I've been doing a lot of work with my therapist and it has been suggested that I might have a mix of both Autism and ADHD.

I have always related to Autism to a certain extent but I would never say it because I felt like I didn't really fit because some things I do don't make sense it that context. I was also obsessed with learning to be human since young and have a lot of systems to deal with it and apparently that means I've been masking for a very long time.

But my therapist also brought up ADHD and that has explained a lot about some the things I'm still currently struggling with. But again, when I look it up, I don't feel like I fully fit. But also, I have developed a lot of systems over the years to deal with my issues and function like a normal human being. So a lot of the things I struggle with is hidden because I've "fixed" them.

I'm still reluctant to say I have either of those two things because I feel like an imposter. So I've just settled on Neurodivergent and think that I can always learn the tools that help people with ADHD even if I don't have it. Because if the tools work for you, then why not?

But my therapist has suggested getting diagnosed because it does change what kind of medication you might get. I'm currently on medication for anxiety and depression.

So now I'm wondering how common it is to have a mix of both ADHD and Autism. For those who have both, what is it like for you? What is your daily life like? What are your struggles and how do you deal with them? When did you realise you might have a mix of both? How do you feel about yourself and your brain?

I apologize if this isn't the right place to ask this. I don't post very often and am getting used to it.

The last time I cried was probably like 3 years ago. I have no idea why. I know that not being able to cry can be a result of depression, or some sort of trauma, or having to suppress your emotions for a long time - but I never experienced any of that. I just suddenly stopped being able to cry and it sucks because crying is a great emotional outlet and sometimes I really feel like I want to cry but just can't for some reason.

Has anyone else dealt with the same thing?

I'm 46 years of age. My childhood and youth and post-youth life wasn't traumatic or anything. I had an okay life. I guess I might even have had a good life. But for some reason, reminiscing about it just doesn't feel pleasant. Some folks find talking about their past highly enjoyable. So why don't I like it? Is this normal?

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.

I'm not here to talk about the New York Times bestseller, so apologies to anyone who's come looking for an informed discussion on that. Apologies if I'm posting this in the incorrect place, please move or delete the post if it's inappropriate. I had something of a breakthrough in therapy recently and I don't have anyone to share this with (for reasons that may become obvious) so I'm turning to Tildes to vomit these thoughts out into the world somewhere.

Like a lot of us growing older, I've been spending a some time trying to better understand myself and come to peace with the person I am. One of the aspects people around me (and myself) find perplexing is how I'm able to be personable and friendly, even popular in some circles, but given the choice I will stay away from people as much as possible (except for a very select few I can count on one hand). I often joke that if it weren't for my wife and kids I'd probably be feral and live in the woods, bite anyone who tries to get too close. That lady that lived alone in a cave for over a year? Life goals. I thought I was just a mega introvert, but something my therapist and I discussed made me realise that that side of my personality may be (at least partly?) a manifestation of past trauma. So here is my villain origin story.

I've shared before on Tildes that I was very sick with cancer for a good chunk of my infancy. Whenever someone finds out I had cancer (it's left fairly visible marks, so the topic inevitably comes up) I always say it's ok, I don't remember it at all, so really it's my parents who lived through the trauma, not me, ha ha. I no longer believe that is entirely true. The body does keep the score after all. My therapist pointed out that I must have spent many moments alone dealing with the consequences, unable to fully share or understand what I was going through. Moments where I was physically manipulated whichever way, by people and instruments, dealing the nausea, the pain and the fatigue. I was too young to fully articulate my distress, ask for help (beyond crying) or seek solutions to the problems I faced. So for some moments at least I had only myself to rely on. Did the part of me that would normally seek out others die a little then?

My parents used to remark that as a child I never cried out, just tears streaming silently down my face. They speak of how I used to play contentedly alone for hours. How I rarely asked for help when I really needed it. Don't get me wrong, I'm able to form relationships with people, and I'm perfectly capable of functioning in society. I do seek out others for company, connection, validation, love, etc, and vice versa. But I can't shake the feeling that there's something broken in those connections. It feels like something is amiss, even if I've mostly come to terms with being this way. I'm left thinking - did the trauma (at least partly) make me who I am? Where does the trauma end and where do I begin? How many of us are potentially totally different people today because the body remembers when we have completely and utterly forgotten? And if that's the case, is that...ok?

This is a post about the topics mentioned in the title, and how they are related in my life. I suspect it might provide a point of consideration and discussion for other members, as I provide an argument that could be applied to other people and situations.

For good or bad, I put much value on morality, and see the world through a moralizing lens. This is not necessarily a case of reducing everything to "evil choices", it's more complicated than that, but it's been bothering me for a long while. It's partially because I often find myself judging myself too harshly, especially after failing to live up to my moral ideals.

For example, I don't like overconsumption and the surrounding hyperconsumerist ideology, so I hadn't bought any sort of "geeky" merchandise for some years. It's because, even though I thoroughly enjoy fictional works, there's this hyperconsumerist ideology and culture surrounding geekdom. So I thought, and to some extent still think, that buying any kind of merchandise was being tricked by the system.

I bought a simple merchandise item -a mug- the other day, which prompted me to question why I bought it. It feels shameful to write even now, but it's because I thought I should treat myself to something. It was cute, after all. When I thought about this issue, I realized certain things.

For starters, I put too much emphasis on personal responsibility when it comes to moral issues. One reason is I tend to blame myself. I often question myself first before questioning others or the wider picture. Another reason is that there are many, many moral tales that emphasize the role of personal responsibility. Too many stories have the hero look down on the villain and declare: "There's always a choice." And then the hero explicitly or implicitly says the villain just wasn't strong enough.

I think this is to a great degree due to how personal responsibility is mythologized in the contemporary culture. Abrahamic religions often put much emphasis on choosing the morally good choice. After all, the whole afterlife dichotomy is built upon this idea. Furthermore, with the "Enlightenment", the idea that individuals are rational and free to choose has become very prominent. So, both pre-modern and modern beliefs about morality puts much emphasis on personal responsibility.

This has different effects on different people, and I recognize that my experience is not necessarily generalizable, but I do think that it provides a kind of insight on some issues. At least for some people. Basically, I've come to realize that ethical issues have more of an emotional impact on me than most people. I also have a dysfunctional pattern of trying to live up to unreasonable standards. When these two and the emphasis on personal responsibility were combined, it created a very difficult pattern for me. It made me more vulnerable to moral purism.

I've recently realized why this moral purist tendency is straining for me, and there's a very simple why: it's because it's a thought that belongs to a fictional, idealized world. It doesn't consider the complexities and realities of the world I live in, it demands that I should live in that fictional, ideal world. In other words, it fails me, because it doesn't recognize that I'm a human with real needs and wants.

I don't mean this in the cliche "Oh, humans are imperfect," way, because that way of thinking still puts the moral purist way on a pedastal. It just tells you that you are weak and imperfect, and tells you to compromise. I think this is not a good way of looking at it, because it still reinforces the idealized thinking. It just tells you to make concessions, which is unacceptable to a perfectionist.

Instead, I say that it's a shitty psychology. This way of thinking doesn't consider how a human mind works, what it needs to be healthy and happy, and the overall workings of the world. Healthy thinking comes from being able to cope with realities of the world—in a way, it's being in tune with the reality you live in, and that necessitates recognizing your own emotional needs and wants. Moral purism encourages you to neglect your own emotional needs in pursuit of some fictional, impossible person you want to be. It's a fantasy.

In this context, it's healthy to come to terms with your own limits as a single person. The wider picture should be considered. For example, in my situation, buying merchandise now and then doesn't make me a bad person, nor does it make this act morally bad. I live under capitalism, and no matter what I do, as long as I continue to live in a society, I will always contribute to its workings (and healthy people don't go "off the grid"). From my point of view, it's bad that doing things I love contributes to an inequalizing system, but in no reasonable way should I be expected to give up what little or moderate joys I get by participating in this system. Of course, there should be a limit regarding consumption, but the bar is certainly not as high as I thought.

This is my personal experience with moral purism. I think the culture of overemphasis on personal responsibility feeds into it. What are your thoughts about it? Have you had similar experiences? The don't have to be about consumerism, as moral purism is seen many, unrelated issues.

Note: This goes without saying, but this post doesn't suggest that having a better world in mind and striving for it is bad. It just criticizes an unhealthy way of approaching the mentioned topics.

Before we start, no, I don't mean "bring politics into" mental health. Politics obviously covers mental health issues, practices, and institutions. However, I've come to realize a certain approach to mental health has taken root in discussions around mental health. This approach is based on the criticism of mental health from an ideological point. It centers on the idea that mental health is treated only as a chemical imbalance in the brain, and that sociopolitical conditions aren't considered. One of the most prominently figures cited for this is Mark Fisher.

“The current ruling ontology denies any possibility of a social causation of mental illness. The chemico-biologization of mental illness is of course strictly commensurate with its depoliticization. Considering mental illness an individual chemico-biological problem has enormous benefits for capitalism. First, it reinforces Capital’s drive towards atomistic individualization (you are sick because of your brain chemistry). Second, it provides an enormously lucrative market in which multinational pharmaceutical companies can peddle their pharmaceuticals (we can cure you with our SSRIs). It goes without saying that all mental illnesses are neurologically instantiated, but this says nothing about their causation. If it is true, for instance, that depression is constituted by low serotonin levels, what still needs to be explained is why particular individuals have low levels of serotonin. This requires a social and political explanation; and the task of repoliticizing mental illness is an urgent one if the left wants to challenge capitalist realism.”

― Mark Fisher, Capitalist Realism: Is There No Alternative?, 2009

This, I think, is true to a degree. Denying the mental or physical results of certain policies benefits the rich. However, this criticism, whether intended by Fisher or not, is often used to reduce psychiatry and psychotherapy to mere, atomized, asocial, apolitical practices.

First of all, this hasn't been true in my case. Sure, I have my criticisms of the procedure and the practitioners, but I've talked about a variety of sociopolitical issues in therapy. I mean, how can you not talk about these issues? There are obviously social patterns in a population, and if they're not bad practitioners, the psychiatrists pick up on them. This doesn't mean that I talked about political theory in my therapy, but among numerous topics, I talked about things like the male gender role, the attached aggression and violence, the effects of emotional repression as a result of traditional roles. I know people who extensively talked in therapy about gender roles, queerphobia, and the associated problems.

Therapy helped me on political issues too. I used to be much more repressed, unable to express my disapproval, unable to handle any conflict. But with the help of psychiatry, I started expressing my opinions, including my disapproval, more and more. This included standing up for myself, and while there are many power structures I can't overcome as an individual, this change helped me better stand up for myself against people who have power over me. It also helps me feel not as much like a piece of shit when I can't, because learning to face my emotions helps me realize I have limits.

But, according to the Fisherian argument I've seen repeated countless times, this isn't what psychiatry does. It just treats you like an asocial animal, which is not true at all. If anything, psychiatry emphasizes, again and again, that humans are social animals, therefore, have social needs, and that not meeting those needs will lead to mental problems. Seriously. Search "humans are social creatures psychiatry" on whatever search engine you use and also on Google Scholar. You'll find, page after page, pop article and scientific article, talking about the importance of this.

The second thing I want to mention is that links between inequality and mental health are an important area of research. You can search for keywords like "socioeconomic status mental health" and "inequality mental health" on Google Scholar to see many articles written about this. You can alternatively replace "socioeconomic status" with "SES" and "mental health" with "mental illness" or a mental disorder of your choosing.

To add further support to my argument, let's look at the textbook "Psychology, Global Edition, 5th Edition" of Pearson, which is a very widely known publisher. It has an entire chapter dedicated to social psychology (Chapter 12). The chapter about psychological disorders, Chapter 14, has the following listed as one of its learning objectives (emphasis mine): "Compare and contrast behavioral, social cognitive, and biological explanations for depression and other disorders of mood."

Let's also look at WHO's mental disorders page (emphasis mine).

"At any one time, a diverse set of individual, family, community, and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability, and inequality – are at higher risk. Protective and risk factors include individual psychological and biological factors, such as emotional skills as well as genetics. Many of the risk and protective factors are influenced through changes in brain structure and/or function."

I think one of the other negative things about this argument is that, it denies the possibility that some people face mental illness not mainly as a result of social issues, but as a result of some biological unluck. I haven't checked it out specifically, but I think mental illnesses aren't necessarily mainly a result of social conditions or trauma. I can't claim this with certainty, but neither can the opposing side. However, my approach leaves a possibility open for people who may be experiencing exactly this. Therefore, without knowing, it doesn't claim that certain experiences can't exist.

Before I finish, I want to say that I don't deny the existence of bad practice. I've heard many stories of bad psychiatrists, and even if I hadn't, it would be unrealistic to think they wouldn't have such a problem, considering the problems in education and funding. However, my point is, it's not realistic to say psychiatry overlooks the social reasons for mental illnesses. There may be problems, but in no way they are a shared, distinctive feature of the field.

And last of all, this may be harsh but I think it needs saying, Mark Fisher fell victim to suicide. He's not exactly an epitome of healthy coping mechanisms, and his criticisms about mental health should be evaluated with that in mind. I often think intellectualization tends to come in the way of mental health for, well, intellectual people.

Edit: The last paragraph was poorly explained. I further elaborated here.

This statement by traumatologist John Briere is quoted in Pete Walker's FAQ on Complex PTSD, a proponent of the unified Trauma model of mental disorders. Dr. Gabor Mate has become popular in recent years, who similarly claims that (e.g.) "Attention Deficit Disorder is a reversible impairment and a developmental delay, with origins in infancy. It is rooted in multigenerational family stress and in disturbed social conditions in a stressed society." Another famous champion of this theory was Alice Miller. Quote: "Experience has taught us that we have only one enduring weapon in our struggle against mental illness: the emotional discovery and emotional acceptance of the truth in the individual and unique history of our childhood." A more recent bestseller around this topic is Philippa Perry's "The Book You Wish Your Parents Had Read" (Guardian review).

The various personality disorders from ICD-10 were replaced by a single personality disorder diagnosis in ICD-11, and they finally added Complex PTSD. The director of the largest psychiatric clinic in Germany is in favor of removing the category of "mental personality disorders" altogether (German article).

Studies seem to confirm strong links between "adverse childhood experiences" and various forms of mental illnesses. To pick just one of the many I found: "Compared to children with no Adverse Childhood Experiences, the odds of an ADHD diagnosis were 1.39, 1.92, and 2.72 times higher among children with one, two and three or more ACEs. The ACE most strongly associated with the odds of ADHD was having lived with someone with mental illness closely followed by parent/guardian incarceration." (https://doi.org/10.1016/j.chiabu.2020.104884)

I'm interested in hearing your takes, and potentially this thread can serve as a collection of quotes and links around this theory.