Thank you!

I really need to pull my finger out because I need to write a deep dive post on autistic burnout and catatonia, and another one on how ADHD and autism intersect when they are co-occuring. I suppose I could do another one giving a rundown of the main medications used for ADHD and how they tend to work for people too.

I've been struggling with pretty severe burnout. Honestly, it's the absolute worst of my entire life. So at the moment I get brief jolts of inspiration to reply to comments here and there and then I either lapse back into the void or I have life committments to deal with so these sporadic comments are the best I can muster a lot of the time.

I also have crippling posting anxiety and making a genuine post is hard because I invest too much into it and feel overly responsible for replying and stuff. Is that a symptom of grass-deficiency? It's definitely a symptom of grass-deficiency lol

I read that comment when you posted it!

Oh cool, I'm glad that it got to some of the right people.

I have no idea if stimulants will work well for me. I've definitely used caffeine to self medicate most of my adult life so maybe?

The take from one of the foremost global experts in ADHD is that stimulant meds cover about 80% of ADHDers - methylphenidate/ritalin works well for about 40% with amphetamine-based stimulants (Adderal, Vyvanse etc.) working for about another 40%, so there's a good chance that they'll work for you. Honestly I suspect those numbers are a bit low because there's probably another 5 or 10% at least who find that stimulant meds do work but that they can't continue using them because of certain side effects (e.g. weight loss, insomnia etc.)

If we throw in stimulants that aren't the classical ones, like modafinil, I think that number would probably get bumped up a bit higher too.

But either way I know it won't be a magic bullet, just one thing to try if a doc recommends it I guess.

That's the right attitude to approach stimulants imo.

I honestly don't know what not being able to mask would look like for me, but I work from home on a computer and have very accepting friends so hopefully the adjustment wouldn't be too rough?

Cool, that's one less thing to worry about then.

If you're in a customer-facing job or you're in social circumstances that require high masking it can be really difficult for some people because they often find themselves stuck between choosing to be functional and choosing to be a socially-palatable disaster.

I think not being able to mask often presents as being less concerned or less focused on determining the emotional state of others and attempting to match it, along with stimming more, and being less inclined to put a lot of flair into the way you speak and use gestures and stuff like that. There's probably some other stuff that I can't think of at the moment which I'm overlooking too.

I try not to downplay (or play up) my own struggles but all things considered I've lived a pretty chill life I feel like..Lots of self-repression and some serious struggles socially at times but you know, not outright horribly traumatic? So maybe that helps idk.

That's good to hear. It's definitely going to make things easier for you if you do end up being prescribed stimulants.

Though it's worth keeping in mind that often the self-repression and masking comes due to experiencing a lot of hard knocks socially. This is not to diagnose you or to pathologise what you've been through or anything but sometimes when it's the background noise you just get so accustomed to it being there that it becomes your normal. Stimulants often bring that stuff to a head; I am diagnosed with PTSD and I legit have this condition so this is me just hypothesising but if the stimulants bring that stuff to a head for me then I suspect that it would do the same thing, to a lesser degree, for people who are sub-clinical or who have had some tough battles but where they don't have symptoms of PTSD/they only have milder ones.

All of this is speculation though. This is a massive blind spot in research and as far as I'm aware there's no efforts to really understand this from academia yet. We need more neurodivergent folks in research asap.

Thanks for your prolific support and advice all over the site!

Ah no worries. I'm just glad to help and to do my bit to contribute to the knowledge base on these topics because there's such a gap that exists currently.

I just got new insurance so I'll have to see what it will cost to see someone this summer. I hate to say it but I want to see if I can get the ball rolling on this diagnosis stuff without telling them I'm trans... (is that a horrible idea?) Let's just say I don't want to be on that list given the way the US is going lately... My gender is none of their business and even barring government action, telling your doctor you're trans unfortunately seems like an excellent way to get subpar medical care. Or maybe I'm needlessly paranoid but I'd rather be paranoid and wrong than the target of fascist repression or plain ol discrimination.

Honestly it's one of those things where being cautious is something that I'd recommend, if someone were to ask me.

A lot of things stick with your medical records and, although I'm somewhere in the non-binary spectrum (meaning that I'm not cis so therefore that means I'm trans) I've never really hashed this one out with myself because I have had more urgent priorities so I am happy to sit this stuff out since I'm barely even an expert in my own experience. That means this next bit is just me making an educated guess here but I suspect that if you're trans in the sense of being opposite to your assigned gender and you're open about it with medical professionals then you're probably going to receive less quality of care and you run the risk of having anything you present with as being considered a "trans issue". Idk if I'm making sense here but for people with chronic mental illness they very often report that medical professionals just get locked in on the mental health stuff to the exclusion of everything else, so it's hard to get physical issues considered and often it just gets lumped in as being caused by mental illness or brushed off as a side effect of medication. I have no knowledge about this for trans people but I have a suspicion that, in a similar way, a lot of doctors would be quick to blame ADHD symptoms on a person being trans or on hormone therapy side effects and stuff like that. Hopefully a trans person who is knowledgeable about this stuff might chime in with their experience to let us know what it's been like for them.

Then, as you've mentioned, there's the overarching concerns about politics and long-term safety to consider as well.

So my general advice would be to try and go for an ADHD diagnosis first, if you're able to prioritise it, and go from there. Honestly an autism diagnosis probably only provides you with about the same study and workplace accomodations as an ADHD diagnosis would, and given the cost of an autism assessment it might not be worth the price of admission.

To be clear, my childhood wasn't severely traumatic, but stressful enough that I had forgotten most of my childhood.

I have been diagnosed with Autism and ADHD at an early age. Of course, the doctors said at that time that I would never be able to experience any emotion besides anger and sadness for my entire life, so I would be careful with the information you give to them and try to find a good psychologist/psychiatrist. I have had to jump between multiple as often they were on a grift to get me on a particular med that didn't work for me. This was during the med change after dropping out of college, but I had other doctors before that wanted to use me for profit when I was younger. Others were just backwards and refused to update themselves in their profession.

I have been on the max dose on methylphenidate since middle school. It does work for me, but I have taken it so long that I believe the effects are not enough to overcome my severe burnout. When I quit my job, I am considering going off meds for a week and sleeping all day. When I have had breaks with my stimulant, its effects have improved again for another period of time until the burnout overcomes it again.

I went on antidepressants for situational depression after dropping out of school, and then I continued going through a med change and ended up back on a stimulant again, but this time Vyvanse. It's effects were the same on me, but I believe I felt a bit weird (tingly in the brain?), so I think the side effects were worse on me. I went back to methylphenidate because I was poor and it was cheaper at the time. Going back on stimulants after around a year made me feel much more functional again.

I have also been drinking a lot of caffeine on top of my stimulants, sometimes even 600-1000 mg, because I have been struggling to do work. Once I drink around 900+ mg, I get a terrible headache and stomach ache, so I try to avoid that range.

I have been going very late to my job, and I use the restroom a lot out of anxiety and stress. It's a 35+ min drive to work and a 45+ min back home, and it absolutely sucks. I think I have managed to keep my job as I have made a lot of PowerShell scripts that have helped the company immensely, which I even received a large pay raise and multiple gift cards for. I feel as I have always relied on my ability to do work at a perfectionist quality to make up for my shortcomings.

I went on Jornay during my current job, which seemed to help me get to work on time a little easier, but I had to go back to my old meds because it was very expensive, and it would really suck when I forgot to take it the previous night.

does it mean anything if caffeine can have varied, random effects?

There's a lot of moving parts in that question lol

So different people seem to be more or less sensitive to caffeine and medications or sometimes even other things like diet or especially supplements can affect how caffeine affects you - for example L-theanine with caffeine seems to really smooth the rough edges of caffeine and it's something that naturally occurs in tea so a person might notice that the caffeine from tea doesn't affect them in the same way that coffee does. Likewise different ways of processing coffee changes the amount of caffeine you get so two coffees of the same volume can have different effects due to their respective caffeine levels.

Then there are certain things that can inhibit the way your body processes caffeine so if you drink an energy drink with taurine or guarana in it, for example, then that can interfere with how your body metabolises caffeine, making it feel stronger and making its effects last longer.

Then there's other factors associated with lifestyle that impact this. If we take an ADHDer as an example then it's well known that poor sleep quality really fucks with ADHDers and they might find that caffeine doesn't seem to have much of an effect when the have been struggling with sleep.

There's more that I could go into with this but I'll wind it up there so this reply doesn't drag on unnecessarily.

sometimes it makes me jittery, to the point of anxiety like i'm being chased. other times it makes me blackout tired. there's a spectrum here, and i rarely land in the 'wakeup' zone that most neurotypicals seem to be in it for. it doesn't seem to matter what my energy level is beforehand.

Without knowing more, at a guess that sounds like you might be on the far end of the arousal curve. Don't take this graph as being the be-all end-all but:

Show

Any stimulant is going to push you further to the right on that curve. (I don't think that anxiety belongs strictly in one part of the curve but it'll do as a rough guide.) If you're already feeling fatigue, especially if it's a chronic sort of fatigue then caffeine might push you into hardcore anxiety. Or it might push you beyond that point into the complete exhaustion/burnout zone where you are just ready to collapse.

It gets more complicated with ADHDers because for some ADHDers they find that the stimulating effects of caffeine to help them feel centred and relaxed, so often ADHDers will report that caffeine can put them to sleep. Though that's not the case for all ADHDers, certainly not for myself except in rare occasions, so I wouldn't use this to rule anything in or out especially without knowing a whole lot more about what's going on for you.

General advice?

Sounds a lot like burnout, which can affect anybody. I would do recommend trying out the general advice for burnout management and see if that improves things for you - focus on improving your sleep quality, try to avoid additional stress, opt for light exercise that isn't too prolonged where it's within your capacity to do so, cut some corners where possible so you have fewer demands on yourself, go easy on caffeine/alcohol/other drugs, regular mindfulness and relaxation are good habits to cultivate etc.

Worst case scenario from gradually integrating burnout management advice into your lifestyle?
You end up feeling more relaxed and less overwhelmed so the risks from trying this stuff out are pretty minimal and even if it's not the answer that you're looking for it's probably going to be of minor benefit to you. The risks of not addressing burnout early enough, on the other hand, can be pretty disastrous.

also, i want to thank you so much for your post in the other thread and this one. i've been taking notes since i'm starting on my third journey for treatment.

I'm always glad to share info, especially when it's helpful for others.

Good luck with the treatment!

Keep at it, even if you feel disheartened, because the more treatments you try the more you will be able to narrow down what works for you and what doesn't. Over time this can form a picture of what's going on for you so that you are able to get to a diagnosis/treatment/lifestyle that fits your circumstances.

I can't tell you how much sympathy I have for you. It's tough, really tough, and I get it. Things don't have to be this difficult though.

You deserve to have a life where you are well supported. You can do this 💪

Just a general word: ADHD is a dimensional disorder. Meaning, there isn't a single identifying symptom that differentiates ADHD from say, a more neurotypical person that is a bit disorganised. Everyone forgets shit, everyone is late once in a while and everyone fidgets when they are nervous.

So the question you have to ask yourself (and which will be part of the diagnosis): How often does that happen? Is this majorly impacting the direction your life is going and are you okay with it?

If the answers are "pretty much everyday" and "I would not be where I am, if I didn't behave like that and I feel like I can't do anything about it even though I want to", you have a pretty good indication.

Your wording and descriptions all sound very much like my (inattentive) ADHD to me.

Thr venn diagram looks real circular here. If it is an option I would get evaluated. My GP just gave me the pills to try and asked me if it helped after. The psych doc wanted we to do a weird computer test though. So your milage may vary on that

i don't really notice much from energy drinks. but i take caffeine pills if i got very little sleep and i guess that helps

That's an indication that you may have ADHD.

i'm diagnosed with clinical/major depression from when i was 15. still there i guess but not as bad now? i used to be on meds but i feel like they didn't do shit but make me an emotionless robot

Okay, so it's important to recognise that the symptoms of depression and ADHD can mimic one another. I'm not going to try to convince you either way on this, not would I try to diagnose you if I were qualified to, I'm just going to throw info out there to help you have a better understanding of your own situation.

what makes me think i might have adhd as well:

• even pre-depression i'd procrastinate bad, i'm terrible at starting tasks i don't want to do. from a very young age i've been awful at doing homework despite doing very good in school otherwise, for most of elementary school i didn't even brush my teeth

This is going to sound odd and you don't need to answer this but - do you enjoy putting off tasks? A person who is lazy enjoys putting things off. A person who struggles with motivation wants to do things but is unable to get started, and they generally feel very stuck and very uncomfortable not being able to do what they want to do.

How are you with finishing up tasks? Do you often find yourself nearing the completion of a task, even something like playing a game through to the end, and you lose all motivation so you tend to have a lot of things that are left abandoned at 90% completion?

The typical ADHD experience is that, when the task is near completion, suddenly all your will to get to the finish line just drains away to nothing.

This is distinct from being exhausted and pushing yourself to finish but not quite getting there, and it's particularly noticeable with tasks that are independent of external demands - at work or studying there's a lot of external expectation for you to finish the task so you will probably get there. Outside of that, in your personal life, without those external forces you will likely notice this is a pattern for you if you have ADHD.

• bad at paying attention to things that don't interest me, fixate too much time on specific things e.g. an internet rabbithole

Do you lose all sense of time when you're down a rabbit hole?

What was your ability to pay attention to boring things like prior to being depressed?

When you say bad at paying attention, are we talking like you mind wanders a bit and you have to put in effort to pay attention or are we talking like trying to pay attention to a boring topic makes you feel like crawling out of your skin, like it's almost physically unbearable, or being on a 10-second countdown before you're staring out of the window with unfocused vision until someone starts clicking their fingers in front of your face multiple times before you snap back to reality?

sorry if this is long, not sure how much of these are genuine symptoms just things that seem ND that i experience.

Just a bit of info: neurodivergent refers to people who have atypical neurology. This includes all the different forms of mental illness. I think it's an extremely common misconception that ND just means "autistic and/or ADHD" but that's really not the case.