First…I am NOT an anti-meds person, but I don’t believe that everyone should just be on them. My friend has schizophrenia and absolutely needs her meds. It’s scary when she’s off them because of how negatively it impacts her life.
I called out of work one day due to having an issue and in desperation made a same day appointment with a psych NP. I was surprised at how immediate and quick she was to be like “hey sure yeah you can try meds if you want”. They diagnosed me with the generic “depression and anxiety” and when from there.
Well the NP immediately quit after that and they transferred me to a new NP, who has continued to prescribe different meds for me. I also recently started therapy.
With the first med I tried (an SSRI), I continued to have my episodes, so I initially thought it had zero effect. In retrospect, I do think it slightly lowered my anxiety (but not enough to really do anything). Coming off them was unpleasant and I had another episode that may have threatened my job. I’m not sure if the episode was related to the med reduction or not.
My NP specifically stated that I do NOT have bipolar disorder, but that she wanted to try lamotrigine with me. I have been slowly over many months titrating up to my therapeutic goal dose and reached it a couple weeks ago.
She also recently prescribed me PRN propranolol which I also don’t know if it has any effect. I very rarely get panic attacks. My NP’s idea was that if I have a stressful that happen that day to take it so I am theoretically less inclined to have an outburst of some sort later. Again, I’m not sure if this is really doing anything for me. I don’t notice an effect.
I know propranolol is preventative instead of used during or after, but I can’t always predict when a trigger may occur.
My episodes generally begin with a trigger. So if there are no triggers, I have minimal/no issues. The triggers are not 24/7 and there are sometimes many weeks in between. So how tf am I supposed to tell if the medication does anything???
My issue: extreme negative emotions/spiraling generally tied to a trigger; can cause me want to self harm or do dangerous things, can sometimes cause outbursts at work which threaten work interpersonal relationships and my job. For the most part, my episodes occur outside of work and I am usually (but obviously not always) able to keep it together). So it can be very distressing and unpleasant to live with…but again it’s not 24/7.
Sorry that was long!!!
I was wondering! Your initial account really resonated with me, like something I could have written myself. The only confirmation I needed was if we had the same triggers, which we do. You react just like me too.
For my entire life, I’ve been extremely sensitive to rejection (and criticism, which is really just a type of rejection). Comments that could be perceived as criticism, no matter how implausible or nonsensical that criticism which be, would make me feel stressed or cause a sudden jolt of panic. Real criticism would cause me to stress and fret for hours or days, until I could appease the critic or fix the issue, even if it really wasn’t an issue and they were just manipulating me. Direct rejection, like being turned down for a date, a breakup, being passed over for a job or recognition, or someone telling me they simply don’t like me, would send me into an emotional tailspin for hours, days, or weeks. If any of this came from someone I cared about or was about something I was particularly sensitive about, it was so much worse.
I can tell you what causes it for me and what I’ve done in the hope it might help you, and feel free to ask any questions about anything. Literally anything. I know how awful this can feel, how it can make you feel like life is so unstable and you’re turning into a crazy person that just can’t cope. I really want you to find your way out of this, because you deserve to feel safe and empowered.
I’ll keep this part shorter (for me, I talk a lot) and let you ask for any details you might like. You’re welcome to message me if you want to take anything out of public view.
High level: I have hella ADHD as well as Complex PTSD from childhood emotional abuse and neglect.
ADHD comes with all sorts of fun issues beyond attention and motivation.
CPTSD largely manifests as a suite of unhealthy coping mechanisms and deep-seated beliefs developed as a child due to my parents’ mistreatment of me. These center around having difficulty asserting my needs , issues with self worth, and a drive to seek the validation and acceptance I didn’t receive as a child.
Both are being handled with medication, therapy, a shit ton of self-help books, and a gradually building collection of coping strategies and behavioral changes, like starting meditation, calendars and to-do lists, explaining my situation to loved ones so they understand and know how to react if I flip out, little letters and reminders I write for myself while stable to read in times of instability, etc.
I could write more, but it’s already a ton. If you want to know anything, fire away!
Yes I absolutely relate almost exactly to what you are talking about! It’s frustrating because I feel like I feel these certain things so deeply and others just don’t have that type of intense emotional pain that I do.
It’s funny you mention ADHD because whenever I look up things like “emotional dysregulation” and “rejection sensitivity”…for some reason ADHD is one of the top results/conditions lol.
I relate to all of the ADHD related bullet points that you say, but I just don’t really have core “symptoms” of ADHD. I have the same emotion issues, but I don’t have issues with attention and etc. to my knowledge. I’ve always had issues with things like keeping up with household chores and staying neat, but beyond that none of the “core” features seem to fit me. My older sibling has very obvious ADHD though lol.
Dunno much if any of what I have is real trauma, but my therapist the other day that my frantic efforts to predict and prevent negative emotions from others is a “trauma response”, but idk how much of that is true for me.
I’m guessing the main med helping you is some ADHD meds, right? Do you take anything else?
Just wanted to let you know I haven’t forgotten you. I’m extricating myself from an abusive relationship, so life is a little tricky. I’ll start writing you a proper response tomorrow.
Jeez I’m so sorry. Please be safe. :( I’m happy you’re getting out of there at least.
Oh fuck me! Almost two weeks later… Sorry! Things have been hectic and I’ve been a bit overwhelmed, so I lost track of some things. Okay, most things.
Regarding ADHD, don’t discount it or really any condition without digging deep into it with a professional. You might be surprised. Here’s my experience.
I didn’t get a proper ADHD diagnosis until my early forties. I was shocked as I was absolutely certain I didn’t have it. Even then I didn’t get properly medicated - my initial diagnosis had me on guanfacine as I wasn’t seen to have many ADHD issues and they weren’t severe. It made a huge difference and guanfacine barely does anything compared to other meds.
A few years later, I met with another psychiatrist who helped me realize I had several more issues than I thought and they “weren’t too severe” because I was handling them through insane amounts of complex coping mechanisms and good ol’ brute force. This explained why I was always emotionally and mentally exhausted, why I’d wake up and just sit in bed for hours despite not being depressed in the slightest.
If you had any childhood trauma, including emotional trauma like neglectful, emotionally absent, manipulative, and/or verbally abusive parents, I cannot recommend Pete Walker’s “The Tao of Fully Feeling” and “Complex PTSD: From Surviving to Thriving” enough. I may have mentioned those before but they’re my two go-to books out of the literally dozens I’ve read. The Tao of Fully Feeling is also just great for anyone dealing with issues with emotions.
I’m on on a few meds:
Jornay PM: time delayed, extended release Ritalin. You take it at night and it kicks in the next morning. On Ritalin, I feel 10x smarter and I can actually get moving to get things done! I don’t have as many issues with sensory or mental overload and can earlier identify when that might be happening. I can better stay calm in stressful situations, mentally juggle complex thoughts, and keep track of more than one thing at a time.
Guanfacine ER: A blood pressure med that helps with the executive dysfunction aspect of ADHD. It makes my brain “quieter” and helps me with impulsiveness, anxiety, and emotional regulation.
Propranolol ER: a beta blocker that helps with anxiety and tamps down the somatic effects of anxiety and panic. SSRIs work great for my anxiety but they blunt my emotions. I’m working with my therapist on consistently feeling my emotions (I tend to repress, then have massive anxiety instead), so that’s a no-go.
Bupropion XL: Originally I took this as an SSRI alternative for seasonal depression, but it’s great for ADHD! It helps a lot with motivation and impulsivity.
Let me know if you have any questions on this or anything else. Just know you’re always welcome, even encouraged, to bug the shit out of me if I don’t get back to you in a timely fashion.
I’m not the person you have been responding to but thank you for the resources, I’ll be checking them out as well.
You bet! Let me know if you have any questions.
Are you ok at least? I know you said you were trying to get out of an abusive relationship?
I mean I’ve never had an issues with attention so it just doesn’t make sense to me. Obviously I have emotional problems, but that would be my only “ADHD trait” which is shared by many “conditions”. What other traits do you have?
Yeah some of my online friends seem to think I have a lot of trauma. But the weird thing with that is like… doesn’t literally everyone? Why would some be more effected than others? Some people are horribly abused and it makes sense…but many of us have a lot “milder” traumatic experiences.
I have been consulting ChatGPT (lmao) and it seems that guanfacine is the most common indicated thing for emotional dysregulation in complex trauma. I had never heard of it before.
Yeah thing is I’m totally fine when I have no triggers. But when I do, I go from 0 to 100 and have a hard time getting out of it (whether it’s an activated state more damaging to the self or a low energy state where I have a hard time physically walking or moving). I think my baseline leans normal to slightly depressed.
How do you feel about taking so many meds? I’m already a bit turned off from meds. I have always been of the opinion that while some people really do absolutely need them that a lot of people are over medicated.
After my negative experiences I kind of want to stop trying meds but I’m afraid to get off them after my last experience. I had a reaction in SSRI withdrawal that severely threatened my job. And now my provider has me on lamotrigine, but research that I’ve done seems like it does nothing for emotional dysregulation.
Do you know how much I would have loved to be blunted on SSRIs lol? My issue is too many and too strong emotions, so feeling less would have been helpful!
Oh and why are you taking both guanfacine and propranolol? They both seem to cause a “body calm”, so it seems odd you’re prescribed both.
Sorry for the long response lol