added a graphic to elaborate on the specifics of what i’m trying to say.
basically, everybody changes all the time for all sorts of reasons. don’t let the myth of static selfhood trick you into thinking you’re unworthy. the only way to go is forward, which would be the case no matter what, and that’s okay.
big fan of characters who have it all under control when theyre put in situations but no idea how to be like a regular guy doing regular stuff when all is said and done.
Adult children of addicts. I had a two-panel comic about the League of Adult Superhero Children of Addicts where they’re all laying around their secret base or failing at simple tasks until the crisis alert comes on and they’re all suddenly hyper-capable heroes again
there is strong evidence to suggest, and I certainly believe, that c-ptsd causes an adaptation to long term, ongoing stress by compensating with chronic cortisol underproduction, leading to an endocrine disorder where you're only getting enough stress hormones to be functional when your house is burning down. this is why a lot of us only feel normal, or good even, when dealing with some sort of emergency.
the problem with looking for this function of the endocrine system in the scientific literature is that PTSD and CPTSD still arent reliably clinically separated even though they have very different symptomology, and people with one-time-incident PTSD don't tend to show the endocrine damage. so studies on "people with PTSD and their cortisol levels" show inconsistent results.
this study from 2018 notes that the cortisol in female subjects and subjects who had PTSD from sexual and domestic assaul--two groups whose PTSD is almost always C-PTSD rather than short term, like natural disaster or combat trauma--was significantly lower than in combat veterans, illustrating my point without apparently knowing or speculating on the reason behind it.
this is an extremely useful adaptation because it restores stress hormone homeostasis (balance) to a person who is trapped in a nightmare situation. the problem is that it also causes you to start feeling "worse" as soon as you are no longer in a crisis. this can cause malfunctions of your "gut check" processes because sometimes, for some people, you feel better when you're actively in danger, a thing thats been observed by researchers and emergency workers who work with domestic violence situations and adult victims of childhood trauma for a century, and makes a lot of the "trust your body" type advice actively counterproductive.
minor effects include reinforcing the ADHD tendency to leave everything until the last minute because you know and have learned you literally cannot do it unless it's an emergency, but it also creates people like my aunt who very observably creates emergencies for herself through various little choices like intentionally ignoring her check engine light because she has been so dysfunctional for so long that she can't operate at all unless she's trying to outrun falling dominoes.
anyway I think low dose corticosteroid treatment will probably be officially discovered as a treatment for C-PTSD within the next five years and be clinically applied at some point after that. one of the discouraging things about this process is that the endocrine system doesn't seem to adapt to relative safety very quickly or at all for many people, including myself. either it's impossible for the affected person to achieve the level of security required to actually readjust and small stressors keep signaling to the body to maintain the incorrect stress responses (common for people who are stuck in poverty by disability or mental illness), or theyre like my aunt and either consciously or unconsciously maintain their own emergencies to stay on an even keel.
cortisol is also necessary for trauma recovery. there have been studies where patients in the ER who were dosed with additional cortisol following traumatic incidents like fires and car wrecks were less likely to develop PTSD in the following months than the control subjects. if you're constantly dealing with emergencies without an emergency-level cortisol dump, yeah sure you'll be very calm and functional during the emergency for everyone, but maybe you're not getting enough cortisol to avoid developing even more PTSD, and certainly not enough to control the related inflammatory processes. this could be contributing to the increased incidence of inflammatory chronic illness in C-PTSD patients.
It doesn't mean that any random shit you do is fine so long as you're angry or sad. It means that the anger and sadness is fine, attacking the emotion is pointless, and it's your behaviour in response to it that can help or harm.
when it’s really bad again and it’s still way better than it used to be but it’s still really bad. and you do all the right stuff and you try and try and it still really hurts but it’s working but it still hurts and you go see the beautiful majesty of nature and your soul is so close to being at peace but your mind is still in pain. and it’s better but it’s still bad. and the sun is setting.
one day you'll wake up and think, "life is okay". it'll happen gradually. you'll start to notice flowers blooming in a new light. your evening shower will be a sweet refuge. your morning coffee will warm your soul. things will seem bright and beautiful, and you'll wonder how you ever wanted to leave such lovely things behind
A commonly overlooked symptom of depression is anhedonia, the inability to feel joy or pleasure. The reason that it’s easy to overlook is that it’s easier to miss the absence of something that’s not around all the time than it is to miss a symptom that causes active distress, such as feeling tired and miserable all the time.
Anhedonia is good at being a persistent undercurrent to your life. My aunt, who has major depressive disorder, related to me that she figured out that something was wrong when she looked at the daffodils she had planted blooming, and couldn’t recognize the emotion that she felt when she looked at them. It had been long enough since she had felt happy that she lost the ability to recognize the emotion.
It’s a particularly dangerous depressive symptom, because it robs you of the ability to feel those little spots of joy that keep a lot of people going, while not doing anything to impair your ability to function. If you don’t know that this is a treatable symptom of depression, it’s easy to assume that your ability to feel good is permanently broken, and decide to commit suicide because you don’t want to live like that. It’s not an irrational conclusion, but it is an uninformed one, and everyone deserves to have all the information when making a major decision.
This is what a lot of questionnaires are trying to look for when they ask about “loss of enjoyment”. If you can’t remember a loss of enjoyment because you can’t remember enjoyment, then you probably have anhedonia. If you struggle to define how it is to feel “happy”, “content”, or “good”, or how it feels when you feel those emotions, you probably have anhedonia. If you can’t remember feeling any of those emotions for a week or more, you probably have anhedonia.
Symptoms commonly co-occurring with anhedonia are fatigue (often the cause), clear and thoughtful consideration of suicide, loss of desire to socialize or do activities that used to make you happy, and weight loss (due to lack of enjoyment of food).
This section is anecdotal. In what I have observed, anhedonia due to fatigue rarely responds well to depression treatment unless depression was causing the fatigue. If fatigue and anhedonia are co-occurring and are not both alleviated by depression treatment, consider other causes for the fatigue.
A couple notes that I forgot when I originally posted this:
It’s also a common symptom of schizophrenia and schizoid personality disorder, but often doesn’t respond to antipsychotics. In addition, in schizophrenia and schizoid personality disorder, anhedonia generally tends to “come and go”, as opposed to depressive disorders, where when untreated, it often doesn’t let up for months or years. This can make it more difficult to spot and treat than in depressive disorders.
ADHD can also have “come and go” anhedonia as a symptom, and ADHD medication has mixed results with alleviating it.
An early warning sign is if you’ve tried the “enrichment in your enclosure” by rolling out something new and fun or something you rarely do that generally brings you joy, and the result is an emotional reaction you can describe as “null”.
I’d like to try a metaphor, if you will indulge me.
Let’s pretend that in a human mind, there is a status bar for “mood.” It can run from -50 to +50, with a set point in the middle for “neutral mood, feeling nothing in particular, neither good nor bad.”
And let’s pretend that in the regular course of things, events that happen in your life can make the bar tick either down or up. Little things have little effects, big things have big effects. So you can have big things like “I won the lottery +50” or “My spouse died -50.” But you can also have little things; “I got cut off in traffic. -2” “The weather was beautiful today +5” “My boss belittled me in front of the team -10” “I saw a movie I really enjoyed! +7” And even if nothing in particular is happening, over time, the bar will generally drift back to its set point.
When anhedonia is in the picture, the “mood go up” mechanism is broken. It just doesn’t work. You can have an objectively great day, and it’s still like – The trees are in flower here and it’s beautiful +0. I got my favorite drink from Starbucks +0. I spent time with a good friend +0. I met an adorable dog today and got to pet him +0. And the mood also doesn’t return to the set point on its own.
But the “mood go down” mechanism still works. Somebody yelled a slur from a car -5. We’re overdue on bills this month -7. Got rained on -2. So the longer the anhedonia spell goes on, the mood bar just keeps ticking down, down, down. You can try to insulate yourself from losses, but life happens – sooner or later somebody is going to be rude or you’ll see something awful on the news or you’ll bend an ankle going down the stairs. Tick tick tick, down down down.
You can go day after day trying everything you can think of to make mood bar go up – reading your favorite books, talking to old friends, looking at cute kitten pictures, treating yourself to an ice cream sundae – and it doesn’t work. There’s just nothing. Mood bar go up machine broke.
So if it goes on long enough, eventually you’re left sitting there with a mood bar at 0, feeling like the world is ending around you and there’s nothing left to do but sit there and silently cry, even though you know perfectly well from a logical and objective standpoint that nothing is wrong.
"someone who really has pOCD would be disgusted and horrified at their intrusive thoughts" or maybe i'm in therapy & am going by the books, being radically ambivalent to my intrusive thoughts instead of wasting energy mentally washing my paws of sin. i'm not going to perform my rock bottom for you for the sake of being believed.
also like... something something, being afraid of healing because you're afraid of letting go of the stability of misery, letting go of the narrative you made up to feel worthy of attention, letting go of your "sympathy cred," this narrative has probably killed a few ppl.
like i always thought I'm being overcorrect or being a bit arrogant for the impulse to, well, put every little thing that people say about me into context and overexplain.
But it really is shame and fear of being shamed at the core there huh
thinking about how when you experience a lot of shame in your formative years (indirectly, directly, as abuse or just as an extant part of your environment) it becomes really difficult to be perceived by other people in general. the mere concept of someone watching me do anything, whether it's a totally normal activity or something unfamiliar of embarrassing, whether I'm working in an excel spreadsheet or being horny on main, it just makes my skin crawl and my brain turn to static because I cannot convince myself that it's okay to be seen and experienced. because to exist is to be ashamed and embarrassed of myself, whether I'm failing at something or not, because my instinctive reaction to anyone commenting on ANYTHING I'm doing is to crawl into a hole and die. it's such a bizarre and dehumanizing feeling to just not be able to exist without constantly thinking about how you are being Perceived. ceaseless watcher give me a god damn break.
Even if I didn’t have a solid plan, in the back of my head, I always assumed I’d kill myself.
Now I’m an adult and people my age have their lives in order and I’m stuck here, confused, because I never planned to be alive and I’m so far behind.
New addition two years later. I’m still going strong!
I’m getting married. I’m still in that loving relationship.
I’ve learned that there’s no real timeline. It’s okay. And while it sucks that I lost time, there’s still so much for me to experience and enjoy.
I got married last month! My dog is laying on me snoring. I’ve learned to have healthy friendships and relationships. I’ve learned that I’m not alone and that even when things are hard, I’m going to be okay.
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