Help me break through my malaise- Depression, ADD, CPTSD
May 15, 2021 4:50 AM Subscribe
I had a breakdown in 2016, and I don’t feel I’ve ever fully recovered. Help me get out of this rut and help myself. Trigger warning for assault.
About 5 years ago I got dumped and fired in quick succession. The relationship had been abusive, my career had been miserable, and I’m pretty sure I got into both because of childhood issues. The breakdown seems inevitable to me now, and I think would have happened sooner or later even if those two things didn’t happen when they did.
I became very anxious and depressed. I took medication but had a very bad reaction (severe suicidal ideation). This has made me very averse to medication. I’ve also seen 4 therapists in the last 5 years, read a lot of self help, done courses in mediation, yoga, and tried various forms of self care.
There have been some big improvements- therapy made me better than before at relationships (all my past relationships were abusive), and I’m now married to a wonderful man who I adore. I’ve gone back to school and I’m retraining for a career which I hope will be a better fit.
So why do I still have such crippling depression? When my husband’s away (which he is at least 2 nights a week), I barely get out of bed. We’re both working from home most of the time, and he goes off to diligently work in one room and I’ll faff around achieving nothing in another. I’m overwhelmed by schoolwork and procrastinate badly. I need good grades (and I’m capable of achieving them) for the next step in my career plan, but I’m undercutting my ability by leaving things to the last minute and missing deadlines. My house is messy and cluttered and I can’t be bothered to do anything about it. I am a bad friend and get back to people sporadically or not at all.
I have ADD (recently diagnosed by a psychologist- although I’m not sure if it was a formal diagnosis- I filled in a form and we talked about it). I feel like the ADD and depression feed each other. I’m unmotivated, don’t achieve things, I feel guilty, become more depressed.
Before I had a breakdown I had enough energy and drive to break through the chaos, but now it’s like... everything feels pointless and overwhelming. I’ve done so much work in and out of therapy and I just feel defeated- why go to the trouble of mild (or not so mild) discomfort when it doesn’t work, and instead I can numb myself by staying in bed, binge eating, watching trash tv, and browsing the internet. My skin is so thin. I stay in bed rather than exercise or study, because those things are hard and even slight discomfort is intolerable for me. Sometimes even brushing my teeth feels too hard.
I just had a second session with a new therapist (the psychologist I mentioned above). She told me about her approach- Acceptance and Commitment Therapy- and while I bought into what she was saying, I felt so defeated. I know all this, I’ve tried this. It doesn’t work.
I was seeing a different therapist last year who I liked a lot (who told me I had C-PTSD), but I had to stop because I didn’t feel I was making any progress and I felt so guilty it was making me feel worse. I was finding it so hard to be compliant/do my homework. I know I can’t change without putting in the work but for the last couple of years it just feels impossible. I don’t feel able to let go of thoughts that I know are destructive and unhealthy. Saying “notice your thoughts and dismiss them” or whatever feels like telling an alcoholic to just stop drinking.
I was on a good trajectory after my first year or so of therapy and was in a good-ish place in mid/late 2017. I then had a short but quite traumatic relationship, which I think might have set me back (this person was into BDSM and used this to repeatedly violate my consent. He choked me with a belt during sex without warning. This memory came back to me suddenly about 2 years later and I still don’t remember the details, but when I remembered it and recounted it I had a trauma response, and I have a trauma response to anyone putting their hands on or around my neck or even seeing this sort of thing on TV).
I’ve recently been opening up more to my husband about my depression (I feel very ashamed of feeling this way), and the struggles I have with ADD. He thinks I’m being too hard on myself and I’m doing much better than I think. He doesn’t really believe I have ADD (he’s British and in his 40s, so he doesn’t really believe in ADD at all- although he’s promised he’ll read up on it- if you have any ideas for reading material I can share with an ADD sceptic please let me know!), and thinks I’m just a bit messy and disorganised. Maybe this is true- the therapist I saw the other day said that my thoughts have me in a headlock, so maybe I’m not seeing the wood for the trees. He thinks I should stop seeing my latest therapist and talk to him more. In one way that sounds really good, but another part of me is so scared of pushing him away by showing him what a mess I really am.
I think a big part of the problem is I feel very guilty about feeling this way, and sort of don’t believe that I have the right to. Maybe I’m just a lazy person, pathologising my character flaws to let myself off the hook. What if I invented that memory of being strangled, what if I’ve exaggerated the neglect and emotional abuse from my parents and past partners? And I’m not doing things I know would make me feel better, like exercising regularly, getting outside, journaling. So maybe I want to feel this way?
Can anyone relate to any of this? I don’t know if there’s anything anyone could advise that would help me when I don’t seem able to break through this malaise, but I feel pretty desperate would be very grateful to hear your thoughts.
About 5 years ago I got dumped and fired in quick succession. The relationship had been abusive, my career had been miserable, and I’m pretty sure I got into both because of childhood issues. The breakdown seems inevitable to me now, and I think would have happened sooner or later even if those two things didn’t happen when they did.
I became very anxious and depressed. I took medication but had a very bad reaction (severe suicidal ideation). This has made me very averse to medication. I’ve also seen 4 therapists in the last 5 years, read a lot of self help, done courses in mediation, yoga, and tried various forms of self care.
There have been some big improvements- therapy made me better than before at relationships (all my past relationships were abusive), and I’m now married to a wonderful man who I adore. I’ve gone back to school and I’m retraining for a career which I hope will be a better fit.
So why do I still have such crippling depression? When my husband’s away (which he is at least 2 nights a week), I barely get out of bed. We’re both working from home most of the time, and he goes off to diligently work in one room and I’ll faff around achieving nothing in another. I’m overwhelmed by schoolwork and procrastinate badly. I need good grades (and I’m capable of achieving them) for the next step in my career plan, but I’m undercutting my ability by leaving things to the last minute and missing deadlines. My house is messy and cluttered and I can’t be bothered to do anything about it. I am a bad friend and get back to people sporadically or not at all.
I have ADD (recently diagnosed by a psychologist- although I’m not sure if it was a formal diagnosis- I filled in a form and we talked about it). I feel like the ADD and depression feed each other. I’m unmotivated, don’t achieve things, I feel guilty, become more depressed.
Before I had a breakdown I had enough energy and drive to break through the chaos, but now it’s like... everything feels pointless and overwhelming. I’ve done so much work in and out of therapy and I just feel defeated- why go to the trouble of mild (or not so mild) discomfort when it doesn’t work, and instead I can numb myself by staying in bed, binge eating, watching trash tv, and browsing the internet. My skin is so thin. I stay in bed rather than exercise or study, because those things are hard and even slight discomfort is intolerable for me. Sometimes even brushing my teeth feels too hard.
I just had a second session with a new therapist (the psychologist I mentioned above). She told me about her approach- Acceptance and Commitment Therapy- and while I bought into what she was saying, I felt so defeated. I know all this, I’ve tried this. It doesn’t work.
I was seeing a different therapist last year who I liked a lot (who told me I had C-PTSD), but I had to stop because I didn’t feel I was making any progress and I felt so guilty it was making me feel worse. I was finding it so hard to be compliant/do my homework. I know I can’t change without putting in the work but for the last couple of years it just feels impossible. I don’t feel able to let go of thoughts that I know are destructive and unhealthy. Saying “notice your thoughts and dismiss them” or whatever feels like telling an alcoholic to just stop drinking.
I was on a good trajectory after my first year or so of therapy and was in a good-ish place in mid/late 2017. I then had a short but quite traumatic relationship, which I think might have set me back (this person was into BDSM and used this to repeatedly violate my consent. He choked me with a belt during sex without warning. This memory came back to me suddenly about 2 years later and I still don’t remember the details, but when I remembered it and recounted it I had a trauma response, and I have a trauma response to anyone putting their hands on or around my neck or even seeing this sort of thing on TV).
I’ve recently been opening up more to my husband about my depression (I feel very ashamed of feeling this way), and the struggles I have with ADD. He thinks I’m being too hard on myself and I’m doing much better than I think. He doesn’t really believe I have ADD (he’s British and in his 40s, so he doesn’t really believe in ADD at all- although he’s promised he’ll read up on it- if you have any ideas for reading material I can share with an ADD sceptic please let me know!), and thinks I’m just a bit messy and disorganised. Maybe this is true- the therapist I saw the other day said that my thoughts have me in a headlock, so maybe I’m not seeing the wood for the trees. He thinks I should stop seeing my latest therapist and talk to him more. In one way that sounds really good, but another part of me is so scared of pushing him away by showing him what a mess I really am.
I think a big part of the problem is I feel very guilty about feeling this way, and sort of don’t believe that I have the right to. Maybe I’m just a lazy person, pathologising my character flaws to let myself off the hook. What if I invented that memory of being strangled, what if I’ve exaggerated the neglect and emotional abuse from my parents and past partners? And I’m not doing things I know would make me feel better, like exercising regularly, getting outside, journaling. So maybe I want to feel this way?
Can anyone relate to any of this? I don’t know if there’s anything anyone could advise that would help me when I don’t seem able to break through this malaise, but I feel pretty desperate would be very grateful to hear your thoughts.
Response by poster: Buried in my question I mention that my experience with medication was rough. Very wary of trying it again.
posted by Dwardles at 5:24 AM on May 15, 2021 [7 favorites]
posted by Dwardles at 5:24 AM on May 15, 2021 [7 favorites]
I started ACT in early 2019 after what I would call a similar breakdown. I'm not sure precisely what you mean when you refer to your breakdown, but in my case I think the more precise technical language would be an adjustment disorder: too many difficult things landed at once for me to handle (this being the catalyst for the part of it that I still think of as "the breakdown"), and I lost touch with everything from sleep/eating/thinking intentionally to having a sense of joy or enjoyment in anything. It was ridiculously disorienting, and it felt permanent. ACT was a real help, though. I encourage you to give it a go and stick with it.
I struggle with what feels like thoughts that I can't escape, and ACT very directly gives you practices that just straight up get you comfortable working around them. 2019 saw them get so loud and persistent that I couldn't function in my work. Hell, I couldn't function in my daily life. You mention your trauma responses about your neck and touch. That resonates. I couldn't handle seeing people on bikes. I mean, that sounds a little funny to me now but I'd watched my then husband have a terrible bike wreck that ultimately changed the trajectory of our lives, and as more things piled on top it seemed like my mind was only able to find purchase by saying, well, ok, everything feels extremely out of control right now but, hey, we can control you not getting on a bike so we're gonna populate your field of view, and your entire mindspace, with graphic memories of that accident everytime you see a bike, someone riding a bike, mentioning a bike, on and on and on. Starting with little baby steps, ACT gave me some quick relief in the beginning by teaching me a bunch of little tricks to "defuse" me from having those thoughts be the guide for how I behaved when they were around. And that little bit of space was enough for me to work with, and keep coming to therapy, and delving into making ACT a practice.
A key part of the grace I found was ACT's centering around finding, exploring, and getting practice articulating your deepest, truest values. Like, values, as deeply as you can trace them down to the tips of their roots. When up against the wall with depression and anxiety, ACT helped me learn and practice some crazy handy techniques for choosing to live my life, or perform like I was living it, in line with what actions would best reflect those deep-ass values. I didn't need to battle the depression to do that. I didn't need to muster will or motivation. I just needed to be able to ask myself, dispassionately, when presented with any decision: which one would I do if I didn't feel like this? It's a simplistic reduction, clearly, but it was a marvel to experience putting those strategies into my life. I went from feeling paralyzed by/in my life to making a few enormous changes that feel really good. In 2019, I couldn't imagine saying something like that ever again.
I offer you a sincere internet hug of empathy from a stranger.
posted by late afternoon dreaming hotel at 5:30 AM on May 15, 2021 [19 favorites]
I struggle with what feels like thoughts that I can't escape, and ACT very directly gives you practices that just straight up get you comfortable working around them. 2019 saw them get so loud and persistent that I couldn't function in my work. Hell, I couldn't function in my daily life. You mention your trauma responses about your neck and touch. That resonates. I couldn't handle seeing people on bikes. I mean, that sounds a little funny to me now but I'd watched my then husband have a terrible bike wreck that ultimately changed the trajectory of our lives, and as more things piled on top it seemed like my mind was only able to find purchase by saying, well, ok, everything feels extremely out of control right now but, hey, we can control you not getting on a bike so we're gonna populate your field of view, and your entire mindspace, with graphic memories of that accident everytime you see a bike, someone riding a bike, mentioning a bike, on and on and on. Starting with little baby steps, ACT gave me some quick relief in the beginning by teaching me a bunch of little tricks to "defuse" me from having those thoughts be the guide for how I behaved when they were around. And that little bit of space was enough for me to work with, and keep coming to therapy, and delving into making ACT a practice.
A key part of the grace I found was ACT's centering around finding, exploring, and getting practice articulating your deepest, truest values. Like, values, as deeply as you can trace them down to the tips of their roots. When up against the wall with depression and anxiety, ACT helped me learn and practice some crazy handy techniques for choosing to live my life, or perform like I was living it, in line with what actions would best reflect those deep-ass values. I didn't need to battle the depression to do that. I didn't need to muster will or motivation. I just needed to be able to ask myself, dispassionately, when presented with any decision: which one would I do if I didn't feel like this? It's a simplistic reduction, clearly, but it was a marvel to experience putting those strategies into my life. I went from feeling paralyzed by/in my life to making a few enormous changes that feel really good. In 2019, I couldn't imagine saying something like that ever again.
I offer you a sincere internet hug of empathy from a stranger.
posted by late afternoon dreaming hotel at 5:30 AM on May 15, 2021 [19 favorites]
On top of all the other terrible things you’ve been through, this sounds a lot like the kind of breakdown that a psychiatrist once told me that he sees a lot in people with ADD. Have you tried medicating the ADD at all, or just the depression?
posted by bq at 5:34 AM on May 15, 2021 [4 favorites]
posted by bq at 5:34 AM on May 15, 2021 [4 favorites]
Sorry if I missed this, but it sounds like you took medication for depression/anxiety, but it's not clear if you've ever been on medication for ADD.
IANAD/IANYD, but I am a person who has very similar mental issues (i.e. original diagnosis of anxiety/depression, later diagnosed as ADHD and C-PTSD). I had a horrible experience with SSRIs - they essentially made me bipolar, I had manic episodes, even though I'm definitely not bipolar. More generally, I am just prone to weird/bad medication reactions.
But taking medication for ADHD was transformative. Now I can't guarantee that it would help, but a lot of symptoms that I attributed to depression actually seem to have been related to the untreated ADHD. What you're describing about just not being able to bring yourself to do the things you know are right for you - I was in that place exactly.
Getting the ADHD treated - it's like I now just have the ability to do things. It's hard to explain but it's night and day.
It won't solve everything, not by a long shot. But it gave me the ability to implement the tools I learned in therapy, to follow through on plans to do things that are good for me like eat right/exercise, to come up with a plan to get work done and follow it.
I honestly feel more like myself on these meds than I did when I wasn't taking them.
It may still take some trial and error, but if you haven't tried this yet, I'd really encourage you to talk to a psychiatrist about this.
(I take Vyvanse fwiw. I did not respond well to Adderrall XR, which is a common first line choice, so don't be discouraged if the first couple ADD meds don't work out for you.)
Hang in there!
posted by litera scripta manet at 5:35 AM on May 15, 2021 [4 favorites]
IANAD/IANYD, but I am a person who has very similar mental issues (i.e. original diagnosis of anxiety/depression, later diagnosed as ADHD and C-PTSD). I had a horrible experience with SSRIs - they essentially made me bipolar, I had manic episodes, even though I'm definitely not bipolar. More generally, I am just prone to weird/bad medication reactions.
But taking medication for ADHD was transformative. Now I can't guarantee that it would help, but a lot of symptoms that I attributed to depression actually seem to have been related to the untreated ADHD. What you're describing about just not being able to bring yourself to do the things you know are right for you - I was in that place exactly.
Getting the ADHD treated - it's like I now just have the ability to do things. It's hard to explain but it's night and day.
It won't solve everything, not by a long shot. But it gave me the ability to implement the tools I learned in therapy, to follow through on plans to do things that are good for me like eat right/exercise, to come up with a plan to get work done and follow it.
I honestly feel more like myself on these meds than I did when I wasn't taking them.
It may still take some trial and error, but if you haven't tried this yet, I'd really encourage you to talk to a psychiatrist about this.
(I take Vyvanse fwiw. I did not respond well to Adderrall XR, which is a common first line choice, so don't be discouraged if the first couple ADD meds don't work out for you.)
Hang in there!
posted by litera scripta manet at 5:35 AM on May 15, 2021 [4 favorites]
Two other things I forgot to address in my already too long answer:
I'd really encourage you to give ACT a try. late afternoon dreaming hotel has already done a good job of talking up ACT's merits, but I just want to second that it is really worth giving a try. I have spent years in individual therapy, group therapy, I've done CBT, DBT, mentalization therapy, IFS, psychodynamic, etc.
I'm only partway through ACT, but I feel like someone looked at CBT and DBT and decided to take what works best about those therapies, augment/perfect it, and then filled in the important stuff that was missing.
My point is, even if you haven't found benefit with other therapies, I would still give ACT a try.
And lastly, I just wanted to comment on this:
I’ve recently been opening up more to my husband about my depression.
He doesn’t really believe I have ADD
He thinks I should stop seeing my latest therapist and talk to him more. In one way that sounds really good, but another part of me is so scared of pushing him away by showing him what a mess I really am.
I don't want to start a pile on with your husband, because it sounds like he may very well have the best of intentions, but just not be super aware/educated of this stuff. But I do find it a bit disturbing that he's encouraging you to stop seeing your therapist and trying to convince you your diagnosis is wrong.
It's great that you are opening up to him! But you may need to have a talk with him about ways he can be supportive that won't undermine the work you are trying to do in therapy.
Treating a loved one as a therapist is poisonous for that relationship. And that's not at all what you seem to be doing. But I think your husband maybe doesn't understand the difference. Some people just think therapy is a place to go to vent or get support, but a good therapist is trained to do a lot more than that.
It sounds like he's willing to educate himself, which is great! You should encourage him to do that - not just about ADD, but about C-PTSD and about how therapy can help and also how he as a partner can be supportive.
posted by litera scripta manet at 5:45 AM on May 15, 2021 [10 favorites]
I'd really encourage you to give ACT a try. late afternoon dreaming hotel has already done a good job of talking up ACT's merits, but I just want to second that it is really worth giving a try. I have spent years in individual therapy, group therapy, I've done CBT, DBT, mentalization therapy, IFS, psychodynamic, etc.
I'm only partway through ACT, but I feel like someone looked at CBT and DBT and decided to take what works best about those therapies, augment/perfect it, and then filled in the important stuff that was missing.
My point is, even if you haven't found benefit with other therapies, I would still give ACT a try.
And lastly, I just wanted to comment on this:
I’ve recently been opening up more to my husband about my depression.
He doesn’t really believe I have ADD
He thinks I should stop seeing my latest therapist and talk to him more. In one way that sounds really good, but another part of me is so scared of pushing him away by showing him what a mess I really am.
I don't want to start a pile on with your husband, because it sounds like he may very well have the best of intentions, but just not be super aware/educated of this stuff. But I do find it a bit disturbing that he's encouraging you to stop seeing your therapist and trying to convince you your diagnosis is wrong.
It's great that you are opening up to him! But you may need to have a talk with him about ways he can be supportive that won't undermine the work you are trying to do in therapy.
Treating a loved one as a therapist is poisonous for that relationship. And that's not at all what you seem to be doing. But I think your husband maybe doesn't understand the difference. Some people just think therapy is a place to go to vent or get support, but a good therapist is trained to do a lot more than that.
It sounds like he's willing to educate himself, which is great! You should encourage him to do that - not just about ADD, but about C-PTSD and about how therapy can help and also how he as a partner can be supportive.
posted by litera scripta manet at 5:45 AM on May 15, 2021 [10 favorites]
Book for your husband: https://www.amazon.ca/When-Adult-You-Love-ADHD/dp/143382308X
I have a similar history. One thing that has helped me through the roughest patches has been David Reynolds’ Handbook for Constructive Living and the question, “what needs doing?” https://www.amazon.ca/Handbook-Constructive-Living-David-Reynolds/dp/0824826000
Seconding the suggestion to consider ADHD medication.
Big hugs. You’re doing better than you think.
posted by sixswitch at 6:31 AM on May 15, 2021 [5 favorites]
I have a similar history. One thing that has helped me through the roughest patches has been David Reynolds’ Handbook for Constructive Living and the question, “what needs doing?” https://www.amazon.ca/Handbook-Constructive-Living-David-Reynolds/dp/0824826000
Seconding the suggestion to consider ADHD medication.
Big hugs. You’re doing better than you think.
posted by sixswitch at 6:31 AM on May 15, 2021 [5 favorites]
Last week I listened to this 1-hour talk [YouTube recording] by a professor at my university who was diagnosed with ADHD about 2 years ago. He talks about the anxiety and the feelings of failure and "why can't I just..." that come from the executive function difficulties associated with ADHD. If you've only recently been diagnosed (whether formally or not), this is probably highly worth watching so that you can start to learn what it means to be ADHD from the perspective of ADHD people (and also think critically about whether the diagnosis "fits" or not).
If this resonates with your experiences, this might also be a good starting point to educate your husband (e.g., watch the video together). It may be that hearing about it from a male, PhD-holding, tenured professor will help him consider it more seriously.
posted by heatherlogan at 6:34 AM on May 15, 2021 [1 favorite]
If this resonates with your experiences, this might also be a good starting point to educate your husband (e.g., watch the video together). It may be that hearing about it from a male, PhD-holding, tenured professor will help him consider it more seriously.
posted by heatherlogan at 6:34 AM on May 15, 2021 [1 favorite]
I bought a copy of Unwinding Anxiety on storybored's recommendation and now I recommend it too. Pretty much everything in there aligns perfectly with the work I've been needing to do internally to keep myself on a tolerably even keel since experiencing a full-on psychotic break triggered by undersleep, work stress and cultural isolation in 2001.
Even in the (I think fairly unlikely) case that you find nothing in it that's immediately actionable, I think at the very least you'll be presented with some workable alternatives to the toxic internal self-talk that's currently doing such an effective job at keeping you stuck.
I also encourage you to spend some time, in fact as much time as you can possibly arrange to, outdoors in non-built environments. Anywhere you can see more trees than buildings is good. Beaches with pounding surf are good. Riverbanks with birds and occasional splashes from jumping fish are good. Grassy paddocks with grazing horses or cows are good. Leave your phone behind when you go.
Finding somewhere like that and getting barefoot in it will help you remember that you are a whole person - a real, physical, living, breathing, feeling creature taking up space in the world - and not a mere collection of grindingly unmanageable thoughts that must be beaten into shape with distressing quantities of drugs and/or discipline.
Note that I am specifically not recommending that you Get Out There And Do Some Exercise Because You Know That's Good For You. Just get out there and see and smell and listen and touch and breathe and be for a while, is all.
posted by flabdablet at 8:35 AM on May 15, 2021 [9 favorites]
Even in the (I think fairly unlikely) case that you find nothing in it that's immediately actionable, I think at the very least you'll be presented with some workable alternatives to the toxic internal self-talk that's currently doing such an effective job at keeping you stuck.
I also encourage you to spend some time, in fact as much time as you can possibly arrange to, outdoors in non-built environments. Anywhere you can see more trees than buildings is good. Beaches with pounding surf are good. Riverbanks with birds and occasional splashes from jumping fish are good. Grassy paddocks with grazing horses or cows are good. Leave your phone behind when you go.
Finding somewhere like that and getting barefoot in it will help you remember that you are a whole person - a real, physical, living, breathing, feeling creature taking up space in the world - and not a mere collection of grindingly unmanageable thoughts that must be beaten into shape with distressing quantities of drugs and/or discipline.
Note that I am specifically not recommending that you Get Out There And Do Some Exercise Because You Know That's Good For You. Just get out there and see and smell and listen and touch and breathe and be for a while, is all.
posted by flabdablet at 8:35 AM on May 15, 2021 [9 favorites]
I would strongly suggest working with a psychiatrist to help you find medication that works for you. Meds can in many cases be the key that unlocks all the skills and hours you’ve put into therapy. And there are a lot of options and avenues to navigate, many complex interactions and possible side effects, but a psychiatrist is specifically trained to interpret all that data and put it alongside your medical history and help you choose the things most likely to work for your specific case. It’s totally reasonable to be reluctant to try again since you had bad reactions the first time, but one thing about ADD is that it apparently often indicates that a person will have unusual responses to medications. So working with a psychiatrist while armed with this new possibility means you will probably be trying some very different medications.
posted by Mizu at 11:46 AM on May 15, 2021 [5 favorites]
posted by Mizu at 11:46 AM on May 15, 2021 [5 favorites]
I came in to say exactly what Mizu said.
The first AD I took was Prozac (way back in 96ish). I pretty much didn't sleep for 2 weeks and I ended up in the hospital inches from a suicide attempt. Next I tried Zoloft, and that made me hypomanic. Many drugs later, many years later, many hospitalizations later, I'm on a mixture of Zoloft and Wellbutrin with Trazodone for sleep issues and the occasional Klonopin.
Psychiatry is not like getting an antibiotic for strep throat. It's often a numbers game. It's frustrating. A lot of people, especially those with complex symptoms constellations, need a number of tries to find something that Just. Works.
For me, I didn't really start to heal from PTSD (probably C-PTSD) until I was able to get the depression lifted a bit and the voice I was hearing due to said depression and the panic attacks to decrease.
posted by kathrynm at 3:11 PM on May 15, 2021 [1 favorite]
The first AD I took was Prozac (way back in 96ish). I pretty much didn't sleep for 2 weeks and I ended up in the hospital inches from a suicide attempt. Next I tried Zoloft, and that made me hypomanic. Many drugs later, many years later, many hospitalizations later, I'm on a mixture of Zoloft and Wellbutrin with Trazodone for sleep issues and the occasional Klonopin.
Psychiatry is not like getting an antibiotic for strep throat. It's often a numbers game. It's frustrating. A lot of people, especially those with complex symptoms constellations, need a number of tries to find something that Just. Works.
For me, I didn't really start to heal from PTSD (probably C-PTSD) until I was able to get the depression lifted a bit and the voice I was hearing due to said depression and the panic attacks to decrease.
posted by kathrynm at 3:11 PM on May 15, 2021 [1 favorite]
This is so relatable and I'm a little heartbroken for you OP, you deserve to have these things come easier for you and I'm so sorry they do not.
No fucking clue, but I can share what has helped me (GAD, dysthymia, probably ADD related executive dysfunction, addiction issues) and it is picking my feet up and taking hour long walks to a very beautiful nearby park every day as early in the day as I can manage. I'm a little hesitant to suggest this advice because I would fucking slap someone who told me "have you tried taking a walk," but it has very much helped me. I couldn't do even this for a few months (okay like 10) but the difference in my motivation and ability to do things for the rest of the day has been night and day.
You're not alone in this if it helps, I'm pulling for you.
posted by moons in june at 4:00 PM on May 15, 2021 [5 favorites]
No fucking clue, but I can share what has helped me (GAD, dysthymia, probably ADD related executive dysfunction, addiction issues) and it is picking my feet up and taking hour long walks to a very beautiful nearby park every day as early in the day as I can manage. I'm a little hesitant to suggest this advice because I would fucking slap someone who told me "have you tried taking a walk," but it has very much helped me. I couldn't do even this for a few months (okay like 10) but the difference in my motivation and ability to do things for the rest of the day has been night and day.
You're not alone in this if it helps, I'm pulling for you.
posted by moons in june at 4:00 PM on May 15, 2021 [5 favorites]
I’ll also chime in to urge you to reconsider medication for ADHD. I had a terrible experience with Prozac 20 years ago. I wish I’d been diagnosed and medicated for ADHD back then - my life would have been so different. The three years since I have been taking Adderall have been so good. I used to finish every single day filled with shame that I’d spent it, as you say, faffing around achieving nothing. I don’t have those days any more. Even when I skip a day or two of medication and deal with that feeling of being overwhelmed by tasks and incapable of even creating a to-do list, it’s not the same because it’s not a lifetime’s worth of things I’ve let slide. It’s such a weight off to know that it’s really not laziness or lack of willpower. I have plenty of willpower; I just lack executive function in my natural state.
posted by Kriesa at 6:40 PM on May 15, 2021 [2 favorites]
posted by Kriesa at 6:40 PM on May 15, 2021 [2 favorites]
As someone who got diagnosed with ADHD at the age of 43, focusing on treating that will most likely help you with everything else. For the love of all that is holy, do not fire your therapist. By all means talk to your husband more if you choose, but a lifetime of experience tells me that someone without ADHD or ADD is simply unable to understand naturally what it is like to have it.
Please keep your therapist, please keep giving ACT a try, and please find a medication specialist who can help you specifically with your ADD. Ultimately I ended up with medication for my ADD and an anti-depressant. But I took the ADD medication alone for years and that helped me accomplish things and also quieted a lot (but not all) of my repetitive, guilt-inducing thoughts.
I cannot state this strongly enough: if you had diabetes, you would not fire your physician and look to your husband for guidance to manage that health condition. Mental health issues are health issues. Your husband can believe in ADHD or not believe in ADHD; That doesn’t matter. What matters is if that diagnosis feels like a good fit for some of the problems with which you struggle.
It is super common that those of us who have ADHD also suffer from anxiety and/or depression. I got the trifecta, and that’s just how it is. But I’ve had lots of therapy and also quite a few years of tweaking meds and now I have something that works really well for me. It’s not magic but my life is much better than it was before. I hope you get the help and support you need. The book listed above for partners is a good one. Good luck!
posted by Bella Donna at 2:32 AM on May 16, 2021 [2 favorites]
Please keep your therapist, please keep giving ACT a try, and please find a medication specialist who can help you specifically with your ADD. Ultimately I ended up with medication for my ADD and an anti-depressant. But I took the ADD medication alone for years and that helped me accomplish things and also quieted a lot (but not all) of my repetitive, guilt-inducing thoughts.
I cannot state this strongly enough: if you had diabetes, you would not fire your physician and look to your husband for guidance to manage that health condition. Mental health issues are health issues. Your husband can believe in ADHD or not believe in ADHD; That doesn’t matter. What matters is if that diagnosis feels like a good fit for some of the problems with which you struggle.
It is super common that those of us who have ADHD also suffer from anxiety and/or depression. I got the trifecta, and that’s just how it is. But I’ve had lots of therapy and also quite a few years of tweaking meds and now I have something that works really well for me. It’s not magic but my life is much better than it was before. I hope you get the help and support you need. The book listed above for partners is a good one. Good luck!
posted by Bella Donna at 2:32 AM on May 16, 2021 [2 favorites]
TL;DR: Do not outsource your healthcare decisions to your spouse. Despite everyone’s best intentions, that will be bad for your health and bad for your marriage.
posted by Bella Donna at 2:38 AM on May 16, 2021 [2 favorites]
posted by Bella Donna at 2:38 AM on May 16, 2021 [2 favorites]
Response by poster: Thanks so much to everyone who responded, I was in a dark place when wrote my question and your support and advice was has been very comforting and helped me get some clarity. I’m still rereading and mulling over the comments, but I’m hearing loud and clear that I should try again with medication.
The medication I referred to in my post was SSRIs for depression. I haven’t seriously looked into adhd medication as I’m in the UK where adult adhd is not really a thing- it’s notoriously difficult to get diagnosed and prescribed medication on the NHS (and it’s eye wateringly expensive to get privately). I’ve been taking something called Modafinil, which isn’t for ADD (it’s prescribed for people with narcolepsy or who work night shifts), but that helps quite a bit sometimes (although I don’t have a prescription and I can’t sleep when I take it).
But the reason I sought out a psychologist specifically was for help with ADD- all the therapy in the world doesn’t help when I don’t have the motivation or focus to implement changes. So I’ve emailed my therapist and asked if she can formalise my diagnosis or refer me to someone who can.
As for my husband, it’s hard for us Brits to get our heads around mental illness, possibly especially ADHD- it’s really not mainstream here and it’s often seen as being a bit of an Americanism, over diagnosing and medicating kids for being kids. This is something I wrestle with myself, even though I experience symptoms and have read a lot about it. So I get where my husband’s coming from.
I’m also not hugely enthusiastic about my new therapist and returned from the last session sobbing. So I understand why he might think I should stop seeing her, but I hear what you’re saying about not using him as a therapist. I don’t think that’s what he meant, more that I should talk to him more about my problems.
Actually, I have a follow up therapist question. There are two things this therapist said that kind of bothered me that perhaps someone could weigh in on- maybe I’m a little too online these days, but both struck me as a bit... Unenlightened?
1. I told her about issues with my weight (from obsessive calorie restriction to binge eating) stemming from my mother’s obsession with my weight and appearance, and that I’ve been falling into bad habits/binge eating recently. She commented that it’s important to control my weight as I’m trying to conceive.
I found this a bit...irritating? Like, I’ve just told you I’ve spent my whole life obsessing about my weight, do you think I need another reason to worry about my weight, or that I don’t already know that weight can affect fertility? And is that really a helpful comment in this precise context? I want to stop unhealthy behaviours and obsessive thoughts about my appearance, I’m not seeing you for help with fertility. I’ve put on some weight in the last year (don’t think I’m alone in that) and I kept wondering after she made that comment if she was thinking I was fat. Obviously this is my issue and most people wouldn’t react this way, but I guess most people aren’t in therapy partly because of obsessive issues with weight and appearance. But maybe she was trying to motivate me?
2. I referred to being assaulted (as mentioned in my ask) but didn’t go into more detail. The first thing (and I think the only thing) she asked was if I pressed charges.
I mean, I didn’t realise it was assault until after the fact (I didn’t even remember some of it until years later), and it was very ambiguous and due to the BDSM element, there would just be no way I’d put myself through all that. I’d be raked over the coals, he’d get off Scott free. I guess it felt a bit judge-y- like she wanted to know if it was “proper” assault and I’d done the right thing? I felt guilty and ashamed. Maybe I should have pressed charges? Maybe it wasn’t that serious? Obviously I’m super sensitive at the moment so maybe I’m reading too much into that and it’s a normal follow up question, but it didn’t feel very helpful.
But from what I gather, ACT isn’t about talking things over endlessly so maybe this was part of it and she didn’t want to go overboard with the empathy or get caught up in the details. But I’ve had a bad experience with a therapist before (I talk about it here if you’re interested) so as some people here have helpfully talked about their experience with this type of therapy, I wonder if you could tell me if I’m being over sensitive or if I should go back to the drawing board and look for someone else?
posted by Dwardles at 3:17 AM on May 16, 2021
The medication I referred to in my post was SSRIs for depression. I haven’t seriously looked into adhd medication as I’m in the UK where adult adhd is not really a thing- it’s notoriously difficult to get diagnosed and prescribed medication on the NHS (and it’s eye wateringly expensive to get privately). I’ve been taking something called Modafinil, which isn’t for ADD (it’s prescribed for people with narcolepsy or who work night shifts), but that helps quite a bit sometimes (although I don’t have a prescription and I can’t sleep when I take it).
But the reason I sought out a psychologist specifically was for help with ADD- all the therapy in the world doesn’t help when I don’t have the motivation or focus to implement changes. So I’ve emailed my therapist and asked if she can formalise my diagnosis or refer me to someone who can.
As for my husband, it’s hard for us Brits to get our heads around mental illness, possibly especially ADHD- it’s really not mainstream here and it’s often seen as being a bit of an Americanism, over diagnosing and medicating kids for being kids. This is something I wrestle with myself, even though I experience symptoms and have read a lot about it. So I get where my husband’s coming from.
I’m also not hugely enthusiastic about my new therapist and returned from the last session sobbing. So I understand why he might think I should stop seeing her, but I hear what you’re saying about not using him as a therapist. I don’t think that’s what he meant, more that I should talk to him more about my problems.
Actually, I have a follow up therapist question. There are two things this therapist said that kind of bothered me that perhaps someone could weigh in on- maybe I’m a little too online these days, but both struck me as a bit... Unenlightened?
1. I told her about issues with my weight (from obsessive calorie restriction to binge eating) stemming from my mother’s obsession with my weight and appearance, and that I’ve been falling into bad habits/binge eating recently. She commented that it’s important to control my weight as I’m trying to conceive.
I found this a bit...irritating? Like, I’ve just told you I’ve spent my whole life obsessing about my weight, do you think I need another reason to worry about my weight, or that I don’t already know that weight can affect fertility? And is that really a helpful comment in this precise context? I want to stop unhealthy behaviours and obsessive thoughts about my appearance, I’m not seeing you for help with fertility. I’ve put on some weight in the last year (don’t think I’m alone in that) and I kept wondering after she made that comment if she was thinking I was fat. Obviously this is my issue and most people wouldn’t react this way, but I guess most people aren’t in therapy partly because of obsessive issues with weight and appearance. But maybe she was trying to motivate me?
2. I referred to being assaulted (as mentioned in my ask) but didn’t go into more detail. The first thing (and I think the only thing) she asked was if I pressed charges.
I mean, I didn’t realise it was assault until after the fact (I didn’t even remember some of it until years later), and it was very ambiguous and due to the BDSM element, there would just be no way I’d put myself through all that. I’d be raked over the coals, he’d get off Scott free. I guess it felt a bit judge-y- like she wanted to know if it was “proper” assault and I’d done the right thing? I felt guilty and ashamed. Maybe I should have pressed charges? Maybe it wasn’t that serious? Obviously I’m super sensitive at the moment so maybe I’m reading too much into that and it’s a normal follow up question, but it didn’t feel very helpful.
But from what I gather, ACT isn’t about talking things over endlessly so maybe this was part of it and she didn’t want to go overboard with the empathy or get caught up in the details. But I’ve had a bad experience with a therapist before (I talk about it here if you’re interested) so as some people here have helpfully talked about their experience with this type of therapy, I wonder if you could tell me if I’m being over sensitive or if I should go back to the drawing board and look for someone else?
posted by Dwardles at 3:17 AM on May 16, 2021
Your therapist sounds a bit dim. Not as cloth-eared as the previous idiot but still pretty dim. If I were seeing that therapist I'd be seeking recommendations for somebody more switched on, preferably somebody properly fat (because I am properly fat, and the less time wasted on having fatness thinsplained to me again the better).
posted by flabdablet at 3:28 AM on May 16, 2021
posted by flabdablet at 3:28 AM on May 16, 2021
Just addressing your follow-up question...
I agree that with those first or early impressions of your new therapist, I’d be thinking, “not the one I want,” and continue the search. I’d be explicitly in search mode, not in “I have a new therapist” mode for the first appointments.
Then, once I did find someone I thought was great for me, I’d still expect them to disappoint me at times. But having a foundation of having thoughtfully selected them and worked with them well for a while, I’d try to notice and express those feelings at the time, and I’d consider that as part of the therapy. E.g., “I’m irritated you’d say that about weight control. I’ve told you that obsessing about my weight has long been unhealthy for me. That kind of comment is harmful to me.” Or, “I feel judged by that question, especially since it’s your very first response to me telling you I was assaulted. I expect a different response from you, not something that makes me feel guilty or ashamed, or like I have to prove to you it was real by having reported it!”
I think both of your examples are BIG misses on the therapist’s part. With a strong foundation, and a really good response to what I expressed, they might be recoverable. Without that foundation, nope, I’d move on.
posted by daisyace at 7:02 AM on May 16, 2021 [2 favorites]
I agree that with those first or early impressions of your new therapist, I’d be thinking, “not the one I want,” and continue the search. I’d be explicitly in search mode, not in “I have a new therapist” mode for the first appointments.
Then, once I did find someone I thought was great for me, I’d still expect them to disappoint me at times. But having a foundation of having thoughtfully selected them and worked with them well for a while, I’d try to notice and express those feelings at the time, and I’d consider that as part of the therapy. E.g., “I’m irritated you’d say that about weight control. I’ve told you that obsessing about my weight has long been unhealthy for me. That kind of comment is harmful to me.” Or, “I feel judged by that question, especially since it’s your very first response to me telling you I was assaulted. I expect a different response from you, not something that makes me feel guilty or ashamed, or like I have to prove to you it was real by having reported it!”
I think both of your examples are BIG misses on the therapist’s part. With a strong foundation, and a really good response to what I expressed, they might be recoverable. Without that foundation, nope, I’d move on.
posted by daisyace at 7:02 AM on May 16, 2021 [2 favorites]
Is it possible that you could find a Health At Every Size - informed therapist to work with? Or at least one that is able to take a weight-neutral approach and focus on your behaviors and thought processes regardless of what your weight is? Given that one of your goals is to work on unhealthy behaviors/obsessive thoughts about your appearance, your current therapist's comment about weight and fertility seems bad.
I've had issues in the past with compulsive overeating as well as compulsive shopping , which I believe were connected to anxiety and undiagnosed ADHD, and I think that those types of causes are often overlooked in many discussions about disordered eating of the overeating variety. But it's also the case that dieting both causes binge-eating *and* makes it hard to recover from it, even if the original cause is rooted in something else. So it seems unhelpful or even damaging for your therapist to be making comments encouraging you to "control" your weight.
posted by dogwalker3 at 12:43 PM on May 16, 2021 [1 favorite]
I've had issues in the past with compulsive overeating as well as compulsive shopping , which I believe were connected to anxiety and undiagnosed ADHD, and I think that those types of causes are often overlooked in many discussions about disordered eating of the overeating variety. But it's also the case that dieting both causes binge-eating *and* makes it hard to recover from it, even if the original cause is rooted in something else. So it seems unhelpful or even damaging for your therapist to be making comments encouraging you to "control" your weight.
posted by dogwalker3 at 12:43 PM on May 16, 2021 [1 favorite]
Are you me? I feel like I could have written large parts of this question. Following the responses eagerly here. But like you I'm at a point where I've been medicated to death, I also can't get on ADD meds for Reasons, all of that is not necessarily the cure-all people think it is.
I guess I'm at a point where I'm just accepting that maybe life for me will not be the same as it is for everyone else; it might be constrained by things other people cannot necessarily see. Try not to hold yourself to the same standards as everyone else. Would you tell someone who grew up in poverty, that they were failing at life compared to someone else who went to world-class boarding schools, who had tutors and nannies and cooks every second of their lives? No? Well, same principle here. Most humans have trauma by virtue of being human, but not everyone has the pile-up of junk that we have. People imagine it's easily surmountable, but it's not.
You sound like you're doing pretty well to me, you have a job and a partner-- you're in school. Life is hard. Life after abuse doubly so. Hope this helps, even a little.
posted by coffeeand at 7:51 PM on May 16, 2021 [1 favorite]
I guess I'm at a point where I'm just accepting that maybe life for me will not be the same as it is for everyone else; it might be constrained by things other people cannot necessarily see. Try not to hold yourself to the same standards as everyone else. Would you tell someone who grew up in poverty, that they were failing at life compared to someone else who went to world-class boarding schools, who had tutors and nannies and cooks every second of their lives? No? Well, same principle here. Most humans have trauma by virtue of being human, but not everyone has the pile-up of junk that we have. People imagine it's easily surmountable, but it's not.
You sound like you're doing pretty well to me, you have a job and a partner-- you're in school. Life is hard. Life after abuse doubly so. Hope this helps, even a little.
posted by coffeeand at 7:51 PM on May 16, 2021 [1 favorite]
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