I’m sorry to hear that.

I’m in a bit of a slump right now so I’m going to scrape together the barebones advice but it’s probably going to be a bit scrappy rather than being a fully-developed effortpost like I can usually produce.

Here goes:

• Try to reduce the demands on you

Create structures and schedules etc. so that you aren’t using up precious executive function trying to figure out what tocook or what you’re supposed to be doing.

Outsource whatever you can, draw on support from loved ones and the community to help you manage things.

Reduce your commitments where possible (study, work, volunteering and organising work etc.)

Opt for the easiest option, wherever possible - takeout, ready meals, getting groceries delivered, protein shakes or smoothies as simple meals etc.

• Do gentle exercise if and when you have the energy to, but don’t push yourself

• Engage in the things that excite you and give you energy - hobbies, deep interests, spending time with good people and pets

• Try to spend some time in natural environments if possible

• Meditation and other mindfulness activities can be helpful

• Allow yourself the opportunity to do less, don’t beat yourself up over needing to recharge

• Try to get vegetables into your diet where possible

• Try to maintain a regular sleep schedule and good sleep hygiene (lots of info online about this)

• Try to reduce/avoid alcohol and most drugs, with the exception of prescription drugs and maybe cannabis if you feel that it is helpful. Try to reduce your caffeine intake as much as possible too.

• Try to engage in stims, especially calming or soothing stims. Schedule this in if you need to. Try to double up on stims at the same time to make the most of it - go for visual, auditory, tactile, gustatory/olfactory, and vestibular if you know what works for you in these domains.

It might be autistic catatonia. Don’t have it in me to write out a post that this topic deserves right now. Here’s the basics:

If you want to test to see if it’s autistic catatonia, taking most benzodiazepines (especially lorazepam) should cause a rapid and noticeable lift in the symptoms. This can also be achieved through zolpidem and zopiclone, which are usually much easier to get your hands on.

Lorazepam and zolpidem/zopiclone are not necessarily going to resolve the catatonic episode but there will be at least a temporary improvement while the drug is working in your system.

If you take zolpidem/zopiclone and you fall asleep then that’s a pretty surefire indicator that you aren’t experiencing catatonia at that time.

(I would anticipate that valerian extract would also work in this respect but to a lesser extent. As it’s a herbal supplement it is easier to access.)

Longer-term management of autistic catatonia requires reducing your levels of stress, especially anxiety, and not pushing yourself too hard.

For longer-term maintenance and prophylaxis of catatonia you want to aim for NMDA antagonists:

• Ketamine therapy

• Topiramate

• Amantadine/memantine (given a choice I’d opt for amantadine as the preference)

• Dextromethorphan (especially combining dextromethorphan and together bupropion but ensure that you’re doing this under medical supervision from your prescribing doctor, or just get your hands on Auvelity through a prescription)

• Tramadol

• Gabapentin

• Nitrous oxide therapy (you would need to find out if there are any clinical trials going on in your region. If you opted for self-administering nitrous, there are risks involved.)

For supplements there are a few options:

• Magnesium

• Zinc

• Vitamin C

• Creatine

• Phenylalanine (aspartame sweetener contains phenylalanine)

• Agmatine

• Guanosine

Some of these things are going to be easier to get your hands on than others. Some are relatively safe at recommended doses, especially magnesium, zinc, vitamin C, and creatine. If it’s within your means there’s little risk of throwing them at yourself (at the recommended dosages) and seeing if there’s any improvements, especially if you have identified that you are experiencing catatonia. Even if you haven’t identified catatonia as a cause, there’s minimal risks associated with those and you may get other benefits from them anyway so you don’t have much to lose.

Dextromethorphan is probably available over the counter where you are. This puts it much more within reach than some of the other medications. Unfortunately it gets metabolised very rapidly for the purpose of treating catatonia and this is why taking it with bupropion is ideal. (There are lots of other CYP2D6 inhibitors out there though and this is getting beyond the scope of the reply and squarely into the territory of needing to do extensive research and, ideally, getting professional advice but fluoxetine, paroxetine, venlafaxine, duloxetine, sertraline, and others also inhibit this enzyme to a certain extent but at the very least if you’re going to take DXM with one of these then make sure that your pharmacist gives it the greenlight first.)

Also some of the medications listed are going to vary with regards to side effects and accessibility - Ambien isn’t that hard to get your hands on, lorazepam is probably going to be a lot harder, most doctors will be baffled if you try to get amantadine but there’s minimal risk of abuse, interactions, and even side effects so if you can make a compelling case then you’ve got a decent shot of them agreeing to it whereas trying to get benzos is probably going to be a lot harder (and rightfully so - I’d strongly recommend avoiding benzos for anything beyond a couple of one-off doses as they are extremely addictive and are very hard to kick once you become dependent).

If you get relief of catatonia be careful not to throw yourself right back into the conditions that produced your catatonia or you risk exacerbating the problem.

Try to treat catatonia as the product of a lifestyle that is unsuitable and unsustainable over the long-term, with medication and/or supplements being a measure to help you get out of the worst of the catatonic symptoms, so that you can start making positive changes to address the root cause(s). Don’t do the equivalent of yo-yo dieting - swinging from catatonic episodes to treating the catatonic episodes to going straight back into a lifestyle that causes catatonia only to relapse into another catatonic episode. Easier said than done though.

Let me know if you want more information about anything and I’ll do my best to elaborate or to point you in the right direction for more info.