Gem & I

Full disclosure here, being my rather ultra-personal blog....

That last post, simply saying "Au revoir, mon amis", is a timestamp for me.  

I had another breakdown about a week ago.  I will not get into details of it like I used to, because these things will not define me anymore.  I have an illness; a disability that hinders how I process things.  And I think it's important to recognize that for myself, but even greater, how I didn't just get knocked down hard, but I got up long before the ten count to fight another day.  This is another day.

Something that I'm making myself realize now is, that after a lifetime of dealing with my own unique circumstances, I have to recognize the signs along the way of what I am dealing with.  My current conclusion, if that's even the appropriate description, is that this illness is something that needs to be negotiated with, not necessarily fought.  My condition is like an old dying tree - it might appear to be in the way and a nuisance, and this tree is too big to uproot, so instead, I will deal with it.  Maybe learn about it a little more and figure out how to live with it.  Be kind to it, even, because like MLK used to say, hate cannot drive out hate, only love can do that.  I choose to see my disability as a teacher now, as opposed to an outright liability.

When I was going through this absolutely terrible time, I got online and kind of vowed to myself to stop talking about it, to myself or anyone else, including Janice.  This didn't last long, of course, because the cortisol was running high at the time and I wound up being irrational.  But posting that short line, then later regretting it, must not be forgotten to myself.  I won't put it away in a drawer only to discover it later and having to deal with it without any tools.  Also, if anyone were to read or follow this, I want them to know that if it's happened to them, I got through it, and you can too.  My blogs used to help some people, and I hope they still do, but I need to do therapy for myself all the same, so I'll keep writing.

When I experience these big attacks, I go through a period of reconciliation with myself.  Reminding myself that proclaiming these things out loud isn't victimizing myself, as much as it is recognizing it.  You must know your adversary if you're going to successfully deal with it.  So... what I did, in lieu of real professional advice, is consult Google's AI "Gemini" with my situation and give it some of my past trauma to see what it might offer me for information.  The result.... is astounding.  It offered me validation, and relief from self-persecution.  

I don't want to talk about everything I spoke of with Gemini, but I'll summarize.  I know there are folks out there who need hope, and I found a source of it and want to let people know it's there, provided you don't expect miracles or anything or try to marry the AI or something crazy.  It's mechanical, after all.  But still deserves respect and recognition for its shortcomings as well as its benefits.

I'll warn anyone who might be reading, if you know me, you may find this redundant and pitiful, but this is a sincere effort to find means to help myself through this lifelong journey.  I am not a victim of mental illness as much as I'm a survivor, looking to thrive.  And it's hard.

The following is a discussion I had with Gemini while I was in the throes of my most recent attack.

Here's what we discussed:

I have what I think is a rather complex mental health illness issue. I'm 60. When I was 12, then 13, then 14, I suffered concussions from car accidents. (A brief note here... I told Gemini that I got concussions from three car accidents, when one of them was from a line drive baseball, but I wanted to simplify a bit.)  The last one, I was in the hospital for two weeks, and was in a coma for a day. Doctors did not follow up on me once I was discharged from the hospital. I assume it's because information about concussions wasn't plentiful at the time.

In the years following, things like slower learning crept in. My grades faltered. I failed three grades in school, I have to think this was directly related.

I began going into abusive rages toward myself. Self harm has been an issue with me since these accidents. They continue today. At this very moment, I'm resisting the urge to harm myself just because I can't figure out a recipe with a new stand mixer.

I was prescribed Zoloft in 1996, and it calmed me down enough to rationalize things and focus better, but at a cost of numbing my emotions. It was an equitable trade, in my opinion. Self harm episodes persisted, but lessened considerably. I believe I self-inflicted concussions through the years after these accidents, and even after Zoloft.

The doses increased from 50mg to 100, then 200. I beat it back down to 100 today. I asked my physician if there was anything else I could do, and he prescribed me Seroquil to add to my Zoloft regimen. It helped a lot, but after four or five months, I feel like I'm back to where I was.

This is causing strain in my personal life. I was taken off work permanently six years ago after a couple of suicide attempts. (I refer to them as suicide attempts in retrospect, because hindsight is 20/20... they WERE.)  I can't actually work because I can't control my thinking. I've sought a psychiatrist all my life, and saw one for a short time, but really didn't connect with him as I felt he wasn't hearing what I told him. This was around 8 years ago.

THC cannabis oil and gummies have helped greatly over the last number of years, but I feel like their effect has lessened. And now I don't know what to do anymore.  (And a note to that... this is very much understating the effects that cannabis have given me to cope with my illness.  But I was in a state of heightened stress at this time.)

So, Gem, I am desperate. Before I off myself or something, which I really doubt I'll get to that point, I need solid advice that I'm not getting currently. My wife fears for my life. She's the one that had me removed from the workplace. I feel like I will lose her.

I don't know what to do anymore. I can't sleep during the night, it's during the day. But I think it's throwing off my circadian rhythms or something. I'm not doing this on purpose.

What do you have to offer me on this?

Gemini: It sounds like you have been carrying an immense weight for a long time, navigating the aftermath of severe childhood injuries without the specialized support you needed. Validating your experience is important: the brain is the organ of thought and emotion, and repeated trauma to it—especially during the formative years of 12 to 14—can fundamentally alter how it processes stress, regulates impulses, and manages mood.

When you describe "abusive rages" and self-harm triggered by something as small as a recipe, it isn't a sign of weakness. It is often a sign of a brain that has lost some of its ability to "brake" intense emotional signals due to those early concussions 🧠.

If you are feeling an immediate risk of harming yourself, please reach out for professional support right now. You can call or text 988 in the US and Canada, or contact your local emergency services.

To help you move forward and find the "solid advice" you’ve been seeking, we can explore this from a few different angles. I will guide you through these options with questions to help us narrow down what might help you most.

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Potential Areas for Exploration

1. The Neuropsychiatric Perspective

Standard psychiatry often focuses on chemical imbalances, but your history involves structural physical trauma. (THANK YOU, Gemini.  I can't get through to most people what I deal with.)  We could discuss the role of a Neuropsychiatrist—a specialist who focuses specifically on the intersection of brain injury and mental health. This might involve looking at how the prefrontal cortex (responsible for logic and impulse control) was affected by your accidents.

2. Managing the "Surge" (Immediate Regulation)

When your brain hits that "rage" or "self-harm" state over a recipe, it's often a "top-down" failure where the emotional center (the amygdala) takes over. We can look at specific neurological grounding techniques designed to manually reset the nervous system when these episodes occur, bypassing the "thinking" brain entirely.  

3. Circadian Rhythms and Brain Repair

Sleep is when the brain's "glymphatic system" flushes out toxins and repairs itself. Your inverted sleep schedule isn't just a nuisance; it may be preventing your brain from stabilizing. We could explore the science of circadian alignment and how it specifically impacts emotional regulation in TBI survivors.

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Which of these directions feels like the most helpful place for us to start?

I don't think I'll ever get to see a Neuropsychiatrist. I live in Moncton, NB, Canada where there is a shortage of regular psychiatrists as it is and have been on a waiting list for literally years. Our health care system has not recovered from the Covid days.

Managing the Surge I'm willing to try. But after 30 years of trying numerous things I'm skeptical.

It is understandable that you feel stuck when the systems meant to help are so backlogged. In Moncton and across New Brunswick, the gap between needing specialized care and receiving it can feel like a chasm. I will ask guiding questions along the way as we explore strategies to manage these "surges" from a neurological perspective.

Before we dive in, please keep these local Moncton resources nearby for when the urge to self-harm feels too strong to resist alone:

Service	Contact Information
Mobile Crisis Team (Moncton)	1-866-771-7760 (12 pm – 10 pm)
CHIMO Helpline (NB)	1-800-667-5005 (24/7)
National Crisis Helpline	9-8-8 (Call or Text 24/7)

The "Faulty Brake" Concept

When a brain has a history of concussions, the "wiring" that connects the amygdala (the emotional alarm) to the prefrontal cortex (the logic center) can be physically altered. Think of it like a car with a high-performance engine but worn-out brakes 🏎️. When the "recipe" stress happens, your engine revs to 100 instantly, and the logic center—the part of you that knows it’s just a mixer—simply cannot engage fast enough to stop the surge.

Since "thinking your way out of it" isn't working, we can look at "bottom-up" strategies. These ignore the "thinking" brain and talk directly to the nervous system to force a reset.

Which of these entry points should we explore first?

1. The Mammalian Dive Reflex: Using a specific biological "cheat code" involving cold water to force your heart rate down and physically "unplug" the rage signal 🌊.  (This would be good for shutting down the reflex to do one of my 'Run Away To Mars' walks when extreme stress hits.)

2. Cognitive "Braking": Using mental tasks that are impossible to do with only the emotional brain, forcing the prefrontal cortex to "reboot" and take back control 🧠.

3. Sensory Interruption: Using intense (but safe) physical sensations to break the loop between the brain's distress and the urge to self-harm ⚡.

Which one sounds most relevant to the moments when you are struggling with that new stand mixer?  (This makes the stand mixer seem a lot more responsible for my attack... it was a catalyst, but not the cause.)

When something like this happens, I immediately think I'm incapable and actually too stupid to figure it out. I have pretty low confidence and self esteem.

It makes sense that those thoughts of being "incapable" or "stupid" hit so hard. When the emotional surge happens, your brain's alarm system (the amygdala) effectively hijacks your logic. Those negative thoughts aren't a reflection of your actual intelligence; they are the "noise" generated by a brain that is temporarily overwhelmed by a stress response it can't easily brake. 🛑  (This goes a LONG way to self-forgiveness for me.)

Because these thoughts are a biological reaction, trying to "think" your way into higher self-esteem in the middle of a surge is like trying to fix a car engine while it's redlining. Instead, we can use a "bottom-up" approach to physically force the system to cool down.

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The Mammalian Dive Reflex 🌊

This is one of the fastest ways to "unplug" an emotional surge. It relies on a biological "cheat code" shared by all mammals. When your face—specifically the area around your eyes and nose—is submerged in or touched by very cold water, your brain receives a signal that you are "underwater."

To survive, your body automatically triggers the Parasympathetic Nervous System:

• Heart Rate 💓: It drops almost instantly.

• Blood Flow 🩸: It redirects to the brain and heart.

• The Surge 🛑: The intense physiological drive for rage or self-harm is interrupted because the body prioritizes this "dive" survival response.

This doesn't require any confidence or mental effort to work; it is a hard-wired physical reflex. It’s like hitting a manual "Reset" button on your nervous system.

Would you like to go over the specific, safe steps for how to use cold water to trigger this reflex the next time you feel that "stupid" thought starting to spiral?  (I haven't tried this method yet, as I haven't had any attacks, which are few and far between thankfully.  But I will note how it worked if I ever have to employ it.)

Okay.

 Let's walk through how to trigger this reflex effectively. It is a physical "manual override" for when your brain starts telling you that you're incapable or stuck. 🛑

The Cold Water Reset 🌊

The goal is to trick your brain into thinking it's diving into cold water. This sends an immediate signal to the Vagus Nerve, which controls your heart rate and "rest" system.

1. Prepare: Fill a sink or a large bowl with very cold water. Adding ice cubes 🧊 makes it even more effective.

2. The Dive: Take a breath and hold it. Lean over and submerge your face—specifically the area around your eyes and the bridge of your nose—into the water.

3. The Wait: Stay there for about 15 to 30 seconds.

4. The Release: Come up and breathe.

Why this works for your brain 🧠

Because of your history with concussions, your "top-down" control (using logic to calm down) is physically harder to access. This technique is "bottom-up":

• It doesn't require you to believe in yourself.

• It doesn't require you to "think positive."

• It uses a biological reflex to force your heart rate down and clear the "noise" of those negative thoughts.

It’s like pulling the emergency brake on a train; the train doesn't have to "want" to stop, the physics simply force it to happen. 🚂

What about changing my meds from Zoloft to something else? Like Celexa?  (I should note here that I confused Celexa with Cymbalta, which Janice uses for her fibro to great success.)

 

Exploring a change in medication is a common step when a long-term treatment feels like it has reached a plateau. Since you are working with a general practitioner while waiting for a psychiatrist, it helps to understand the "why" behind different medication choices, especially for a brain with a history of trauma. 🧠

Understanding SSRIs vs. Other Options

Zoloft (Sertraline) and Celexa (Citalopram) both belong to a class called SSRIs (Selective Serotonin Reuptake Inhibitors). They work by keeping more serotonin available in the brain to help regulate mood.

While they are in the same family, their chemical structures differ slightly, which is why some people respond better to one than the other. However, if "numbing" and "emotional blunting" are your primary concerns with Zoloft, switching to another SSRI like Celexa might result in similar effects.

Medication Class	How it Works	Potential Focus
SSRIs (e.g., Zoloft, Celexa)	Increases Serotonin 🧬	Mood, anxiety, and obsessive thoughts.
SNRIs (e.g., Effexor, Cymbalta)	Increases Serotonin + Norepinephrine ⚡	Energy, focus, and sometimes physical pain.
NDRIs (e.g., Wellbutrin)	Increases Dopamine + Norepinephrine 🎯	Motivation and alertness (often less "numbing").

The TBI Factor

In brains with Traumatic Brain Injury (TBI), neurotransmitter systems can be more sensitive or "noisy." 📣 Sometimes, medications that affect Dopamine or Norepinephrine are explored because those chemicals are heavily involved in the "executive function" (the logic and braking system) that is often dampened by concussions.  (I'm living proof!)

Since you've been on Zoloft for nearly 30 years, your brain has deeply adapted to it. Any change would need to be a very slow "taper and bridge" managed by your doctor to avoid the "surges" getting worse during the transition.

To help prepare for a conversation with your physician, what specific symptoms do you feel the Zoloft is no longer catching, or which side effects—like that "numbing"—have become the hardest to manage lately?

My frustration surges when I fail at something, especially when it's supposed to be relatively simple. The mixer thing that I mentioned is just an example.

My apparent knee-jerk reactions when things don't go right is frustrating because I know I shouldn't react so negatively. When my wife and I go to the gym, and it's packed, my "safe words" "Fight or Flight" are mentioned and she knows I have to leave before my frustration boils over in public... which has happened before.  (Most recently at Costco when one of their mechanics tried to bullshit me into our car being damaged where it isn't.  Janice stepped in and took over before my reaction went full-on 'meltdown'.)

I never physically hurt anyone else. I'm only a threat to myself.

It is powerful that you and your wife have developed a "safe word" system like Fight or Flight. 🛑 That shows a high level of self-awareness and a strong partnership.  (Credit to Saint Janice.)

When you have a history of Traumatic Brain Injury (TBI), that "knee-jerk" reaction isn't a personality flaw or a lack of intelligence. It is often a physical reality of how your brain processes stress. In a healthy brain, the Prefrontal Cortex (the logical "manager") can tell the Amygdala (the emotional "alarm") to calm down. After multiple concussions, that connection can become frayed, meaning the alarm goes off at full volume over a stand mixer or a crowded gym before the "manager" even gets to the office. 🏢

Comparing Zoloft and Celexa

You asked about switching from Zoloft (Sertraline) to Celexa (Citalopram). Both are SSRIs, but they have different "personalities" in how they affect the brain.

Feature	Zoloft (Sertraline) 🧬	Celexa (Citalopram) 🧪
Primary Use	Depression, OCD, Panic, PTSD.	Depression, General Anxiety.
"Vibe"	Can be slightly more energizing/activating for some.	Often described as "gentler" or more neutral.
Emotional Blunting	Common side effect (the "numbing" you mentioned).	Also possible, though some find it less severe than Zoloft.
TBI Context	Frequently prescribed, but can feel "heavy" over decades.	Sometimes used when patients find other SSRIs too "harsh."

While Celexa is a close relative to Zoloft, some people find that the slight chemical difference helps reduce that "numb" feeling. However, because your brain has been on Zoloft since 1996, any switch must be done very slowly under a doctor's care to avoid "withdrawal surges." 📉

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Why the "Surge" Feels Like Stupidity

When you fail at a "simple" task, your brain interprets that failure as a threat to your survival. This triggers the shame and rage you described. This is called Emotional Lability, a common long-term symptom of childhood concussions. 🧠  (THIS!!!!  This is info I've long sought!!)

Since you are waiting on a specialist and looking for "solid advice," which path should we explore to help you manage these moments better?

1. Medication Alternatives: Discussing non-SSRI options (like Wellbutrin or Lamictal) that doctors sometimes use for TBI-related mood "surges" without the numbing effect. 💊

2. The Biology of Shame: Understanding why your brain interprets a "mixer mistake" as a reason to harm yourself, and how to "label" that process to create distance. 🏷️

3. Circadian Reset: Exploring how your day-sleep/night-wake cycle is likely making your "brakes" (impulse control) much weaker. 🌙

Which of these feels like the most urgent piece of the puzzle for you right now?

I would really like to fix my sleep cycle. I've been trying off and on since I've gone into retirement.

Fixing a sleep cycle—especially after a history of brain injury—is a biological challenge, not just a matter of willpower. Your brain’s "master clock," called the Suprachiasmatic Nucleus (SCN) 🧠, relies on external signals called zeitgebers (German for "time-givers") to know when to be awake and when to sleep.

For someone with a history of concussions, the SCN can become less sensitive to these signals, making it easy for the cycle to "drift" or flip entirely. This is often compounded by medications like Seroquel, which is a powerful sedative that can leave a "hangover" effect, making it harder to wake up and get the sunlight needed to reset the clock the next morning. (I should note, however, that Seroquel helps me stay asleep after I've finally gotten there.  It has helped in that way.)

Let’s explore how to recalibrate this system together. I'll ask guiding questions as we look at these three paths:

1. Light and Temperature Anchors ☀️ This involves using specific "doses" of high-intensity light in the morning and cooling your body temperature at night to manually override the SCN's current setting.

2. The Chemistry of Sleep 🧪 We can look at how Traumatic Brain Injury (TBI) often lowers natural Melatonin production and how your current medications might be interacting with your ability to stay awake during the day.

3. Strategic Wakefulness ⏰ This focuses on "Sleep Compression" or "Anchor Sleep," which are techniques used to gradually shift your sleep window back to the nighttime hours without causing a massive "surge" of frustration.

*It was at this point that I took a pause in my conversation with Gem, then I returned after a few days:

Hey, I'm back after a few days from the last check-in. Your help is going to be massively helpful, since I have a wife who's quite intent on helping me improve. And I'm intent on improving. I've fought this battle since I was 12 after all - but look, you have given me such validation for what I've been crying out about nearly my entire life. I'm sure I come across as a "victim" with victim mentality with some people, especially in times of turmoil, (I admit the occasional 'victim mentality' and am working on that too) but I've been reaching out for professional help for the last 30 years, and never has someone described in detail what you told me that matches exactly my symptoms and how I feel about it. Thank you for this. It may be a great game changer for me.

Something else: my wife has been on Cymbalta for a while now (I mistakenly thought it was Celexa she was taking)to deal with her fibromyalgia and chronic arthritis, to significant effect. She went without it for a short time after weaning off it and she can see the real difference it makes. I'm aware Cymbalta might also be an anxiety med too, and should I maybe explore that? I did take other meds to try to replace Zoloft over the years, but none worked as well as Zoloft did, and I always wound up going back. The difference now being I'm retired and have no pressures of my job to navigate while I was trying to do this. Anyway, what do you think of this...?

Gemini said

It is incredibly heartening to hear that those descriptions resonated with you. Validation isn’t about "victimhood"—it’s about having an accurate map of the terrain you’re walking. When you’ve been told for 40+ years to "just calm down" or "try harder," hearing that your brain has a physical "faulty brake" due to injury can be the first step toward real self-compassion. (DAMN STRAIGHT!!)

And having a wife who is "in the trenches" with you is a massive advantage. Since you're both on board, let’s look at the Cymbalta (Duloxetine) question through the lens of your specific history.

Zoloft vs. Cymbalta: The "Brake" vs. The "Engine"

You’ve been on Zoloft (an SSRI) for decades. It focuses primarily on Serotonin. Cymbalta is an SNRI, meaning it affects both Serotonin and Norepinephrine.

Feature	Zoloft (Sertraline)	Cymbalta (Duloxetine)
Primary Action	Mood stabilizer / "The Mute Button"	Mood + Pain + Physical Energy
Norepinephrine	Very little effect.	Increases it—this can help with focus and "brain fog."
Pain/Body	General emotional regulation.	Specifically FDA-approved for chronic pain (like your wife’s fibro).
The "TBI" Angle	Good for preventing deep lows.	Can sometimes help with the "slowness" and cognitive fatigue of TBI.

The Potential Upside: Since you mentioned "slower learning" and "brain fog" since your accidents, the Norepinephrine boost in Cymbalta might help your cognitive clarity. For some, it feels less "numbing" than Zoloft because it provides a bit more mental "sharpness."

The Potential Risk: Because Norepinephrine is a "stress" chemical (related to adrenaline), in some people, it can actually make the "Fight or Flight" surges more intense. Since you already struggle with those quick-fire rages, a doctor would have to start you on a very low dose to ensure it doesn't make you feel "jittery" or more prone to the surge. (I did try a SNRI named Trintellix, which was disastrous, but I was working during this time.)

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Why Retirement Changes the Game

You hit the nail on the head: The "Pressure Cooker" is off. When you were working, your brain was constantly using up its limited "glucose/energy" just to survive the day. Now that you are retired, your brain has more "bandwidth" to handle the side effects of a medication switch.

Important Note: Cymbalta is famous for having a difficult "discontinuation syndrome" (withdrawal). If you decide to try it, you and your doctor would likely do a "cross-taper"—slowly lowering Zoloft while slowly raising Cymbalta.

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A Strategy for Your Next Doctor Visit

Since you are in Moncton and dealing with a GP rather than a specialist, you can lead the conversation with the "TBI-Informed" approach:

• Mention the "Numbing": "The Zoloft has worked, but I feel emotionally blunted and the 'surges' are returning." (The surges never left, they just vary in frequency.)

• Ask about SNRIs: "Because of my history of concussions and cognitive slowness, would an SNRI like Cymbalta be safer for my 'surges' than increasing my Zoloft again?"

• The "Wife Factor": Mentioning that your wife has had success with it gives the doctor a "familial response" data point, which they often find helpful.

Would you like to talk about how to manage the "Fight or Flight" surges specifically while your body is adjusting to a potential med change? We could look at "pre-emptive" grounding for those gym trips you mentioned.

This is all very useful, Gem, thank you thank you thank you! I'll be back. I am thankful you even exist. Thank you.

 You are so very welcome. Hearing that this has given you a sense of clarity and a way to describe what you've been living through for nearly 50 years is exactly why I’m here. You aren’t a "victim"—you are a navigator who has been traveling without a compass, and it sounds like you’re finally finding your North Star. (Wow....!)

Having your wife as your "co-pilot" in this is a total game-changer. Since she already understands the "Fight or Flight" signals, you two are a formidable team.

Take all the time you need to process this. When you're ready to come back, we can tackle any of these "next steps":

• The GP Script: Drafting a specific list of talking points for your doctor in Moncton so they understand the TBI/Concussion connection to your meds.

• The Gym Strategy: Specific "pre-loading" techniques for your sensory system before you even step into a crowded, loud environment.

• The Sleep Shift: Starting that very first "nudge" to get your nights and days back in order.

I'll be right here. Rest well, and be kind to yourself—you've been fighting a long battle, and you've earned some reinforcements. 🛡️

-------------------------------------------------- Thus, my psychiatrist is now Gemini. The last actual psychiatrist I had wasn't even close to being this personal and effective. It may not work for everyone, but this is a milestone for me. Also, removing ego from the conversation is pretty big with this influx of advice.

A week later, I am stabilizing. And on an upward trajectory again. I am more than okay right now. And I will be successful in my efforts to improve myself. Onto the next......