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Woman Standing on Dock
Woman Standing on Docks

Boundaries, Constraints, Overhead, Achievement and Health

My life has been overwhelmingly dominated by my mental health condition.  It affects *every* conscious thought and feeling.  It affects the pace and organization of my thoughts.  It even affects my physical coordination.  It has bounded and constrained everything I’ve experienced and done.

I think that it’s probably hard for healthy people to understand this, but maybe it shouldn’t be.  They are also bounded by their subjective conscious experience.  They go where their minds take them, partially carried by subconscious brain activity, which influences us much more than most people are aware of, and partially by conscious choice.  But they are constrained by where their minds allow them to go.  They encounter obstacles in much the same way that I do.  We all have free will.  But, free will does have constraints.  We just may not be aware of them consciously.

For the healthy, these constraints are relatively benign boundaries that they encounter at the edges of their experience. They can choose to allow these constraints to limit them or they can choose to challenge them and cross into new territory.  They feel a reasonable and manageable level of anxiety, risk and danger at the boundaries.

I think it’s different for someone like me because the boundaries are higher.  They are more threatening.  Crossing them seems more risky and dangerous.  And, even though I’m fully conscious that these heightened boundaries are the product of an illness, that doesn’t decrease their level of intensity.  In fact, one of the key characteristics of the condition, in my experience, is that emotions are relatively disconnected from intellect.  I can know – with certainty and clarity – that something is not threatening and I can attempt to reason myself through it and it will have no effect on how I feel.

I hope it’s obvious what the potential consequences of this in someones life can be.  Take two people who have the same goals and equal levels of ambition and willingness to take risks.  Now think about the trajectory that their lives might take if their brain delivers to them a conscious experience with differently weighted boundaries.  What is going to happen?  It’s a complex question.  Some people accomplish *more* because they have greater boundaries to overcome.  But at some point, the boundaries can overwhelm anyone’s resources.

Why?  Because achievement requires effort, energy, work.  And, there’s always an element of mental and emotional ‘overhead’.  That’s the part of the effort, energy and work that just goes into managing mental and emotional wear and tear.

What the healthy often don’t realize is that for people like me, the overhead can be much higher.  I mean much, much higher.  I believe it can be orders of magnitude higher.  The ‘overhead’ can exceeds the resources.  I’ve been there for much of my life.  There’s some kind of deeper level of reserves of some kind that you have to tap into in this case, but it too is limited.

So, today I am starting as a volunteer at a Elder Care Facility (Best translation I can come up with for the Dutch Zorghuis voor Ouderen).  For the last couple of years, since my health failed the second time in 2010, my ‘job’ has been getting my mental health condition under control and learning to manage it in a sustainable way.  This the first conventional ‘job’ I’ve attempted since then.

I’m scared.

Should I be?  No.  Probably not.  I’m going to be pushing old people around in wheel chairs, for heaven’s sake.

But, what would I be doing if I didn’t have this illness?  I’m a pretty smart and creative guy.  Even despite the illness, the highest level of professional success, without college, was as an IT Project Manager for biotech company.  I worked my way up from personal computer technician.  Not bad, I think.  But that wasn’t sustainable, unfortunately.

It is partially speculation, but had I not had the illness, I think that I almost certainly would have completed a university education with at least an undergraduate degree, but most likely a graduate degree.  That’s if I dropped out to start a company to build iPads or something . In fact, I had just been accepted into the Electrical Engineering program at the University of Utah when my health failed the first time in 1986.

Someone might ask whether there is value in that kind of speculation.  For me there is, because it gives me some insight into what my theoretical capabilities are and as I look to the future it informs my thinking about what ‘subset’ of what I might have accomplished I might still accomplish.

I don’t seem to ever be able to give up on the future … and maybe that’s part of what’s gotten me through this.  I’m only 55, after all.

But because of the elevated, irrational boundaries created by the illness, even simple tasks – like helping elderly people enjoy some time in the open air are dauntingly difficult.

A lot of living with chronic illness is about realistic, often lower, expectations.  And it’s about values.  Maybe building iPads isn’t so important.  Maybe helping old people is.

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