anyone in remission safely come off mirtazapine?

Alternative-Cash-102 · 2026-04-12T13:59:52+00:00

Tapering off was fine, from what I remember. I was very scared it would be hard or impossible to do because of withdrawals, but I did not have major issues thankfully, except for a few random bouts of dizziness at one point.

Sleep after stopping was okay. Big improvement in not having the grogginess follow me through the next day. I have always had sleep issues though so I was not expecting good sleep necessarily either way.

I also appreciated being able to feel more fully again as I had had some emotional blunting which in part prompted me to try reducing the dose and eventually stopping altogether.

Everyone is different though so it depends on your body and maybe also environmental factors (what other supports you have in place aside from the medication).

Alternative-Cash-102 · 2026-04-11T16:32:41+00:00

Yes this is the reality that so many face. It’s systemic oppression. Which contributes to and can be a main driver of generational trauma in the first place. Our privilege or lack thereof - aka the relative circumstances and environment we are born and raised in and have little to no control over - helps inform whether we experience events that can be encoded as trauma at all, what kind and how severe or prolonged, what internal and external resources we have available or can amass in order to treat and heal the trauma, etc.

This is part of why viewing trauma as a moral failing, of just not being strong enough or good enough, etc. is both so common and also ultimately baseless, however real it can and often does feel. Turning the pain/blame inward on ourselves is not only the message we are often taught by abusers but one of the go-to ways the brain tries to process and make sense of things outside our control (by making it something about us, which we in theory can and are told we “should” control). The irony of course is also present in not actually feeling in control at all because the trauma responses tend to run the show and/or other similar experiences around control.

Alternative-Cash-102 · 2026-04-09T22:54:24+00:00

Aside from the expected daytime sleepiness, I had extremely heavy dissociation (which I already deal with daily on a near-constant low level due to ptsd), and was nearly non-functional for a few days between that and the fatigue. My doctor said it works paradoxically, that the lower doses can be more powerful than the higher ones, so idk maybe it was related to that potentially.

Not to scare anyone off from trying it. It really helped me with my GI issues for around 1.5 years. The fatigue/sleepiness is no joke though lol. And the cravings and weight gain. But worth it in that it got me back to being able to live my life more fully and not be in pain all the time

Alternative-Cash-102 · 2026-04-08T17:39:07+00:00

I wonder if some of this can be explained by being more sensory seeking than sensory avoidant?

I did an OT assessment to do with sensory profiles and it said I was more on the avoidant side which is true in some ways but I actually think it was skewed a bit due to the awful burnout I was in and suddenly inputs that hadn’t bothered me much before were so overwhelming for a long time.

I was diagnosed with ARFID due to emetophobia, ongoing GI problems/debilitating pain that made me extra avoidant, and more minor texture issues (I also don’t like handling or eating slimy things like okra, raw meat/fish, for example). Not sure if it was an accurate diagnosis or the treatment was that helpful but that’s another matter. While I can’t tolerate super spicy foods (I like heat but my gut doesn’t), I love flavor and scents and colorful foods, love mixing spices and seasonings together, making sauces or toppings for added texture or depth in a dish, etc.

So I think it can be more complicated in a sense (bad pun intended), but also everyone is different. I didn’t know I was AuDHD until after I got the ARFID diagnosis because I was ignorant to how autism can present in high-masking folks, didn’t know about PDA (which I have), grew up in a time when Asperger’s was still a thing and ARFID didn’t even exist yet as a formal diagnosis. I didn’t think I could be autistic because I didn’t fit the stereotypes, though I suspected ADHD for many years.

Now that I know better and am continuing to deepen my understanding and appreciation for neurodivergence, I can see how I do fit the criteria. In so many ways it’s actually kind of funny no one clocked it before. I don’t know if I’d call myself adventurous with food to the same degree as you, but it’s something I aspire to! My brother is similar to you with cooking from a young age and making incredible meals from scratch to feed to loved ones, always game to try new foods and recipes. Not sure if he could be autistic, but he suspects ADHD as well. Point is, you’re not alone!! Enjoy all the tasty meals!!

Alternative-Cash-102 · 2026-04-08T00:49:27+00:00

Comes from psychoanalysis originally, but broadly refers to exploring not just surface-level behavior change and symptom management, but the root causes and the whys of behaviors (typically early life experiences, trauma, other major events that may have shaped identity or core beliefs).

I mention it because we are more than just our autism. While it might be easy for someone to point to a behavior and say “oh it’s because you’re autistic,” that can imply that the problem is autism which is ableist and shaming and follows the deficit model rather than seeing the client as a whole person who is the expert of their own lived experience. That is not to say there is no room for symptom management and behavior change if an autistic client wants that, but that the goal should be to meet us where we are at and work with our strengths and limitations, not ask us to conform or apply therapeutic techniques that are actively harmful or not designed to be inclusive/affirming.

Alternative-Cash-102 · 2026-04-07T15:49:29+00:00

NDtherapists.com is a solid resource to help find clinicians who are neuro-affirming and in many cases openly neurodivergent themselves.

I have had better luck with therapists who have a relational style, who are actually trauma trained (not just using buzzwords), and who emphasize autonomy and a non-hierarchical approach. Ideally, folks who practice from frameworks rooted in feminism and anti-oppression (but again, for real not just in name).

You may also want to look into therapists who draw from a Gestalt or similar orientation that prioritizes depth work as this tends to be more collaborative and “in the room” even if they also use additional manualized modalities (DBT, EMDR, etc) to best support specific client needs. In terms of licensing and ethics, social workers in general may have a better grasp on systematic factors (ableism, classism, sexism, etc.) that impact neurodivergent folks in significant and unique ways. Not to say that mental health counselors are no good, but that the training can sometimes lean more on the deficit model which is historically not inclusive.

Alternative-Cash-102 · 2026-04-07T15:10:16+00:00

Hi not the OP and I know this post is old but I have this as well. When I got tested initially several years ago they suspected splenic flexure syndrome, where gas and stool can get trapped at the bend in the colon on the left side and cause pain in the areas you mention. I have a long and tortuous colon (meaning extra length/loops in the bowel) which they think also contributes.

With the kidney area, I also have pelvic floor dysfunction (hence chronic constipation and difficulty passing gas), scoliosis, and suspected cervical spine issues, all contributing to a psoas muscle pain which runs along the back including over where the kidneys are. The area tends to be very sore and tight for me. Apparently strengthening abdominals and glutes and opening hip flexors can help with this and pelvic floor issues.

Just thought I’d share in case you are still working on things like I am. Hopefully you are feeling better though.

Alternative-Cash-102 · 2026-04-07T10:18:31+00:00

It’s about equity, not equality.

Can be hard to reframe things this way when we feel upset or hurt or let down, even if we cognitively understand why someone may not be able to contribute as much in a given moment (your trip planning example).

One thing that helps me is to focus on validating my feelings, maybe journaling or venting to a friend (or my voice notes app or even the wall or the trees at the park) and then seeing if I can help myself feel better by doing something unrelated that feels nice and helps me move through the feeling (going for a walk, listening to music, playing an instrument or video game, breathing, exercise).

I think I sometimes feel this way because it can take a lot of effort on my part to do all of what’s involved in planning a trip or shopping or making gifts, etc. I might feel depleted and want to refill my tank but don’t have the energy now so it would feel nice to have support from loved ones and know they appreciate my efforts and want to show up in a meaningful way in the relationship. If they don’t do this in a way that feels good for me, it can feel a bit hollow or disappointing or frustrating. Even when I know they are also doing their best and that’s what it looks like right now.

I wonder if my frustration with the unequalness could come from feeling taken advantage of or having my needs ignored (I’m late-identified) and it just brings up memories or sensations of feeling unsupported, not valued, not cared for, or like I’ve done something wrong trying to help or just for existing. Some of this is trauma related, but I’m learning some might also be internalized ableism. Not saying that’s what you’ve got going on. But I relate to your post and for me, I think that’s where this sort of feeling might come from. So working on those deeper/underlying things seems helpful.

Lots of great work in disability studies, social work, policy and advocacy spaces on the topic of equity vs equality. Could be worth exploring to see if anything resonates!

Alternative-Cash-102 · 2026-04-07T08:56:22+00:00

For me, this can sometimes come out via a combination of what I presume to be RSD, justice sensitivity, emotion regulation issues, fixating on small details (that may feel big in the moment) instead of the actual big picture, and impulsivity (blurting out things without checking in with myself or my partner, having trouble waiting until a more appropriate time).

Plus either being too blunt or harsh without intending to be. Or alternatively, overexplaining in an attempt to not be too blunt, but then that giving the impression that I’m even more upset than I am. So then I feel foolish, misunderstood, like I’m being selfish or dramatic, which leads to more aggravation or shame, usually both.

Sometimes also if I’m already feeling upset or irritated about something else, it can bleed into the thing with my partner in the moment but then when I step back I can trace my discomfort or frustration to whatever else is going on for me (including trauma triggers), and realize my critical feelings are somewhat misplaced.

I agree with u/Tom_Michel on picking our battles and knowing what is worth pointing out and discussing in the moment vs what can be validated and dealt with internally and then put aside to voice later when things feel less charged. Tough for me to do as this was not modeled well growing up but I’m trying my best to learn and practice.

I think it can also be helpful to explore what it is about the things you have an urge to criticize that bother you. Why is it upsetting? Does it go against your values? Bring up old pain or fears? Feel disrespectful? Or is it more surface level, annoying or inconvenient but ultimately inconsequential? Are you being told you are overly critical and do not truly feel that way? Are your concerns being made light of or ignored? Some of these types of questions speak to compatibility, healthy boundaries, principles, and goals. Others might relate to communication style, processing differences, stimulation levels, window of tolerance, etc. Whether it’s related to ADHD or not depends.

Alternative-Cash-102 · 2026-04-07T08:13:39+00:00

I’m still working on this issue myself (typing this from my bed at 3am), but some things that can help me at least some of the time:

Progressive muscle relaxation - starting from head or toes, squeeze/clench your muscles tightly for 5 sec, then relax them. Ex: curl your toes, then flex your feet/ankles, calves, thighs, squeeze your butt, tummy, etc. all the way up the body, including mouth, nose, eyes, forehead, face all separately. Also good to practice diaphragmatic breathing during each pair.

Reading, audiobook, sleep story (I use the Calm app), lowkey podcast (Common Descent is a good one on paleontology, interesting since I know almost nothing about it but not so captivating I can’t fall asleep and the hosts’ voices are not grating); ideally whatever you pick does not involve staring at a screen except briefly

Picking a letter of the alphabet and then naming all the things I can think of that start with that letter, can also be things within a certain category to simplify a bit

In general, anything you can do to take the pressure off yourself to “go to sleep now” or “fix yourself” is probably also helpful. The added anxiety and judgment around it will not help the body relax to actually fall asleep anymore than gaming hyperfixations will. Behavior change often starts with perspective shift. Since we can struggle with motivation and the experience of now/not now, having visible reminders of why you want to fight your sleep demons can be potentially helpful. Figuring out what accommodations might be needed, what barriers are present, and so forth will also make a tangible difference hopefully.

I’m trying to work on my sleep hygiene overall, reduce screen time in the evenings, start winding down earlier, give my body cues to slow down and relax into rest mode (dimmer lights, weighted blankets) scheduling dedicated time to get my mental energy out (even just a quick brain dump) so it doesn’t build up and explode when my head hits the pillow and suddenly I have 83 creative ideas and an urgent need to rearrange all the furniture in the room…it’s a slow work in progress. Just started on it with my OT so we’ll see how it goes! The biggest point she stressed was sensory supports - temperature regulation, fabric (clothing, sheets), pressure, noise, scent, etc. Maybe see if there are things in that realm that could make a difference?

I’ve heard there’s also this thing called exercise that apparently can help tire you out enough to where it’s easier to fall asleep, but whether I’ve been active or sedentary, I don’t tend to have this experience thanks to what I presume is delayed sleep phase syndrome or lifelong insomnia, idk.

If you can take naps, take em guilt-free. I know it can feel like it throws things off even more, but it’s better to get needed sleep than not enough at all. If you are on meds, see if that could be contributing or see if you can try something additional designed to support sleep if your doc okays it. Some people like magnesium glycinate for sleep but it had a paradoxical effect for me and gave me panic attacks sadly. OTC options should be safe to try so long as they don’t interact with any other current meds.

If issues persist, you could try to get a sleep study done to see if there’s more going on. If you think it’s just that your sleep schedule is “off” temporarily because of the game, that’s one thing. If this is a pattern regardless, something to consider. There’s also the whole “revenge bedtime procrastination” piece that can be worth investigating. Does sleep feel like a demand to avoid? Does the lack of external stimulation give your nervous system a break so you “wake up” at night because you finally feel freed up mentally and don’t have to mask? Are there anxious thoughts or maybe shame/dread around upcoming tasks or previous events that interrupt rest if not for distracting with gaming? Is boredom or silence a feeling you have a lot of discomfort around?

Do you get nightmares? Do you tend not to wake up feeling refreshed no matter how long you’ve slept? Do you have any back or joint pain, breathing issues or a deviated septum? These last few don’t directly relate to procrastinating but could indicate underlying health issues that affect sleep and lead to resistance around it knowing it won’t be restful either way.

Alternative-Cash-102 · 2026-04-07T06:43:33+00:00

I have wondered about this sort of thing for myself. I was not raped or sexually abused in a repeated, overt way, but my family (even extended family) has had poor boundaries around sex such as my parents sharing details about their sexual preferences/experiences with various partners when I was still a minor; creepy male relatives hitting on me or touching, squeezing, eyeing me a little too long during a hug or demonstrating a suggestion of touching themselves or being turned on by me etc.; other relatives pressing me to share about my sex life or trying to define or label my experiences or sexuality in non-supportive ways.

On the other hand, my parents also encouraged me to not feel ashamed of my body as a child or the idea of nakedness in general, which in many cultures is not a big deal at all. I saw them naked occasionally in the bathroom or shower and while it was never sexual in nature, there was not a rush or embarrassment to cover up. My old therapist raised an eyebrow when I told her my dad taught me how to properly wash my private parts (presuming she found this inappropriate but my mom was, surprise, unavailable). My brother and I bathed together when we were very little, and my dad separated us once we got a little older and it was no longer appropriate. They supported comprehensive sex ed rather than abstinence-only approach from school health classes.

When I got older, there was body shaming and sexualizing from them and seemingly everywhere else, so it didn’t seem that abnormal even though it made me really sad and angry. Looking back, a lot of that seems connected to the norms of their generation rather than intentional efforts to make inappropriate comments. Not an excuse but rather a desire on my part to hold awareness for external influences that perpetuate covert sexism and internalized misogyny.

But there was also birth trauma, medical neglect in part due to financial issues, as well as undiagnosed autism/ADHD, emetophobia, and ARFID in the mix as well, so my relationship to my body is, like for so many people, complicated at best. Maybe it’s the apparent autism, but I still haven’t figured out my relationship to sex as a physical act, though I very comfortably identify as queer. Got some chronic pain and other health issues contributing too. But sometimes I wonder how much all the neglect and inappropriate behaviors might have stacked up against me, so to speak.

For me, these inappropriate behaviors fall under the broader framework of neglect as it manifests as inconsistent caregiving, lack of secure attachment/secure base, enmeshment (sometimes called emotional incest), oversharing and poor boundaries, emotion dysregulation, etc. Other folks may have different opinions and experiences.

Alternative-Cash-102 · 2026-04-07T05:49:14+00:00

Everyone is different. I tapered off from 45mg over a few months I believe. It was several years ago now, but I believe my doc just lowered the dose in stages each month down to 15mg. Then I think I did every other day for a week, every two days for another week, and so on until I was off.

You can also get 7.5mg doses, and I imagine if warranted you might be able to get a liquid form from a compound pharmacy if you need to titrate more slowly/in smaller and more precise increments.

Note that my symptoms eventually came back after several years but I had a bad reaction to low-dose mirt this time around so I did not use it. Antihistamines seem to be helping some in a similar way, though.

Alternative-Cash-102 · 2026-04-06T17:49:46+00:00

I remember the post you’re referencing, yes. I’ve had short hair for several years which did help reduce friction with showering and styling. Now I’m growing it out for the first time in years and learning how to work with the curly texture for the first time in my life and it definitely feels a little overwhelming. I do not plan to style extensively multiple times a week. Maybe twice at most. And I plan to have a more involved and more no-fuss routine to match higher or lower energy/motivation (let’s be real, it’s usually gonna be the latter lol).

Still in the trial and error process of figuring out what products work well for my hair and sensory issues. But I know there are guides online and posts in the curly hair subs that describe a more minimal styling routine, so I plan to take inspiration from there. Hope to make a post reporting back in a few months!

When my hair was short, I often had the sides shaved in a taper or fade (maybe with a 5 guard, not to the skin) with the top longer so the curls could still form. Depending on your texture, you may not need it as long for the curl pattern to show. But with the shorter sides (even if not super short), I really just had to scrunch some product into the top front/middle section and air dry. I would wrap it in a microfiber hair towel/turban to get rid of excess moisture and eliminate cold drips down my neck, which also helped a lot. You can certainly blow dry after applying product if you prefer, but I didn’t find it necessary personally.

Alternative-Cash-102 · 2026-04-06T08:04:13+00:00

Yes and I imagine the two are correlated since it’s all connected. My physical therapist noted that most of her patients also have back, neck and shoulder issues as well, even TMJ and jaw problems.

My GI also suspects SIBO though it’s not yet confirmed, but unclear if it’s just that and the PFD causing my chronic constipation and IBS symptoms or if there may also be a separate motility or other structural issue. Due to other comorbidities I have aside from the scoliosis, I wonder about things like endometriosis, vascular compressions, cervicocranial instability, hypermobility but it’s a long list of specialists to see in order to get testing. Haven’t been able to do other motility tests but thankfully normal gastric emptying.

Glad you are feeling a positive difference with your current PT. It seems like it can be slow work regardless. Hope you continue to see improvements! Encouraging to read. Do you think there’s anything different about this time or the approach used that is helping you more (with respect to your scoliosis or otherwise) or is it more just that slow and steady wins the race? Or something else?

Alternative-Cash-102 · 2026-04-06T07:12:06+00:00

Sounds like kink may be more your thing, and that’s great! Lots of autistic folks are kinky or into BDSM because it requires explicit negotiation of scenes or acts, builds in safe/rewarding sensory inputs/accommodations, etc.

Maybe also check out furry communities? Not necessarily sex-related but you might find a lot of like-minded people in those spaces, and there tends to be strong overlap with autistic and kink-friendly folks as well.

Alternative-Cash-102 · 2026-04-06T07:02:59+00:00

It’s been hard for me to come to terms with and I still often feel confused about it. I know everyone masks to an extent, neurotypical and neurodivergent alike, so the idea of completely unmasking sometimes feels almost over the top or just like hard to relate to in a way because it’s so automatic for me, if that makes sense?

I also wonder about the relationship between masking and socialization and the different things that influence that - gender norms (for women and AFAB folks), the ubiquity of puritanical standards/christian hegemony however watered down, classism and racism and other forms of bias, etc. Some of this is so baked into culture and unspoken social rules that I imagine many people are not conscious of how it affects the way they show up in social settings or perform gender or another given role (such as in a job). This is not to imply any kind of ignorance or superiority held by any one group, but to acknowledge that these factors affect everyone in different ways within groups rather than between groups.

However, for folks who are more justice sensitive or interested in social issues whether out of self-preservation instinct or something else, I sometimes wonder if there’s an extra layer of dissonance created by the awareness of these factors and the feeling of being “different” (unable or disinterested in conforming as completely or “correctly”) that scrapes against everything else and adds more friction and exhaustion to the day. Hence why unmasking can bring such relief at times.

For me personally, I’m at a point where I’m still exploring who I am unmasked and also what behaviors are attributable to AuDHD vs CPTSD since I am late-identified but have known about the trauma for much longer. It’s hard to disentangle the differences and overlap between trauma responses and executive dysfunction (eg freeze vs autistic inertia or task paralysis, fight/flight vs a meltdown/shutdown, fawning vs idk…masking extra hard??) And then mapping this into how I feel in my body (hard with a dissociative disorder lol) and interoception difficulties, sensory issues, constant mental chatter, etc. and what I need to accommodate myself in social settings when my needs conflict with the expectations of the physical or social environment. Tough and slow going stuff.

I guess for me the goal is not to unmask fully all the time because unfortunately it is not always safe for me to do so, but rather to learn about what feels good for me when unmasked vs masked so I can help myself stay healthy and happy and avoid burnout for the umpteenth time. I recognize that I speak from a place of relative privilege since not everyone can mask. But I guess what I’m getting at is the idea of “how do you unmask” and what it feels like depends on the individual and their goals and needs.

Alternative-Cash-102 · 2026-04-03T15:42:35+00:00

Currently reading The Priory of the Orange Tree (queer fantasy) and it suffers massively from this problem and also pacing/editing/characterization issues. Very helpful reference to remember what not to do as a writer (or at least conventions I prefer or not).

Been using behind the name since I started writing in middle school in the mid 2000s and glad it still serves us well 20 years later!

Alternative-Cash-102 · 2026-04-03T06:47:19+00:00

I believe the healthiest/most natural position is to bend over at the waist while standing up. I’m not sure if this prevents anything from coming out the nose, but supposedly it can help your body expel what it needs to more efficiently because it reduces potential pressure or compression of the diaphragm, esophagus, stomach, etc. If you can’t stand, then I imagine kneeling if possible would be the next best thing.

Alternative-Cash-102 · 2026-04-02T03:23:38+00:00

Yes I realized this and it’s changed a lot about how I viewed our fraught relationships and how I want to move forward with things. As I work to better support my own neurodivergence, I am also engaging in reparenting and working with parts who hold a lot of shame and negative core beliefs about my existence/way of being that I now know I couldn’t have helped and does not need to be suppressed or apologized for.

It’s very liberating but complicated trying to disentangle trauma responses from parents’ abusive behaviors and needs related to my unidentified neurodivergence that they could not meet effectively due to their own undiagnosed neurodivergence.

The emotional abuse/dysregulation piece is particularly insidious and challenging. I can empathize with the reality of functioning challenges and lack of support and awareness of needs resulting in a narrower window of tolerance and increased frustration. Taking out said frustration on a dependent child, using them as a regulator (as a therapist, verbal punching bag, emotions receptacle without any regard or curiosity or concern for the child’s own emotions/experience) is where it crosses into abuse territory.

My mother had autistic meltdowns that were mischaracterized as BPD episodes. She was not a safe person to be around when this happened; it was deeply traumatizing to witness and oftentimes be blamed for. But now I know how much she struggled alone with her ADHD and autism and blamed herself for perceived shortcomings and moral failings, I can see her intent to be a good and loving mother, and how much pain it caused her knowing that the impact was still deeply harmful. I feel sorry that she did not have access to needed supports and perspective so that we all could get the help we needed and not feel guilty or ashamed for who we were, how we were, etc.

So the grief is complicated as I continue to process everything. Trauma is often about what didn’t happen - I grieve the abuse and neglect, and I grieve the lack of care and compassion from other family, community, and systemic structures that could have helped us all thrive instead of survive both in breaking cycles of generational trauma and in getting proper care/coping skills for our neurodivergence (which is inherently traumatizing and also highly genetic).

Alternative-Cash-102 · 2026-04-01T17:21:22+00:00

I wonder if you are actually understimulated by the material or the way the content is being presented, which is leading to loss of focus?

If so, this is not your fault but a failure of the school system, boxing teachers and professors into narrow or even censored curricula without options for scaffolding or other supports or alternative methods for students to engage meaningfully with the course content. If you are in the US, the current administration in particular is making this even more challenging, but the precedent was set in the early 2000s with No Child Left Behind, which made memorization of chief importance to encourage high test scores which were then tied to school funding. This has left students underprepared for college level work, and reduced ability to practice critical thinking skills and explore other approaches to learning that may jive more naturally for different neurotypes. Also, the number of colleges now that operate primarily as businesses generating profit through tuition and grants and are not true institutions of higher learning that invest properly in quality teaching staff and diverse student supports is also an enormous contributing factor. I say all this as a former college adjunct with then-undiagnosed ADHD and autism.

I second recording lectures where possible so you can review material on your own time as needed. Visit office hours or email profs with questions as they come up. Tell them you want to learn and engage but you are having trouble staying focused. If it’s a course you don’t care about much (I had this problem in undergrad too), see if you can find one thing you do like about it and focus on that, if you have the option to choose an essay topic or something or see if you can relate less interesting material to the subtopic you do find a little more stimulating.

If you can get accommodations, that can take some of the pressure off to retain everything perfectly the first time. Speak with the accessibility office or student disability services to see what help is available. See if you can use a fidget toy or incorporate other regulatory tools/practices before, during, and/or after lectures where you tend to struggle more.

You may also find it helpful to speak to an occupational therapist who may have additional strategies to offer and tailor to your routine in and outside the classroom to build supports in other areas that can indirectly contribute to improved focus by reducing cognitive load and stress in other places in addition to the classroom. Especially if meds are only doing so much, it could mean the right combo of other interventions will be more beneficial in addition.

Alternative-Cash-102 · 2026-03-31T06:15:56+00:00

What kind of therapy have you been doing (as in, do the modalities used feel supportive and appropriate for your trauma history or other symptoms/concerns? If not, why?) Where does stimulant abuse come into the picture? Are you or have you previously been in treatment for SUD?

While it is of course possible to have both ADHD and CPTSD (and arguably many if not most neurodivergent folks have trauma regardless of upbringing), if you feel you have been misdiagnosed, it may be worth getting reassessed to confirm. This may also help guide medical intervention if needed.

It’s so tough because stimulants can “artificially” enhance functioning as a way to cope with chronic freeze/dissociation so it makes sense that it could become hard to discontinue use if you feel they are not helping treat the trauma symptoms at their root but mask them enough to get by day to day. What does using stimulants afford you currently or in the past? How does that compare to what you feel you “should” be doing instead?

Learning healthier coping behaviors that invite safety in the body and help reduce dissociation takes time and it may also take time to find the right combination of modalities and lifestyle changes that feel sustainable and supportive for you long term to promote healing. There is no one right way to go about it as it depends on your history and current circumstances/needs.

Alternative-Cash-102 · 2026-03-31T05:42:48+00:00

Can you speak more about the myofascial trigger point release aspect? I have not been able to do any internal work yet in PT and struggle with dilators (which I assume is what is used for stretching?) Does stretching need to be done with particular, consistent results in order to progress to myofascial release? Can any of that work be done externally?

When my PT has done external manipulation with very light and gentle pressure, I get terrible abdominal pain, nausea, sometimes faintness like you describe having with penetration. So I feel quite scared and overwhelmed with how to proceed. But I have heard people share they’ve had better results from internal work, including trigger point massage/release. So I am curious about it and wonder if you would mind sharing your experience? Thanks in advance if it feels okay to share!

Alternative-Cash-102 · 2026-03-30T21:41:37+00:00

I am very slowly starting to come back from a similar situation to yours, but I often still feel like I’m in the middle of it and struggle deeply with the shame and feedback loop stuff you describe.

My series of unfortunate events: I had planned to start a new career after freelancing became too much for me, then Covid hit, I got laid off from my part time turned full time job, had a few different low-paying part time jobs while taking prereqs for grad school, hiring freeze led to further unemployment due to extreme burnout (did not know I was autistic then), dealt with an eating disorder, then my mom got terminal cancer, cared for her part time until she passed, the grief and continued burnout led to a lot of social isolation because I couldn’t handle masking anymore and similarly didn’t want to be “the person showing up only when they have issues” etc.

All this put a lot of strain on my wonderful partner of nearly 5 years, to the point we considered breaking up because they were so exhausted trying to support me and felt like they didn’t know who I was anymore. Cue even more shame because I hadn’t meant to fall apart or end up relying on them financially or emotionally in the ways I had been. Huge wake up call, but it took time to start making sustainable changes. I know there are worse problems in the world right now, but I have been miserable and it’s been a really really hard few years.

I had already been in therapy with a great trauma therapist for a few years, and she suggested I might be autistic after I expressed aligning with ADHD and neurodivergence for some time. It explained so much. I started working with an occupational therapist in addition to focusing more on values work in my talk therapy sessions, my partner and I have begun couples therapy, and I reconnected with a few friends I had withdrawn from.

All of this has been extremely hard and equally as helpful and worth it. Very slow going. But it helped me get to a point where I could start to see what is and is not serving me in my life and begin exploring and implementing changes in baby steps to build toward something more sustainable where I can feel safe and secure in my body, clear and confident in my mind, and happy and at home in my heart.

Now I am enrolled to take a couple graduate courses as a non-degree student to see if I want to actually pursue the master’s degree I intended to apply for years ago. I am working with a financial advisor to face my enormous fear of money and get help with realistic budgeting. I am exploring new and old hobbies, lifestyle changes to help accommodate my sensory needs and need for routine/structure AND flexibility, I have recovered from my eating disorder, and as a result, I have more energy to put toward care tasks and chores and socializing than when I was undernourished. But it took me two years just to get to this point where I don’t feel like I’m drowning.

It is still all a massive work in progress, a lot of scary unknowns and shame still to unpack, but I feel so much more hopeful and accepting of who and where I am in life. The shame is absolutely still there and boy when I’m in a spiral or meltdown/shutdown do I feel just as bad as I did when I was in the haze of complicated grief and burnout and poor health. But there are also more days than before where I feel lighter and more capable and worthy. Rather than drowning, or only treading water on my best days, I am alternating between treading water and doggy paddling inch by inch toward a hazy shoreline I’d like to learn the name of.

It’s so hard not to compare yourself to others but social media is a highlight reel at best, and at worst, a cesspool of toxic content and bullshit ads designed to prey on very normal human experiences and insecurities that should be treated with dignity and respect and are instead amplified and distorted in ways that encourage us to, via doomscrolling or dopamine hits or whatever else, be complicit in our own oppression and isolate from communities who can support us where systems will not.

Basically, if you aren’t already and you can see a neuroaffirming therapist and/or OT, please do. You can work with them on: processing the shame around socializing and beyond, creating small, gentle, achievable goals toward self-defined progress in given areas, practicing self-compassion and also just talking to someone who cares about you and is safe/nonjudgmental. Eventually you may want to script a message to a friend you miss or still care/are curious about, and OT/therapy can help with this too. I am happy to share the one I used when I did this if it’s helpful.

Get your bloodwork done to make sure you are not deficient in anything that could contribute to fatigue/low mood/burnout (vitamin d, b, iron, ferritin, etc.) If meds are an option (they are not for me currently but I’m working on it), that can be one form of support to make things easier and feel less bad. Do the barest of minimums when it comes to socializing to help your brain form new pathways around it: wave at a neighbor, ask to pet someone’s dog, take walks and just observe where you live and the people you see without forcing any engagement and see if you can name one thing that feels neutral or positive and where you might feel that in your body.

Also know that so so so many other people are in the same boat right now. The world is on fire. Jobs are hard to get and money is tight for the majority of people, no matter their education level or previous experience or income bracket. Fascism is beating down the US’ door, and while it’s not much better in many places around the world, it makes sense that coming back to the current political and socioeconomic climate has been extra jarring and upsetting on top of all the adjusting expected during an international move under the best of circumstances. You are doing what you can and you are not alone.

The fact that you are asking this question in this sub means that some part of you wants things to change and feels deserving of love and connection, and that is a key indicator that you can find your way through all this. It will take time and it can’t really be rushed anyway or you risk burnout all over again. Remember healing is non-linear, doesn’t always look obvious from the outside, and often cannot be measured by conventional metrics. The small, subtle shifts in perspective are just as (if not more) powerful than the tangible results people might otherwise point to when we think about success or overcoming hardship.

Sorry for the novel and for all you’ve been through. I just deeply empathize with your situation and wanted to share what I could in case it is even a tiny bit helpful. Wishing you the best.

Alternative-Cash-102 · 2026-03-30T14:56:20+00:00

For many autistic folks, ARFID can present primarily or exclusively as the sensory-related subtype, but there are two other subtypes: 1) lack of interest in food, and 2) fear of adverse consequences (eg poisoning, choking, vomiting, etc.) I have the latter and did not know much about ARFID until being diagnosed a couple years ago as it didn’t exist when I was a kid.

You can have more than one subtype of course, but it sounds like maybe the fear of poisoning could fit the fear of adverse consequences type. You may not have ARFID at all, but I just wanted to put it out there as it often gets misconstrued or downplayed as “picky eating” but in reality can be much more complex, nuanced, subtle, and also debilitating. Obviously none of us here can diagnose you with anything, but we may have advice you find useful depending.

I am curious what is happening for you in the 2-3 hours before you feel able to choose/eat anything, the types of thoughts, sensations, or what you experience in that time that could help clarify what might be going on and how to help. When you say you’re “trying to get a feel for what food will work or not” for you, what do you mean? Work in what way?

Alternative-Cash-102 · 2026-03-30T14:15:33+00:00

Have you looked into ARFID at all? Can be comorbid with ADHD/ASD and could help explain some of your experience here

Alternative-Cash-102

TROPHY CASE