-drowning that explains it. The same sensitivities that kept me from participating in swimming lessons have persisted into my adulthood. I dislike the unsteadiness of water, the unpredictability of how it will splash, the feeling of water on my face. And yet, when I’m reclined in my doctor’s office, ketamine moving into my bloodstream, visions of water are soothing. I can feel the cool, constant pressure of being underwater without the anxiety or the sensory overload. I can feel myself standing on the deck of a boat, watching the foamy water beneath me leap forward and recede, and I feel peaceful. I’ve seen whirlpools, rivers, melting glaciers, and the unbelievable enormity of oceans. It’s a strange experience to suddenly realize what water might be like for other people, as those feelings are foreign to me in my waking life.

I feel as though, unhampered by the symptoms of my sensory processing disorder, I can connect to a larger, evolutionary interest in water that I am unable to find under normal circumstances. Humans have been fascinated with water for millennia. In fact, some evolutionary anthropologists believe that nearness to water supported the development of large brains – that we are, in part, the heritage of small, coastal communities of early humans whose lives revolved around the movement of water and the food within it. To this day, many island and coastal cultures retain great reverence for the ocean. When we gaze out upon a watery horizon, it is difficult to not be awed by the vastness before us. In my eye, to find our place in relation to bodies of water is akin to our struggle to find our place in the vastness of space. Questions of identity and survival are found in the depths, and I believe we carry the answers within ourselves.

My depression is a constant in my life. It is all-encompassing, lonely, and feels like drowning. I’m not one to find meaning in every dream, but the images of water that I experience during ketamine infusions have begun to feel profound. What does it mean? Certainly not that I should give in, wave a white flag and let the water crush me. Nor should I wait breathlessly under the ice, squinting as if to look through a frosted pane of glass, uncertain if I’m even above or below. Rather, I believe my visions of water are windows into the nature of the human experience. Perhaps they’re snapshots of how I feel – how depression feels to me. My mind is an ocean, and at times, it’s oppressive. I sink within myself, finding it easier to let the water cradle me as I descend than to keep swimming. At other times, I find comfort in accepting the changing nature of my illness. Like a river flowing downhill, impermanence is unstoppable, and the emotions of being a human move inexorably back and forth. When we crest the top of a wave and begin to fall down the other side, we wait for the next one, just as we take each arriving day. And when you are drowning, reach up. A helping hand may be just about to break the surface.

To start at the beginning of my journey with IV Ketamine for treatment-resistant depression, check out Part 1

The Sensory Meditation of Flow

When you’re reading a good book, playing a familiar song on your instrument, doing a word search or a jigsaw puzzle, or any number of absorbing activities, you might be experiencing flow.

A while back, my occupational therapist explained the concept like this:Flow

If the difficulty of whatever you’re doing is too high and you haven’t spent very long doing it (aka: have a low level of skill), you’re likely to be above the “flow” line and feeling stressed.

If the difficulty is low and you just started, you’re probably pretty close to flow from the start. The longer you do it, though, the more skilled you get and the more bored you become.

This is probably pretty intuitive to most people. To stay close to flow, you need to adjust the difficulty level to match your skill. Otherwise, you get either overwhelmed or bored. Everyone has unique sensory needs, so your nervous system might react differently to inputs that create a perfect state of flow for another person. For instance, my ability to follow a cardio dance video is atrocious, but someone with awesome praxis skills might think it’s exactly right for them.

Currently, my favorite leisure activity is embroidery.

embroidery-of-wooden-fence-and-red-poppies

I started out with those pre-packaged kits that have the image inked onto the fabric, like a paint-by-numbers but for stitches. That was great because I didn’t know what I was doing, but as I learned and got more comfortable with it, those kits became a little boring. Now, I make it up as I go, so it takes some focus and creativity but it’s also repetitive and relaxing.

If, like me, you have trouble with sensory discrimination and often don’t know what you’re feeling or what qualities of something you do or don’t like, finding an activity at the right difficulty to produce flow might be tricky. Trial and error is always a good way to approach this. Give the “trial” enough time that you’re able to decide whether you like it or not, and why. When you do find something that gets you to a state of flow, don’t forget to up the difficulty on occasion. The challenge is what makes it interesting!

woman in orange jacket holding flowers in front of face

5 Tips for Therapy Clients Who Hate Talking About Themselves

If you ever feel like a deer in headlights when asked to talk about yourself, I empathize. Whether it’s one of those dreaded get-to-know-you icebreakers or your therapist asking you a question, having to talk about yourself is uncomfortable for many people. By now, I’ve been in mental health treatment for several years, and I have a few tips for therapy I’d like to offer.

When I first sought therapy for myself, I found it extremely difficult to engage with it fully. If you don’t like being the center of attention, beginning therapy can be overwhelming. After all, the entire point of it is to focus on you. Early on, talking about myself in therapy felt, at times, nearly unbearable. Too many questions too fast made me shut down, and too loose of a structure lead to lots of awkward silences, both of us waiting for the other to say something. Over time, however, I’ve gotten much better at it. Here are some of the ways I’ve found to help me feel more comfortable about talking about myself in therapy.

The Essentials

Any list of tips for therapy wouldn’t be complete without a soapbox moment about the therapeutic relationship. It doesn’t matter if you’re just starting therapy or you’ve been in it for a while; it’s vital that you like your therapist. The struggle of talking about yourself will be even worse if you don’t feel understood or accepted in therapy. In fact, research shows that therapy is much more effective when you and your therapist click. Don’t feel bad about shopping around or about switching therapists if it’s just not working out.

Secondly, remember that therapy sessions are for you. Push yourself out of your comfort zone, but go at your own pace. Therapy is your time to do with it what you will.

Communicate What You Want From Sessions

This is a tough one. There’s a lot that falls under this umbrella, but mostly what I mean by it is: tell your therapist if you would like to direct the topic of each session or be given more structure. Maybe it’s hard to talk about yourself because answering questions feels too probative, and you’d rather start off with a narrative. I prefer to have more structured questions because if I’m given free rein, I go blank and have absolutely nothing to say. Regardless of which end of the spectrum you’re on, your therapist is always there to help direct you and keep you on track.

Practice Saying How You Feel

I struggle hardcore with identifying how I feel. Maybe it’s sensory processing disorder, maybe it’s Maybelline. Sensory discrimination issues have extended into the emotional realm and mean that I often don’t know how I feel about something. If you have a hard time verbalizing how you feel, my advice is to practice. It sounds silly, but just as if you were a little kid, practice saying “I feel ____” and then fill in the blank with something more specific than “okay” or “fine”. Even on your own, check in with yourself; am I feeling excited? Lethargic? Irritated? It really does start to feel more natural over time.

Make the Space Comfortable

Of course, it’s not your office. You can’t go swapping out furniture and changing the overhead lights. But you can do some things to make the space more comfortable for you. A therapist I saw in college noticed that I have a very wide bubble of personal space and offered to move her chair a little further away from me. You can ask to close the blinds if it’s too bright for you, bring a small blanket to help you feel cozy, and be sure to wear comfortable clothing.

Stay (Mildly) Busy

Something that I learned in occupational therapy but haven’t put into practice (maybe I should!) is that talking about difficult things is often easier when your hands are busy. Bring a coloring book, a fidget toy, or a craft- if you’re a knitter, crocheter, or have some other portable project. Of course, this is one of my tips for therapy clients that is only good advice as long as your therapist doesn’t need you to be completely present during your work together. It doesn’t hurt to ask.

For us reticent folks, therapy can be scary even just to think about. But, like so many things in life, working on what’s difficult often leads to the best outcomes. With time and practice, talking about yourself in therapy gets easier, especially if you find what will support you and then advocate for yourself.

yearly calendar on table with cup of coffee and dish of paper clips

December Resolutions

The yearly frustration that most of us can likely relate to is that our New Year’s resolutions only last a few weeks, or at best, a few months, and yet we continue to make them. It’s relatable because change is hard, and the excitement of turning over a new leaf soon gives way to the stresses of normal life and the reality of breaking old habits. But there’s something so attractive about starting fresh; new calendar, new me.

Clearly, I like the idea of making a deliberate change on a specific date. Something about marking your resolution with an external, cyclical change makes it feel more decisive. Unfortunately, I am so put off by the pressure of an entire year ahead of my resolutions that I simply don’t make any. I’ve made New Year’s resolutions in the past but petered out before they really formed habits. Then, the internal shame of having failed a New Year’s resolution discourages me from trying again mid-year. Because really, why can’t I just resolve to change whenever I want? Because human brains like to impose order on things like arbitrary laps around the sun.

Instead of griping about the pitfalls of New Year’s resolutions and why I can never seem to make it work for me, I’m going to try something different.

~*~*~*~December Resolutions~*~*~*~

This sounds incredibly silly and I think that it’s a little bit sad that it’s come to this, but I think I need to trick myself into meeting my goals. Instead of making a list of resolutions and waiting until the new year to begin, I’m going to have a trial month for my new habits. December will be my 31-day behavior test, and if I hate the goals/habits I come up with, no big deal. I won’t feel bad about quitting because it’s only my December resolutions, not the monumentally more important New Year’s resolutions.

(Yeah. It’s exactly the same thing, but shhh, don’t tell my brain.)

Bonus, if I do like my resolutions and am happy to keep going with them, I won’t have to face the overwhelm of a brand new year stretching ahead of me. I’ll already have a whole month under my belt.

I really think this is going to work for me, at least better than the usual resolution schedule does. Here’s my list of December resolutions, but remember, it’s low-stress, low-commitment, so these can change without me feeling like a failure. At least, that’s the theory.

  1. ACTUALLY start volunteering. Somewhere. Anywhere. Don’t just think about it.
  2. Keep running regularly (yay, I’ve already started!) See if I can reach a comfortable 5 miles by January. I’m more than halfway there, so this seems very doable.
  3. Reestablish a skincare routine, aka get my psoriasis under👏 control👏.
  4. Welcome the hostile Duolingo owl back into my life and start re-learning German.

These seem reasonable to accomplish within a month. The one that I’m definitely most apprehensive about is volunteering. At this point, I’ve thought about it for so long and looked at opportunities in such detail that I really have to just go and do it, and try not to worry about all of the unknowns (thanks, SPD).

Ok, internet, hold me accountable.

nighttime time lapse of mountain road curving and car lights driving around pine tree

Sensory Processing Disorder and Driving

Ah, driving. The ultimate achievement of teenage freedom (in the US, at least). For anyone learning to drive, teenage or adult, the convenience and independence of a license is powerful motivation. I’ve been driving for years, now, but it wasn’t an easy process to get my license. At the time, I wasn’t as cognizant of my symptoms, but looking back, I can see why I struggled so much with having Sensory Processing Disorder and driving.

Proprioception in Cars

Sensory Processing Disorder (SPD) makes it hard for me to interpret sensory stimuli, including proprioceptive information. Proprioception is the sense that tells you where your body is located in space. I struggle with motion sickness on buses, boats, even escalators, because the movement doesn’t match my brain’s sense of where my body should be. Initially, this made driving a car incredibly stressful; relative to your body, the car is not moving, but relative to the ground, it’s moving a LOT. Coordinating the movements of driving with the interpretation of how the car responds took a while to become natural. Once it did, though, it made my motion sickness in cars much better, as long as I’m the one driving.

Peripersonal Space

When you’re driving a car, your “body” sense expands to include the dimensions of the vehicle. This is called “peripersonal space”- the sense that expands and contracts to include the objects in our immediate surroundings. In The Body Has a Mind of its Own, authors Sandra and Matthew Blakesley explain,

“When you drive a car, your peripersonal space expands to include it, from fender to fender, from fender to door, and from tire to roof. As you enter a parking garage with a low ceiling, you can “feel” the nearness of your car’s roof to the height barrier as if it were your own scalp. This is why you instinctively duck when you pass under the barrier.”

Learning how to manage Sensory Processing Disorder and driving took me a while, in part because it was a challenge for me to get a sense of the dimensions of a car. Now that my brain has established it as effectively a part of my body, driving is much simpler. However, there are additional layers of difficulty that, no matter how much I learn, might always be challenging.

car side mirror with city and other cars in reflection
Photo by Onaivi Dania on Unsplash

Visual Challenges

The visual tasks involved in driving can quickly become overwhelming. Monitoring the movement of cars around you, watching for signals, brake lights, and obstacles in the road is already a lot to handle. Add to that the stress of driving in an unfamiliar area and attempting to read street signs and highway exit signs while managing the rest of your visual tasks, and you have a veritable mountain of sensory stimuli to deal with.

Driving with Dyspraxia

I think that the processing power I dedicate to handling visual stimuli while driving leaves little for planning complex movements, known as praxis. I have symptoms of dyspraxia, meaning I have trouble following sequences of actions and, even more so, planning the steps involved in getting from A to B by myself. If I can prepare ahead of time, I’m fine, but I really struggle to make decisions in the moment because I feel like I can’t process all of the information fast enough to take the right action.

Driving with dyspraxia makes me an anxious planner. If I’m going somewhere new, I study Google Maps obsessively, considering the factors I do or don’t like in each route. Is there a highway involved? Can I take a route with fewer lanes? If I miss a turn, how easy would it be to fix? How early should I leave to account for any mistakes? As I’ve become more comfortable with the other aspects of driving- the sensitivity of the pedals and the steering wheel, the dimensions of the car, predicting what other drivers are going to do- I can dedicate more mental energy to handling praxis. I still plan my routes in new places, but I’m more confident in my ability to get back on track if I get lost.

Sensory Processing Disorder and Driving Takes Practice, Practice, Practice

If you’re struggling with Sensory Processing Disorder and driving, an occupational therapist can help you identify your particular difficulties and come up with ways to make them easier. Whether you work with an occupational therapist or not, the best way to get comfortable with driving is to practice. When you’re overstimulated in the car, the last thing you feel like doing is getting back in the driver’s seat, I know. Trust me, I rolled my eyes so hard at everyone who told me that practicing would make it feel more natural; I felt like I just wasn’t made for driving and no amount of practice would change that. I admit- I was wrong. Practice does help, and I find that now that I’m adept at each aspect of driving and can better regulate my nervous system, my sensitivities probably make me a more mindful, safer driver than I would be otherwise.

portrait view of black dog with pointy ears sleeping on bed with pillows

3 Things My Dog Teaches Me About Listening to My Body

Ever since I welcomed my puppy, Stella, into my life, I’ve noticed some things about how she treats her body. Unlike Stella, I have trouble recognizing what my body needs; Sensory Processing Disorder can make it hard to discriminate one feeling from another, and to identify what actions would fix an uncomfortable sensation. My dog, however, is especially in tune with her body. Sometimes I marvel at how good she is at giving herself what she needs. In honor of that, here are three things I’ve learned from Stella about listening to my body.

Test Your Surroundings

Stella has no qualms about finding a new place to hang out, no worries about offending others by moving. She goes from place to place as she wants. If the bed becomes too hot or too soft, she switches to the floor. If she feels too exposed around loud noises, she finds somewhere sheltered to lay.

The number of times I’ve kept myself from moving or adjusting my surroundings because I might stand out is too many to count. The little things can make a big difference in how you see your environment and how you feel in your body. Small adjustments help us regulate our nervous systems– a cold drink can wake you up while a warm one can calm you. Do you like your feet to feel secure, or do you prefer the freedom of open-toed shoes? Break up the monotony of your schedule by riding your bike to school or work every once in a while. I work on the computer a lot, and when my slouch has reached extreme levels, I know it’s time to get up and stretch. Take a page from Stella’s book, and feel free to get comfortable in your environment.

Express Your Emotions

Dogs don’t lie about how they feel; if you know how to read their body language, it’s easy to tell when they’re feeling happy, anxious, confident, or any other reaction to outside stimuli. There’s a certain amount of uncomfortable stimuli that we all must face every day. Maybe you hate the feeling of brushing your teeth, yet you do it because it’s important for your health. Maybe you’re sensitive to temperatures and dislike walking to work in the heat, but have limited transportation options. There are times that we have to prepare ourselves for and recover from unpleasant feelings that are unavoidable. There are also times when we suppress our instincts because we think we “should” be able to handle something. If there’s a way that you or someone else can adjust your surroundings to make you more comfortable, speak up!

Look for Joy

Stella loves a lot of things; she loves barking at rabbits, playing in sprinklers, and rolling in the grass. The things that she enjoys the most are the ones that require spontaneity. She approaches every dog she meets with a play bow; there’s no time like the present to make a new friend. She lives entirely in the moment, and whatever feels right to her is what she does– (sometimes to my immense frustration).

Look for joy in the little things. Find ways to have fun with boring activities. When no input is exciting or fun, we become understimulated and listless. So, jump in those puddles, paint with your fingers, and put your waste paper basket far away so you have to toss things from your desk. I don’t know, whatever brings you joy.

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Traveling with Sensory Processing Disorder

I’ve been traveling a lot lately, and I’m worn out. While waiting to board my latest flight home, I pretty much sat at the gate in a sensory stupor while the gate agents droned on the speaker about checking your carry-on bag. Because I have Sensory Processing Disorder, I needed an afternoon (or more) to reset my nervous system and return to the real world as a functioning human being. Unfortunately, airports have very few places in which to hide from the noise, movement, and general chaos of airport activity. (But for help finding those rare spots, check out sleepinginairports.net)

And, it’s not just the crowds of people that are overwhelming- it’s also the tasks you have to do in order to get onto your flight. Standing in lines is okay for me; it’s ordered, it’s neat, and the most difficult part for me is identifying which kiosk just opened up (might take me a little longer, but I’ll get it eventually). Security is a mess. People crossing from the main line to a security line across the room, the choices involved in preparing your things to go through the imaging machine (should I take off my shoes first? What about my belt?), and then all of a sudden the line has moved ahead and I’m the dam holding back a flood of grumpy people trying to catch their flights. At least, that’s what I always worry will happen. In reality, it usually goes more smoothly than I expect, and I imagine we look more like ants, focused on our own tasks with occasional hiccups but somehow hurrying around one another to reach our destinations without incident.

Airports are visually busy, and with loudspeaker announcements, children crying, businessmen talking shop on their cell phones; it’s a barrage of auditory assaults for people with sensitive nervous systems. Not to mention the vestibular hurdles- the moving walkways clogged with people, the escalator that somehow jostles you up and down while also transporting you diagonally to the next floor. Too much of this, and I begin to get vertigo, letting me know that I’m nearing my limit.

My Tips for Traveling with Sensory Processing Disorder

Airports are challenging places to navigate for people with Sensory Processing Disorder. Luckily, there are strategies you can use to make your airport experience less stressful.

  • Get organized the night before to set yourself up for success
  • Bring things that ground you- mints, strong smells, weighted lap pad
  • Give yourself time to recover after your flight
  • Be patient with yourself and others. There are a lot of moving parts in air travel, and getting frustrated often doesn’t accomplish anything
  • Take care of the needs you can control- food, water, wear layers, bring headphones
time lapse photo of blue and red lights moving erratically

Science Saturday: Sensory Processing Disorder

Today’s topic is Sensory Processing Disorder. I didn’t have a specific question to answer, so I decided to make this post an overview of our current understanding of SPD. As with all of these posts (so far), it’s important to know that I’m affected by the topic at hand. I’ll do my best to remain objective, but I do have some biases when it comes to SPD.

Sensory Processing Disorder as a Diagnosis

SPD was first described as a construct by Ayres in 1964. At that time, it was known as Sensory Integration Dysfunction. Now, SPD has several subtypes, including Sensory Modulation Disorder.

Sensory Modulation Disorder

Three main categories compose SMD: sensory overresponsivity, underresponsivity, and sensory seeking. Sensory Over-Responsivity (SOR)  can be defined as:

…exaggerated responses to one or more types of sensory stimuli not perceived as threatening, harmful, or noxious by children and adults who are typically developing.

Analysis by different authors of data from a 2004 study that investigated the prevalence of SPD among kindergarten children in a Colorado school district found the prevalence of sensory over-responsivity to be between 2.8 and 6.4%.

Experiencing Sensory Under-Responsivity (SUR) might look like:

…quiet and passive, appearing to disregard stimulation by not responding…[they may have] inadequate body awareness, poor endurance, and movements that are not appropriately graded.

And lastly, sensory seeking, or Sensory Craving (SC), is “…craving sensory stimulation and appearing to be obsessed with obtaining additional sensory input.”

SBMD and SDD

The other two subtypes of SPD are Sensory-Based Motor Disorder, which includes dyspraxia and postural disorder, and Sensory Discrimination Disorder, which can affect one or more sensory systems. A diagnosis of Sensory Processing Disorder can include symptoms in each of the subtypes; in fact, it’s often a mishmash of seemingly contradictory symptoms that fit into different types.

SPD and its subtypes are included in the 2005 version of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R). However, it’s not included as its own disorder in the Diagnostic and Statistical Manual (DSM), which only perpetuates the idea that SPD symptoms are just behavioral and temperamental issues, rather than a real, neurological diagnosis.

Neurological and Physiological Research

Fortunately, there is evidence supporting SPD as a valid diagnosis. A 2013 study compared the brains of boys with and without SPD (sample size of 40) using diffusion tensor imaging. Significant differences in white matter microstructure were found in the posterior corpus callosum, corona radiata, and thalamic regions. This study used the cardiac vagal tone index to measure the physiologic reactivity of 15 children. The results were significant and showed that the kids with SPD had less effective vagal tone than kids without SPD. This indicates that people with Sensory Processing Disorder may have impaired parasympathetic functioning. I have no reason to doubt this result, I just wish the sample size were larger.

Not Significant?

I wanted to include this study, and as I read through it, I reached the part where they break it to you that the results were not statistically significant. Darn! (Remember when I said I was biased?) In any case, it’s still interesting, and this is part of what science is about; you can still learn something from insignificant results.

An EEG study with a sample size of 53 tested kids’ brain waves by introducing a “conditioning” stimulus followed by a “test” stimulus. The idea is that your brain becomes accustomed to stimuli that it deems safe, so the test stimulus elicits a smaller reaction than the conditioning stimulus. This is called sensory gating. As a group, the kids with sensory processing disorder showed less sensory gating than the comparison group (p= 0.04), but it wasn’t statistically significant when an adjusted alpha level was used. If the results are robust enough, it indicates that people with SPD don’t get conditioned by stimuli like people without SPD. Every instance of a startling stimulus produces the same reaction as the first one did.

Sensory Processing Disorder and Autism

The vast majority of people with Autism Spectrum Disorder (ASD) also have sensory challenges. Yet, not everyone with SPD also has ASD. Research is beginning to tease apart where the overlaps lie. Using the same imaging technique as in the study above, researchers found differences between the white matter in boys with autism and the white matter in boys with SPD alone. Compared to a control, both groups’ white matter differences overlapped in tracts thought to contribute to sensory processing. However, the boys with ASD had additional white matter differences in tracts linked to social processing. Other research suggests that assessing cognitive styles may be a good way to differentiate between Sensory Processing Disorder and Autism Spectrum Disorder.

Sensory Processing Disorder and Mental Health

If you’ve been keeping up with my blog (if not, welcome), you know that I have sensory processing disorder and depression. I stumbled upon a couple of studies that show correlations between sensory dysfunction and mental disorders. This one, for example, shows that both under-responsiveness and over-responsiveness correlate with depression and impulsivity. Another one suggests that under and over-responsiveness may be “trait” markers for people with major affective disorders. That last one seems like a stretch to me, but my own perception of those studies is that a.) perhaps there’s some neurological connection between the white matter changes of SPD and mental illnesses, and/or b.) it’s tough to live with SPD, leading many with the disorder to develop secondary disorders.

This is a complex topic, and I’d love to hear your thoughts. Let me know what you think in the comments.

prickly-pears-in-rocky-mountains

Why I Love Hiking: a Sensory Photo Narrative

Mud squelches underneath my boots, and I reach out with my fingers to balance myself against a tree. I can feel the pack on my shoulders, hear birds chirping, and smell the sharp scent of pine needles.

I love hiking both because I love nature and because it fulfills nearly all of my sensory requirements. I can go at my own pace and under the power of my own body; only the weather and the wildlife are out of my control. When the world around you is overwhelming and hard to understand, it’s nice to put on a backpack with everything you’ll need for the day and let your legs carry you just as far as you want to go. Along the way, every element of a hike serves as a sensory “snack”. The vestibular input of balancing on rocks as I cross a stream. The feeling of my arms swinging at my sides as I get into a rhythm. The soft, spongy moss that I pause to touch with my fingertips.

close-up-of-green-moss-on-multi-colored-rock

piece-of-quartz-on-rock-with-dried-moss

 

 

I don’t like the dried moss surrounding it, but I notice a smooth piece of quartz that draws my eye.

 

muddy-hiking-boots-on-feet-of-hiker-sitting-on-large-rock

 

 

Later, we stop for lunch and I study the rust-colored mud on my boots.

 

 

 

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My pack feels secure; it’s a comforting weight. We get up to investigate the surrounding plants, and I look back at our lunch spot. It’s breathtaking in the sunlight.

 

 

 

 

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I hear my dog lapping up some water from her bowl, and I take a moment to appreciate her presence.

 

 

 

 

 

We find some prickly pears and admire their toughness. Centers chewed through, their spiny armor breached, they continue to survive. We don’t touch them; we just look at the color and shape of them.

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Across the path, a Ponderosa pine stands tall and broad. This one isn’t in the sun, but I gently scratch the bark and lean in to smell it. Warm Ponderosa pine bark smells like vanilla, and it’s one of my favorite parts of hiking. This one offers a very faint fragrance. It smells like vanilla and fresh cookies and hiking and happiness.

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After lunch, we decide that it’s time to head back. Back through the forest, back through the mud, back through the tall grass at the base of the mountain. When we get home, I settle on the lawn with my dog, our muscles tired but happy, and our senses satisfied. Time for a well-deserved nap.

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College and SPD: Dealing with Overwhelm

In my last “College and SPD” post, I talked about what I wish I had known about living with Sensory Processing Disorder while in college. This time, I’m going to share what I learned about self-regulation throughout my four years at a large university.

First, a Story

Let me set the scene: I was a sophomore, sitting in the largest lecture hall in the Chemistry Building at my university. The class was Organic Chemistry, and the year was 2015. It was the height of popularity for Bruno Mars’s song, “Uptown Funk”, and nobody was safe from its groovy, brass beat. My 200-some classmates and I were sitting there, trying to draw the chair conformation of alpha glucose with the same finesse as Professor N., when from the back of the hall came the sharp staccato of percussion instruments. If I could describe the look of pure bewilderment on Prof. N.’s face as a group known for interrupting lectures launched into a truly impressive rendition of “Uptown Funk”, I would. But it escapes description. As for the song: it was loud, it was exhilarating, and it left the class reeling for the remaining 30 minutes. Prof. N. was commendably patient and picked up her lecture where she left off, but my peers were distracted and buzzing with excitement.

The spike of adrenaline that I get from the sound of a dropped saucepan or a vacuum being turned on is just like the feeling of having your train of thought derailed by six thespians with trumpets, a bass, and some killer vocal cords. That day in Organic Chemistry was one of the few times I haven’t felt alone in my sensitivity. It was so jarring that you couldn’t help but react, and I wasn’t the only one!

There’s Always Something

Musical interruptions are not commonplace, at least not at my alma mater. There are, however, plenty of stimuli to put you on edge.

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Why do you have to scream? Also, how is this legal?

From the hordes of students clogging the walkways to the documentary clips played at full volume during your history class, to the inebriated bachelorette party on that weird bicycle/drinking bus that passes under your window at midnight.

I quickly found that I needed more time to recharge than I did before college. I also found that it was more difficult to find time to do so. I was swamped with assignments, study groups, and exam prep, and feeling the pressure of those expectations that I should live it up.

I Did Not “Live it Up”

My sophomore-year roommate and I went to one (1) party and spent the entire time shouting over the music to help a drunk student whose friends had lost track of her. For a while, I thought there must be something that I was missing out on. Why would so many people enthusiastically subject themselves to that? The answer is that my threshold for intense stimuli is probably much, much lower than that of someone who loves to party. Parties are loud, crowded, and messy; all things that raise my nervous system’s arousal past where it’s comfortable. While a little bit is enough to overwhelm me, it’s perfect for someone who craves that kind of input. Eventually, I accepted that the party scene just isn’t my thing, and I was much happier for it.

Find What’s Soothing

While you can simply choose not to go to parties, there are some aspects of college life that are unavoidably draining. For the general stress of being a college student, I found that establishing a routine was immensely helpful. Breakfast is my favorite meal and probably my favorite time of the day. I’d wake up at the same time, head down to the dining hall with my own mug, get some coffee and food, and start my day off right (read: predictably).

Having my own space set up the way I liked it was also helpful. Many people don’t have the option of living alone in college, but even when I had roommates, I tried to make my desk and bed into little sanctuaries where I could shelter and recharge. My weighted blanket is wonderful, and I learned to never underestimate the power of changing into pajamas.

When my insomnia was at its worst, it took me two hours to fall asleep at night. I just couldn’t settle down; I’d consciously relax my body, and then ten minutes later, realize it was tense again. All the while, my mind was running through deadlines and anxieties. Taking some time in between schoolwork and bed to do something soothing helped my insomnia. I brought my favorite poetry and fiction books from home so that I could read something enjoyable but not too exciting. I also did mental word games to keep my mind occupied until I could fall asleep.

I would have done some things differently if I’d known more about SPD, but I still found ways to cope. Looking back, I suppose that means that I shouldn’t discount my intuition. Listening to it and not judging it is the hard part.