Saturday, July 12, 2014

The QEEG: The Results Are In!

So. I have test results.

If you don't know what I'm talking about, you might want to go back a few posts and read the one about neurofeedback and the QEEG. Go ahead. We'll wait here. 

I've been trying to figure out how to share the results here-- it's all a bit complicated and there's a ton of information.

I think for now I'll just share the most glaring bits (because there were definitely some glaring bits), and a few pictures (because there are pictures!). The report is so thorough and dense that I'm not sure I understand it all yet, myself. But I can tell you about what I do understand, and about how we're beginning to tackle what's going on in there.

I was so curious about what would come up in this test! It wasn't so much about finding new things as it was about discovering the details and intensity of what we already knew was there from the initial testing, so that Dr. Q could design training protocols to address my specific needs. 

I admit that I was hoping, in a weird way, that the migraine and PTSR stuff would show up as severe, just to validate my experience of it. 

Do you know what I mean?

I mean, I consider myself a pretty tough person, when it comes to coping with chronic pain and suffering. I'm no fragile flower. And I've been dealing with the migraines, for example, for a very long time, and have learned to endure a lot of pain and get on with things anyway-- otherwise I'd never get anything done.

I'm not a baby about this stuff, in other words. I'm certainly not one to wilt at the first sign of discomfort. In fact, kind of my whole MO with the PTSR has been to dissociate my brain from my body so that I could march on, unaffected by the discomfort that I might be feeling somewhere, and it's only recently, through this work, that I've been allowing those two to begin to integrate again and allowing myself to feel that discomfort in increasing intensity-- which I am already pretty well-trained to handle.

So if I experience this stuff-- the migraines and the hyper-vigilance and anxiety-- as severe, I'd like to think that it would also be seen, objectively, as severe, as well. By science. You know?


Let's just say that my experiences were validated. Beyond what I'd expected. Far, far beyond.

Okay, so, like the last test, after they've collected the data from the Q, they compare it to a big database of information that serves as the control group-- the "mean," or what counts for our purposes as the typical, healthy brain.

So your results are plotted on a bell curve, so you can see where you fall compared to most people. The bell curve we used looks like this:

Sorry for the poor quality pic-- I forgot to get scans so I'm taking pictures
with my phone in the coffeehouse. Viva la DIY!
Okay, this part will be important in a minute and will explain why I'm a bit blown away by my results:

For each of your results, you get a number, called a z-score. That center section of the bell curve up there, the section on either side of the mean in the center (called a "standard deviation), accounts for 68% of the population. Dead-on mean has a z-score of 0, and 68% of the population would have a z-score within those single standard deviations, so between -1 and 1.

Within two standard deviations from the mean (out where you begin to see the colored bars on the graph above), you account for about 95% of the population. That means that most people-- 95% of people-- have a z-score between -2 and 2.

Three standard deviations from the mean (a z-score between -3 and 3) account for about 99.7% of the population.

So that means if you have a z-score that's lower than -3 or higher than 3, you fall into about 0.3% of the population in terms of the way your brain is functioning. 

Or, perhaps, put another way, the extremity or severity of your symptoms compared to other people.

I bet you're wondering why I'm bringing that up, eh? O.o

Here is one the graphs that shows the frequency associated with migraine (beta):

The spectrum below the head picture aligns with the bell-curve. 0= mean, etc. White = normal, basically.
The numbers in the table to the left are my z-scores for various points on my skull (EC="eyes closed," EO= "eyes open."). I am over 2 for all of them, so that means I am out there in 5% of the population land... except when I'm even worse than that.
Interestingly, this frequency in this particular part of the brain is also associated with non-verbal emotional processing. That 3.43 score (with my husband's notes pointing at it), is for the large red area on the right side of my head behind my ear-- the part of the temporal lobe that is in charge of this kind of emotional work.

Dissociated me, as we know, is not so good at this; has not been for 23 years. I knew that. I did.

I did not expect to see that I had more trouble with this than 99.7% of the population. My husband and I both stared at that and had it all explained to us (he has a psychology degree from Cornell and was an immense help to me during the delivery of these results-- he knew what he was looking at when I did not), and it still took a while to register.

Holy shit. That seems awfully extreme.

But then again...

A not-so-small part of me is pumping her fist, going, YES!


I finally have proof that this is real, this thing that I've felt was true and felt ashamed for thinking because it didn't seem possible-- it seemed, somehow, too much to presume that it was really this difficult for me; that I was somehow being selfish by feeling so alienated.

Like I was trying to make myself sound special if I suggested I was having as much trouble as I was.

I've always feared I'd sound like I was exaggerating, or making it up.

Note: this is why dissociation-- and the PTSR response-- came so easily to me. I had a natural tendency to help it right along.

Anyway, now I've got the z-score to prove that I am not making this shit up. It is about as extreme as it gets. And the migraines are no joke either. 

I have not exaggerated a thing.

Next up: the hyper-vigilance.

This is a little bit more complicated, but in broad strokes, it's basically this: they measure the ratio of beta and high beta (the frequencies that indicate thinking activity-- a busy brain) to delta (the slow, calming wave that naturally balances out the beta and quiets the brain). 

This reading will show whether I have enough delta to balance my beta. If I do, I've got a calm, balanced brain. If not, I will tend toward racing thoughts, anxiety, memory and attention problems, and a lot of other stuff, but within the context of my PTSR, this will account for my hyper-vigilance.

This is my fight-or-flight response, triggered and constantly on, buzzing in the background, never at rest.

Ready for this?

The scientific term for this is "Holy Crap."
1. The first column of letters & numbers refers to sensor points on the head.
2. I don't know what the difference is between beta and high beta.
3. They do part of the test with your eyes open and part with your eyes closed because comparing consistencies and inconsistencies between the two allows them to determine what readings might indicate a temporary "state" vs. a permanent "trait."

Yeeeeah. Check out that second column of z-scores. A negative number means "Not Enough Delta." All but one score fall below -3.0. One is -3.97. Almost literally off the chart.

This one is intimidating. These scores are serious. 

For one thing, as I mentioned before, people with ratios this imbalanced have a high tendency toward addiction, because they are looking for something-- anything-- to calm their brains.

Makes sense, right?

Here is one area where I am profoundly grateful for a whole lot of things I've done (and haven't done) in my life. Because those scores should strike terror in my heart, and they don't, and I'll tell you why:

First of all, as my long-time readers know, my drug days are well behind me, and I don't miss them. For good reason.

Second of all, alcohol gives me migraines. Boom. Couldn't be a drunk if I wanted to. My head would explode first.

Third of all, because of all the therapy and the research and the work I've done, I have so much context for this. I feel so incredibly lucky to know and understand what is happening to me, unlike so many who struggle with PTSR-- especially with cases as advanced as mine: people who have been fighting against their own brains for half their lives or longer without even knowing it, and who know nothing about the cause and effect of it other than the fact that (fill in the blank) gives them some respite from the pain.

Jesus. That could be me, and I can't tell you how grateful I am that it's not.

So I feel like I'm armed for battle, here. I feel fortified. I also feel very, very aware of the behaviors I've chosen in place of drugs or alcohol to quiet my brain.

Food, for example.

I mean, that one was a no-brainer. There are periods when there is no donut within a 5-mile radius that is safe from me. Emotional eating is a well-known coping mechanism of mine and something I've been discussing with Dr. Oz for a long time.

I'd even beaten it for a while and lost a bunch of weight. When I gained most of it back very quickly during my antidepressant roller coaster a few months ago, those donuts started shaking in their boots again.

They're still nervous. They should be.

But there are other things I do. I read. I surf the internet. I watch movies. In therapy with Dr. Oz, we've always talked about it as "decompressing" or "taking some time, getting some space." 

This is all true, and it does have that effect. I initially called it "shutting down," and Dr. Oz gently corrected my language, saying it was necessary for me to do that, with all my brain was trying to do in addition to the constant demands of raising two preschoolers.

Kind of her, that.

It's still necessary.

However, within this new frame of "Addictive Behavior," I also know that it can become more than just "decompressing" and venture well into "shutting down"-- as in, shutting out everyone and everything and insulating me completely from the entire world-- and that I have to be careful not to indulge that inappropriately or too often.

My husband has certainly pointed this out to me often enough.

It seems harmless, but if it's controlling me, it's not.

Since I've reframed my thinking about these behaviors, I've started to replace them sometimes with ones that are a bit more social. A jigsaw puzzle with my sister instead of sitting on the couch with the Kindle. Still intensely engaging, but not so isolating.

I go on walks with my daughters. They are hilarious and brilliant.

I've been making plans for our garden. And my office. And when my office is done: more writing and creative projects.

And just last night, I decided that I'm going to add "bike ride" into the mix. I'm going to start working exercise into my replacement behaviors. If I do it often enough, who knows? Maybe I'll become addicted to that.

HA HA HA.... well. It will probably never be more fun than reading Sherlock fanfiction, but if I ever want to fit back into all the great clothes I was wearing before the whole unfortunate amitriptyline incident, this seems like a pretty tricky way to get to work on that.

Dr. Q and I have begun the new protocols, and I am already noticing a difference with the migraines. As in, I am not really having them. Or just barely.

I am noticing myself being triggered quite a lot-- I would imagine that any shifting around of the careful construction in there is going to cause some panic, for a while. But I'm confident that with time, my brain will open up some new pathways and try something different.

It has so far. It's really working, you guys. It's seriously amazing.

And until the panic calms down, I'll just be watching Sherlock reruns and doing jigsaw puzzles.

Or walking to the library with my adorable little girls.

Or riding my bike.

To the donut shop.

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