Sorry everything I write is the worst kind of venting monologue, something brainworms. Why am I awake at 4am.
I really wish that the desire for socialisation was not a natural part of being human because socialisation causes me brain damage now and has done for a long time. I’m a serial message deleter, I will comb back over messages and conversations and wondering what subtexts and implied meanings I have missed, in what ways I have unknowingly jammed my foot in my mouth. If I’m lucky it becomes obvious days or weeks or months, or even years later, and I get to feel fucking mortified about it. I refuse to keep putting myself through that.
So I wish my brain would stop feeling lonely and shitty and sad and desiring to talk to people about stuff. I barely even have the means now anyway, I have no idea where to find servers or groups or whatever else to talk in, and no I will not try to go out into the real world and talk to people. That seems like a really atrocious idea, I can barely manage speaking any of what pops into my brain irl, it just becomes painful and stilted script following. Plus, where do you even find opportunities like that? Fuck putting myself into new and scary situations that might not even benefit me.
In many ways I actually really regret doing the digging-around about autism. I miss the blissful unawareness I had; I used to just think things were fine, or if they obviously weren’t people were just being weird, people were just weird sometimes. That’s the correct mindset, because fuck neurotypical social rules obviously. I knew (know? idk) someone who told me just that, but since the NT rules are the assumed ground rules, I always find myself checking for what I missed. Sitting with the vague and unhelpful notion that I said or did something wrong. This is the part of being a person that I despise.
Also using semicolons is cringe, I’m pretty sure I don’t even use them right.
This is probably the single most unhinged thing I’ve ever put on this website, but people have told me not to self censor and delete shit instead of posting it. I’m always losing that battle but I still have to try.
BONUS POINTS EDIT:
This is so stupid it’s embarrassing but also as I started leaning all the way left I’ve basically alienated everybody I know. I’ve leaned pretty far left for my entire adult life and longer, but I didn’t have a coherent framework or lens through which to view the world and make anything make sense.
My wife introduced me to hexbear and the discovery of political theory, of coherent leftist politics, basically busted my brain. There were a good few weeks where I was literally incapable of seeing people bitch about rising prices or rent or stuff and not going “workers of the world death to the bourgeousie” etc etc etc, infantile disorder. My favourite place to do it was in and around that one stupid lib-ass queer discord I talked in, which was fun, they had to make a rule against it.
The worst part was when I did it in a group chat I’d been invited to by two girls who apparently thought I was okay. For a few months it was cool and it almost seemed like I had friends for a bit. But 1) I made the mistake of going on an insane rant when one of them did a “haha korea great leader” joke, and I left that chat afterword. 2) After that I realised that I’d been putting in the majority of the relationship effort, i.e. was always the one starting conversations with people, and having to bug people to follow up so we could talk again. I decided right then that I was gonna start leaving people on read, and wait for them to message me, just once.
The majority never did, and the few times anyone did I flipped out and went on more rants which honestly was probably some kind of defense mechanism. But the other girl from that chat, not the dumb korea jokes one but the other one, who was really into internet fic, she literally just has never messaged me again which honestly still kind of hurts. She’s also disappeared completely from that server and I wonder if I did something so wrong somewhere that she just quit discord. Obviously all that has caused a decent bunch of psychic damage regarding talking to people, yay. I also haven’t even really talked to my family since I became the most unhinged & useless online commie. I suspect it will go poorly, Idk.
If you don’t mind me asking, what flavour of neurodivergent are you?
Autistic with bonus depression/anxiety diagnosis!
So going by Harvard’s recommendations the prime candidate for a medication given what you’ve described would be buspirone but it might also be worth considering beta blockers such as propranolol.
Personally I’m auDHD and I have found that I respond particularly well to clonidine for the sort of symptoms you’re describing here (which fit pretty closely to what is known as rejection sensitive dysphoria - a contentious set of symptoms but one which I’m convinced of the existence of) and clonidine being an alpha agonist, it tends to work in a similar way to a beta blocker. But clonidine is one of the drugs that has been identified as a good second-line treatment for ADHD, with the other being guanfacine, so ymmv. (Sidebar to mention that ADHD occurs in autistic people at a rate of about 20-40% so it’s not wildly outside the bounds of possibility that you may have ADHD as well.)
For the more general anxiety stuff, outside of benzos (which are very tricky with regards to addiction and which I’d strongly recommend against in most cases) I have found that amantadine works really well but it has a pretty narrow body of evidence supporting its use and what evidence exists seems to indicate that when prescribed for autism it isn’t particularly useful however for a range of mental illnesses it works quite well. In my experience, I wasn’t seeking to treat symptoms that are integral to autism with amantadine but instead to treat symptoms that I understand as being sorta secondary or the product of environmental factors and my autistic nature responding to those factors, if that makes any sense lol? (What I’m trying to describe here is like - I’m always going to have sensory sensitivities. I don’t think there’s anything out there which will treat this. But for example I find that being exposed to lots of auditory stimuli, especially loud and abrupt noises, sets my nerves on edge and I end up with anxiety that gradually ratchets up during the day in response to this central experience of autism - being sensitive to sound. Amantadine has worked well to help me manage my “secondary” symptoms of anxiety.)
There’s also risperidone or aripiprazole to consider here but they tend to have a broader side effect profile and I’d probably consider them as more of a last resort.
Woah you can medicate rejection sensitivity??? Damn, I want some of that. Noting these medication names, ty.
I have a couple of ADHDish symptoms but I dob’t think I qualify mostly :)
Thank you for all of these excellent potential recommendations, I might bug my doctor avout a buncha these!
Basically, yeah.
I wouldn’t go into this with the expectation that medication will eliminate it but the working hypothesis is that rejection sensitivity on the nervous system level is a lot like what happens with a PTSD trigger; you get this inordinate response to stimuli and your body goes into a fight-or-flight mode, or at least something pretty close to it.
Rejection sensitivity (at least in ADHDers) is really closely linked to heightened emotional reactivity at its core. I’m of the opinion that there’s a lot of environmental factors that feed into this, where a person gets into a positive feedback loop where they are exposed to a lot more negative feedback and rejection by others compared to their peers and the response to this compounds over time. I’m also of the opinion that with emotional reactivity in ADHD it tends to follow one of two major paths over the course of a person’s development - you have the outwardly expressed form which is much more closely linked with hyperactivity, and that is where you get the more oppositional defiant disorder-style of responses (I object to the framing of this disorder and I don’t really like how it’s understood or pathologised but I’m using it as shorthand here) and then you have rejection sensitive dysphoria style of responses, which is more closely linked with the inattentive type of ADHD and which I see as the inwardly-expressed form of this phenomenon.
So if you can use medication to reduce emotional reactivity and the associated physiological response then you can reduce the symptoms of rejection sensitivity and that’s what can make a really big difference in developing or implementing behavioural strategies to manage this. Obviously if you’ve gone through your whole life experiencing rejection sensitivity then it will take a good amount of time to adjust to things and to develop a different approach and a different understanding of things so I see medication as being the first step in a strategy to treat/manage full-blown cases of RSD.
With all of that in mind, for ADHDers the two medications that have the best outcomes for emotional reactivity are guanfacine and clonidine but because I’m no psychiatrist or anything I can’t say that they would be just as effective for a non-ADHDer that is, for example, autistic. If the rejection sensitivity is more akin to a sort of low-grade PTSD due to the cumulative effects of socialising as an autistic person who is in an unsupportive environment or because they went undiagnosed as a child then my hunch would be that beta blockers might be more useful here.
Beta blockers and clonidine have an immediate effect. For guanfacine it’s a bit more of a mixed bag - the physiological effects should be fairly immediate but they say that it takes a few weeks for the full effect to be achieved, and I’m assuming that this is mostly because of how guanfacine affects the brain (but that’s a long story in itself). One of the good thing is that these meds are much easier to start on or to taper off of compared to antidepressants.
Inordinate stimuli response, fight or flight is EXACTLY what I get, all the time. Not even just for rejection sensitive stuff, (most intense tho) but also for just talking to people, which is why I’m basically taking today off for social battery purposes. I want these drugs now.
I am saving your comments, thank you for the superb advice.
I was actually prescribed Abilify (aripiprazole) for OCD and it made me anhedonic, emotionally blunt etc on a really small dose. I had the same reaction to Prozac so I thought that maybe the dopamine lowering (if I have to describe it in a vulgar way) meds have a bad effect on me due to the ADHD (stimulants fucked my OCD on the other hand). Do you have any experience with those? I am curious because you are a fellow AuDHD
I’ve taken aripiprazole as an adult and I definitely noticed a reduction in my experience of agitation due to sensory overload and similar autism-related stuff.
I tolerate antipsychotics well so I didn’t notice any significant emotional blunting and, unfortunately, I struggle with anhedonia in a major way so I didn’t notice it affecting my anhedonia significantly in a positive or a negative way.
Aripiprazole is a complicated drug with regards to dopamine as it’s a partial agonist so at low doses it increases dopamine in the hippocampus and the prefrontal cortex, but not in the nucleus accumbens. At a moderate dose it reduces dopamine release in the nucleus accumbens but not the prefrontal cortex. At a high dose it reduces dopamine in both regions.
To add to the complexity, it’s an antagonist for one serotonin receptor and it’s a partial agonist for a different serotonin receptor and to put it in simple terms serotonin sorta competes with dopamine in the brain so if the partial agonist effect is increasing serotonin at a particular place in the brain then it could be negatively impacting upon the dopamine levels there too.
Because of all that I think it would be really hard to figure out exactly what the cause of the emotional blunting and anhedonia was without having a better understanding of the dosage range that you were at and also looking at how you have responded to other meds that affect dopamine/serotonin in similar/opposite ways, particularly in the regions of the brain mentioned above, but in short this is something that’s way above my paygrade and you’d need the supervision of a psychiatrist who is attentive to this stuff to start to puzzle out exactly what caused tjese effects in you. You could say that it’s very common for antipsychotics to come with side effects of anhedonia and emotional blunting but that feels a little bit of a dismissive response tbh.
Yeah, I should probably talk to my shrink in detail about this. Thanks for responding