My brain needs a hard reset
December 16, 2015 1:13 PM   Subscribe

This is the weirdest, longest mental health setback I've had in years. I've been managing my ADHD, anxiety and depression 'like a pro' for quite some time until this past year. I've tried to overcome the setback using every approach in the book (so it would seem). It's not working. My hard-earned executive functioning skills have mostly disappeared. I think my brain needs a hard reset. What is going on?

YANMD.

I have fallen into a hole of anxious procrastination. I also feel consistently if mildly paranoid about being or becoming a failure at what I want to do with my life. There is a bit of impostor's syndrome involved. And my ADHD inattentive symptoms are blowing up in my face after years of being under near-perfect control.

It's not as bad as it could be. But just enough for it to feel 'abnormal' and to have an adverse impact on my happiness, given how far I'd come in surmounting these things.

Just to be clear, I follow AskMeFi pretty regularly and have tried (or still am trying) most of the tried and true methods for grappling with mental health setbacks.

What I already do on a regular basis (TL;DR: seeing doctors for everything and doing what they recommend, eating right, sleeping right, exercising regularly, healthy social life)
- See a (great) mental health/ADHD therapist with whom I've discussed this, but I don't feel like we're getting anywhere new
- See a (great) psychiatrist for my medications and we've already tried some options for changing up my medications one-by-one over time, but nothing has worked as well as my standard course of medication, which I've now been back on for a few months
- Recently saw my primary care doctor to get a physical/blood analysis for any issues/vitamin deficiencies/other health problems, and everything checked out fine- they had no explanation for why I feel so tired and unmotivated
- Limit my alcohol and caffeine intake, especially before bed
- Also before bed, I limit my use of 'screens'/all things that emit blue light
- I go to bed at the same time every night and fall asleep easily; I don't wake up easily or often (if ever) in the middle of the night and have had a sleep test showing no issues like sleep apnea, etc
- I wake up at the same time every day using a sunrise alarm clock
- Focus my diet on foods that are high in lean protein, iron, omega 3, potassium, magnesium, vitamin C, vitamin A, B12, and also take liquid fish oil, vitamin D, B complex, CoQ10 supplements (and my doctors are aware of my diet and supplement use, and there are no issues/contraindications of which they've made me aware)
- Engage in daily, vigorous exercise as well as deep stretching (running intervals, cardio weightlifting, restorative and vinyasa flow yoga, foam rolling)
- Have good relationships and as much contact as I need with my loved ones
- Likewise, still get sufficient 'me/alone time' (in terms of length of time; maybe not so much 'quality of time') for my needs as an introvert
- Volunteering to help others in need
- I took a week-long staycation recently (cannot currently afford a vacation that requires travel, despite wanting to be able to do this very badly) and it was nice... for as long as it lasted

There are things that aren't working out, of course... Work is highly stressful (busiest time of year + we're understaffed) so I feel like I'm spinning my wheels there despite all my effort; also, no amount of light therapy or going out in the sun on my breaks has ever changed the fact that I just don't do well from November - February when the days are short.

I think the real root of my anxiety is that I'm still working on changing careers and I feel like I may be screwing things up because of the vicious cycle of "I'm too mentally exhausted to work hard on career change (skill building/job applications) > therefore doesn't work as hard on those things as I'd like to > start losing sight of prospects or opportunities, or at least I psych myself out into thinking that this is what's happening."

In August and September, I started to feel hopeless a career change would ever happen. Then I had a few 'big advancements' in the last 2 or 3 months (call back for a job, finding mentors and some great networking, a possible intern position at a place I'd die to work at) but things have gotten a bit quiet. My last two mentor appointments were canceled (by the mentor), I haven't heard back about the internship (I got mixed signals about when that would be; I'm too terrified to follow up, at least before the new year). Granted, I am dealing with people who are employed in the public sector (where I'm looking to go) and things don't always move along as quickly in the public sector as they do in the private; also, it's the holidays and that can put a hold on things, too. But the fear of not knowing if these prospects are going to come to fruition (after letting myself feel a little too happy and excited that things were finally starting to change after putting in a lot of hard work this past year) is really creating anxiety.

I just feel "more ADHD than ever." I have a lot of career-related skill building to work on in my personal time and I can't seem to get motivated to start or finish any of it, even using the pomodoro technique and breaking things down into the tiniest possible tasks. I am mentally exhausted but the more I 'let myself go', the more anxious I get because I feel like I'm letting my day job "kill me" to the point where it's affecting my ability to put in the extra work I need to put in to change careers.

Yes, I have a lot of anxiety, and I definitely use my anxiety medication and it helps. The same goes for stimulant medication to treat the ADHD. But it's not a cure-all, and I need to make sure that I'm still developing the appropriate skills to manage my life whether I have access to anxiety and stimulant medication or not. (I'm a notorious "busy procrastinator" who likes to find other things to do; I'm also an anxious procrastinator).

Since I can't seem to find any health or medication issues that may be the source of this (other than maybe existential loneliness?)... what else could I be doing to approach all of this with a fresh perspective? How do I stop freaking out and not feeling like an impostor, or a lazy jerk, or a silly dreamer?

I feel like I spend every day thinking and worrying about the average to poor state of my mental health and my tendency to either hyperfocus on things that don't matter, or outright procrastinate.
posted by nightrecordings to Health & Fitness (16 answers total) 44 users marked this as a favorite
 
This post seems very organized and like you do have your executive functions in control. You seem burnt out and anxious to me.

People with ADHD can sometimes have insane expectations for what we "should" be doing because it's hard to shake the feeling that we're wasting insane amounts of time doing nothing. Because in the past, we were wasting insane amounts of time doing nothing.

You sound, to me, super, super burnt out. You need to actively and purposefully take a break. You need to literally think of things you want to do that are fun and then do them in your "personal time". I suggest consciously putting off your career change for a few months.

I would also consider a few days as a med holiday where you sit around and again, purposefully achieve nothing. This can help enormously. You also seem anxious and that's a stimulant med thing, too, honestly.

I would also 100% cut out all caffeine all the time.
posted by internet fraud detective squad, station number 9 at 1:20 PM on December 16, 2015 [15 favorites]


Like, as someone with ADHD, I feel like we never quite "get" the normal amount of time people spend on normal things and so we are always convinced we're slacking

I've been convinced I was slacking and not doing much when I was working 50 hours a week, a single parent, and taking a rigorous hard science college course. Because I have a warped perspective where I am kinda always convinced that I'm slacking. It's not the case.

You're having a busy season at work. You're always having a hard time this time of year. The next few months is not forever!
posted by internet fraud detective squad, station number 9 at 1:24 PM on December 16, 2015 [6 favorites]


Suggest doing CBT from Feeling Good by Dr. David Burns.
posted by Ironmouth at 1:29 PM on December 16, 2015 [1 favorite]


I think the real root of my anxiety

So, most of my anxiety is somatopsychic: It is a mental health side effect of physical ailments. And I have tried different things at different times to treat the (physical) root cause.

At the moment, I am eating foods high-ish in selenium, like sunflower seeds. Brazil nuts are crazy high in selenium. A single brazil nut is all the selenium you need for an entire day, but I am having trouble finding a reliable source of them and that is a little pricey. (The last bag of "mixed nuts" I bought apparently had a single brazil nut in it, so I spent like $4 for a single brazil nut, basically. :-/) So sunflower seeds are working better because they are cheap and reliable. And when I get all grumpy frustrated and my complainy verbal ticks come back, I eat more sunflower seeds.

So I am wondering if adding selenium to the supplement mix might be helpful for you.

Best of luck.
posted by Michele in California at 1:38 PM on December 16, 2015 [2 favorites]


Oh my golly, you are a rock star at self-care! Seriously, when I read your post I am awed by everything you are doing to take care of yourself. Also, you note that you will be feeling kind of sucky until the end of February, regardless. So please, cut yourself some slack if possible. Find some way to take a break and/or give yourself a piece of joy (however you define it, however small) every day. Also, consider a goal or work buddy. I've had several. Checking in with someone else who share my wiring and/or tendencies (procrastination, etc.) helps me get moving. And I get more done when I have a goal buddy than when I don't. Do give yourself credit for everything you have done and everything you are doing to be healthy. Try to remember that you won't always feel this way. And do give yourself pleasure and joy (walks, TV/movies, chocolate, novels, hugs, whatever as long as it feels good rather than bad or unhealthy). Because you should get to experience those things. You need those things. We're rooting for you!
posted by Bella Donna at 2:21 PM on December 16, 2015 [3 favorites]


what else could I be doing to approach all of this with a fresh perspective?

Take a vacation! Or a few days off.

This sounds like built up stress, not a failing on your part.
posted by zizzle at 2:34 PM on December 16, 2015 [1 favorite]


I agree, you sound like you are doing really well with ticking all the self-care boxes, but sometimes there is just no substitute for actually taking a break. Even the best self-care is not going to be effective in high-stress situations without a break, it's just supposed to maximize your good times and help you through the bad times until you can relax and recharge.

If you can, take a long weekend, or better yet a whole week (I know you said this is the busiest time for your work, but maybe you can explain to your manager how burnt-out you are and that you want to come back with all engines on or whatever the appropriate metaphor is). Either travel somewhere super relaxing if you can afford it, or just stay at home, watch Netflix, get lots of sleep, do something fun and low-stress, and try to put all this out of your mind completely for a while.

If you really can't swing a break now, schedule some time off once things settle down and focus on that. Often knowing we have a break coming up can help us power through until we get there.
posted by ananci at 2:38 PM on December 16, 2015 [1 favorite]


It sounds to me like you're just having a tough time right now, with the career search being a bit stalled. The list of stuff that you managed to accomplish regularly: exercise, eating well, working, seeing doctors regularly... And still getting a good night's sleep? Damn. Impressive.

Literally everyone gets stressed out by working on changing careers. There's no reason why you should get to be an exception to that - it's not a personal failing. So you may just need to accept it and be nice to yourself a bit, cut yourself some slack in the winter holidays and pick back up later.
posted by Lady Li at 2:41 PM on December 16, 2015 [2 favorites]


It seems like you're stuck in that classic anxiety feedback loop, where you're anxious about being anxious.

You obviously have a chronic anxiety disorder, but it's worth reminding yourself that it's completely normal to be anxious once in awhile. A big change in your life is bound to cause anxiety. Ditto overwork. Ditto funds shortages. It's still anxiety, and it still totally sucks, but it's supposed to.

Being anxious about being anxious, though: That's just your brain being a jerk.

In all honesty, that, combined with your long list of complete-shit-togetherness-having leads me to suspect that it might just be that your stimulant dosage is a little too high. (Seconding zero caffeine, ever, ever, ever.)
posted by Sys Rq at 2:57 PM on December 16, 2015 [1 favorite]


Dude, if you're taking such good care of yourself, and holding the fort at work during a time of insane stress, you're actually doing about as well as a person without ADHD would be doing.

Sometimes it's just really hard going and that's it, you know? I'm not surprised you don't want to come home and launch into a big pile of homework. Sucks if you really absolutely have to do it, but maybe the fact that you're struggling is NOT a symptom of ADHD but rather a symptom of having too much to do.

Lately I, too, have been convinced that my life is a total mess. Had my yearly checkup last week, and once we assessed it it turns out my symptoms are mostly under control - I'm just a tremendous night owl and I have problems getting started. It's easy to think of everything as a global miasma of mess - which, to be fair, is sort of a result of being a procrastinating night owl, but whenever I do manage to get up early everything falls into place, so it really is basically that one thing.

Lastly, good for you on the whole exercising, eating right, limiting screen time before bed, and washing behind the ears thing. You're doing better than most people! Pat yourself on the back!

One suggestion, which you don't mention if you're doing or not: do you take one day a week completely off? Where you don't do chores beyond what is immediately strictly necessary (like scooping the cat litter, feeding small children, etc)? And when the unavoidable immediate chores that can be done by your partner get delegated to them (in exchange for your doing the same for them on another day? unless you both take the same day of course in which case the deal's off). And you order takeout instead of cooking? And you very strictly don't *have* to do anything at all? It's a sin to work 7 days a week, because humans really aren't built for that. Maybe you're going to be all "noooo I have to pick this oakum so I can change careers" but honest to God, you'll be better for having that day off.
posted by tel3path at 3:12 PM on December 16, 2015


Drink one more 12 oz glass of water per day. Make this one small, but significant ritual. Without sunscreen, greet the sun either at sunrise or sunset every day. Linger for at least five minutes or until a deep sense of connection sets in. Let the light filter through your eyelashes. Smile while you do this. We have ancient clocks that run in rhythm with the natural world. Losing contact with the sun is disorienting on some deep level. Don't forget to smile and affirm, and take a deep, relaxed breath or six. This equals a solar mini vacation/reset per day.
posted by Oyéah at 4:53 PM on December 16, 2015 [7 favorites]


- Recently saw my primary care doctor to get a physical/blood analysis for any issues/vitamin deficiencies/other health problems, and everything checked out fine- they had no explanation for why I feel so tired and unmotivated

Just double-checking, did they test for all of the following?
- thyroid
- iron
- vitamin D
- vitamin B12
- rheumatoid arthritis
- Epstein-Barr virus

no amount of light therapy or going out in the sun on my breaks has ever changed the fact that I just don't do well from November - February when the days are short.

Well yeah you're really far north. If this has always been the case you may need to seriously consider moving to a different part of the world. Since you're already working on a career transition, can you try for overseas positions in cities closer to the equator?
posted by Jacqueline at 4:53 PM on December 16, 2015 [2 favorites]


Also, if it's mostly anxiety that's driving everything else, perhaps try clonazepam (Klonopin)? I found that 1 mg/night for a couple of years reprogrammed my brain to stop habitually falling into the anxiety rut.
posted by Jacqueline at 4:55 PM on December 16, 2015


My recommendations and opinions below are based on the premise, from my own experience, that sometimes things just suck and you have to ride it out.

Your self-care routine sounds like a second job. Don't get me wrong, everything you're doing is great, but it sounds to me like you're holding your self-care routine before your wellness sometimes. TIME TO GET SHIT DONE I'VE GOTTA GET 20 THINGS DONE SO CAN RELAX GOTTA STAY ON TASK BECAUSE PEACE OF MIND WILL FOLLOW. It's okay to do seventy percent sometimes. Like, aside from the therapist and psychiatrist bits, shake things up sometimes if you feel like it. Use a screen after 11 with a glass of wine, eat some crap food because it's snowing and that justifies crap food. Hit the snooze because bed is warm and your commute is not. Don't turn that into your life, but cut yourself two or three breaks a day.

I'm having some trouble with momentum/executive function at work right now and one thing that helped me was to make a phone call if I wasn't sure what to do next. All I do is make phone calls, really, and I will worry for an hour about who to call next because everythingissoimportant, but now when I get there I just make a phone call. It's better to do one thing than think about doing twenty.

Right after my ADHD diagnosis in 2014 I threw myself into self-care/organization overdrive, and my god it worked. But I was in school and working full-time and I had so much going on that I needed that Rube Goldberg set-up of organizational tools. Then I stopped following it and got really stressed because I had a bazillion notifications on OmniFocus and hadn't touched it in forever, but I realized hey, shit's getting done. I guess I don't need that right now. I certainly will again, but for now I shouldn't worry about not following a routine I don't need. Don't set standards to relax that stress you out.

There's not a career-change train you're going to miss. I realized around the same time as you that "Oh, SHIT I do not want this job/field to be my life" and the feeling was suffocating. I felt trapped and scared like there was nothing else I could ever do besides that job because I was almost 30 and I couldn't possibly do anything else after a decade in the same job in a highly specialized field. It's a really scary feeling, and "it will be fine" and "look where I am now!" don't help at all, but no job posting you pass up is going to be the last job posting in the field.

I was in a funk like yours right after my diagnosis in 2014 and I finally realized that 80% of it was my godawful soul-sucking job and workplace. What really shifted my mindset was when I for sure made the decision to leave my job. After making that decision and long before I had a plan or gave notice I walked in the door every day thinking, "What are they gonna do, fire me?" and you know what? I was more confident, relaxed, and competent than I had been in about four years. That gave me the peace of mind and momentum to network, dedicate myself to school, and work on self-care I had been avoiding forever.
posted by good lorneing at 9:42 PM on December 16, 2015 [7 favorites]


Stop thinking about the others, just think about yourself, really, you are the most important person right now, more important than anybody else. think about an emergency button, your emergency button, it is time to press it and think only about you.
posted by nims at 7:26 AM on December 17, 2015


I agree, you are a rock star at coping. So, congratulate yourself, spend a little time reminding yourself that you are doing a pretty great job of dealing with anxiety, that it's really hard, and you deserve a break. Some of your self-care can be being kind to yourself. I had a very bad patch this summer, finally got the meds corrected, got over the worst of it, and life is better. This will not last forever, you will be okay. Good luck.
posted by theora55 at 10:41 AM on December 17, 2015


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