[CW: for all the typical heavy metal health stuff]

I think this is going to be more of a vent post than anything. I’m not expecting anyone to provide me with a comment that will be a watershed moment for me.

Here’s the backdrop:

I was caught in a bad long-term relationship and didn’t know it.

A had a crisis of political beliefs that really shook my worldview to its foundations because what I thought I knew about things and the way that I understood and moved in the world was all through that political lens.

I had been dealing with poor mental health since forever but I reached a turning point where I finally acknowledged that I was autistic, which again shook my worldview because it was a massive shift in I thought I knew about myself and my interpersonal relationships, as well as my relationship to myself.

I got a curveball diagnosis of ADHD along the way, and one of the things that they don’t tell you when you start on ADHD meds as an adult is that you can expect your relationships to others to change and that often if you have a bad relationship, ADHD meds can be the catalyst for change there. They also don’t tell you if you have a significant history of trauma, especially if it hasn’t been processed, that when you start ADHD meds your brain is going to find itself with a whole lot more presence and a whole lot of reserves so you’re probably going to start dredging up and processing that old trauma whether you like it or not.

As I got things together and found some of the right meds, my long-term relationship deteriorated. I started to keep track of things a lot better and this helped me to realise what was really going on in the relationship.

Anyway, shit got really bad with my ex engaging in medical abuse, using the cops as leverage (e.g. physically assaulting me and then calling the cops on me) and lots of stuff like that.

I was already burnt out before she started becoming openly abusive of me. I didn’t have anyone that I could fall back on for support. I was preparing to become homeless and to live out of my car, until my ex stole it. The stronger and more independent I got, the more of a threat that was to my ex and the worse the abuse got. Those who do not move do not notice their chains, and all that.

And meanwhile the ADHD meds were working pretty well but they were also making me much more prone to full-blown anxiety and I was processing old trauma while getting fresh trauma heaped on me. I needed them to be able to get my shit together but I desperately needed to not take them because for as much as they were helping me, they were also making things that much harder too.

Anyway, I get out of the situation and I start again basically from scratch. Except I have a pile of trauma to deal with, even more than before.

By this point I had been redlining it for a very long time and I was so focused on survival that my mental health went to shit. I started suffering bouts of catatonia and I had to rely on myself to figure out what was going on and to ascertain the cause of it, without knowing what it was. That took a heroic effort on my part because I was dealing with really intense suicidality, trying to work through the trauma, trying to rebuild my life, and between all of that I was getting pummeled by these periods where I was barely able to care for myself in the most basic ways. Then I had to try and scrape together whatever was left over to determine the etiology of these mysterious bouts where I was debilitated -I had to catalogue all of the symptoms and potential triggers and then I had to make a list of causes and to eliminate the easiest and most likely ones until I figured out what was happening to me.

And there was stuff that had to be dealt with in the court system and with police and other government agencies because my ex did shit behind the scenes like committing fraud in my name and stealing restricted meds (think Schedule II if you are in the US) and having to report this to the police because otherwise the risk was that my ex would have these meds with my name on the prescription and that this could possibly be used to either cause me legal trouble or that I could get my authority to be prescribed those meds rescinded because there was “evidence” of me giving them to others/selling them. I hate dealing with the cops but it was a situation where I couldn’t afford to risk my access to the meds and I couldn’t let my ex exploit this potential vulnerability if the theft wasn’t reported immediately. So I had to compromise on my principles. Hooray! 🎉

Anyway, I determine that the most likely candidate for those debilitating bouts is catatonia and so I scrape whatever I can into researching this for myself. I had to do a medication review for myself because I suspected that some meds were aggravating the suspected catatonia because if you go to a pharmacist or doctor and request a medication review because you suspect you’re catatonic they’re going to look at you like you’re completely unhinged.

Stuff falls into place and the catatonia hypothesis fits - it explains some anomalous responses to other meds and it has a lot of explanatory power.

I make my case to my psychiatrist but unfortunately the gold standard for diagnosing and treating catatonia is the lorazepam challenge (a benzo) and I didn’t want to come off as drug-seeking so I had researched alternatives to this and had a breakthrough with treatment when I requested a different drug to use as a trial. A couple more positive responses to the drugs and taking them once when I wasn’t catatonic, yielding a completely opposite response, made the catatonia diagnosable.

I get through the legal stuff. I start dealing with managing the difficult side effects from the ADHD meds through the same sorta process as above, except it required more of a self-inflicted crash course in psychopharmacology. My life becomes stable.

And since that point I’ve been so, so pervasively tired. I was ready to give up before any of all this shit started.

I’m dealing with immense (autistic) burnout coupled with crippling depression and it’s hard because half of the advice for dealing with depression is contradicted by half of the advice for dealing with burnout and vice versa and because I just don’t have the energy to do much or to make positive changes in my life, so I feel completely hamstrung.

The things that give my life meaning are hard to participate in because I am very often too tired to engage with them.

I have to swallow my outrage at the state of the world because I am mostly incapable of contributing towards change (e.g. going to rallies for Palestine.)

I almost never have the energy and focus to read and so I’m basically stuck in a holding pattern with regards to resolving my internal crisis of political beliefs until I’m able to sit down and go back over the things that I had read with a strong ideological bias.

Rebuilding interpersonal relationships is difficult because it’s hard for me to be consistent at all and I just end up turning down invitations to do things because I don’t have the capacity most of the time, and it’s just plain hard for me on account of the fact that I’m autistic. Also it’s hard because I’m exhausted and miserable, so it feels like a choice between bringing all of that to a friendship (which is a huge downer) or putting on an act to give people the impression that I’m fine (which makes me feel inauthentic and it tends to aggravate my feelings of isolation.) It’s probably obvious but my trust is pretty broken too so this adds a layer of difficulty.

Rebuilding a positive sense of self is really difficult for me because my ex exploited my vulnerabilities, on account of being multiply-neurodivergent, and it’s hard to feel anything but regret and resentment towards being the way that I am.

I barely have the energy to take care of my basic needs let alone to do anything else and I’m so anhedonic that even if I do have the energy to do something that I used to enjoy, I get nothing from it and then I just feel the need to grieve the loss of a thing that used to make my life enjoyable.

It’s hard to find the will to persevere, especially when all of the things that could help me get well are out of reach to me and it feels like I’ve reached an absolute impasse.

I’m just so tired.