Insight into Motivation #1: Hard work is easy if you are enjoying yourself

During my "lazy period", I thought that hard work would kill me. Honestly. I thought that limiting free time to a few hours per day (rather than having free time be almost the whole day) would be painful, a constant uphill race to nowhere. After all, the rare times when I forced myself to do work were torture.

Which is a lovely example of how you get what you expect. William James once said that "my experience is what I agree to attend to". When I sat down to work and set the timer, I was anticipating a painful experience of having to constantly readjust my focus, forcing my bingo brain to pay attention. 

I thought that I wasn't capable of doing more than 2-3 hours of work outside of class per day, so that was my reality for seven years. 

But the limit only existed in my head.

I tested the limit a week ago, inspired by a friend who studies all day, everyday. I thought that if he could do it, then maybe I could try. 

I found that when I opened up my mind to the possibility that I was indeed capable of studying an entire day, it wasn't so bad. There is a concept in physics that there is more friction involved in starting to move an object than in continuing to drag an already moving one. After some time of sitting at your desk looking over your notes, you will begin to face fewer distractions and experience less tension and resistance. Maybe not every time, but most times.

And you might discover that what you are doing is actually fun, maybe even more fun than browsing FaceBook. I fell in love with biology back in high school for a reason, and rediscovering that passion is exhilarating. The challenge of understanding, on a deep level, how the human body functions is very compelling. It's much easier to study for seven hours on a Sunday, when your exam isn't for another week, when learning the material is a reward in itself. 

The inverse of this is also true: if you absolutely dread doing something, you will do less of it less efficiently. 

If you want to motivate yourself, an effective method is to figure out why your assigned task brings you pain, and then rectify it. 

For me, the resistance came from both the belief that all work would be dreadful, and the nasty feelings of guilt that I associated with my failure to work hard (which inevitably came up whenever I attempted to get something done).

Discovering that the work wasn't so bad, along with realizing that I could forgive myself for my previous shortcomings, has helped my productivity immensely.

I also decreased the dose of my risperidone (with the approval and assistance of my doctor). This drug blocks the dopaminergic D2 receptor. Dopamine is involved in reward and pleasure, so you can imagine how dampening it can lead to motivational problems. You should never change your meds on your own, but if you take antipsychotics and you feel unmotivated, it might be worth talking to your doctor about decreasing the dose or finding another treatment option.

If you really want to be productive, you need to make life fun. I don't just mean rewarding yourself with chocolate after a day of hard work, or listening to music while you study to make it more fun. Those things can help, but what you really need to do is to live a high-dopamine lifestyle. Make your life as thrilling and pleasurable as you can. Exercise, get your blood pumping. Drink that extra cup of coffee. Eat that piece of cheesecake, unless you get a bigger jolt out of exercising self control, in which case don't eat the cheesecake. And play. Learn new things, sing in the car, call that friend you haven't spoken to in years. Live to the point where your soul catches fire and your mind can no longer keep up its deception that the world we live in is anything less than miraculous.

If you do this, you will probably find some fun in whatever it is that you need to do. If all that doesn't work, then you should consider delegating the work or choosing a different career path.

You can't cry your way to greatness, and you can't apathy your way there either. 

You are not your imperfections

I am currently going through a personal renaissance. It's wonderful, and honestly, it is all that I have wanted for a very long time. It is the answer to a lot of prayers, the true dawn signifying the end of a long night (though the sun has been rising for quite a long time, the sunrise is clear and brilliant now). I have energy. I am getting things done, after 7 years-7years!-of laziness that I desperately tried to escape from. It is like I just found the cage unlocked and ran right out.

I feel smarter, maybe because I have confidence in my own reasoning again. I feel in control of my destiny (to the extent that any human can control their destiny) and I truly feel that given enough time and work, I can accomplish just about anything. And I've been having a lot, a lot, a lot of revelations concerning riddles that have baffled me, traps that have ensnared me, and heavy weights that have kept me from flying.

I plan to share some of them with you over the course of the next week.

The first one is one that I had last night.

You are not your mistakes, failures, insecurities, imperfections, and transgressions.

You are going through a life journey, and the goal is to learn how to do better. How to be smarter, kinder, more present, more alive and awake, more human. Along the way, you will inevitably run across intermediate states that are less than ideal. Maybe you had a phase where you didn't work hard enough, or betrayed your best friend, or committed a crime, or forgot to brush your hair for two weeks.

And it is okay. These shortcomings are temporary-if you agree to change them-and they do not define you.

We all know someone who never apologizes when they have done something hurtful. I suspect that this is because their ego is threatened by admitting that they made a mistake. But doing something mean does not make you a mean person, even if you have been nasty for decades. You can always choose a kinder path.

It is a famous paradox: how to accept oneself as you are, while still working to improve yourself. I think it can be resolved by remembering that you are something so much more enduring and worthy than the temporary state you may be in in this moment. Love yourself for your positive traits, and seek to reform your negative traits, because they only determine who you are if you refuse to change them.

So many times, my focus on my work has been compromised because I felt a deep sense of guilt and shame for not working earlier, more, and harder. Ironically, the guilt led to me working later, less, and with a weaker intensity! In high school, I was a hard worker. I gave 100% of myself in everything I did. My senior year, I had a depression that killed my work ethic, and from then until just a few days ago, I had been operating at 10-20% of my true capacity.  I acted lazy, but now I am hardworking again. I realize now what I didn't know then: I was acting lazy, but I am not a lazy person. I could change, and now I have changed. But the guilt from the belief that I was a lazy person made attempting to do any work 1,000x harder than it needed to be.

Your shortcomings only dictate who you are if you let them.

In the next post, I will discuss how to cultivate motivation so that you can make these shortcomings a part of your past.

Don't Settle for a Life That is Less than What You Are Capable of Living

As I prepare to go to medical school in less than 2 weeks, I am reflecting on the reasons why I have chosen this long, at times arduous, at times beautiful, path towards a life destination that will always be worth the climb. 

I don't want to just pass through medical school, get an MD, and be an okay doctor. 

I want to revolutionize the field of psychiatry. 

God knows we need a revolution. During my time at the care center, I saw so many clients stuck in the same cycle of repeated hospital admissions, step down care with us, getting released back into the community only to end up acutely ill and back in the hospital weeks or months later. I know of many more people (including myself for a long stretch of time) who may avoid the hospital, may even avoid serious symptoms most of the time, but don't really ever reach their premorbid level of functioning again, let alone become the best possible versions of themselves that they could be. 

Neurodivergents everywhere are settling for lives that are less than what they are capable of living, and-quite sadly, quite wrongly-mental health professionals are encouraging this. 

Patients with severe mental illness are often encouraged to apply for disability benefits because they are too sick to work. Rather than being a temporary measure to keep them afloat until a way is found to get past the period of decreased functioning, many of these patients are on disability permanently. I don't mean to downplay the severity of serious mental illness, and I know that there are many, many people who cannot work because of how sick they are. The problem with people going on permanent disability is not that they don't need it, but that they are assumed to always need it. It is like their doctors and loved ones are giving up on them-"you're too ill to work, to have a normal life, and you always will be". How could anyone not have their sense of self-efficacy decreased (if not altogether abolished) when that is their care providers' attitude?  Believe me, an episode of mental illness already takes away all sense of self-efficacy. The last thing that patients need is to be told that they cannot. 

Not being able to pursue your career goals is not living!

And then there are the neurodivergents like me who are "high functioning". Let me tell you what "high functioning" means to mental health providers: it is a term used to describe patients who are "getting by". They probably can work or go to school, they get out of bed in the morning, they shower and are able to take care of their nutritional needs. They get by. Most of them are not thriving, or even living. They are surviving, doing the bare minimum to function in society. 

High functioning bipolar for me meant eating almost all my meals alone my first two years of college because I was too anxious/depressed to form meaningful friendships. It meant that throughout college I could not study for longer than 40 minutes at a time without losing all focus and motivation, and that as soon as I absorbed some knowledge I forgot it three seconds later because my shriveled hippocampus (hippocampal size decreases during depression) could not hold on to the information. As a result, I got 4 "Cs" in college, killing my chances of going to a US medical school and what was left of my self-esteem along with it. High functioning bipolar meant for me that when I was in my masters program last year I was so flooded with anxiety that driving to class and sitting through lecture like a vegetable was all that I could do. My scores on exams in grad school were often more than a standard deviation below the class average, despite that my MCAT score was above the class average. 

That is not living!

This is what it means to live: to get out of bed every morning exciting to greet the sun. To eat a delicious and nutritious breakfast while engaging in some mindful practice before heading off to your challenging, meaningful, job that both sets your heart on fire and is well compensated. To be able to work without staring at the clock every 30 seconds to see how much closer you are to going home. To walk or drive home from work without fear that something terrible will happen to you. To go home and have a spouse to kiss if you want one. To fall asleep in your loving spouse's arms, basking in the warmth of peace and gratitude. And more than anything, to live means to know that you have control, that you can keep improving your life, that you are special and important (and everyone is special and important) and that you have a life's mission to carry out. 

I will not be satisfied with my life until I get there, but I will keep striving, keep trying, keep improving myself intellectually, physically, and emotionally. 

And I will help my future patients get there too. Depression, anxiety, psychosis, and even the general trials of life can be overcome. True living is possible. I've experienced being fully alive before, during periods of hypomania. It is possible and obtainable. 

I will help people reach their potential and live meaningful lives during their recovery from mental illness. I can't wait to be that kind of psychiatrist!