About 3 or 4 times a year I will get pretty powerful manic episodes. Usually for a few days I'll stay at the office until late at night, I'm in an amazing mood, I'm always excited and have trouble sleeping. My focus is so powerful, If I could be this version of me all of the time I genuinely believe I could do anything.

It's like a totally different person from my usual self who is easily fatigued, slow to start, and generally lethargic.

Knowing this side of me exists is exciting but also kind of depressing given my awareness of its fleeting nature. How have you dealt with this? Any reading you could recomend?

I'm working on pruning the sources of information that come into my Readwise/Read Later feeds down based on usefulness/actionable in my life and quality. My priorities are for data sources to expand my 'reality tunnel', to provide unique insights (not an echo chamber), and to remove a lot of the 'noise' of the day-to-day information overload. I'm considering what those sources might be. If you have a moment, I'd appreciate your thoughts, advice, and links to any writings or videos that speak to this similar goal and how others have done it. Thanks in advance!

Nick Milo said:

The noise is deafening, but I promise to focus on the high-value signal.

I'm seeking to reduce the noise, and increase the signal of my Reader feeds.

I am 20 and I was going to move to a different country to pursuit my bachelors. I was going to make my parents proud! But, 2 days ago, I had a severe panic attack in the middle of a night and a terrible nightmare which preceded the attack. I started seeing weird things when I closed my eyes and I couldn’t manage a day without crying and continuously kept having tremors so I sought professional help.

Now, I have been diagnosed with severe depression and moderate anxiety and I have deferred my plans to pursuit my higher education.

I was once ahead of my peers and enthusiastic about life but now I just feel stuck in life, I feel worthless, undeserving and a piece of shit. I haven’t accomplished anything in the past 4 years which could work as a groundwork for my motivation and I only seem to fall deeper into despair. 

I feel as if I won’t be able to accomplish my goals or achieve anything in my life.

I haven't thought of harming myself but I think the fear of not being able to achieve anything might just make me suicidal.

I have found the tildes community to be observant and kind, I was a lurker before and asked someone for an invite just to post this here. I don't know if I am looking for advice or comfort or anything else but I sure wanted to put this out here.

Symptoms from my diagnoses of bipolar 2 and social anxiety disorder kept me from working, socializing, forming relationships, and living independently for more than a decade.

I worked my ass off to improve my wellness, and for the past 6 years I have worked as a Peer Support Specialist for 2 different public agencies. I tell my story to other people with mental health and substance issues as part of my work. If anyone’s interested, I’d love to share it here too.

https://theappeal.org/dc-police-mental-health-crisis-response-aclu-lawsuit/

The American Civil Liberties Union of Washington, D.C., filed a lawsuit in federal court Thursday alleging that the district’s practice of sending police officers—instead of mental health specialists—to mental health emergencies violates the Americans with Disabilities Act.

“Someone who calls 911 for a physical health emergency gets trained medical providers who can treat and stabilize them,” said Susan Mizner, director of the ACLU’s Disability Rights Program, in a press release. “But someone who calls 911 for a mental health emergency gets a police officer with handcuffs and a gun.”

According to the lawsuit, these differing responses constitute a breach of the Americans with Disabilities Act, which prohibits government entities from denying people with disabilities equal access to government services and programs. The ACLU is suing on behalf of Bread for the City, a local nonprofit that provides healthcare and social services to lower-income and unhoused communities.

I figured I would help kick off this new subgroup by starting a discussion on how people with ADHD try to manage it.

I had a late diagnosis a couple years ago as an adult, and I have been working with a counselor to develop some behavioral techniques (in addition to medication). Not all of them stick, which in my experiences is the primary challenge of this disorder, but I've had good results when I do use them.

Primarily, I have a calendar where I put reminders and plan things out. If I have parts of a project I need to get done, I lay those out and assign them to certain days of the week. Working in academia, I live my life a semester at a time and this helps me reevaluate certain goals and it feels reasonable to me to plan out a few months at a time.

One thing I struggle with when it comes to planning is coming up with accurate estimates of how much time it might take to spend something. This was always a big obstacle in my way when it came to planning things out before - I wanted to know the exact time on how long it took to do something so that my schedule would be perfect. My counselor suggested that I come up with an initial estimate of how long something should take based off my intuition, and then double it (e.g. if I think a task should take 30 minutes, plot it out for 60 minutes of my day). This has been great for me because usually it's a win-win. Often, my initial assessment is underestimating how long something takes, so by accounting for slippage in time I can better chunk out my day. On the other hand, if I do get it done sooner I can pat myself on the back and I now have extra time in the day to get other things done.

I wanna find better ways of trying to stay on track with habits. I've tried some different apps and none are working too well. Recently I picked up Sunsama which has helped in terms of reviewing the day and looking at subtasks, but as I've gotten busy with experiments I've kind of lost track of that. What are some things that you do to accommodate the way your brains works?

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.

Traumatic brain injury multiplies the risk of major depression eightfold. While the emotional trauma of whatever caused such deep damage may be understandable, from a blast in a war zone to a blow on the playing field, there’s a physiological component, too, that neuroscientists have long suspected but have been unable to identify.

“As clinicians, a lot of us had a gut feeling that [TBI-associated depression] is a different disease,” said Shan Siddiqi, a Harvard Medical School assistant professor of psychiatry and a clinical neuropsychiatrist at Brigham and Women’s Hospital in Boston. “Why did nobody detect it before? I think the reason is because unlike other psychiatric disorders, TBI caused a sort of structural reorganization of the brain.”

https://www.statnews.com/2023/07/06/depression-after-traumatic-brain-injury/

I have lost my r/finch community, and am feeling curious to see if there are any folks here who also find apps can be helpful for their mental health.

I struggle with anxiety and am processing a lot of grief, and may or may not have ADHD (I am in the process of getting tested, but it takes a while). My experiences with therapy are a bit mixed, so I am currently going down the route of trying to DIY my wellness a little. Starting simple with things like, sleep more, try to focus on drinking enough, go out in nature, switching off podcasts and phones and reading more. It's actually helped me, bit by bit.

One of my 'tools' is an app called finch, a virtual pet that encourages you to set goals, check in how you are feeling, journal, do mindful breathing and such. I tried many things and this app is the one that stuck and actually works.

Just wanted to ask, do any others here use wellness apps? And have they worked for you? Which do you recommend?

Just to be clear, I mean apps that work as a stand alone solution, rather than apps like 'better help' which ultimately just connect you to a therapist. Although Better Help has its uses too!

A recent thread had me reflecting on my own mental health journey and what really made a difference for me, I was interested in opening a discussion about what other people found most valuable too. I'll add my own as a comment.

...When I can't complete a task right now but instead have to wait for some reason. For example:

• When I have to complete a task list for school, and would love to just blitz through it all, but have to wait on someone else to fill out some form. Then I get it in an email a day or two later, but have already completely forgotten about the list and things I should do, because something else took over my mind. And I put it off because I have other things to do. Then the deadline comes and goes, and I'm sitting there thinking "Well shit, if I could have done it immediately then it would have been fine."

• I ask my kids for things they want at the store. I know I need to add it to the grocery list app immediately or I won't remember it, but I'm driving them to camp and can't use my phone. By the time I've dropped them off, I forgot already. Then they're upset with me because I forgot their things, and I'm upset with me because I forgot their things.

All these little things that just add up to make life a little more frustrating and annoying.

Anyone else with ADHD, have any tips to overcome these? Frustrations of your own to vent? How do you explain to others that it isn't you being careless or lazy, but instead it's your brain working against itself?

I have a very close friend that has been in the deepest troughs of depression for the past couple of years. They live about an hour away, so though my wife and I try to physically show up to support them whenever we can, that's much less often than we'd like. Their support network is thin, and day-to-day basically consists of only their partner, with whom they live, and who is visibly fraying at the seams.

This person (I'll just call them John for the sake of readability) is currently on medication for their depression and OCD (I'm nearly certain it's Lexapro, can't remember for sure) and has on and off therapy, though they often find themselves at odds with their therapists' perspectives. Some of this is because it feels like the profession has been flooded with folks who lack experience with patients with severe chronic mental illness, and some of this is (I suspect) John's illness distorting their thinking, leading to frustration and anger in the moment that doesn't make sense in retrospect.

John had a particularly bad day yesterday, and after I spent some time with them, we started talking about how they felt like they needed considerably more support than they were able to get in their current situation. Unfortunately, the only option he was aware of was "group homes", which seems like a pretty broad term and I don't know much about what they look like (or how successful they are at helping people like John).

I'm trying to get a sense of the spectrum of options available for people like John who are suffering from severe chronic mental illness. On the one end, there's what we're doing now; regular psychiatry and counseling, and on the other end, I guess, is involuntary in-patient behavioral health/medicine clinics. Being involuntarily committed to such programs has been a source of trauma for them in the past, so I'd like to avoid anything even close to that end of the spectrum, if possible. I know that there are, for example, 90-day rehabilitation centers for folks with substance use disorders (I have a family member that found a lot of success at one of these), but do similar programs exist for folks non-substance-related mental illness? Does anyone have personal experience with any of these programs?

Thanks in advance to anyone who takes a moment to read and share their thoughts; I know this is a really challenging topic.

I'm writing this post in the spirit of the powerful conversations that I had participated in on reddit in /r/adhd. I'm giving up reddit, after this recent fiasco. And, so, I hope to find a similar community here.

And, so, here we go.

I recently quit my job in Big Tech after 7 years in that space. Corporate America, and Big Tech in particular (among other fields) is a human meat grinder. Humans go in and husks come out. After taking a medical leave of absence from work due to complications from anxiety, and multiple medical interventions, I realized that I needed to evaluate whether my job, even my career, was sustainable for me. It only took a few weeks, after returning to work, to accept that, yes, this job and perhaps this career are actively harming me. After talking about it with my wife, at length, I found relief in quitting.

At the core of it: my career has simply been incongruent with my values.

Sure, I've always been a nerd. I was the "brainy" kid. I didn't know how to people well (though I'm told that I'm not on the spectrum or not in any meaningful way). I'd always been overweight and prone to stress. Throughout my life, I was often labeled as the "sensitive" one by people. I rarely felt as though I fit in with any group of people, save perhaps for the other misfits who would band together because they didn't with in with any group of people.

Just before the pandemic began, at the tender age of 47, I was diagnosed with ADHD Combined type. More recently, I was diagnosed with C-PTSD, that I have likely suffered for 40 of my 50 years.

Now I know where that weight comes from: self-medication to give me a dopamine hit and numb me to layers of trauma. I also know where the emotional reactivity comes from: emotional flashbacks resulting from the C-PTSD.

1. Lexapro for well over a decade. It helped to blunt the lows but, I've found, also the highs. I rarely feel poignancy with Lexapro. When I have occasionally been able to ween from it, I have felt a far greater range of emotions.
2. I've had an excellent therapist for going on 8 years who practices ISTDP. He's helped me learn to show up for my more challenging emotions instead of instantly reaching to numb them.
3. Adderall and Vyvanse both used to help until I received a stellate ganglion block (Disclaimer: I have been a client of Dr Mulvaney's practice though I link to it as his explanation is excellent; I'd make this a footnote alas tildes doesn't support that extension for markdown)
4. Ketamine (prescribed) to better address the depression and anxiety. Ketamine, as a psychedelic, combined with the skills learned in therapy has let me dig deeper into my layers of trauma, leading to better overall mental health and better self-understanding.
5. Stellate Ganglion Block mentioned above. Short version: it reduced my seemingly PTSD-driven emotional reactivity to about 10% of what it was prior to the SGB. It's like getting a new nervous system. Unexpected side effect: medications that act on my nervous system now respond differently. As a result, stimulants are now extremely uncomfortable for me whereas before they were effective. Before the SGB, I would say that fear was my primary emotion. Now, I feel things.

I know: I'm privileged. I'm an "old white dude who profited from being in Tech". Yep. True. But I can't retire yet; we don't have that kind of money. We do, however, have enough such that I have the luxury of time to figure out my next steps.

What I have right now is the plan to make a plan. The core of it: live a life congruent with my values--not just at some far off retirement but here, now.

At first, step 1 was to answer this question: "What is the minimum amount of money that I need to earn for us to not massively disrupt our lives?" But then I realized that this is a fear-based question. It means starting out by saying "no" to everything that doesn't earn "enough" money for some arbitrary value of enough.

Where I'm at now, Step 1 Mark II, poses a more inspiring question: "What does retirement look like for my wife and I?" I don't know that we truly get to retire in the sense of living a life of leisure as seemingly many Boomers and earlier were privileged to do. Besides, part of my sense of accomplishment and peace is knowing that I did something to make the world better.

So what do you struggle with?
How are you doing?
What are you doing about it?

Be well.

P.S. This is me trying to do my part, as a new member of this community, to encourage growth not in membership but into different areas of discussion.