How do you get "back on track"? Could use advice.
I have a very long history of mental illness from age 10, and though I've cycled through a lot of explanations the diagnoses that best match my symptoms currently are currently ADHD and CPTSD. I am medicated for both, and although I am not in active therapy I have also done therapy. I consider my mental health relatively well-managed currently: at least, I am not in any urgent danger of hurting myself and it has been a very long time since I have been. Certainly things could be better but I'm usually functional.
But sometimes I go through these phases, generally 1-3 months long, where my ability to function on a normal level slips dramatically. It never gets to the nightmarish state I was in when I was a teenager, but it becomes hard to... oh, make appointments, do the dishes, walk the dog, just generally deal with the obligations of being an adult. My house is never in GREAT shape but it becomes a disaster. Work performance suffers a lot, my relationships suffer. I also start experiencing emotional PMS symptoms (or perhaps I just lose the ability to suppress them), and while I'm not the type to have "emotional outbursts" I do experience deep and irrational sadness or anger on those days. I also tend to end up dealing with insomnia, which is like a force multiplier on feeling overwhelmed.
It sucks especially because it's like I'm watching myself do it, and I feel as though I don't have enough control over myself to nip it in the bud, and sometimes the damage I do during these times is not fixable at all. It's almost like an unplaceable craving, like there's some thing I'm missing and my subconscious and my body are trying to send me signals, and I just can't interpret them right and figure out what I need.
How I generally get out of these phases is -- well, it's a bit chicken-egg, because the turmoil makes it difficult for me to reach out for help or even do anything to help myself, so to me it seems like sometimes the wave just passes. I'll say, "ok, this time I'll get my shit together", download some new app or whatever, organize my time or tasks via some new fascinating system, and that'll work... but it feels like it's only because I'm "ready" for it to work.
I think it's unlikely I'll find a solution that will work indefinitely to prevent these slips (hooray, novelty-obsessed brain). And anyway - as though it even needs to be said - I'm sulking in the midst of one now, so prevention or reduction tips might be helpful later, but for this moment I'm mostly concerned with getting out once I'm in.
If you have "swingy" mental health, or phases, or waves - what do YOU do about it, if anything? Therapy? Do you change your medication? Do you take a vacation? Commiserate on your favourite internet forums? What works for you?
I'll be fascinated to hear other's responses to this as I also struggle with similar issues. For me, I'm at a stage where I've come to accept the swings rather than keep trying to prevent them. I guess I'm old enough and been through so many that I've realised that I always come through them sooner or later.
The big things that have made all the difference for me are:
So my advice, for what it's worth, is to try to be kind to yourself. You're not behind, you're just going on your journey.
My heart goes out to you, rogue_cricket. I've always loved your presence here on the site, so it hurts to know that you're hurting.
I see a lot of myself in your words. I was diagnosed with major depressive disorder a long time ago, and I now live my life with that label mostly in the rear view mirror. Most days are good, happy, fulfilled days for me.
Every so often though, the tide of depression comes back up and I have to deal with it until it subsides. I'm not in therapy or on any related medications anymore. I mostly get through these periods by acknowledging that they are temporary, they're distortions, and that I only have to do what I can during those times, not what I should. I intentionally lower my expectations for myself because my throughput is so reduced.
Here's an excerpt from something I wrote as I went through a low point a few weeks ago. I initially intended it as a blog post but, like most of what I write, never posted it anywhere (that's another tip: sometimes writing things helps get them out of your head and lets them live somewhere else -- and that's especially true for things no one else will ever read). I share it here less as advice and more as commiseration:
My journaling ended there, at a low point, because I was in a low place. The good news is that I'm no longer there, and I'm back to my baseline: generally happy, fulfilled in what I do, sharing in my students' joy, etc.
A lot of getting through the dark periods is simply trusting that I'll return to my normal baseline, which, thus far, I always have. The other part is, weirdly enough, not trying to fight the depression head-on. Instead, I almost invite it in -- like an unwelcome houseguest. Yes, they're going to make a bit of a mess of things and take over my schedule and overstay their welcome, but I always make sure I'm viewing them as a visitor and not a cohabitant. Those things I wish I could do or want to make happen get scheduled for after they decide to leave.
I give myself permission to not be optimal, efficient, and productive. I give myself permission to sit in sadness without fighting it. I give myself permission to not need a reason for what I'm feeling or how I'm thinking. I visualize all of this as a sort of polite listening to my houseguest, letting them talk on because it's easier than trying to interrupt or argue with them. It takes up time and energy, yes, but, eventually, they'll stop talking and I'll be able to leave the conversation, and, eventually, they'll head out and I'll get to clean up after them.
I'm no therapist, and I don't even know if my way of dealing with it is healthy or maladaptive. Maybe some people with depression are able to fully escape it and I'm actually sicker than I think I am? So, don't necessarily look at what I'm saying as any sort of prescription or fix or even sound advice.
Just know that I'm hoping for the best for you. One of the other things that grounds me, when I'm in my depths, is that other people care about me, even when I don't. It's one of the "feet on the floor" I use to try to keep my baseline in sight and in memory.
Know that I genuinely care for you, rogue_cricket, and I wish you peace.
Thanks for your genuine and vulnerable words.
The biggest thing for me is having what my therapist likes to call “a lot of tools in the toolbox”. Targeting the real reason I’m disinterested in something means more successful strategies to navigate. Something that works really well for a while can wane in efficacy, so I try something else out. Dani Donovan’s Anti Planner has been a godsend in that way; as an ADHD artist and designer she wrote it specifically for ADHD people. Pomodoro timer working? Great, I’ll use it until it doesn’t. If it’s not working I’ll flip through the book to see what else I can be doing instead. I HIGHLY recommend, even if it’s kinda pricey.
Another thing I do is a “good enough” job. Meaning, the dishes don’t have to be perfectly done, they just have to be put in the dishwasher. I don’t have to put away ALL of the groceries, just the stuff for the fridge/freezer. I didn’t put my clothes away, but they’re washed. I won’t clean the bathroom, I’ll just wipe out the sink. Usually doing a small part of a task is enough to break the hurdle of inertia and get me farther than my intended goal: just the sink turns into just the sink and the toilet turns into just the sink and the toilet and the tub, then the bathroom is clean. Putting the spoons away from the dishwasher turns into emptying the dishwasher.
It’s not a perfect system, and sometimes I offload the task to outside help. I reach out to friends and family, ask them to FaceTime while I do dishes or something, or set challenges for myself. The goal is not perfection, it’s working with yourself to move through life.
I will say the sleep disregulation is probably playing a bigger part on you than you think. I notice my adhd is worse on days I’m tired: I need a second dose of afternoon meds those days, or I need to be more strict with myself on daydreaming/time wasting. I’d say to try and get your sleep back on a schedule. Even if you can’t fall asleep i recommend listening to podcasts (Sleep With Me is fantastic for getting me to doze back off) rather than getting up and reading or scrolling on your phone. Meditating is also fantastic for me to settle myself and calm my mind.
Best of luck, buddy. You’re not alone and it’s not hopeless.
I struggled with addiction, which was related to my underlying depression and probably some other trauma. I only got a diagnosis for the former. I still get these swings, where I'm down and slightly depressed for several months. Thankfully, it now seems to happen one time per year, on average.
The biggest help for me is thinking that nothing is permanent. Both the good periods and the bad ones will pass, eventually. I think that this helps me not stress out too much - when I'm in a good state, I'm not anxious about what's to come. When I'm in a bad state, I'm not pressuring myself into trying to feel better.
As someone with a bipolar diagnosis (among others), the pendular nature of your mental health makes me think there may be something to explore in regard to your diagnosis. A conversation with your doctor may be worthwhile. Bipolar disorder, cyclothymia, and seasonal affective disorder are possibilities that come to mind.
Speaking from experience, mood stabilizers are aptly named and highly effective.
Good luck! :)
This post reverberates a lot.
I am diagnosed with BPD, not ADHD, but I sometimes think I have CPTSD too. But yeah BPD is one of the very swingy/wavy/phase-y diagnoses, however it's way shorter term than the month-long time frame you're talking about. I do get the longer lasting ups and downs too, but that's probably a generally human type of thing.
I have ruined my life multiple times because of these mood swings. Even if the episode it has only been for a single day or a week, that's enough to quit your job, leave school, blow up at a friend and lose them forever... I have learned to see the signs as I've gotten older though (30) - but as a teenager I was wildly unpredictable to everyone, including myself.
I guess I don't really have much to add, certainly not an answer to your questions aside from some generic "we'll figure it out" advice. But I really do believe we'll be fine eventually.
I really relate with your experience and will be following the thread
A lot of good suggestions and advice in here; however, I'd add that I think it's good to ask yourself what your social support system looks like. A partner, friends, a therapist, a psychiatrist, a mental health peer support group, a hobby group, etc. Having at least a few of those would be a good start to help keep you on track.
It also might be helpful to reconsider your perspective on therapy. While it may not be as necessary as it once was in the past, it might be good to revisit. It can be good just to check in rather than seeking treatment for a specific diagnosis.
So for people who have OP’s issue or similar, what do other people do for you that helps?
Patience.
I don't struggle with month long swings like OP but I have very similar experiences to them. My loved ones know that I'm not always up to talk/come over, and that if I don't respond it's not personal.
For me, the absolute best thing other people can do is understand - even if they don't. Many struggle to visualize how these struggles feel and work and try to take it upon themselves to be helpful, but sometimes that only leads to feelings of guilt for relying on others.
So, I guess my little piece is to never lose empathy. Remember that even if they're acting a little strange or struggling to keep up with life's responsibilities, they really are trying their best to trudge through the mud and get out of the swing.
I've been dealing with periods of pretty bad depression for a while, and the best trick I have to follow to help climbing back up the hill rather than falling in deeper: set one reasonable, somewhat simple goal for the day, and if you do that goal, it was a good day.
"If I do 15 minutes on the Elliptical, today was a good day."
Getting that little win can really matter. For me, it would often trickle through into other parts of your day. It lets you give yourself a break -- you can actually pause and do something for yourself without feeling guilty, if you've already met the "today was a good day" goal you set earlier.
Also, exercise is incredibly important. Most of my 'little goals' are exercise based, because I know damn well if I exercise, I'll do more with the rest of the day too.
One thing I'm practicing is write out all the things that annoy you or all the boundaries you're not setting or enforcing with people in your life and slowly start to speak out (with empathy and politely) about certain things so people know in no uncertain terms that you're not accepting whatever anymore and that they need to work with you to help start falling in line with these boundaries.
Make sure the boundaries are appropriate and that you have a right to expect them and that there needs to be a gradual acceptance and acting within them in order for that relationship to continue being enjoyable and productive or even just sustainable.
You'd be surprised how resentful you can become aware of feeling with people who constantly undermine or refuse to accept basic rules of decency or things that you value that they are perhaps unintentionally flouting and continuing to do so on an ongoing basis and how disempowering that is when you aren't being respected in the way(s) you need.
Break down things you see as more helpful or aspirational and then break those actions into smaller steps. Like, exercise can be a one kilometer run or a five minute walk, which can just be a two minute sit outside, which can just be a plan to go outside tomorrow and deciding to relax today. Relaxing and enjoying yourself can also be an accomplishment. Enjoy your accomplishments and find your limits, so you know what to expect of yourself, rather than following perhaps arbitrary societal ideas of what you're supposed to be doing.
Once you slip, focus on the basics, whatever those are for you, and reset. Consider putting a name to patterns or setbacks and try to identify them, eventually trying to predict and head them off at the pass.