They laid off almost everyone at my old job on a few Monday's back. I was already trying to get off pot and booze because they were frankly killing me. I had started Wellbutrin but it was still the 2 week period where that stuff kicks in. When I got told that I was going to be let go I had a really bad mental breakdown. I have PTSD from having an utter shit childhood and really bad episodic MDD. I could not focus and was crying in public which has not happened in a while. I also might have been hearing voices but they are not there anymore. I ended up in a partial hospitalization program under recommendation of my therapist and while it sounded scary it has turned my life around in only 3 days of going.

Next step is they are going to be putting me on Abilify to even out the spikes I have been having. While the Wellbutrin is handling some of my ADHD I want to see if I can change it to 300mg to see if it squashes it along with my MDD episodes that its handling now. The psychologist says I should not be scared of the Abilify even tho I kind of am. She says it will even out the spikes and dips I have been having. Those are what are causing me to cry. I read on the internet too it should be helpful with my autism spectrum issues.

I have been white knuckling it alone for so long that seeing some light on the horizon makes me want to cry with joy. I just hope some of the bridges I have burned can be built back up again because I have left a trail of fire behind me. I am really hoping to figure out this whole vegan thing that I have been so hardcore in hating now that I am not consumed by thoughts of death.

Lastly, I dont know if any of you have had some experiences with Abilifiy if you do I would like to hear about them bad or good. Thank you for reading this my friends, and if you think there is no hope out there remember that other humans have beat what you have and you dont have to go at it alone.

  • ReadFanon [any, any]M
    ·
    6 months ago

    I think my BP is so high because of my anxiety and stress. But I will talk about that in a another part. I am going to talk about this Guanfacine to my psychiatrist and see what they say. It sounds like it fits my profile.

    Oh my bad, I misinterpreted what you said and thought you were dealing with hypertension as a separate health condition.

    Given this clarification, personally I'd be scrambling to get my hands on guanfacine (or clonidine) if I were in your situation because it has a lot of potential to help.

    I ended up having a PTSD episode in front of staff because of a confrontation I had with someone between groups. I got agitated by some comments someone made and communicated it to the person who did it, and they reacted badly back to me even tho it was a reasonable request. I really could not handle his response which would require me to escalating things and instead I grabbed my bag and walked out.

    Sorry to hear that you're having a stressful time. It sounds like you're managing it well though.

    I never really have been able to figure out what is happening to cause me to go all emotional during events like this because normally I am a rational person.

    So I'm going to reiterate that I don't hold a qualification or anything but there are a few things that I can recommend looking into or considering with regards to this:

    • Overstimulation

    When you're overstimulated, especially if you've had to deal with a lot of "bad" stimuli, it's very common to have a meltdown or a shutdown. You can also experience the same thing by being emotionally overwhelmed too. So if you're having a big outburst of emotion it can be that your nervous system is just overwhelmed, either in an acute episode or a more chronic build-up that occurs over the course of a day or longer.

    In this situation it can be helpful to tune into how you're managing your sensory input and to adjust so you have more of the positive sensory input and less of the negative. Stimming can really help with regulating your nervous system too.

    Another thing that is helpful in this situation is to try to take little sensory breaks if possible. Even 5 or 10 mins with sunglasses on, headphones in, and disconnecting from the outside world to make yourself comfy can help you manage when you do re-engage with the world.

    • Poor interoception

    Autistic people often face significant difficulty in identifying their emotional state. I know for me my interoception isn't great so I often feel like I'm working downstream, like my awareness works on a delay and I'm always trying to catch up - when things are good and I'm taking care of my needs that delay can be very short and maybe only a few seconds but if I'm overwhelmed and I'm not attending to my internal experience then that delay can be hours or even days, meaning I won't realise that something irritated or upset me until much later on.

    There's a lot out there on autism and interoception so if this feels like it might apply to you then I'd recommend watching a few videos about it and stuff like that to better understand it.

    • Masking

    This is my own opinion but I think that masking dovetails into interoception issues because masking requires you to put a lot of energy out into the world and to really attune yourself to the emotional state of others and to work hard to do things like modulating your tone and carefully selecting your words to avoid unintended implication and doing eye contact "right" and displaying the "correct" body language and facial expressions etc. etc.

    All of that is pretty damn exhausting but moreover if you're doing all of that then it's really hard to be connected to what's going on internally for you.

    There is tons out there about autistic masking and I guess in short if this feels like it might be applicable then the next step would be to work on becoming a bit more conscious and purposeful in how you mask and to what extent you mask, as well as giving yourself permission or setting your intention to reduce your masking somewhat. Also taking regular breaks so that you can catch your breath, drop the mask, and check in on yourself is very useful too.

    • Trauma response

    ADHDers, especially ones who aren't appropriately medicated (this varies between individuals and it's not a value judgement - appropriately medicated might look like being unmedicated for one person and it might look like multiple medications for another person), tend to be much more emotionally reactive because that's just what comes with the territory.

    When you throw in PTSD and a proper trauma trigger then you have a sort of perfect storm where it gets amplified but there's this thing where ADHDers tend not to have that half second or longer where their emotional state begins to shift and they can choose to deploy strategies to manage this emotional shift in the way that their neurotypical peers do.

    For ADHDers who have PTSD the emotional response can be like a hair trigger and it dials up to 11 seemingly instantaneously and you're left trying to manage the fallout. It was a bit of an eye-opener for me taking stimulants, to a lesser extent, and definitely with clonidine because I found that I suddenly had more ability to direct where my emotional state was heading; if I were to put it metaphorically, it used to feel like these big emotional shifts were a stampede and I was caught under it but with the right meds for me it felt more like I was riding a horse - sure the horse has a mind of its own and it will respond to situations but being on top of it means that I can direct where it goes and I have a lot more influence over it. Or maybe it's like the difference between being caught as a wave crashes down on your head vs surfing that wave - you can't control the tide but you can adjust how you navigate the wave you happen to be riding at that moment.

    Anyway I'm rambling again. I guess one thing that's tricky is knowing that it can be a combination of some or all of these things so yeah. My best advice is to do a bit of research, try adjusting things, and see if it makes any positive impact.

    Honestly the worst case scenario is pretty much this: you take more breaks, you put in more effort to make yourself feel comfortable, and you put less energy into masking or appeasing others and you redirect that energy into connecting with your own emotional state. Seems like even if this doesn't address the underlying cause you're still going to benefit from it anyway.

    [Continued]

    • ReadFanon [any, any]M
      ·
      6 months ago

      [Continuing]

      I never really thought of PTSD affecting normal people like me because its all about the troops and shit when people talk about it. I have been in denial with what was happening to me when people would relate their experiences of it in group about it. That is why I never really looked into it seriously before and did not internalized it when they told me before about it when I started the program.

      Yeah, that's understandable. I don't know your story but one thing that has been useful for me with framing this sort of experience is recognising that because it's something that has always been there in my life, or it's something that feels that way, then it can be really hard to identify it because that's just your baseline.

      This famous bit by David Foster Wallace comes to mind.

      I just assumed I was bipolar but my episodes are not psychotic in nature. The things happening to me are reactions to real events, and the emotions are rooted in my past, and my body shows it to people who can see these things in people I think. I am not really reliving the moments as much as I just get raw emotions that override anything I am feeling. I need to map my triggers now which is gonna take time because I have no idea what is doing it when I think back on situations like this. I need to be able to make it though a 60 min therapy session without using 30 of it to cry that is for sure. The meds they say will help stabilize me for that. I am just glad I was around people who could spot PTSD episodes and know how to deal with them.

      Yeah this is really typical for what you have described.

      It can be easy to think that staying up all night because you're hyperfocused or the ADHD impulse purchasing is actually a symptom of (hypo)mania and stuff like that.

      The emotional swings that come with being ADHD and having PTSD can really come off as bipolar-esque mood swings, especially because you aren't necessarily able to identify how or why your mood just plummets or why you suddenly feel a surge of overwhelming aggression or whatever else bubbles up to the surface in response to what you experience.

      I'm not saying that you aren't bipolar, or that you are, but when it comes to complex and comorbid conditions like autism, ADHD, and PTSD together then it's super important to approach this very carefully and to take inventory of all the assumptions and things that you might be taking for granted. Being very diligent and taking a scientific approach of "Observation > Hypothesis > Experiment > Collect Data & Analyse Results" to rule things in/out is extremely important imo.

      I have a new thing for my list too and that is my silly ruminations I do on the type of events that happened at the PHP building. I will be up for 2-3 hours just ruminating on events and cant really stop unless I totally shut down the thing in me that wants to rehash shit. Like flat out saying out loud we are not going to talk about this. I hate it because it will toss things at me like comments from a peanut gallery. It stops me from sleeping and if I wake up getting back to sleep is impossible.

      That does sound a lot like the intersection of Rejection Sensitive Dysphoria and being autistic, where you take hard knocks from the RSD and being autistic you just run into social rejection more often and you have the tendency to experience perseveration. On top of that I think that it's common for autistic people to sort of decompress and analyse their interactions from the day or the week to scour it for any missed details or faux pas and similar stuff. This can also include determining how certain things made you feel in the moment as well. Part of this is a deeper aspect of masking imo but I think there are other facets to it as well.

      If it's causing you distress then yeah, use those strategies to manage it. But I also think that doing this can be fairly neutral too - I know that sometimes I'm experiencing a difficult emotion and I can't pinpoint the what or the why but by replaying the events from the day I can glean insight and often things fall into place for me (e.g. upon reflection I suddenly realise that I have been carrying a lot of frustration because earlier in the day someone had misinterpreted what I was saying and so I can deconstruct that by reminding myself that I put a lot of effort into communicating, I was being clear in my communication at that point in time, and that I don't need to take on the blame for them not listening or seeking clarification from me before jumping to conclusions.)

      I think it depends on whether or not it's "pathological"; is it causing you distress? Does it interfere with your ability to enjoy things? Does it serve a purpose? etc. etc.

      One thing I have noticed is how much my body reacts to these episodes... I also have some other symptoms that are really allergy like that intensify after episodes. I get a sore throat where I can also feel some swelling that might be my uvula, I sweat a lot, I get itchy, and my nose goes all runny. Its like my body is attacking itself when episodes like this happen.

      This is getting a bit into the weeds but autistic people are more likely to experience auto-immune diseases and similar. It's pretty well known, although it's not necessarily established in scientific literature, that chronic stress aggravates this stuff, and we know that autistic people experience really high levels of stress compared to their allistic counterparts.

      I really want to get off this Abilify at one point but I think that might be years away. I live on my own and really do not have anyone that looks after me physically and so my place is a hoarders hell.

      Experiencing serious trauma, experiencing executive dysfunction, neurodivergent burnout... these things are a recipe for hoarding. And that's without even mentioning the socioeconomic factors because hoarding is very often a response to poverty or significant experiences of deprivation (e.g. childhood neglect, even if poverty itself wasn't a factor) and neurodivergent people are so often overrepresented in poverty stats as well as often experiencing deprivation due to stuff like being too burnt out or too overwhelmed to make food so you just don't end up eating, that sort of thing.

      Once I clean up my life I was thinking about getting one those psychiatric service dogs. I have a friend who is a DID system and they have one that helps them with their problems. They do tasks for them so they can remain independent which is what I want to be. I know the dogs take years to train but I also have years to train myself on how my body actually deals with things.

      Sounds like it would be a wonderful thing to have!

      A service dog can be trained to respond to your emotional state and to alert you to it or to take actions to intervene (e.g. laying their body on your torso to provide deep pressure stimulation to help calm you down). It might be really handy to have a dog who helps you with identifying and managing this stuff rather than trying to do it all by yourself.

      Thanks for listening to me again. It helps me a lot.

      Any time! I hope that things improve for you.

      (Also apologies for rambling and apologies if I have lectured you about stuff that you're already aware of - my intention isn't to make myself out to be some sort of expert who knows better than you do, I just try to resource people and often it's sorta like dropping PSAs for other people who might be reading this and notice that certain things are resonating with their own experience.)

      • CoolYori [she/her]
        hexagon
        ·
        6 months ago

        Hey just to let you know I am just seeing your reply now. Its gonna take me a little bit to process it but I let you know what I think.

        • ReadFanon [any, any]M
          ·
          6 months ago

          No worries, I know it's a ton of information and I've got a tendency to be verbose a bit a lot.

          Take your time and don't feel like there's any obligation to respond.