Be it fiction or non-fiction, what books did you find helpful for accepting the uncertainties of life? I used the word anxiety in the title, because that's the angle I'm mainly interested in right now, but in no way I'm just asking about psychology books. All kinds of books are welcome.

At 22 years old, after months long assessments, I have been diagnosed with severe ADHD, depression and moderate anxiety. Here is a quick timeline of my experience:

• May - August :
  • I started CBT therapy and Sertraline 50mg
  • Gradually I was upped to the a dose of 75mg.
  • In this whole period I did not experience any improvements or side effects, except a loss of appetite in the first few days.
• September:
  • I started taking Methylphenidate 18mg and went back to just 50mg of Sertraline.
  • From the first day I had felt a sentiment of calmness and control. But it slowly faded away and I still felt I could not concentrate on things or act productive.
  • I also stopped going to therapy as I saw that CBT was not effective for me.
• October - November:
  • This was a completely different month. I wasn't fully in control of my attention span but it was much better than I've ever been. What was more shocking was how internally I felt at peace and something that I'd describe now as euphoric (as I assume this was just a side effect of the medication). U
  • Until mid november I was actually going around telling people I think I might not be depressed anymore, as I had felt for the first time in a way that I haven't felt since early childhood. I was able to accomplish incredible feats related to discipline and I saw my academic results improving greatly. Unfortunately this sentiment slowly faded away and I was back to my old self by the end of November.
• December - Now I was upped to 36mg of Methylphenidate and I noticed a much better control of my attention but unfortunately I have not felt that feeling of relief again. And as it seems the effectiveness of the dose diminished from the first few days to now.
  Since December I've had numerous breakdowns, feeling completely exhausted and burnt out. I suffered from classic problems of procrastination starting to work on difficult projects only a couple of days before the deadline and it was all crashing down. I submitted multiple disgustingly low quality pieces of work because I just did not work in time enough but the few days I did work I did incredible amounts of effort and I do feel like the pills helped me stay focused. After this deadline period though I was just met with my normal depression symptoms where I had a long streak of days that I could not even get out of bed or brush my teeth.

I don't know what more to do. I always knew I was broken and needed help. And for all my life I thought that seeing a psychiatrist is a last resort in case "I can't fix myself" on my own. Now it's been almost a whole year and I am in a critical time period where I need to excel and put in the work but I find myself succumbing to my symptoms while jumping up and down with the doses of some pills that barely seem to have an effect.

I didn't have many people around me from the start, and many of them would not understand my condition at all (nobody from my family does). But now it seems that even the few that were empathetic I have unfortunately tired out. I've heard my fair share of bad remarks that have gradually demoralised me (ADHD is not real. I'm just lazy. I just like to complain. etc) and due to the fact that I also have codependency problems this has greatly hurt me and made me feel like I am completely alone and nobody cares for my troubles or has my wellbeing in their best interest. Right now I just wish I'd know what to do. I wish there was some clear step by step goal oriented way to "happiness" or at least normality. I don't even know what more to tell my psychiatrist other than how I don't feel well, which is what I've been telling him since the start.

If you've been through a similar journey, I'd love to hear your experience and any advice you wish you had received earlier.

To preface, I have accounts on multiple link aggregators, three microblogging platforms, and I have my own (transiently online) blog. I'm a member of more niche Discord servers than I can count, and I'm in a few other nooks where people generally seem to gather and talk. Despite all that, I find that it's incredibly rare that I ever actually participate in any of the discussions that I see taking place, and that's something that I think I'd like to change.

I think part of the problem is that I grew up in the formative years of the "modern" net, and was always taught that you should be careful about what you say online (and, implicitly, that saying nothing is probably even better), lest an axe murderer track you down and explodify your tibia while you sleep.

So, does anyone else, or have stories about, posting anxiety? Anyone gotten over it? Am I just crazy?

I often find myself ruminating over something I said that didn’t get the “right” feedback. Maybe this means my opinion wasn’t validated, or someone proved I was wrong, or I was completely ignored. The repetition of these moments in my head can last for days, sometimes years. I’ve learned a few coping mechanisms because no one can be perfect, for example, just telling myself that it’s a learning lesson and realizing that most of the “embarrassing” things I’ve said in the past are completely forgotten by anyone else who heard usually helps get me through. Can anyone who relates to this share some other good tips/tricks?

Author's note: I'm mostly typing this up for myself as a writing exercise to sum up my situation, so that I can present it to a doctor one day if I can find one who will listen. It's a long read, and I don't expect anyone to seriously read it? But, if you happen to make it through and have any advice, or recommendations for specialists I could seek out, I would really appreciate that.

I work remotely as an open source maintainer for a university research lab, so I spend a lot of time at my computer. Throughout my adult life, I've found that I work best when sitting in my bed with my laptop. Yet, I figure sitting in my bed isn't the best for my body, so I've tried hard over the years to make a desk setup that's as accommodating as possible:

• I have a big corner desk with lots of tabletop space and overhead cabinets.
• I've set up cozy under-cabinet 2700K LED strip lightning.
• I've decorated the space with nice sentimental things.
• I've got a foot-warmer under the desk (since I have chronic ice-cold feet for reasons I don't yet understand).
• I own a (secondhand) Steelcase Leap v1 that I've meticulously adjusted to my body, making sure all of the heights and distances are within typical ergonomic recommendations.
• I have an ergonomic keyboard with a sliding under-desk tray
• I've gotten dual monitors, with one being a modern 1024*1280 monitor to avoid whiplash from an extra-wide double-1080p monitor setup.

Despite all of the above, every time I go to use my setup, I feel a big sense of revulsion and a big urge to just curl up in bed with my laptop.

I've spent a lot of time thinking about why I react this way, and I attribute it to a whole bunch of underlying factors:

1. I'm autistic+anxious (ASD/GAD diagnoses), and I was previously diagnosed with ADHD, too.
2. I struggle a lot with pain/physical discomfort:
   • One of my brain quirks is that I have big sensory sensitivities surrounding my body. I'm hyperaware of any uncomfortable sensations in my body, and pain/discomfort can completely derail my ability to focus and be present in the moment. For example, if I eat too much and feel overfull, the sensation of my stomach pressing against my other internal organs drives me crazy, to the point where I can hardly even watch a show or listen to music. The same goes for when I'm constipated or have an upset stomach. When I get like this, it's like I can't feel any emotions. The discomfort/pain are the only physical sensations I can take in, because they crowd everything else out. I can't feel warmth or happiness or fullness in my heart. All I feel is discomfort.
   • My anxiety results in a near-constant state of tension. I'm often very aware of the booming of my heartbeat, or tightness in my chest. I fall into a negative feedback loop, as it makes it very difficult to relax, which further triggers anxiety and tension. (Side note: Beta blockers are the most effective anti-anxiety medications I've ever been prescribed for exactly this reason. They target the physical sensations, and helped me feel an overall sense of calm. I haven't been prescribed them in 7+ years, though, because every new GP/psych I visit automatically discounts them as off-label/not-first-line approaches, even though I've had direct success with them when other approaches have failed. I wish doctors would listen to me. Would weed help?)
   • When I get anxious/depressed, I find that my posture suffers a lot. My body sort of curls in on itself, as though it were attempting the fetal position. It takes an exceedingly difficult amount of effort to preserve good posture the more fatigued I get. But, in such a state, I don't have the spoons to exert this effort -- it gets harder and harder until I inevitably curl up in bed.
   • Wouldn't you know it, I have chronic pain, too. Multiple times a week, it manifests as this combo of upper-back/shoulder/neck/sinus/behind-the-eyes pain. It typically happens only on one side of my body (though which side it happens on is not consistent). The sinus pain is curious, too: I regularly have a "cold nose" (similar to my cold feet), and breathing in feels icy and sharp, with a tingle like I'm about to sneeze. I find myself reflexively picking or prodding at my nose just to distract from the painful sensations. I often cover my nose with my shirt so that I can breathe in my warm, moist, exhaled breath. It doesn't really warm up my nose, but it provides some in the moment relief.
   • You can imagine what this chronic pain does to my ability to feel emotions or focus on tasks... I rely a LOT on Aleve. ;;
   • I'm also sensitive to temperature: I really dislike being too cold or too hot. I often change clothes multiple times a day, from shirts to sweaters and back + shorts to sweatpants and back, because I'm constantly adjusting my temperature.
   • I also am particular about pressure and textures on my skin. I don't really like having my skin exposed? I like big comfy sweaters and a specific kind of sweatpants that Uniqlo used to sell. I also really adore this specific duvet I got from IKEA, because it's big and fluffy and weighty. It's like a semi-weighted blanket without being so densely concentrated (I have a glass bead weighted blanket I hardly use because of how icky it feels).
   • Because of all of this, my ideal state of being is one where my body just kind of... disappears from my consciousness? I strongly wish I could exist without being aware of my physical form, because I'd say at least 90% of my waking hours I'm feeling some form of discomfort or another, and thus 90% of the time any happiness is blocked by the discomfort.
3. As far as working on a computer, I find that I'm most productive when I can sink into a state of hyperfocus/flow and attack a task for hours at a time in a single sitting. I'll lose track of time, come out of the state wondering where the day went, yet be insanely productive during that period.
   • Naturally, this goes against conventional advice for computer-based WFH, since in this state I don't take stretching breaks, don't adjust my posture, don't rest my eyes, etc. But, I find forced breaks tend to rip me out of my focus, and it takes a lot of self-regulation/spoons to get back on track after a break.
   • Despite the terrible ergonomics of hyperfocus, it counterintuitively acts as a needed respite from the pain/discomfort. Being hyperfocused is one of the only states that supersedes the sensory sensitivity I have. I'll often be so focused that I don't notice the state my body is in, which is pretty much my ideal! (Side note: Because of this dynamic, I often lean on rhythm video games as a respite for pain, too. They're easy for me to hyperfocus on, which makes passing the time a lot more bearable for me when I'm in pain.)
4. And, the environment most conducive for sparking a state of hyperfocus is my bed, rather than a desk.
   • Even with all my adjustments, my desk feels very finicky and dynamic. The chair rolls, the keyboard tray slides, the chair back reclines, my foot warmer slides around. Rarely do I feel anchored, and rarely does everything feel "just right". I can't really find a "locked in" position for hyperfocus, as my body is always interacting with its environment via subtle little tics and adjustments.
   • I also find that sitting at a desk leaves me feeling rather exposed? Even with clothes on, I just... don't have enough weight on my legs to feel fully comfortable.
   • When I do try to sit at a desk, I may be somewhat comfortable at first, but as time goes on I get more and more uncomfortable. Maybe a tricky task temporarily spikes my anxiety, which causes tension and pain, which makes me focus on the pain, which makes it harder to think clearly about the task at hand, which makes me more anxious, which begins to affect my posture, which makes it harder to properly sit in my ergonomic chair. I'll fidget and shift, and start to lean on one arm. It often escalates to the point where it feels like torture to hold my own body up, because I feel like a ragdoll in my chair.
   • My bed, by comparison, doesn't ask any effort of me at all. I'm fully enveloped by the mattress and my pillows, so if I end up in "ragdoll anxiety/depression" mode, I'm supported in exactly the same way I would be if I was in "full spoons" mode. I also get the comfort of my duvet, with fluffy warmth and weight on every part of my body, and very little of me being exposed.
   • This means that I can somewhat ignore my body when I'm in my bed. Even if I'm in pain, even if I'm anxious, I don't really have to... DO anything about it? I don't have to physically move my body in a specific way in order to keep hacking away at a task. The pain will still be there, but the hyperfocus state can win out, and I can work away while feeling like my laptop is an extension of my body.

Surely this isn't good for me, right? Surely I should be attacking the root of the problem so that I don't devolve into a ragdoll mess of pain every time I try and use a desk? Surely lying in bed for hours at a time isn't good for my body, right? But, with this multi-layered set of factors, with many of them being inherent anxious/autistic traits, I don't know how to create an environment that's any better for me than my bed is.

What do?

My spouse and I adopted a 9 week old Husky puppy this past weekend who is suffering greatly from separation anxiety and we are at a bit of a loss on how exactly to deal with it. This is not our first puppy or Husky puppy, but the separation anxiety is new territory for us. We have spent a lot of time reading guides on helping a puppy adjust to being on their own and talking with a close friend who is a vet tech, but I wanted to see if there are any things we may have overlooked.

Things we are already doing:

1. Daily walks - we typically take 2x 10-20 minute walks during the day, depending on the weather. We are in the southeastern part of the US and it is unbelievably hot during the day so we go early in the morning and late at night, afternoon is pretty much not an option with temperatures reaching the upper 90's.
2. Lots of play time - tug of war and fetch are the most entertaining for her right now. We also have a neighbor that adopted a German Shephard puppy that is about the same age and they have loved playing together.
3. Crate training - We have a crate in our room which she sleeps in overnight and one in our work area for during the day when she naps.

Things we are starting to implement:

1. Leaving the room for short amounts of time. We are giving her a treat that is only used for this type of training that she really likes in hopes that she associates us leaving as a good thing because she gets a yummy treat.
2. Returning to the room before she gets really anxious so she doesn't associate the crying and destructive behavior with us coming back.
3. She has two Kong toys that I am going to put yummy food in before we leave the room to keep her mind occupied on that instead of the fact that were not there.

I guess I'm looking to see if there are any other tips or tricks we haven't thought of? Any advice or things that worked for your puppies?

The past few years I have been gradually starting to use ASMR to relax. I have had increasing bouts of anxiety and can't take too many kinds of medications since I am on blood thinners. So I rely on different relaxation methods to get me through.
I am fond of shoe and purse tapping but can't take mouth noises. Actually most tapping sounds seem to be the best fit for my ears. Maybe the occasional crinkling here and there. Perhaps even some whispered talking but I prefer just the sounds.
Some of these folks really go out in their productions. It's been amazing watching the evolution over the years.

Insight once came to me after I was prepped for a surgical procedure. As my body's weight began to evaporate, a pain I had never recognized, but which must have always been sounding in the background noise of my being, vanished. The superadhesive worry--which sometimes frightened others as much as myself, that in order to socialize, I had learned to sometimes twist into a temporary shape resembling charm--came unstuck and peeled away. Then followed a great thought, a mandate for how I should spend the remainder of my life. Also, I needed to poop. But more than that, I needed to get out of this semi-public hospital bed and to a private space immediately, so I could allow this cosmic insight a moment to fully bloom. Time was against me. Anesthetized, I knew I was slipping toward, maybe even over, the falls past which I would forget everything of this experience until a groggy post-procedure awakening brought dull daylight and its senseless aches back to me. I had to somehow save the thought. I searched, but the bathroom gave up no markers, no specimen cup labels to write on. I wondered about tearing toilet paper into little letters, hiding them above the cabinet. But would I remember to return to read the message? With an increasingly calm desperation, I dug my nails into the flesh of my hand and repeated again and again the life-saving insight delivered during communion with the world that lay beyond pain. Please remember, please remember this thought.

When I regained consciousness, it was waiting for me like a friend who had lost patience, and now seemed much less attractive. What I had somehow stolen from the gods, secreted in my closed palm through a swim across the river Lethe, was this message: “Do Drugs.”

I had realized that analysis, working on the problem of myself both mentally and verbally, had won me no appreciable gains. Insight, I had. But relief, happiness, an improved outlook? Nothing I had done had really helped me feel better. Anesthesia instantly had. These aren’t the words of an addict coming on-line. I was a reluctant user of any substance. However, in the years following I forced myself to again undertake drug trials with my psychiatrists. Methodically, I worked through every class, waltzed backward through the eras of drugs, danced off-label with each oddball wallflower, ingested every twisted molecule to ever win over the FDA with a promise of psychiatric benefit and maybe some that merely had intrigued one of my more historically-curious doctors. When Eddie Haskell, MD wanted to resurrect a drug of the bad old days just to see what it’d do to a person, I was the patient with his hand out.

I overslept and didn’t sleep. I gained and lost a third of my body weight. My head felt like a styrofoam block, then like the slate of a blackboard being scraped with tableware. I was more or less charged, sweaty, sensitive to light, and shaky. Some drugs make you feel like Benjamin Braddock in his birthday diving suit. Others make you feel like an amnesiac idiot in Benjamin Braddock’s birthday diving suit. A common theme emerges. These substances could help me feel slower, distant from the world, claustrophobic, clammy, sensorily distorted. Sometimes, they dulled my anxiety, or dried my hair-trigger tear ducts, but they accomplished this through impairment, and very clumsily. I have never been drunk, but I think it’s like a drunk traffic cop: success in psych meds comes about by the stopping of certain avenues, slowing up of traffic, blocking lawful turns. And it’s sometimes noted in the overall impact that fewer crashes have occurred. To me this is not success. Impairment so far hasn't been healing for me. I want my turn at quoting the line, "I feel like myself again."

And so, my heart sinks at every day's new headline about psychedelics. If you follow health news at all, you know they are a hot topic, showing a ridiculous amount of promise. Despite fitting the diagnostic profile, my former home was far from anywhere with signups for studies. I reached out to several "clinics" offering psychedelic-assisted therapy. They struck me as resembling many legal weed shops--loads of young bros polishing their presentation and sanitizing an extortionate drug deal in hopes of financing a Tesla. With fees starting at 8x the plane ticket to administer and contextualize a drug that costs less than $20 a dose, I wouldn't credit their soft patter as containing much idealism.

And here I am--for other reasons besides. Yes, a part of me thought living here would put legal psychedelics within my reach, but I'm not seeing any opportunities. Now I'm kicking myself for never having tried to cultivate mushroom spores, never having ventured to ask acquaintances for a hand. I'm marooned here and psilocybin is about blow up in the States.

I mentioned in this weeks "What are you playing" thread that I'm starting Fallout: New Vegas. I'm really digging the game, but I'm also having a hard time playing it, mentally.

I've got something of a phobia when it comes to nuclear radiation, specifically in the context of, say, a nuclear apocalypse or meltdown. The issue is that any amount of knowledge about nuclear safety doesn't help, the very topic causes anxiety. I use the term "phobia" because I haven't got any rational reason to respond this strongly to this concept, especially since like most people I'll never actually be exposed to dangerous amounts of ionizing radiation. Surprisingly, I have no problems getting x-rays.

The specific issue I'm having is with the entire setting of Fallout: New Vegas, and the rest of the series, being in a post nuclear apocalypse setting. I get extremely anxious when my Geiger counter goes off, even if it isn't affecting my RAD levels in-game. I flinch when I do something that increases my RAD level like eating or drinking new items, and am paralyzed when it comes to consuming anything that boosts the RAD level, even after reading about the system and how it works. I was wound so tight tonight I blacked out for a short moment when a robot came around a corner and surprised me. I'm not screaming or anything, and it's not giving me nightmares or anything, I'm just panicking even just walking peacefully around the world dealing with minor enemy encounters.

My current solution is short frequent exposure to the game at appropriate times of the day/night. I want to play this series and at least finish the main stories of the games.

Does anybody have any similar experiences, and any advice on dealing with this fear and anxiety? I don't see not playing as an option simply because I'm enjoying the hell out of the game, so I'm trying to find a healthy way forward with this.

EDIT: More for posterity if somebody stumbles into this.

Radiophobia was a part of it, but the other part was a sensitivity to sound. The sound design of the game messes with me, and causes me to have a panic attack. It does not happen in FO4, but does in FO3, which uses similar techniques. It doesn't happen with TES4: Oblivion, which is on the same engine from a similar era, but the sounds are different. I don't know what it is, but it did result in me ultimately abandoning the early Fallout series. I can't do it, the joy doesn't outcompete the dread and panic.

Hello everyone,

I recently got put on some SSRI for my worsening suicidal ideation and honestly I can't believe the difference it's made. It's like a version of myself that I find hard to believe existed, but can draw parallels with the version of me before I got depressed, etc.

I'm just curious how I should be viewing these changes in me: Are they really me without depression/anxiety or is it a more lurid exaggerated version of that?

Any other thoughts on SSRIs in general welcome! I'm interested in seeing Tildians' thoughts on them :)

I've had derealization since august 2019, and about 1-2 months after that I started having uncomfortable existential thoughts. It all started with super reductionist thinking which made me aware of nihilism and had me struggle with that for a while before I finally stumbled upon existentialism which basically rendered nihilism void.

However, after that I read about Sam Harris and got into the whole free will rabbit hole, but nowadays I take solace in knowing that most philosophers believe in free will and think Sam Harris is a goof.

After that they kinda subsided for a while... but nowadays I freak out over the whole "self is an illusion" thing that's super prevalent in buddhist/drugs users/science circles, and it's by far the hardest to overcome. Like, with nihilism the solution is existentialism, with free will, well, there's compatibilism, but this? It seems like everything skews toward it being true and it deeply scares me. In fact, if it is true indeed, doesn't that automatically render existentialism and free will impossible as well? I mean, existentialism relies on the self and free will to create meaning, so if those aren't real, then the meaning crumbles apart as well. And free will also seems dependent on a self to exist.

Most people seem to not really care either way when I talk about it with them but for me it's nearly an obsession and I feel like I've discovered some sort of dark secret truth that I wasn't meant to see.

Does anyone else have this issue?

I'm usually the least anxious person among all the people I know, even when shit is hitting the fan. I practically revel in hardships for the problem solving.

But, what is freaking me out right now is this mass panic. It started off as a joke but now it's real, people are literally selling toilet paper on craigslist of whatever. Maybe it's still a joke, I don't know. But mass hoarding of important goods seems to be causing disruptions already, from a lack of toilet paper to a shortage of surgical masks for medical professionals.

I would like to ask the community here what they think about this and how they expect things to go on. Are we going to have a second-order crisis in supply shortages? Are shipping route delays going to hit us on top of the local supply shortages? Because right now it's feeling apocalyptic, and I'm struggling between not acting like a selfish hoarder but also making sure I can get through this.

EDIT: Toilet paper is just a prominent example, not my primary concern (we have plenty still). I'm more concerned about e.g. pharmacy goods and produce, since where I live literally 95% of our produce is imported.

EDIT 2: This article articulates what is on my mind much better: An Infectious Diseases Specialist Reflects on COVID-19