How can I get unstuck?
September 12, 2022 10:16 PM   Subscribe

I am not managing to get very much done and need to find a way to get myself doing more. Can you suggest strategies that have worked for you or people you know? Factors include anxiety, depression and ADHD.

My work is freelance and until a couple of months ago I'd been working flat out for about 18 months. I took some leave in August and am now working reduced hours. There are a lot of things I need to do - house stuff, life admin, volunteer projects, and I'd like to do some things I enjoy too, but I'm having trouble motivating myself to do anything apart from mess around online, play Solitaire or read undemanding stuff.

I have a diagnosis of ADHD and have been prescribed atomoxetine, but I haven't been able to make myself start taking it. I have long-term anxiety and depression, which I'm not currently treating. I have not found anti-depressants helpful in the past, and therapy and CBT only of limited use. I did ask my GP about anti-depressants again recently, but he said I should try the atomoxetine first. I have tried stimulants for ADHD, which did not have an effect.

My house is a tip - I set a goal yesterday of tidying the table, which contains craft stuff, books, papers, life admin, stuff to go to charity shops, early Christmas presents I've bought etc. I did sort things into neater piles and throw a few things away, but then I had to find something in a hurry and hurled the piles around again. I feel overwhelmed by it all. Where do people put things they want to keep? I go through stages of putting things in boxes then the boxes move around the house getting deeper into the strata. The house smells of cat pee [the cat doesn't have a health problem, it's just something he does sometimes] which gets me down but the thought of washing the carpet is overwhelming. I've tried several types of odour stuff but it doesn't cover it.

I would like to do some fun things! I have a jigsaw I started in January which I haven't touched for months. I have knitting I know I would enjoy if I could make myself do it. I would like to eat food I like rather than the absolute easiest thing. I have lots of books I know I'd enjoy but which feel too demanding to start. I keep thinking, Now I'll get up and do [enjoyable thing] and I just ... don't.

I am lacking in energy; I think I may have low iron and I do have iron tablets but again can't seem to manage actually to take them. I have a family history of low thyroid and have bought a test to take for that [test at the GP a few years ago was normal] but again ... I feel as if I have just run down and stopped. A friend has suggested I need some do-nothing time to recharge, which is fine, I understand the concept and I have now had a lot of days of doing nothing - interspersed with work and family commitments - but literally doing nothing is not helping with depression and self-loathing, and I think I'm in a cycle where eating poorly and not exercising are compounding the problems.

I realise I'm in a "yes but" or "I can't" state but how can I manipulate myself out of it? What has worked for you? I have put off posting this for some time thinking I will get answers like "try to get out of the house at least once a day", or "start taking HRT", which I know could be good things, but I need to go a step back from that to suggestions about how to get myself to do them.

I'm in the UK, in case that affects people's answers, and I'm fiftyish.
posted by anonymous to Health & Fitness (15 answers total) 20 users marked this as a favorite
Can you book an NHS Health Check? I think you can get them free every 5 years. This might identify any underlying deficiencies that might be contributing to your lack of energy.
posted by unicorn chaser at 10:34 PM on September 12, 2022 [1 favorite]

If you have a friend you feel comfortable talking to about this, could they be your texting task buddy? Then schedule a time to text them that you took your ADHD meds and they’ll text you that they did Thing B.

Once you have your ADHD meds going for a day or two, add a short walk. So you have to text your friend every day that you’ve taken your pill and gone on a ten minute walk. Keep that up for a couple days and then add on another small, manageable task, etc, etc.

Also, once you’re walking and taking the ADHD med and have seen your GP, consider checking out Boss as a Service, Adult Study Hall, and the app The Fabulous, all of which can help with ADHD.
posted by hungrytiger at 11:33 PM on September 12, 2022 [3 favorites]

Your 4th paragraph sounds exactly as my psychiatrist once described a type of untreated ADHD which fits my mother to a T, and to a lesser extent myself. But I am treated. The meds work for me, but my meds are not your meds. But a person who supposedly is trained and experienced has proscribed you some meds. Do you have reason to believe the proscriber isn't competent or does not have your best interests in mind? Do you have more to lose by taking them, than by not taking them? Why are you considering 'manipulating' yourself out of it instead of doing what's been medically recommended? Do you doubt that there are real causes behind your challenges, and believe that you're just making things up and can snap out of it?

If you have been diagnosed with anxiety, depression, and ADHD, then no wonder you are struggling in the ways your have described. Besides the direct effects of any one of those on executive function, to be living with one -- and all -- is exhausting. It's hard to follow through things, or to perform multistep complex tasks, when you're exhausted. Just trying to function as an adult while weighed down by the mental, emotional, and -- yes, physical -- difficulties of living every day with anxiety, depression, and ADHD, isn't going to leave you much energy for anthing else. You're not struggling because you are weak or unmotivated. You're struggling because you need help.

I have a theory about why your Dr may have chosen not to treat your anxiety yet, until the ADHD is treated. My anxiety was off the charts before my ADHD was treated. It is SO much better now. When one becomes able to focus and follow through; and see Accomplishment as a result of their own efforts; and think & speak in an organized way, it is ENORMOUSLY helpful towards improving one's sense of agency, and confidence. Having those -- for me -- greatly reduced my anxiety. Perhaps some experiences like that would apply to you. I don't know. You don't know. The only way to know is to try. Usually that's trying something new.

If you decided to follow your doctor's recommendation and take the medication, please be patient with yourself and with it. Medications can take time to work, or to work 'just right'. It can be an iterative process. Sometimes you need to switch. Many times not. You'll never know what does or doesn't work until you make a choice to try something, and then have hard experiential data on what it all means, which is far more powerful and useful and in actual service to your well being than any of the thoughts you may be having about why not to take that medication. I'm not proposing you blindly take the meds just because your Dr said so ; if there's a known allergy or contraindication then I can support the hesitation, but if not.... unless you have a hard reason to believe there is zero chance they will help, then I propose you ask yourself how many more days do you want to live with exactly the same results you are currently getting?

Are you able to find/afford a therapist? If not, I wonder if you can find an online support group. If for no other reason than to hear some other perspectives. Hear what others say about how they meet their struggles. To interrupt the dialog inside your head which I'll venture a guess is ruminative, repeated, cyclical. To create an opportunity for the tapes playing inside your head to 'pause'. You know, the tapes playing over and over about how your bad at this, no good at that, unable to do anything, etc.

You are a smart and capable person. You write very well. I see you have the capability to organize your thoughts and express them articulately. And you have the emotional intelligence to reach out, ask for help. All that -- that is the foundation you need for moving from the place you are to the place you want to be. You're halfway there. If there are others, like your Dr, who are reaching out their hands to help you the rest of the way, reach out and grab those hands.

Feel free to MeMail me.
posted by armoir from antproof case at 11:35 PM on September 12, 2022 [12 favorites]

It sounds like you have lots of things that you want to get done, but can't prioritize and are paralyzed by too many choices. This is a really common problem for us depressed neurodivergents. I had very similar issues when I was dealing with burnout after working 60+ hour weeks for a year and was stuck in a funk like this for months. When we're working crazy hours and everything is on fire, it's pretty easy to be motivated and get things done because everything is important. But it can take the brain a long time to adjust to the lower urgency of normal life and until it adjusts nothing actually feels important. And then because everything is equally unimportant, it's hard to find motivation to do any of it. And for reasons that aren't entirely clear, that priority confusion can really destroy our physical energy level.

My solution (recommended by a similar post years ago) to this was a to do checklist and stimulants. I used Wunderlist at the time, although I'm not sure what I'd recommend now because that turned into Microsoft To Do. But, I wrote down 20 things I wanted to get done, in order, and I made myself try the first thing on the list that was possible on each particular day. If I had trouble motivating myself to do it, I took a nap, drank an energy drink (yerba mate instead of red bull), and tried again. It didn't always work, but I started getting things done and enjoyed checking things off the list. The checking off part is important because it helps retrain the brain to feel like progress is real.

You will probably feel really stupid about doing this, and that's normal and fine. It doesn't really matter if you feel stupid, or it takes too long, or you don't have enough energy or skill to finish the task the first time you try. What matters is making actual progress and acknowledging that progress. If the task is too big to finish in one day, break it down. If you start to do the task and don't think it's actually worth it, make a conscious decision to move it down the list and try something else. Doing a jigsaw puzzle is a great thing to put on the list. From what you say you have several good ideas for how to improve your energy levels, and trying one of them is a great place to start a to do list.

You already made good progress on the list by doing the first half of tidying your room. It may feel like you didn't succeed, but you made progress and things are better than they were before. You are not the only person on MeFi who has struggled with this, and other people will have good advice. You can definitely get past this!
posted by JZig at 11:40 PM on September 12, 2022 [15 favorites]

What matters is making actual progress and acknowledging that progress.

Yasssssss. THIS. Anon, what JZig wrote is spot-on. All of what JZig wrote is such spot-on, high-quality guidance.
posted by armoir from antproof case at 11:46 PM on September 12, 2022

If you can admit this to someone in your life, it does help so much to be accountable to someone who'll go "go on, find that pill and take it right now while we're on the phone". Or who'll take a look at your list and pick something for you to do. Even better if they can come over and even just sit there and direct you, never mind actually help. It's your executive function that's drowning under three different conditions that all impact it, you literally physically can't decide to just get better. (And piles are a perfectly valid ADHD friendly organisation method as long as you can find something without mixing them with other piles! Get see-through baskets so that you can only dump out that particular pile and easily put it back in!)

The other thing: honestly, silly phone games help SO MUCH with the do-nothing recharge phase. They distract your brain into rest, they give you quick dopamine hits, and after half an hour of playing I could actually tackle a task even in my worst moments. Especially if I told myself that after that I could play until level X.
posted by I claim sanctuary at 12:08 AM on September 13, 2022 [3 favorites]

Sometimes it helps to just talk kindly to myself. Direct my eyes away from whatever drain has me, and say kindly (like I would to a tired and sad toddler) "hey, buddy, I know you don't wanna move, let's go get some water though. It'll be okay. Yeah, I know."

Another thing that sometimes gets me off my phone is putting on some bouncy music. A Taylor Swift playlist or some Bollywood or show tunes. Like I need SOME stimulation and I will just keep refreshing the internet looking for it but if I put on music then I'm still getting that interaction and pleasant low effort stimulus but my hands aren't full and my eyes aren't busy. And the sound of the music seems to snap me out of my phone fugue a bit.
posted by Lady Li at 12:28 AM on September 13, 2022 [3 favorites]

it does help so much to be accountable to someone who'll go "go on, find that pill and take it right now while we're on the phone"

This is what I was going to suggest. Can't help with the rest of it, am similarly drowning at the moment and have been for quite a long time, but there is a very good chance that the medication will help, and if you can't motivate yourself to take it, having a friend sit there on the phone (Facetime, Slack, whatever, as long as it's real-time) and insist you take it then and there might do the trick.
posted by ManyLeggedCreature at 2:29 AM on September 13, 2022

I feel like this a lot of the time.

Regarding the potential low iron — one easy thing you can do is start taking a multivitamin every day. I know research on the benefits of multivitamins is somewhat mixed, but I have disordered eating due to ADHD, and I’m pretty sure I’m missing out on some nutrients. I am surprised by how much better my energy levels are when taking a daily multivitamin. You can figure out blood testing, etc. later but a vitamin is an easy first step that will help with any major deficiencies.
posted by mekily at 4:57 AM on September 13, 2022 [1 favorite]

I switched to atomoxetine after years of stimulants that did little to no good for me.

I knew almost right away that atomoxetine was different. It took a while to find the perfect dose but I am so glad I persevered with it. Everything is better: procrastination, depression, impulsivity and anxiety.

My only side effects have been some insomnia, lowered appetite, dry mouth and initially some minor irregularity.

Please give it a try!
posted by i_mean_come_on_now at 6:02 AM on September 13, 2022 [3 favorites]

I currently have essentially the same things, including the ADHD, mental health, low iron.

I think you should try to reduce the load of energy draining things as much as possible, and direct all of your energy to these parts: "haven't been able to make myself start taking it" and "I do have iron tablets but again can't seem to manage actually to take them."

If you're like me, I'm guessing you struggle to establish habits. Assuming this is the reason rather than qualms, is there any habit or routine activity you do that you can attach taking the medication to? Getting in and out of bed are the natural ones. Phone reminders, giant post it notes, whatever it takes. Your job is to take the meds. Everything else is secondary.

I had a long call with my doctor about this situation, and while saying that we will work on improving capacity, it's much easier to reduce the load. Forgive yourself for the state of the house and everything else you wish you have done and haven't.

At the same time, if you can marshall external assistance or spend some money on the house, changing the environment could make a big difference.

The low iron could be having an enormous impact on the mental health.

For the anxiety and depression, some people recommend tackling the ADHD since it can be causing these things. My anxiety and negative self-talk is a coping mechanism for the ADHD - it ramps up the domains enough to get the task done. With the meds working well, I have less of it.
posted by lookoutbelow at 6:19 AM on September 13, 2022

Keep the iron pills in the bathroom. Take them every time you poop.
posted by nouvelle-personne at 6:43 AM on September 13, 2022

I echo the others that say to focus your energy on taking the ADHD medication. There is a very good chance that that pill will help you to feel better than you have in a long time - like others, it seriously helped my anxiety and depression once I started taking it - and help you do the rest. Get it in your body and then reward yourself for your efforts by setting the goal of taking it easy today.
posted by urbanlenny at 8:20 AM on September 13, 2022

I wish there were separate words or notions of depression and the consequences of un- or undertreated ADHD that feel like depression. Same for anxiety. I got (mis)diagnosed with depression before anyone thought to evaluate me for ADHD, because some symptoms are observationally equivalent and their source gets mixed up. The way I disentangled it for myself is to ask whether I feel like I want to do things and lack the energy and bandwidth to do them (ADHD-derived feeling of depression) or whether I lack the desire to do things, like nothing feels appealing (more “pure” feeling of depression). And for anxiety, am I anxious because of all the things I need to do, am running behind on, have overcommitted and overpromised on (ADHD-derived feeling of anxiety) or am I taking on the burdens of the world, worry and ruminate on war, death, global warming, the pandemic, etc. (more “pure” feeling of anxiety). And that is a long way of saying: do try the ADHD meds, they may be getting at the cause of the feeling of depression.
posted by meijusa at 9:49 AM on September 13, 2022 [4 favorites]

You don't have to get yourself to do all these things. You only have to get yourself to do one thing: take the atomoxetine. That's where all your focus can go right now. Do that one thing.
posted by bluedaisy at 6:02 PM on September 13, 2022 [4 favorites]

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