Stop the meltdowns
October 29, 2022 2:06 AM   Subscribe

I am a grown-ass woman who has embarrassing meltdowns a couple times a month when I feel I am under too much stress or stimulation. Like I will go cry uncontrollably and hyperventilate and it will take me hours to calm down. I’ve thrown a ton of money and time at this problem but nothing seems to stick and every therapist has a different idea of what’s wrong with me. How can I Not Do This?

I am so so embarrassed that I do this. What usually happens to me is that I will start feeling stressed and irritable for a few days. And I’ll keep it together by resting and exercising and eating healthy food and all that. But then something will happen to trigger me, and I’ll get upset and start to cry, and then I’ll go lock myself in the bathroom and lose it. Full blown sobbing and hyperventilating and once it’s happening, I can’t really stop. I can be crying for anything from ten minutes to an hour. Once I stop crying I will need to lie down for a while and then I’ll feel better and like the tension is relieved. But I hate so much that I do this.

It’s so embarrassing, and it’s very stressful for my partner, and I worry all the time that people in the next apartment can hear me. (Luckily I work from home so this doesn’t really happen in public.)

Triggers are usually feeling stressed, overwhelmed or overstimulated — like if multiple people are messaging me at work, and there’s a lawnmower outside, and then I get a phone call. My other big trigger is when I have an argument with my partner, and say something I wish I hadn’t, and instead of just apologizing and moving on like a normal person I’ll get into the shame spiral and lose my shit.

I don’t really know what my diagnosis is because every professional has a different idea. A psychiatrist diagnosed me with GAD and I’ve always struggled with anxiety, but it doesn’t affect my life badly besides these situations. One therapist told me I had BPD, but I don’t relate to the other symptoms besides the emotional dysregulation, though I wonder if I’m fooling myself because I just don’t want that diagnosis. My current therapist thinks I’m on the autism spectrum, which rings truer for me, especially my behaviour as a child, but I’m not sure it’s worth it to pursue a diagnosis in my mid-30s. I don’t have any trauma history so no CPTSD.

I don’t have severe mental health issues otherwise, just anxiety and sometimes periods of low mood, but who doesn’t these days? I have a good job, hobbies, relationship and friends, I don’t have or want kids, I exercise and eat well and I don’t have any health problems. Most people have no idea I do this as if I feel it coming on in public I am able to get myself home, but I guess I’m just not able to keep it together in my home and I don’t know why. I feel bad that my partner has to see this (they are generally supportive but disturbed by these episodes).

I’ve been in therapy for years, for this and just general anxiety and stuff. I’ve seen many therapists. I’ve done CBT and completed a DBT course which have helped with my life in general but just doesn’t seem to stick when I get in one of these episodes. I’ve been on various antidepressants and they all did nothing for me, plus bad side effects and horrible withdrawals, I don’t want to go down that route again. I guess benzos might help but I don’t think I’d be able to get them prescribed. I am not able to get a family doctor and when I’ve seen a psychiatrist in the past they will only give SSRIs. I live in Canada so I can’t just go private and the healthcare system where I live is very overloaded.

I just want to stop doing this, I don’t want to live the rest of my life throwing tantrums like a child. I just don’t know what to try now.
posted by anonymous to Health & Fitness (46 answers total) 26 users marked this as a favorite
Would it help to try shifting the problem you're trying to solve off the physical need to run a regular physical emotional release process, and toward achieving the same release in ways that other people are less likely to perceive as something in you that needs to be fixed?

You're characterising your present process as "throwing tantrums like a child" but there is not a single thing that's childish about becoming overwhelmed, especially given the state of the world today, and there is not a single thing that's childish about responding to overwhelm with a breath-centred process like the one you describe. There is no substitute for a good, thorough, uninhibited howl when a good, thorough, uninhibited howl is what's required.

Personally I do mine in the car instead of the bathroom, because cars are easier to get to places where other people are not going to be distressed by the associated rather extreme noises; nobody gives a shit what kinds of noise come out of a car parked nowhere special by the side of a major arterial road with no buildings nearby. And I find that calming down afterwards takes a lot less time since I've accepted that (a) I need to do this sometimes and (b) I don't need to beat myself up for needing that.
posted by flabdablet at 2:25 AM on October 29, 2022 [34 favorites]

Flabdablet's final bit of advice is really good: you need to vent your frustration regularly, and it's ok to have that need. That's clearer the question you're posing to us right now (not to dismiss your initial worry - understanding why this is happening is just as important as treating it), which means a therapist will have a lot more ideas on how to help you with it. Helping patients accept part of themselves is the equivalent of a treating a common cold for therapists and I think you'll at least find the meltdown less stressful if this type of treatment succeeds.

FWIW, I can't think of a reason for these meltdowns to happen without a buildup of stress. You probably deal with work messages AND lawnmowers AND a phone call, all at the same time, almost every day. You make an effort to squash down the stress you're experiencing in the moment so you can deal with your obligations - but the stress always comes back up, and what do you do when you have no more energy left to fight?

Another potential cause of meltdowns to think of: could they be happening on or around your period?
posted by wandering zinnia at 2:52 AM on October 29, 2022 [2 favorites]

You’re doing great work already in trying to understand yourself and the part of you that bodily reacts when feeling overwhelmed! I admire your courage and dedication to learn more about this response, and with the hope to find ways that make YOU feel better about how you respond when overwhelmed.

You mentioned that shame is a big component here, and you are in Canada, so I highly encourage you to look into Compassion Focused Therapy. Please MeMail me directly if you want to — but if you want to investigate a bit more on your own, this is the first of a 4-part lecture on CFT that gives you a great basis: . Please do watch all four parts; the core of the practice is in the last 2 videos, but the framework is helpful, too.

Also, from what you describe: the overwhelmed by too much stimuli to the point of meltdown can happen with people with autism. Do you think this is a possible avenue to explore?

And good luck on your journey. You are hitting it out of the park with your courage and curiosity here.
posted by Silvery Fish at 3:09 AM on October 29, 2022 [5 favorites]

Do you chart these meltdowns? Is there a chance they are tied to your menstrual cycle? I was diagnosed with PPMD and the drug treatment for that was a game changer for me?

This kind of struggle with self-regulation is often seen in adults on the spectrum as well. Can you get a referal to be evaluated?
posted by DarlingBri at 3:37 AM on October 29, 2022 [20 favorites]

Can you afford to spend three figures on a shot in the dark?

I'm a very tense, anxious, panicky, possibly-autistic person. I don't handle stress well, and there are a lot of things I find stressful that others do not. I've tried CBT; I've tried various supplements; I've tried eating better and getting more exercise. And the thing that actually seems to work for me is a Sensate. It's a small pebble-like device that sits on your chest and vibrates soothingly, with an accompanying soundtrack (there's a choice of a few, varying in length from 10 to 30 minutes).

The idea is that if you use it regularly it tones your vagus nerve and makes you more resilient to stress... personally I'm not good at consistently finding the time to do that, but even if all it's doing is occasionally forcing me to lie down for ten minutes and focus on sound and touch instead of the chaos inside my head, well, nothing else in my life ever does that. It helps me relax physically, which is extremely valuable in the "keeping it together" phase.

I can't tell you with certainty that it helps prevent meltdowns. Mine usually happen in public, and circumstances mean I've been able to avoid the usual triggers for the last few years. However, there have been a number of occasions this year on which I would expect to have ended up a sobbing heap and... haven't; I've just stayed incredibly wound up for a while, and then gradually calmed down again.
posted by ManyLeggedCreature at 3:45 AM on October 29, 2022 [10 favorites]

I would keep a log for a couple of weeks.

Not just of the meltdowns and any emotional stimuli, but of your diet, any physical symptoms, and of your menstrual cycle if you have one.

Sometimes these strong emotional reactions can have a physical cause, such as a food intolerance spiking your irritability and reducing your coping skills, a chronic health condition, or hormone changes.

I realized from my own log that a low, spiky mood was typically a precursor to a migraine flare, and learned to take a triptan to help ward it off.
posted by champers at 3:57 AM on October 29, 2022 [4 favorites]

I think your best bet is reframing. Instead of being ashamed/ embarrassed by releasing your stress in this way, be proud that you have a relatively efficient way to let go and move on with your life. It sounds like if you take two hours or so to do this you can get back to handling the world again and that is pretty darn quick. If you don't think of it as a failure, does it still feel terrible?

You might be able to reduce its frequency or intensity by intentionally choosing to release the stress before reaching a point when you need to. Have you tried deciding to take some time to yourself to cry in the days before you completely lose control? That might be less uncomfortable (you may not end up hyperventilating for example) and you could do it at a time when you may have the apartment to yourself so you feel less embarrassed.

Reading about autistic meltdowns and autistic burnout might be helpful for you to view this from a different perspective and get some different ideas for managing it. You don't need a formal diagnosis to utilize resources that might be relevant to your experience.
posted by metasarah at 4:47 AM on October 29, 2022 [16 favorites]

Oh, hey, this happens to me too! I've had meltdowns that lasted for 8 hours straight. I hate it. Like you, this tends to happen when I'm tired, stressed, overwhelmed, etc.

In addition to looking into autistic meltdowns and burnout, it's also worth noting that ADHD can cause meltdowns and emotion dysregulation. (I have ADHD.) Just something to consider.

Unfortunately, I don't have any good answers for how to avoid this happening.
posted by litera scripta manet at 4:53 AM on October 29, 2022 [13 favorites]

What usually happens to me is that I will start feeling stressed and irritable for a few days. And I’ll keep it together by resting and exercising and eating healthy food and all that.

What happens if you don't "keep it together"? What happens if you give in to the stressed/irritable feeling immediately and express your irritation or cry or something closer to when things start? (You can always rest and exercise after.)

(I realize you're anon so most likely won't respond to this, and I know this is kind of a basic thing that you have likely tried some version of before but it sounds like expecting the meltdown must be stressful in and of itself - maybe getting it out of the way earlier would help?)
posted by mskyle at 5:15 AM on October 29, 2022 [6 favorites]

I've had a lot of success with somatic therapy in working with my own meltdowns and building resilience and gathering tools to see the overwhelm gathering or to do damage control after one. This work is all about learning how to tune into your own body and pay attention to where you're at when there's discomfort or shutdown or whatever form your stress response takes. And then learning how to work with whatever is going on and guiding it back to a relaxed place (or at least manageable).

If you are in NY or CT (maybe even NJ), I can recommend someone who does online sessions and takes some types of insurance. Memail me if that'd be helpful.
posted by kokaku at 5:44 AM on October 29, 2022 [2 favorites]

In addition to everything else suggested, I wonder if there are ways for your partner to be less distressed about it. Like, I'd find this scary too in their shoes, but if it was part of living with someone I loved then I'd want to make peace with it.

Can you ask them to make a project (when you're not mid-meltdown) of figuring out how they can take better care of themself when this is happening, so that you don't have to worry about it?
posted by nebulawindphone at 5:53 AM on October 29, 2022 [9 favorites]

I would look at how your breakdowns relate to your menstrual cycle. After ovulation progesterone spikes and that hormone is a real mother trucker. I have dealt with PMDD most of my adult life which includes all sorts of lovely thing like suicidal ideation, self-harm, emotional dysregulation as a result of this progesterone surge. The minute progesterone drops, signaled by my period starting, I am back to my usual self.

It doesn't happen every cycle. If my life is going pretty good and I am exercising, sleeping and eating well it usually isn't an issue. Once stress creeps in and I am not taking good care of my body PMDD comes back in full force. If what you are dealing with is caused by progesterone there are various medications that can help.

I am sorry you are dealing with this. I hope that you are able to find relief soon.
posted by a22lamia at 6:00 AM on October 29, 2022 [13 favorites]

If you are a candidate for anti-depressant medication, that can help with emotional regulation.

(Even if you're not depressed, it can have a stabilising effect, making you feel more sanguine.)
posted by chariot pulled by cassowaries at 6:02 AM on October 29, 2022 [2 favorites]

How's your sleep? Could you have untreated sleep apnoea?
posted by chariot pulled by cassowaries at 6:03 AM on October 29, 2022

How's your blood sugar? Could you get hypoglycemic (low blood sugar) episodes?
posted by chariot pulled by cassowaries at 6:03 AM on October 29, 2022 [1 favorite]

I'm also wondering about food intolerances.

Food intolerances = mast cell activation can cause extreme emotional states.
posted by chariot pulled by cassowaries at 6:07 AM on October 29, 2022

My current therapist thinks I’m on the autism spectrum, which rings truer for me, especially my behaviour as a child, but I’m not sure it’s worth it to pursue a diagnosis in my mid-30s.

I think your current therapist is probably right, because this sounds like absolutely classic autistic meltdowns. They are caused by stress and overwhelm. The way to stop them is to reduce your stress and overwhelm. The way to reduce your stress and overwhelm is to learn what causes your stress and overwhelm and reduce the amount of it you're exposed to -- these are often different things and at different intensities for autistic people than what the average person finds stressful, and learning about your own triggers (especially seemingly-innocuous sensory stuff) is extremely valuable.

You don't have to pursue a formal diagnosis if you don't want to. (I, a woman, was formally diagnosed at age 47 in Ontario.) Self-identification is fine and is widely accepted by the autistic community. But I do suggest connecting to the autistic community (online) and reading a bunch of stuff to (1) see whether it rings true for you and (2) gather tips and ideas to try to reduce your day-to-day stress and overwhelm.

In the mean time, here is the recording of a very good webinar about trauma and burnout in autism in which the (autistic) presenter talks about her strategies around stress and overwhelm.
posted by heatherlogan at 6:33 AM on October 29, 2022 [21 favorites]

Yeah this absolutely sounds like autistic meltdowns, or at least someone who is neurodivergent. It’s totally ok to get overwhelmed and I promise you’re not alone—it may feel like you’re the only person struggling with this, but a lot of neurodivergent people, myself included, just have their meltdowns in private. It’s hard and can feel embarrassing but it happens.

With that said, I really wonder if you’ve tried medication. This sounds like it is triggered by anxiety and neurodivergence. Medication can make a huge difference. Life is too short to struggle this much.

Getting an official diagnosis can also be validating and there are changes you can make to calm yourself down. I’d wonder about different sensory strategies to calm yourself down during the day, I.e. some means of getting deep pressure or some form of heavy work like walking with a weighted backpack. Chances are this will be most successful if you get an official diagnosis and look into medication first.

Good luck! I promise you’re not alone and having hard moments is ok
posted by Amy93 at 6:54 AM on October 29, 2022 [7 favorites]

I also wanted to mention checking out PMDD, if these meltdowns are happening at around the same time each month. PMDD can have some pretty severe psychological symptoms and it's not widely known
posted by winterportage at 7:02 AM on October 29, 2022 [5 favorites]

Ok sorry I missed the last part of the post.

I know you’ve tried SSRIs before, but I do wonder about exploring medication again—SSRIs aren’t your only option. Benzos may help. SNRIs like strattera may be more effective. Maybe a mood stabilizer would be more effective. It may be worth getting on a waitlist for a family doctor or different psychiatrist? I know it may take a long time but the time is going to pass either way.

Good luck
posted by Amy93 at 7:09 AM on October 29, 2022 [2 favorites]

What usually happens to me is that I will start feeling stressed and irritable for a few days. And I’ll keep it together by resting and exercising and eating healthy food and all that.

So first of all I really don't think there's anything to be ashamed here about at all. If you were taking out your feelings on someone else (say, lashing out verbally or physically) that would be one thing, but you're just going off for a bit on your own. That's not a child's tantrum at all. Your partner can learn to see that as a good thing you're doing for yourself, and I think you can too. Like, as you're doing it, let yourself also think "I'm doing a good thing here, it's good that I'm doing this."

That said, reading the above I wondered if you were also resting and exercising and giving yourself time to reduce stress in general, not just after the stress has already started. And I wonder if it might help to do more explicitly stress-relieving things regularly, or at least when you've noticed stress is stressing to pile up. Some people go for very intense exercise (hard running, kick/boxing, heavy weightlifting, etc.) Some people do art. For me singing can help - not necessarily songs but just singing out slow deep notes. Maybe because it's a kind of breath control; who knows. Some people do muscle relaxation exercises or go get a massage (and some people find themselves sobbing during a good massage - it's not uncommon.) Some people do meditation, but it doesn't work for everyone and I think it helps most if you do it on the regular. Regardless, and regardless of what causes this for you, I'd try looking for ways to let stress out more often. Worst case, you might feel better the rest of the time.
posted by trig at 7:27 AM on October 29, 2022 [1 favorite]

Do you have ovaries? Because I am now almost to the other side of perimenopause and look back on my life of overblown emotional reactions and realize it was ALL HORMONES. What changed is I started an estrogen patch. I have to take progesterone ten days a month and that hormone is indeed a motherfucker, but the whole time I'm taking it I still have the estrogen patch on, so I have a higher, steady estrogen level all month long. I am on such an even keel now I don't even recognize myself. I'm not saying that's your exact solution, just that I would definitely take a hard look at whether this is linked to your cycle.
posted by HotToddy at 7:29 AM on October 29, 2022 [5 favorites]

Sounds like neurodivergent meltdowns to me. Invest in ways to make the spaces you spend time in quiet, like sound insulation or noise cancelling headphones. If arguments with your partner are inevitable and low-stakes, give them structure and formality so they feel like they have an endpoint. Engage in physical movement that might feel “childish” (but really isn’t) when out and about or when having big emotions, like rocking, wiggling, shaking shoulders and arms, snapping and clapping, humming, etc. Go through your wardrobe and only keep things that have good textures and no annoying seams or tags, including (maybe especially) underwear and socks. All of these might seem small or pointless or unnecessary but added up they can make a huge difference.

Also I’m another one that just wants to say this doesn’t sound childish or like tantrums at all. There are a lot of ways to be “normal” and ways of being an adult mostly chalk up to being respectful both to others and ourselves. It seems like for now you have a coping mechanism that doesn’t harm others and only lasts a discrete amount of time. Be kind to yourself.
posted by Mizu at 8:15 AM on October 29, 2022 [11 favorites]

So first of all I really don't think there's anything to be ashamed here about at all. If you were taking out your feelings on someone else (say, lashing out verbally or physically) that would be one thing, but you're just going off for a bit on your own. That's not a child's tantrum at all

I want to underline this. There are narcissists in my family, whose temper tantrums always involve lashing out at others, with an ultimate goal of manipulation. That is something to be ashamed of (imho).

Your description reflects none of that at all. I'm impressed by your understanding of why your crying jags happen, what they do for you, and your concern with other people's reaction.

You need a good cry every now and then. It fills your needs for stress relief. You are doing well with self- care in other ways too. Sounds pretty straightforward to me.

I honestly think the best thing you can do is accept these jags for what they are - a basic need - and work on shaming yourself less over it. I'm sorry to go against what you asked for, but.
posted by Dashy at 8:17 AM on October 29, 2022 [11 favorites]

Another thing: our (toxic masculine) society teaches us from an early age that crying is childish and shameful. This is incorrect, and damaging to internalize.
posted by Dashy at 8:24 AM on October 29, 2022 [5 favorites]

I had/have similar issues (do OK on a day to day basis until everything sort of boils over); my psychiatrist has me on a beta blocker, since I didn't want to start on the whole SSRI journey.

I was diagnosed with GAD; my first (kinda terrible) therapist dismissed me when I brought up autism as a additional diagnosis. I'm still wondering if it's a factor, but in any case, the beta blocker is helping me. It helps with the physical manifestations of stress and let's me step back and evaluate/take other mitigating steps if something comes up without getting into a spiral ( I'm anxious so I feel anxious so I get more anxious...)
posted by damayanti at 8:58 AM on October 29, 2022 [1 favorite]

I second checking for ADHD as it can involve sensory sensitivity that leads to greater overwhelm, and difficulties with emotional regulation.

They do sound like meltdowns that are associated with autism, but that doesn't mean that a neurotypical person could not have reactions like this.

It seems likely that your fear of this happening, anxiety about it, rumination, negative self-talk, and/or shame is making it worse. Nthing that this is not embarrassing or shameful. I'm somewhat like this, prone to sobbing intense reactions to things. They're kind of a brain chemical thing, it's just how I'm wired and no amount of 'willpower' can change that. The sense of embarrassment makes them immensely worse than they have to be. I do not think this has to be framed as a pathology requiring medication, unless that's a helpful framework to you.

For your partner, perhaps it's helpful to understand that the magnitude of the external reaction does not correlate to the same depth of emotional turmoil or pain that might provoke that reaction in a differently wired person. I try to explain to people that it's just a thing that happens, but they don't need to worry that I'm horribly in pain or suffering emotionally. Especially since the concern of others worsens my sense of embarrassment.

Notoriously, trying to push away emotions makes them worse. What if, when you feel one of these coming on, you try to find quiet time to intentionally let go and cry and release the feelings?

Increasing your attention to emotional states and stress may also help to better understand it. Stress makes me less tolerant to overstimulation. Processing sensory information is a cognitive task and when there are many others and my cognitive resources are depleting, seemingly small things can be the straw that breaks the camel's back.

Mindfulness is often recommended as the way to do this. Trying to give emotions and bodily feelings associated with them more descriptive and specific names has also been scientifically shown to help regulate them – try sitting down and giving as many names as you can think of to the feelings you are having.
posted by lookoutbelow at 9:09 AM on October 29, 2022 [3 favorites]

Women are taught to cray; it is very effective at keeping us from speaking. There's an accupressure point; hold the fleshy area between thumb and forefinger.

I think it would help to approach this from the standpoint of controlling behavior. Search Vagal Nerve Stimulation. I used to carry a washcloth so I could find a bathroom and put a cold wet washcloth on my face, and I use that and other vagal stimulation to address heart arrhythmia. I have a heart rate monitor on my phone, and use it for low-key biofeedback; I breathe calmly and observe my heart rate settling down.

When you are aware that stress is building up, the breathing technique of consciously releasing tension as you breathe out, starting with your toes, and doing your whole body, is effective. Regular meditation might be useful.

And Xanax is extremely useful when used occasionally. I don't currently have a prescription, but just carrying it allowed me to feel better because I knew I could take a tiny amount (1/4 of a small dose) and it would hep manage the physical panic, anxiety, and stress, and I could take another tiny amount if needed.

I'm sorry you feel shame about this. It's a common and reasonable reaction; stress is very physical. Good luck.
posted by theora55 at 9:11 AM on October 29, 2022

Some tactical advice: loop ear plugs! I noticed some of your overstimulation triggers are sound based. Earplugs help me. It also helps me to put on or in headphones and listen to playlists on Spotify for deep focus or neurodivergence.
posted by CMcG at 9:17 AM on October 29, 2022 [2 favorites]

This happens to me. It is a well-known symptom of ADHD (which I have) and autism (which I don’t). Before I was diagnosed, I managed by controlling my environment as much as possible to avoid overwhelm, but also had a lot of meltdowns, as well as many, many days and full weekends when I would have to go into what I thought of as a near-coma state just to recover from normal levels of activity and stimulation. I would not leave the house, cook, clean, talk to another human being, or do anything that wasn’t maximally soothing: rewatching old tv shows, rereading favorite books, etc.

Now that I am medicated, my ability to cope with overwhelm is greater and I have more capacity available to manage my symptoms and environment before I reach the overwhelm stage. It is a truly remarkable difference and a major improvement in my quality of life. If anything about ADHD or autism sounds familiar or right to you, I really encourage you to seek care and diagnosis, and to channel your search for coping mechanisms toward people in this community. There is a really pervasive, damaging, and wrong idea that diagnosis is only useful for kids who are in school, but nothing could be farther from the truth.

I also want to nth what many other posters have said regarding shame. Your post is infused with it, and it makes me so sad that you feel this way. Neurodivergence is just another way bodies are made; it is completely morally neutral. You wouldn’t think yourself weak or childish for needing to wear glasses, or not seek care for your eyesight because you no longer have to read a chalkboard, right? Adults have perfectly legitimate mental and physical health care needs, too, and this is one of them.
posted by CtrlAltDelete at 9:58 AM on October 29, 2022 [6 favorites]

Some very good suggestions on this thread. I would start by affirming that having your meltdowns is not a problem, not a failure, not a fault or something wrong with you. It's your body's normal way of expressing and releasing feelings resulting from what seems like an intolerable situation, even if that's just accumulating from normal challenges.
Your physiology is doing this so there's a benefit, it's not a flaw in the machinery. Really your question might be how can I release stress or build-up of tension so it doesn't all come out at once so I can be less reactive in this way and healthier overall.
Here's a therapist who teaches shaking your body as a means to release stress.
My suggestion would be to find practices you can do daily that naturally and progressively release build up of the day's stressors and you may find you can mediate having big releases more effectively.
posted by diode at 10:03 AM on October 29, 2022 [1 favorite]

Benzos should be used with caution, but in this case, given how much therapy and other classes of drugs haven't helped, I would consider whether you could get a modest supply of one of the faster-acting ones prescribed p.r.n. (i.e., for use only when needed). They do work well on panic attacks; it's just that they have addictive potential (and shouldn't be mixed with, e.g., alcohol).
posted by praemunire at 10:33 AM on October 29, 2022 [1 favorite]

One more vote for considering whether this could be ADHD. I have experienced this in the past, though not as frequently as you describe. My child also tends to be this way. It has gotten 1000% better for both of us since we've been properly medicated.

I wasn't diagnosed or medicated until my 40s. It has made such a tremendous difference to literally every aspect of my life - previously, I had internalized a lot of my ADHD behaviours as character flaws. I try not to think too much about how my childhood and early adulthood could have been different if I had been diagnosed earlier, because it is just too sad and overwhelming.
posted by barnoley at 10:34 AM on October 29, 2022 [3 favorites]

Another thing: I previously suspected I could have an anxiety disorder. However, taking stimulants for ADHD has dramatically reduced my anxiety levels. It sounds paradoxical, but I think my brain was previously so clouded with random thoughts that I got overwhelmed and anxious.
posted by barnoley at 10:42 AM on October 29, 2022 [2 favorites]

Sounds like autism to me. I am self-diagnosed at age 39 and had a therapist confirm my suspicions as well, but no grand neuropsychology assessment at this point.

I get a form of this but mine often looks like anger. It took me years to realize that anger was really overwhelm that happened so quickly I didn't realize it was happening. It usually means I am overstimulated.

I find that sound is the biggest sensory issue for me. If I am feeling off then I need to wear noise reduction tools of some kind and go somewhere that I can control 100% of the sound for a bit.

But I also struggle with having any variety of sensory issues at once, that I'm not mindful about. Today I wore a Halloween costume to an event and as soon as the event was over, my skin was asking quite loudly to take it off as it was horrid synthetic fibers of some kind. Years ago I wouldn't notice that AS that, just get exhausted or cranky or suddenly angry. Now I listen, and I change what I can change about my environment or experience to reduce the onslaught of unpleasant sensory information.

If you are autistic then your brain doesn't work like a neurotypical brain, your nervous system is tuned to be highly sensitive compared to someone without autism, and this means you cannot realistically hold yourself to the standards of a neurotypical person. We don't want to act out in a way that hurts others or ourselves, but we also need to understand that ignoring our needs because we "don't think we should" have those particular needs IS a form of self-harm (once we are aware of this being a thing for us).

So consider not shaming yourself because your brain is so good at processing everything to such a great level of detail that it might take less to hit a wall than it would for someone else. The more you reject your body's signals that you're hitting a limit, the lower that limit becomes, which is how that burnout happens. Giving into our needs more regularly, even if they might seem strange to other people, is how we can partner with the body's intelligence to keep us healthy and functional.

Also, if this resonates, please understand the world is only recently starting to realize the autism tests are all based on young white boys basically, so things like emotion regulation issues, better (apparent) social functioning, and special interests that might be less intense or more socially acceptable, are only now being considered part of the picture. What you have seen about autism might be grossly inaccurate since a lot is based on non-inclusive data. Aspergirls is old, but a reasonable primer into what it's like to be autistic and a woman, if this all sounds feasible. And if you're already past the questioning stage then I recommend that you look into something like Unmasking Autism for a path to self-acceptance without shame. Good luck and MeMail me if you want to connect around this further.

On preview:
Seeing others mention ADHD. I have that too, diagnosed as a child. To me the key difference to source a meltdown is whether it's more about processing (too many people talking at once) or sensory in nature (one person talking but I hear the air conditioner hum or the super high pitched TV crystals sound or my shirt is tight and suffocating me or OH MY GOD I HAVE TO GET THESE SOCKS OFF MY FEET RIGHT NOW or someone just touched me with wet hands I didn't know were wet and now I am trying not to throw up.

And ADHD is also a sign of a brain that isn't built like a neurotypical brain so that stuff about honoring our reality and needs even if they seem strange still applies.
posted by crunchy potato at 11:21 AM on October 29, 2022 [11 favorites]

Do you often have low level physical pain?

Because that can REALLY sap your emotional reserves and ability to self regulate, far more than you might think that "mild" pain could.
posted by chariot pulled by cassowaries at 12:02 PM on October 29, 2022 [3 favorites]

Just wanted to come back in and mention that the ADHD diagnosis and meds did really help with meltdowns. I used to think I had anxiety/depression, tried SSRIs, Wellbutrin, lamictal, nothing worked, then I started stimulants and I was suddenly able to do things and not be depressed or anxious (mostly).

But it's not a silver bullet. 3 years ago, I developed health problems (chronic), which led to me being a lot more tired and stressed and the meltdowns came back after going years without them. I still am having them, though I am trying to learn to take them as a sign that I need to cut back - they sort of feel like my body's way of signalling to me that I'm pushing too hard.

I would describe my meltdowns as almost feeling like my brain has short circuited. Like you described, I can often feel them sort of building up.

One strategy that I find is helpful is when I feel it start to build up, I don't try to fight it, but I try to address it before it boils over. So that might mean doing some intense exercise (if my health allows), or maybe giving myself some time to chill out in bed and watch trashy reality TV while cuddling with my puppy, or talking to a friend who can be comforting and supportive.

My therapist suspects I could have autism, and there is a fair amount of overlap between autism and ADHD, but I haven't pursued a formal diagnosis, and honestly, I feel like ADHD explains a lot of what I've experienced. (I also have CPTSD, so there's that too.)

In addition to treating ADHD, I recently started taking buspirone (buspar), which is not an SSRI or a benzo, but is used to treat anxiety. They say it takes weeks to work, but I found it kicked in within a couple days. I had to titrate to get to the right dose, and it's not a silver bullet, but I've found it has evened out my anxiety and seems to play well with the stimulant I'm on (Vyvanse). So whatever else you pursue, that might be a med worth talking to your psychiatrist about. It's easier to go on and off of then a lot of SSRI's/SNRI's.

Lastly, I do find there's a link to my menstrual cycle, though for me, it's not progesterone itself, so much as it seems to be the up and down hormone roller coaster - so I get increases in meltdowns around ovulation and also starting about a week or so before my period. I probably should try some sort of birth control, but I admit the side effects have always scared me off of it. Definitely worth tracking your meltdowns for awhile to see what patterns you can find.
posted by litera scripta manet at 1:32 PM on October 29, 2022 [3 favorites]

I get these! It’s ok, and not childish. I get them a lot less often now because I wear really good sound canceling headphones most of the time. Living in an apartment was really hard for me in this regard - so many noises that subtly increased my stress levels! - and being able to control my auditory environment is really helpful. I also wear soft fabrics and pay attention to how I’m physically feeling. Sometimes, though, the only thing that really works as a reset is having a meltdown. And it sucks!! But it has gotten better now that I understand it’s just part of my body’s stress regulation response. I don’t lock myself in the bathroom anymore, and just get in bed so I can be comfortable and not add to my overwhelm by sending the signal to myself that this is so shameful I need to be locked away. And afterwards, I have something nice to drink like a cup of tea and ask for a hug. I think it’s still somewhat distressing for my partner, but talking about it as just part of how my body regulates has helped. I also try to let myself cry about it earlier in the build up phase you describe, because sometimes that means I don’t have to have a full blown meltdown.

Good luck. You aren’t broken. It’s ok to have different emotional regulation processes than some ideal person you are imagining. This does work for you - you said yourself it does! Just love yourself through it and allow yourself not to feel shame or guilt about it.
posted by Bottlecap at 1:38 PM on October 29, 2022 [3 favorites]

First thing I thought was Autism spectrum, and then you mentioned it yourself. Read more about the experiences women specifically have with Autism and see if they resonate and are illuminating. A lot of people may explain this in a million different ways, but if its Autism that may be a big relief and give you more to go on than general anxiety relief ideas. Sounds like sensory overload and Autistic meltdown, and that requires different strategies and a different mindset than other generic explanations
posted by asimplemouse at 1:46 PM on October 29, 2022 [3 favorites]

I get these as well, I've accepted them as part of my makeup and adjust! Meaning reduce my stress as much as I can and give in quickly and readily when I do feel I need to cry. Sometimes they're intense, like on the floor wailing, but I always try to drain every last drop and the relief feels so good. I use self compassion and speak to myself in a really nurturing, sweet, "ideal parent" voice during them and after, which also helps so much and feels healing.

Our society is scared of emotion, we're expected to hide it and it's relegated to the realm of childish or hysterical. But fuck that. I have big feelings and that's okay! Let em reign/rain.
posted by EarnestDeer at 3:49 PM on October 29, 2022 [2 favorites]

What you describe sounds relatable to me, a person with ADHD. This bit, especially around the shame spiral, also sounds like a classic ADHD symptom:
My other big trigger is when I have an argument with my partner, and say something I wish I hadn’t, and instead of just apologizing and moving on like a normal person I’ll get into the shame spiral and lose my shit.
ADHD can contribute to anxiety/depression, as well.

And like autism, ADHD in women tends to get underdiagnosed.

FWIW, I was only diagnosed aged 47, and there are plenty of others like me. So I don't think your age should be a barrier, if you want to explore diagnosis.
posted by Pink Frost at 9:29 PM on October 29, 2022 [2 favorites]

A good emotional crying jag raises your oxytocin level and produces endorphins. It's also good for your heart. So if you look at your issue in physiological terms, this is something your body needs and is good for you. Being ashamed of having crying jags is a bit like being ashamed of getting sleepy and needing to go to bed early, or being ashamed of getting too hungry to think clearly while working with complex algorithms so that you have to grab a snack because you can't keep doing it until lunchtime without something to bring your blood sugar up.

First, I'd start by looking for patterns in exactly what stresses tip you into the meltdowns. If you can figure out, say, that the jags are always triggered by deadlines, or always triggered by people wanting stuff from you and you needing to not let them down, or maybe it happens when you are not able to perform at a level other people will admire, then you'll be able to figure out exactly how the stress level is building. Consider also if there are conditions that trigger them, like having to be exposed in public places, or drive in scary traffic, or to perform in public, or stand around in noisy locations, or not getting to eat on your own preferred schedule.

Something is triggering a flight or fight response and you are not getting to either fight or run. You are toughing it out, and then after it is over the meltdown is what returns you to homeostasis. What is causing the flight or fight response?

If you can find patterns, you can look for ways to stop the stress building. For example if deadlines are triggering the meltdowns, you can choose to drop everything except the deadline work, or let people know you can't meet those deadlines, or deliberately violate those deadlines, or get started days earlier. Or if your meltdowns occur after work has required you to go on site with all the noise and moving people, and then only let you eat at the yucky company cafeteria two hours after you were fed up and feeling starved, bring earplugs and a sandwich, and pull the sandwich out of your pocket and eat it then and there while standing in the middle of the bustle.

Stress is what you experience when you have to do things and don't want to. Seriously consider and figure out exactly what it is you are having to do that you don't want to do. Maybe you just want to crawl back to bed but things are MUCH to busy. It's possible that whenever your immune system is trying to cope with the latest virus, your ordinary life gets overwhelming, because your immune system is eating up all your resources fighting the germs inside you. Sometimes the sensible thing to do is to take the afternoon off and spend it in bed, even if everything comes tumbling down. Consider if you would rather take the afternoon off or having a crying jag?

Finally, if you can't find a way to prevent the stress, you can try to deliberately raise your oxytocin level and your natural endorphins a day or two before the crying jag is probably going to occur. Get a massage from your spouse. Meditate. Masturbate. Put on some music that makes you euphoric. Do or see something that really moves you. Try a weighted blanket. Sing your heart out. Meticulously groom the dog. Eat a box of chocolate truffles. Watch a video that will make you cry with happiness when the happy end occurs. Get a big teddy bear, and cuddle it and complain to it and have a private whimper and whine session saying all the things quietly to the bear that you would be wailing out loud if you waited until it all burst out uncontrollably.

Tantrums are what two year olds do. But when a two year old has a tantrum what you do is double down on taking care of them. You don't punish or scold, you comfort them. You feed them, you wash their face, you hold them and you put them to bed. So when you feel a tantrum building, double down on taking care of yourself.

Maybe you just need to be looked after and sometimes it gets put off too long.
posted by Jane the Brown at 10:27 PM on October 29, 2022 [3 favorites]

Oh, my heart breaks for you. Please stop beating yourself up or thinking yourself less of an adult for having these overwhelming feelings!

I have anxiety/panic attacks that sound very, very similar to what you describe. (I've been diagnosed with GAD, but who knows if that is exactly right.)

For me, benzos are a wonder drug. I know you said that you likely can't get them, but I'd urge you to look for a psychiatrist who is open to the idea. Some people (like me) don't get "addicted" to them as the medical establishment fears. For many years, I've taken a low dose of lorazepam on the days when I start feeling edgy. On the rare occasion that I have an attack anyway, I take a somewhat larger dose and the panic/crying fades in about 20 minutes.

By all means, follow the self care advice of the above posters, but if you can, I'd really suggest looking into benzos.
posted by quiet wanderer at 5:27 AM on October 30, 2022

Oh my gosh I could have written this exact question, almost word for word.

Most of what I would say had already been covered, but in order of most helpful for me:

1. SELF LOVE. A regular, focused practice of self compassion, through mantras, conversations, meditation, visualization, therapy, catching my negative self talk over and over.

Put another way: acceptance. This is just the way my body works. It’s different than the way my partner’s body works, so it’s hard for him to understand. That doesn’t mean it’s wrong, selfish, childish, or dramatic! It’s just what’s happening. I need to work with it, not fight it. Fighting it causes the shame spiral, and exacerbates the meltdown. Instead, I observe it and I try to talk to myself like a beloved friend. It is really, really hard. But it’s the thing that’s helped the most.

2. Meditation

Particularly loving kindness (as above) but also mindfulness practices in general - they help with overwhelm leading up to the meltdown.

3. Birth control

Not taking it for this reason, but as mentioned above it does seem to even out the swings somewhat.

4. One song dance parties

Particularly music that makes you feel emotional, cathartic songs you might want to sing along to. I pretend all the emotional build up is coming out of my extremities sometimes! Like I’m dancing out all the stress (or overwhelm about the state of the world, the suffering of my loved ones, etc.)

5. In the moment when I feel it starting to happen: GET IN THE SHOWER! Or brisk walk, or a long tight hug, or just splashing water on my face. Anything to interrupt the thought process.

Lots of love to you. I leave you with some Bright Eyes lyrics:

But you should never be embarrassed by
Your trouble with living
Cause it's the ones with the sorest throats, Laura,
Who have done the most singing

posted by Isingthebodyelectric at 7:12 AM on October 30, 2022 [1 favorite]

you don't mention your age, but if you're late 30s or older it could be perimenopause. here's a comment i made recently about some menopause books.

i was thinking of making a post just like this, almost word for word including the partner being distressed. for me, it's because my cat is dying and my electricity isn't working and i'm perimenopausal and there's so much inflation and everything is so expensive, etc. etc. as others, and my therapist, have pointed out, this is a lot, and you aren't wrong for being stressed and upset. and sometimes a good cry or scream is quite helpful. i struggle a lot with shame around my "outbursts" as well and so you're not alone.
posted by misanthropicsarah at 12:00 PM on October 31, 2022

Please send a memail to me if you would like a list from someone else about how they approached getting some sensory and stress triggers out of their life and got to melt down free! I got permission to share privately but not on the open internet.
posted by Bottlecap at 6:46 PM on November 3, 2022

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